Iranian Journal of Parasitology 2017. 12(4):470-481.

Perspective on the Genetic Response to Antiparasitics: A Review Article



Background: Drugs’ pharmacokinetics and pharmacodynamics can be affected by diverse genetic variations, within which simple nucleotide polymorphisms (SNPs) are the most common. Genetic variability is one of the factors that could explain questions like why a given drug does not have the desired effect or why do adverse drug reactions arise.

Methods: In this retrospective observational study, literature search limits were set within PubMed database as well as the epidemiological bulletins published by the Mexican Ministry of Health, from Jan 1st 2001 to Mar 31st 2017 (16 years).

Results: Metabolism of antiparasitic drugs and their interindividual responses are mainly modified by variations in cytochrome P450 enzymes. These enzymes show high frequencies of polymorphic variability thus affecting the expression of CYP2C, CYP2A, CYP2A6, CYP2D6, CYP2E6 and CYP2A6 isoforms. Research in this field opens the door to new personalized treatment approaches in medicine.

Conclusion: Clinical and pharmacological utility yield by applying pharmacogenetics to antiparasitic treatments is not intended as a mean to improve the prescription process, but to select or exclude patients that could present adverse drug reactions as well as to evaluate genetic alterations which result in a diversity of responses, ultimately seeking to provide a more effective and safe treatment; therefore choosing a proper dose for the appropriate patient and the optimal treatment duration. Furthermore, pharmacogenetics assists in the development of vaccines. In other words, the aim of this discipline is to find therapeutic targets allowing personalized treatments.


Antiparasitics, Genetic response, Review article, Mexico

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Watkins BM. Drugs for the control of parasitic diseases: current status and development. Trends Parasitol. 2003; 19(11):477-8.

Hameed P S, Solapure S, Patil V et al. Tri-aminopyrimidine is a fast-killing and long-acting antimalarial clinical candidate. Nat Commun. 2015.6:6715.

Skinner-Adams TS, Sumanadasa SD, Fisher GM et al. Doolan. Defining the targets of antiparasitic compounds. Drug Discov Today. 2016; 21(5):725-39.

Pérez JL1, Carranza C, Mateos F. Revisión de los fármacos útiles en el tratamiento de parasitosis clásicas y emergentes. Rev Esp Quimioter. 2009; 22(2):93-105.

Sinniah B, Hassan A KR, Sabaridah I et al. Prevalence of intestinal parasitic infections among communities living in different habitat and its comparison with one hundred and one studies conducted over the past 42 years (1970 to 2013) in Malasya. Trop Biomed. 2014; 31(2):190-206.

Jones BA, Betson M, Pfeiffer DU. Eco-social processes influencing infectious disease emergence and spread. Parasitology. 2017; 144(1):26-36.

Andraghetti R.OPS/HSD/IR/RSI. Enfermedades emergentes y reemergentes, factores condicionantes para la aparición de estas enfermedades y su prevención y control. In: Curso OPS de comunicación en riesgo. Februery 15th, 2011. [accessed March 7th, 2016].

Maskery B, Coleman MS, Weinberg M et al. Economic analysis of the impact of overseas and domestic treatment and screening options for intestinal helminth infection among US-bound refugees from Asia. PLoS Negl Trop Dis. 2016; 10(8):e0004910.

Organización Panamericana de la Salud-OPS. Un llamado a la acción: Hacer frente a los helmintos transmitidos por el contacto con el suelo en Latino América y el Caribe. Banco Interamericano de Desarrollo. 2011.

El Safadi D, Cian A, Nourrisson C Prevalence, risk factors for infection and subtype distribution of the intestinal parasite Blastocystis sp. from a large-scale multi-center study in France. BMC Infect Dis. 2016;16(1):451.

Apt WB. Infecciones por parásitos más frecuentes y su manejo. Rev Med Clin Condes. 2014; 25(3): 485-528.

Elyana FN, Al-Mekhlafi HM, Ithoi I et al. A tale of two communities: intestinal polyparasitism among Orang Asli and Malay communities in rural Terengganu, Malasya. Parasit Vectors. 2016; 9(1):398.

Jimenez-Gonzalez DE, Marquez-Rodriguez K, Rodriguez JM et al. Prevalence and risk factors associated with intestinal parasites in a rural community of central Mexico. J Parasitol Vector Biol. 2009;1(2): 9-12.

Mirza H, Teo JD, Upcroft J et al. A rapid, high-throughput viability assay for Blastocystis spp. reveals metronidazole resistance and extensive subtype-dependent variations in drug suscepti-bilities. Antimicrob Agents Chemother. 2011; 55(2):637-48.

Apt WB. Parasitología Humana. McGraw Hill Interamericana Editores S.A. México, 2013. ISBN: 978-607-15-0876-8.

Rodríguez E, Mateos B, González JC, Aguilar YM et al. Transición parasitaria a Blastocystis hominis en niños de la zona centro del estado de Guerrero, México. Parasitol Latinoam 2008; 63:20-28.

Diaz E, Mondragon J, Ramirez E et al. Epidemiology and control of intestinal parasites with nitazoxanide in children in Mexico. Am J Trop Med Hyg. 2003; 68(4):384-5.

Rodríguez Guzmán LM. Epidemiología de la parasitosis intestinal en México. Epidemiología. Sistema único de información. 2003; 20(20), mayo.

En: Anuario de morbilidad 1984-2015. Morbilidad por enfermedad [acceso 04 de octubre de 2016].

Vásquez-Garibay EM, Campos-Barrera L, Romero-Velarde E et al. Cambios en la prevalencia de deficiencia de yodo y hierro, y parasitosis en escolares de Arandas, Jalisco, México. Salud Publica Mex. 2014;56(3):238-9.

Pérez-Molina JA, Díaz-Menéndez M, Pérez-Ayala A et al. Monje B, Norman F, López-Vélez R. Tratamiento de las enfermedades causadas por parásitos. Enferm Infecc Microbiol Clin. 2010; 28(1):44-59.

Utzinger J, Becker SL, Knopp S et al. Neglected tropical diseases: diagnosis, clinical management, treatment and control. Swiss Med Wkly. 2012; 142:w13727.

Azam A, Peerzada MN, Ahmad K. Parasitic diarrheal disease: drug development and targets. Front Microbiol. 2015;6:1183.

Kulakova L, Galkin A, Chen CZ et al. Discovery of novel antigiardiasus drug candidates. Antimicrobial Agents and Chemotherapy. 2014;58(12):7303-11.

Lorenzo FP. Velázquez. Farmacología básica y clínica. 19th. ed. México: Editorial Médica Panamericana; 2017

Medina NP, Mingala CN. Transporter protein and drug resistance of Trypanosoma. Ann Parasitol. 2016;62(1):11-5.

Pirmohamed M. Phamacogenetics and Phamracogenomics. Br J Clin Pharmacol. 2001;52(4):345-347.

Motulsky AG, Qi M. Pharmacogenet-ics,pharmacogenomics and ecogenetics. J Zhejiang Univ Sci B. 2006; 7(2):169-70.

Kalow W. 2005. Methods in Molecular Biology. Pharmacogenomics: Methods and Protocols. Vol 311. Edit. Innocenti F. Humana Press Inc., Totowa, NJ

Venter JC, Adams MD, Myers EW et al. The sequence of the human genome. Science. 2001; 291(5507):1304-51.

Baye TM, Wilke RA. Mapping genes that predict treatment outcome in admixed populations. Pharmacogenomics J. 2010; 10(6):465-77.

Wang L, McLeod HL, Weinshilboum RM. Genomics and drug response. Genomic Medicine. N Engl J Med. 2011; 364(12):1144-53.

Yang L, Price ET, Chang CW et al. Gene expression variability in human hepatic drug metabolizing enzymes and transporters. PLoS One. 2013; 8(4):e60368.

Drew L. Pharmacogenetics: The right drug for you. Nature. 2016;537(7619):S60-2.

“Instalación y operación de la farmacovigilancia”. Norma Oficial Mexicana NOM-220-SSA1-2012.Diario Oficial de la Federación, 7 de enero 2013

Aguilar DHE, Medina ML. ¿Qué es la farmacovigilancia? Revista COFEPRIS.2016; 2:26

Zavaleta BM, Rosete RA. Reacciones adversas a medicamentos (RAM) en el hospital médica sur. Avances y dirección de nuestros logros. Médica Sur. 2007; 14(4): 169-175


Buschini A, Ferrarini L, Franzoni S et al. Genotoxicity revaluation of the three comercial nitroheterocyclic drugs: nifurtimox, benznidazole, and metronidazole. J Parasitol Res. 2009; 2009:463575.

Zhang G, Nebert DW. Personalized medicine: Genetic risk prediction of drug response. Pharmacol Ther. 2017; 175:75-90.

Thorn CF, Klein TE, Altman RB. Phar-macogenomics and bioinformatics: Pharm GKB. Pharmacogenomics. 2010;11(4):501-5.

Aldaz A. La Farmacogenética y la farmacia de hospital. Farm Hosp. 2011; 35(4): 163-164.

Lesko LJ, Woodcock J. Pharmacogenomic-guided drug development: regulatory perspective. Phar-macogenomics J. 2002; 2(1):20-4.

Girelli D, Martinelli N, Peyvandi F et al. Genetic architecture of coronary artery disease in the genome-wide era: implications for the emerging ‘‘golden dozen’’ loci. Semin Thromb Hemost. 2009; 35(7):671-82.

Olivo-Diaz A, Romero-Valdovinos M, Gudiño-Ramirez A et al. Findings related to IL-8 and IL-10 gene polymorphisms in a Mexican patient population with irritable bowel syndrome infected with Blastocystis. Parasitol Res. 2012;111(1):487-91.

Roden DM, Wilke RA, Kroemer HK et al. Pharmacogenomics: The genetics of variable drug responses. Circulation. 2011; 123(15):1661-70.

Horn D, Duraisingh MT. Antiparasitic chemotherapy-from genomes to mechanisms. Annu Rev Pharmacol Toxicol. 2014; 54:71-94.

Fricke-Galindo I, Céspedes-Garro C, Ro-drigues-Soares F et al. Interethnic variation of CYP2C19 alleles, ‘predicted’ phenotypes and ‘measured’ metabolic phenotypes across world populations. Pharmacogenomics J. 2016; 16(2):113-23.

Cabaleiro T, Abad-Santos F. Farmacogenética. Presente y futuro. Actualidad en Farmacología y Terapéutica marzo 2011. 9(1): 13-19.

Lindpaintner K. Pharmacogenetics and the future of medical practice. Br J Clin Pharmacol. 2002; 54(2):221-30.

Köhler P. The biochemical basis of anthelmintic action and resistance. Int J Parasitol. 2001; 31(4):336-45.

Roden MD, Altman BR, Benowitz LN et al. Pharmacogenetics Research Network. Ann Intern Med. 2006; 145(10):749-757.

Cerecetto H, González M. Antiparasitic prodrug nifurtimox: revisiting its activation mechanism. Future Microbiol. 2011; 6(8):847-50

Preissner S, Kroll K, Dunkel M et al. SuperCYP: a comprehensive database on cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010; 38(Database is-sue):D237-43.

Preissner SC, Hoffmann MF, Preissner R et al. Polymorphic cytochrome P450 enzymes (CYPs) and their role in personalized therapy. PLoS One. 2013; 8(12):e82562.

Rendic S. Summary of information on human CYP enzymes: human P450 metabolism data. Drug Metab Rev. 2002; 34(1-2):83-448.

Asteinza J, Camacho-Carranza R, Reyes-Reyes RE et al. Induction of cytochrome P450 enzymes by albendazole treatment in the rat. Environ Toxicol Pharmacol. 2000;9(1-2):31-37.


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