Genetic polymorphisms associated with upper gastrointestinal bleeding: a systematic review

Pharmacogenomics J. 2021 Feb;21(1):20-36. doi: 10.1038/s41397-020-00185-6. Epub 2020 Sep 18.

Abstract

Non-variceal upper gastrointestinal bleeding (non-variceal UGIB) is a frequent and severe adverse drug reaction. Idiosyncratic responses due to genetic susceptibility to non-variceal UGIB has been suggested. A systematic review was conducted to assess the association between genetic polymorphisms and non-variceal UGIB. Twenty-one publications and 7134 participants were included. Thirteen studies evaluated genetic polymorphism in patients exposed to non-steroidal anti-inflammatory drugs, low-dose aspirin, and warfarin. Eight studies present at least one methodological problem. Only six studies clearly defined that the outcome evaluated was non-variceal UGIB. Genetic polymorphisms involved in platelet activation and aggregation, angiogenesis, inflammatory process, and drug metabolism were associated with risk of non-variceal UGIB (NOS3, COX-1; COX-2; PLA2G7; GP1BA; GRS; IL1RN; F13A1; CDKN2B-AS1; DPP6; TBXA2R; TNF-alpha; VKORC1; CYP2C9; and AGT). Further well-designed studies are needed (e.g., clear restriction to non-variceal UGIB; proper selection of participants; and adjustment of confounding factors) to provide strong evidence for pharmacogenetic and personalized medicine.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Gastrointestinal Hemorrhage / genetics*
  • Gastrointestinal Hemorrhage / pathology
  • Gastrointestinal Tract / pathology
  • Genetic Association Studies*
  • Genetic Predisposition to Disease*
  • Hemorrhage / genetics*
  • Hemorrhage / pathology
  • Humans
  • Polymorphism, Genetic / genetics
  • Risk Factors