Traditional Medicine to Modern Pharmacogenomics: AyurvedaPrakritiType and CYP2C19 Gene Polymorphism Associated with the Metabolic Variability

Abstract

Traditional Indian medicine—Ayurveda—classifies the human population into three major constituents orPrakritiknown asVata, PittaandKaphatypes. Earlier, we have demonstrated a proof of concept to support genetic basis forPrakriti. The descriptions in Ayurveda indicate that individuals withPitta Prakritiare fast metabolizers while those ofKapha Prakritiare slow metabolizers. We hypothesized that differentPrakritimay have different drug metabolism rates associated with drug metabolizing enzyme (DME) polymorphism. We didCYP2C19(Phase I DME) genotyping in 132 unrelated healthy subjects of either sex by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. We observed significant association betweenCYP2C19genotype and major classes ofPrakrititypes. The extensive metabolizer (EM) genotype (*1/*1, *1/*2, *1/*3) was found to be predominant inPitta Prakriti(91%). Genotype (*1/*3) specific for EM group was present only inPitta Prakriti.Poor metabolizer (PM) genotype (*2/*2, *2/*3, *3/*3) was highest (31%) inKapha Prakritiwhen compared withVata(12%) andPitta Prakriti(9%). Genotype (*2/*3) which is typical for PM group was significant inKapha Prakriti(odds ratio = 3.5,P=  .008).We observed interesting correlations betweenCYP2C19genotypes andPrakritiwith fast and slow metabolism being one of the major distinguishing and differentiating characteristics. These observations are likely to have significant impact on phenotype-genotype correlation, drug discovery, pharmacogenomics and personalized medicine.