CRISPR-Based Assay for Point-of-Care Pharmacogenetic CYP2C19 Genotyping

Multiplexed CRISPR assay combining isothermal amplification and dual guide RNA detection (LwaCas13a/LbaCas12a) for rapid genotyping of *CYP2C19* \*2, \*3 and \*17 alleles

This study presents a rapid, multiplexed CRISPR assay for point-of-care genotyping of key CYP2C19 polymorphisms (\2, \3, \17), which modulate clopidogrel and mavacamten metabolism. The assay combines isothermal amplification and dual guide RNA detection, with fluorescence or lateral-flow readout. In a validation cohort of 110 participants, concordance with Sanger sequencing reaches 97.3% (\2), 100% (\3) and 99.1% (\17). The protocol supports simplified DNA extraction, paving the way for decentralized genotyping.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

The main barrier to clopidogrel pharmacogenetics remains turnaround time — a point-of-care test in minutes is a game changer in acute interventional cardiology. The ≥ 97% concordance with Sanger is reassuring, though allelic coverage is limited to three variants. CRISPR programmability hints at extension to other pharmacogenes, but real-world clinical validation remains to be demonstrated.