Abstract

Polymorphic expression of CYP2D6 contributes to the wide range of activity observed for this clinically important drug metabolizing enzyme. In this report we describe novel CYP2D7/2D6 hybrid genes encoding non-functional and functional CYP2D6 protein and a CYP2D7 variant that mimics a CYP2D7/2D6 hybrid gene. Five-kilobyte-long PCR products encompassing the novel genes were entirely sequenced. A quantitative assay probing in different gene regions was employed to determine CYP2D6 and 2D7 copy number variations and the relative position of the hybrid genes within the locus was assessed by long-range PCR. In addition to the previously known CYP2D6*13 and *66 hybrids, we describe three novel non-functional CYP2D7-2D6 hybrids with gene switching in exon 2 (CYP2D6*79), intron 2 (CYP2D6*80), and intron 5 (CYP2D6*67). A CYP2D7-specific T-ins in exon 1 causes a detrimental frame shift. One subject revealed a CYP2D7 conversion in the 5′-flanking region of a CYP2D6*35 allele, was otherwise unaffected (designated CYP2D6*35B). Finally, three DNAs revealed a CYP2D7 gene with a CYP2D6-like region downstream of exon 9 (designated CYP2D7[REP6]). Quantitative copy number determination, sequence analyses, and long-range PCR mapping were in agreement and excluded the presence of additional gene units. Undetected hybrid genes may cause over-estimation of CYP2D6 activity (CYP2D6*1/*1 vs *1/hybrid, etc), but may also cause results that may interfere with the genotype determination. Detection of hybrid events, “single” and tandem, will contribute to more accurate phenotype prediction from genotype data.

Highlights

  • CYP2D6 is a highly polymorphic drug metabolizing enzyme

  • The CYP2D6 gene locus has been extensively studied for allelic variation and ethnic differences

  • The CYP2D locus contains three highly homologous genes (CYP2D6, 2D7, and 2D8) along repeat motifs constituting a perfect target for homologous recombination events

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Summary

Introduction

CYP2D6 is a highly polymorphic drug metabolizing enzyme. The collection of known alleles comprise variants encoding no, reduced, full, or ultrarapid CYP2D6 activity and give rise to corresponding poor (PM), intermediate (IM), extensive (EM), and ultrarapid (UM) metabolizer phenotypes. While the most frequent sequence variations are single nucleotide polymorphisms (SNPs) or small insertions/deletions, this gene locus undergoes major recombination events creating alleles harboring large deletions, duplications, multiplications, conversions, and combinations thereof (Zanger et al, 2004; Gaedigk et al, 2007; Kramer et al, 2009; Gaedigk et al, 2010). The CYP2D gene locus contains direct repeat regions and highly homologous gene units which facilitate unequal crossing-over that can lead to allelic variants with large deletions and duplications (Hastings et al, 2009). Most prominent examples are the CYP2D6*5 gene deletion, CYP2D6*1xN, *2xN, and *4xN gene duplications/multiplications and gene tandems such as CYP2D6*36 + *10

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