Copy number variation and warfarin dosing: evaluation of CYP2C9, VKORC1, CYP4F2, GGCX and CALU

Pharmacogenomics. 2012 Feb;13(3):297-307. doi: 10.2217/pgs.11.156. Epub 2011 Dec 21.

Abstract

Aim: To determine if copy number variants contribute to warfarin dose requirements, we investigated CYP2C9, VKORC1, CYP4F2, GGCX and CALU for deletions and duplications in a multiethnic patient population treated with therapeutic doses of warfarin.

Patients & methods: DNA samples from 178 patients were subjected to copy number analyses by multiplex ligation-dependent probe amplification or quantitative PCR assays. Additionally, the CYP2C9 exon 8 insertion/deletion polymorphism (rs71668942) was examined among the patient cohort and 1750 additional multiethnic healthy individuals.

Results: All patients carried two copies of CYP2C9 by multiplex ligation-dependent probe amplification and no exon 8 deletion carriers were detected. Similarly, quantitative PCR assays for VKORC1, CYP4F2, GGCX and CALU identified two copies in all populations.

Conclusion: These data indicate that copy number variants in the principal genes involved in warfarin dose variability (CYP2C9, VKORC1), including genes with lesser effect (CYP4F2, GGCX), and those that may be more relevant among certain racial groups (CALU), are rare in multiethnic populations, including African-Americans.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anticoagulants / therapeutic use
  • Aryl Hydrocarbon Hydroxylases / genetics*
  • Calcium-Binding Proteins / genetics*
  • Carbon-Carbon Ligases / genetics*
  • Cohort Studies
  • Cytochrome P-450 CYP2C9
  • Cytochrome P-450 Enzyme System / genetics*
  • Cytochrome P450 Family 4
  • DNA Copy Number Variations / drug effects*
  • Dose-Response Relationship, Drug
  • Ethnicity / genetics
  • Exons
  • Female
  • Gene Deletion
  • Gene Duplication
  • Humans
  • INDEL Mutation
  • Male
  • Mixed Function Oxygenases / genetics*
  • Vitamin K Epoxide Reductases
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • CALU protein, human
  • Calcium-Binding Proteins
  • Warfarin
  • Cytochrome P-450 Enzyme System
  • Mixed Function Oxygenases
  • CYP2C9 protein, human
  • Cytochrome P-450 CYP2C9
  • Aryl Hydrocarbon Hydroxylases
  • Cytochrome P450 Family 4
  • CYP4F2 protein, human
  • VKORC1 protein, human
  • Vitamin K Epoxide Reductases
  • Carbon-Carbon Ligases
  • glutamyl carboxylase