Table 1.
Gene | CYP2C9 | VKORC1 | CYP4F2 | CYP2C | GGCX | CALU |
---|---|---|---|---|---|---|
Location [41] | Chromosome 10 | Chromosome 16 | Chromosome 19 | Chromosome 10 | Chromosome 2 | Chromosome 7 |
Function [6] | Encodes for CYP2C9 enzyme which metabolises the more active S-warfarin. | Encodes for VKOR enzyme which changes oxidized vitamin k into reduced (active) vitamin k, which activates the clotting factors. | Encodes for CYP4F2 enzyme which deactivates the reduced form of vitamin k. | Intergenic cluster, could affect CYP2C9 gene activity. | Encodes for GGCX enzyme which activates the coagulation factors. | Encodes for CALU protein which chaperon GGCX enzyme. |
Common variants and most prevalent race [6, 34] |
CYP2C9*2 (rs1799853): Missense variant.: in Caucasians. CYP2C9*3 (rs1057910) Missense variant: in Caucasians. CYP2C9*5 (rs28371686) Missense variant: in Africans. CYP2C9*6 (rs9332131) Frameshift variant: in Africans. CYP2C9*8 (rs7900194) Missense variant: in Africans. CYP2C9*11 (rs28371685) Missense variant: in Africans. |
VKORC1 c.-1639G > A upstream single nucleotide variant.: AA: common in Asian population AG: common in Caucasian population. GG: common in African population. |
CYP4F2*3 (rs2108622)Missense variant: Most common in Asians and Caucasians and associated with a higher warfarin maintenance dose. |
SNP (rs12777823) Most prevalent in Africans and associated with a lower warfarin maintenance dose. |
Non-synonymous variant (rs11676382). Prevalent in Caucasian and associated with lower warfarin maintenance dose. [42] |
Intronic SNP (rs339097) Associated with higher warfarin maintenance dose in Africans. [43] |
CALU: Calumenin, CYP2C9: Cytochrome 450 2C9, CYP4F2*3: Cytochrome 450 4F2*3, GGCX: Gamma glutamyl carboxylase, SNP: Single nucleotide polymorphism, ,VKORC1: Vitamin k epoxide reductase complex 1