| Title: |
A genome-wide association study of plasma concentrations of warfarin enantiomers and metabolites in sub-Saharan black-African patients |
| Authors: |
Asiimwe, Innocent G.; Blockman, Marc; Cohen, Karen; Cupido, Clint; Hutchinson, Claire; Jacobson, Barry; Lamorde, Mohammed; Morgan, Jennie; Mouton, Johannes P.; Nakagaayi, Doreen; Okello, Emmy; Schapkaitz, Elise; Sekaggya-Wiltshire, Christine; Semakula, Jerome R.; Waitt, Catriona; Zhang, Eunice J.; Jorgensen, Andrea L.; Pirmohamed, Munir |
| Contributors: |
National Institute for Health Research |
| Source: |
Frontiers in Pharmacology ; volume 13 ; ISSN 1663-9812 |
| Publisher Information: |
Frontiers Media SA |
| Publication Year: |
2022 |
| Collection: |
Frontiers (Publisher - via CrossRef) |
| Description: |
Diversity in pharmacogenomic studies is poor, especially in relation to the inclusion of black African patients. Lack of funding and difficulties in recruitment, together with the requirement for large sample sizes because of the extensive genetic diversity in Africa, are amongst the factors which have hampered pharmacogenomic studies in Africa. Warfarin is widely used in sub-Saharan Africa, but as in other populations, dosing is highly variable due to genetic and non-genetic factors. In order to identify genetic factors determining warfarin response variability, we have conducted a genome-wide association study (GWAS) of plasma concentrations of warfarin enantiomers/metabolites in sub-Saharan black-Africans. This overcomes the issue of non-adherence and may have greater sensitivity at genome-wide level, to identify pharmacokinetic gene variants than focusing on mean weekly dose, the usual end-point used in previous studies. Participants recruited at 12 outpatient sites in Uganda and South Africa on stable warfarin dose were genotyped using the Illumina Infinium H3Africa Consortium Array v2. Imputation was conducted using the 1,000 Genomes Project phase III reference panel. Warfarin/metabolite plasma concentrations were determined by high-performance liquid chromatography with tandem mass spectrometry. Multivariable linear regression was undertaken, with adjustment made for five non-genetic covariates and ten principal components of genetic ancestry. After quality control procedures, 548 participants and 17,268,054 SNPs were retained. CYP2C9*8 , CYP2C9*9 , CYP2C9*11 , and the CYP2C cluster SNP rs12777823 passed the Bonferroni-adjusted replication significance threshold ( p < 3.21E-04) for warfarin/metabolite ratios. In an exploratory GWAS analysis, 373 unique SNPs in 13 genes, including CYP2C9*8 , passed the Bonferroni-adjusted genome-wide significance threshold ( p < 3.846E-9), with 325 (87%, all located on chromosome 10) SNPs being associated with the S-warfarin/R-warfarin outcome (top SNP ... |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| DOI: |
10.3389/fphar.2022.967082 |
| DOI: |
10.3389/fphar.2022.967082/full |
| Availability: |
https://doi.org/10.3389/fphar.2022.967082; https://www.frontiersin.org/articles/10.3389/fphar.2022.967082/full |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.D85AAC0B |
| Database: |
BASE |