Cytochrome P450, Subfamily IID, Polypeptide 6

Alternative Names

  • CYP2D6
  • CPD6
  • P450DB1
  • Debrisoquine 4-Hydroxylase
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OMIM Number

124030

NCBI Gene ID

1565

Uniprot ID

P10635

Length

9,723 bases

No. of Exons

9

No. of isoforms

2

Protein Name

Cytochrome P450 2D6

Molecular Mass

55769 Da

Amino Acid Count

497

Genomic Location

chr22:42,125,656-42,135,378

Gene Map Locus
22q13.2

Description

The enzyme encoded by the CYP2D6 is a member of the cytochrome P450 superfamily of enzymes that are involved in drug metabolism and synthesis of cholesterol, steroids, and other lipids. It is estimated that 20-25% of clinically prescribed drugs are metabolized by CYP2D6, which is cellularly localized to the endoplasmic reticulum. The CYP2D6 gene is highly polymorphic with certain variants conferring decreased metabolism of substrates leading to the poor metabolizer phenotype. At the other end of the spectrum are the extensive or ultrarapid metabolizer phenotypes. CYP2D6 substrates include certain anti-arrythmic agents, adrenoceptor antagonists, and antidepressants as well as many environmental chemicals. Therefore the impact of CYP2d6 variants on bioavailability and toxicity of these chemical substances is quite significant.

Molecular Genetics

The CYP2D6 gene is nearly 18Kb long, and it has over 120 allelic variants resulting from point mutations, rearrangements, additions, deletions and duplications. These mutations are linked to varied metabolizing abilities; for example poor metabolism of Debrisoquine is observed with variants such as (Gly169Ter, Pro34Ser, 1-bp del, 2637A), while ultrarapid metabolism was linked to (Arg296Cys and Ser486Thr). Furthermore, alternatively spliced variants of CYP2D6 have been identified.

Epidemiology in the Arab World

View Map
Variant NameCountryGenomic LocationClinvar Clinical SignificanceCTGA Clinical Significance Condition(s)HGVS ExpressionsdbSNPClinvar
CYP2D6*102United Arab EmiratesNC_000022.11:g.42129821G>A(;)42127941G>A(;)42126611C>GDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.5990C>T(;)7870C>T(;)9200G>C; NM_000106.6:c.269C>T(;)886C>T(;)1457G>C267608309 16947 1135840
CYP2D6*103United Arab EmiratesNC_000022.11:g.42126611C>G(;)42127941G>A(;)42129042T>C(;)42129821G>ADrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.5990C>T(;)6769A>G(;)7870C>T(;)9200G>C; NM_000106.6:c.269C>T(;)496A>G(;)886C>T(;)1457G>C267608309 1135824 16947 1135840
CYP2D6*104United Arab EmiratesNC_000022.11:g.42126611C>G(;)42127941G>A(;)42129071T>ADrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.6740A>T(;)7870C>T(;)9200G>C; NM_000106.6:c.467A>T(;)886C>T(;)1457G>C16947 1135840
CYP2D6*105United Arab EmiratesNC_000022.11:g.42126611C>G(;)42127523A>G(;)42127941G>ADrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.7870C>T(;)8288T>C(;)9200G>C; NM_000106.6:c.886C>T(;)1097T>C(;)1457G>C16947 1555888910 1135840
CYP2D6*17United Arab EmiratesNC_000022.11:g.42126611C>G(;) 42127941G>A(;)42129770G>ADrug ResponseDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:6041C>T(;)7870C>T(;)9200G>C; NM_000106.6:c.NM_000106.6:c.320C>T(;)886C>T (;)1457G>C28371706 16947 1135840830235
CYP2D6*2United Arab EmiratesNC_000022.11:g.42126611C>G(;)42127941G>ADrug ResponseDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.7870C>T(;)9200G>C; NM_000106.6:c.886C>T(;)1457G>C16947 113584016895
CYP2D6*27United Arab EmiratesNC_000022.11:g.42126938C>TDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.8873G>A; NM_000106.6:c.1228G>A; NP_000097.3:p.Glu410Lys 769157652
CYP2D6*29United Arab EmiratesNC_000022.11:g.42126611C>G(;)42127608C>T(;)42127941G>A(;)42129130C>G(;)42129132C>TDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.6679G>A(;)6681G>C(;)7870C>T(;)8203G>A(;)9200G>C; NM_000106.6:c.406G>A(;)408G>C(;)886C>T(;)1012G>A(;)1457G>C61736512 1058164 16947 59421388 1135840
CYP2D6*35United Arab EmiratesNC_000022.11:g.42130761C>T(;)42127941G>A(;)42126611C>GDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.5050G>A(;)7870C>T(;)9200G>C; NM_000106.6:c.31G>A (;)886C>T(;)1457G>C769258 16947 1135840
CYP2D6*4Lebanon; United Arab E...NC_000022.11:g.42128945C>TDrug ResponseDrug ResponseBreast Cancer; Drug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.6866G>A; NM_000106.6:c.506-1G>A; NP_000097.3:p.?389209716889
CYP2D6*41Lebanon; United Arab E...NC_000022.11:g.42127803C>TDrug Response, Likely BenignDrug ResponseBreast Cancer; Drug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.8008G>A; NM_000106.6:c.985+39G>A2837172539381
CYP2D6*43United Arab EmiratesNC_000022.11:g.42130715C>TDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.3:g.4277G>A; NM_000106.5:c.77G>A; NP_000097.3:p.Arg26His28371696
CYP2D6*46United Arab EmiratesNC_000022.11:g.42126611C>G(;)42127941G>A(;)42129075C>T(;)42130715C>TDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.5096G>A(;)6736G>A(;)7870C>T(;)9200G>C; NM_000106.6:c.77G>A(;)463G>A(;)886C>T(;)1457G>C28371696 28371710 16947 1135840
NC_000022.11:g.42132969C>TLebanonNC_000022.11:g.42132969C>TDrug ResponseBreast CancerNG_008376.3:g.2023G>A28360521
NM_000106.5:c.281A>GUnited Arab EmiratesNC_000022.11:g.42129809T>CDrug ResponseDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.3:g.5183A>G; NM_000106.5:c.281A>G; NP_000097.3:p.His94Arg28371704829654
NM_000106.5:c.496A>GUnited Arab EmiratesNC_000022.11:g.42129042T>CLikely BenignDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.3:g.5950A>G; NM_000106.5:c.496A>G; NP_000097.3:p.Asn166Asp1135824675907
NM_000106.5:c.886C>TUnited Arab EmiratesNC_000022.11:g.42127941G>ABenignDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.3:g.7051C>T; NM_000106.5:c.886C>T; NP_000097.3:p.Arg296Cys16947242771
NM_000106.6:c.100C>TLebanon; United Arab E...NC_000022.11:g.42130692G>ADrug Response, Likely BenignDrug ResponseBreast Cancer; Drug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.5119C>T; NM_000106.6:c.100C>T; NP_000097.3:p.Pro34Ser106585216893
NM_000106.6:c.1012G>AUnited Arab EmiratesNC_000022.11:g.42127608C>TLikely BenignDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.3:g.7384G>A; NM_000106.6:c.1012G>A; NP_000097.3:p.Val338Met59421388598263
NM_000106.6:c.1316-11C>AUnited Arab EmiratesNC_000022.11:g.42126763G>TDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.9048C>A; NM_000106.6:c.1316-11C>A548264542
NM_000106.6:c.1457G>CUnited Arab EmiratesNC_000022.11:g.42126611C>GDrug ResponseDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.4:g.9200G>C; NM_000106.6:c.1457G>C; NP_000097.3:p.Ser486Thr1135840242701
NM_000106.6:c.505+25A>CUnited Arab EmiratesNC_000022.11:g.42129008T>GDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.3:g.5984A>C; NM_000106.6:c.505+25A>C; NP_000097.3:p.?200002499
NM_000106.6:c.832G>AUnited Arab EmiratesNC_000022.11:g.42128185C>TDrug ResponseDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.3:g.6807G>A; NM_000106.6:c.832G>A; NP_000097.3:p.Glu278Lys77913725828886
NM_000106.6:c.836T>AUnited Arab EmiratesNC_000022.11:g.42128181A>TDrug ResponseDrug ResponseDrug Metabolism, Poor, CYP2D6-RelatedNG_008376.3:g.6811T>A; NM_000106.6:c.836T>A; NP_000097.3:p.Met279Lys1135828828887

Other Reports

Saudi Arabia

McLellan et al. (1997) characterized the distribution of CYP2D6 alleles among Saudi Arabians using restriction fragment length polymorphism (RFLP) analysis and allele-specific PCR amplification. A total of 101 individuals were genotyped, 21 of those had CYP2D6 gene duplication, whilst only two were heterozygous for a deletion of the whole gene. The frequency of the most common loss-of-function allele among Caucasians, CYP2D6*4, was only 3.5% in the Saudi population. Also, other alleles associated with decreased enzymatic activity, such as CYP2D6*10 and *17, were found at lower rates (3% each). Therefore, the prevalence of the poor metabolizer phenotype is relatively low among Saudi Arabians. Few years later, Lundqvist et al. (1999) presented evidence that CYP2D6 gene duplications occurred through unequal crossover at a breakpoint in the 3-prime flanking region of the CYP2D6*2B allele with a specific repetitive sequence. Alleles with 13 copies of the gene were likely formed by unequal segregation and extrachromosomal replication of acentric DNA. Lundqvist et al. (1999) suggested that the high frequencies of multiduplicated genes in Saudi Arabian and Ethiopian populations indicated that a dietary selective pressure existed in those regions in the past. These variants may have been introduced into the Spanish population during the Muslim migration.

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