1
|
Samarasinghe SR, Lee SB, Corpas M, Fatumo S, Guchelaar HJ, Nagaraj SH. Mapping the Pharmacogenetic Landscape in a Ugandan Population: Implications for Personalized Medicine in an Underrepresented Population. Clin Pharmacol Ther 2024. [PMID: 38837390 DOI: 10.1002/cpt.3309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/27/2024] [Indexed: 06/07/2024]
Abstract
Africans are extremely underrepresented in global genomic research. African populations face high burdens of communicable and non-communicable diseases and experience widespread polypharmacy. As population-specific genetic studies are crucial to understanding unique genetic profiles and optimizing treatments to reduce medication-related complications in this diverse population, the present study aims to characterize the pharmacogenomics profile of a rural Ugandan population. We analyzed low-pass whole genome sequencing data from 1998 Ugandans to investigate 18 clinically actionable pharmacogenes in this population. We utilized PyPGx to identify star alleles (haplotype patterns) and compared allele frequencies across populations using the Pharmacogenomics Knowledgebase PharmGKB. Clinical interpretations of the identified alleles were conducted following established dosing guidelines. Over 99% of participants displayed actionable phenotypes across the 18 pharmacogenes, averaging 3.5 actionable genotypes per individual. Several variant alleles known to affect drug metabolism (i.e., CYP3A5*1, CYP2B6*9, CYP3A5*6, CYP2D6*17, CYP2D6*29, and TMPT*3C)-which are generally more prevalent in African individuals-were notably enriched in the Ugandan cohort, beyond reported frequencies in other African peoples. More than half of the cohort exhibited a predicted impaired drug response associated with CFTR, IFNL3, CYP2B6, and CYP2C19, and approximately 31% predicted altered CYP2D6 metabolism. Potentially impaired CYP2C9, SLCO1B1, TPMT, and DPYD metabolic phenotypes were also enriched in Ugandans compared with other African populations. Ugandans exhibit distinct allele profiles that could impact drug efficacy and safety. Our findings have important implications for pharmacogenomics in Uganda, particularly with respect to the treatment of prevalent communicable and non-communicable diseases, and they emphasize the potential of pharmacogenomics-guided therapies to optimize healthcare outcomes and precision medicine in Uganda.
Collapse
Affiliation(s)
- Sumudu Rangika Samarasinghe
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Manuel Corpas
- College of Liberal Arts and Sciences, University of Westminster, London, UK
| | - Segun Fatumo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Shivashankar H Nagaraj
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Translational Research Institute, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
2
|
Mishra M, Nahlawi L, Zhong Y, De T, Yang G, Alarcon C, Perera MA. LA-GEM: imputation of gene expression with incorporation of Local Ancestry. PACIFIC SYMPOSIUM ON BIOCOMPUTING. PACIFIC SYMPOSIUM ON BIOCOMPUTING 2024; 29:341-358. [PMID: 38160291 PMCID: PMC10764069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Gene imputation and TWAS have become a staple in the genomics medicine discovery space; helping to identify genes whose regulation effects may contribute to disease susceptibility. However, the cohorts on which these methods are built are overwhelmingly of European Ancestry. This means that the unique regulatory variation that exist in non-European populations, specifically African Ancestry populations, may not be included in the current models. Moreover, African Americans are an admixed population, with a mix of European and African segments within their genome. No gene imputation model thus far has incorporated the effect of local ancestry (LA) on gene expression imputation. As such, we created LA-GEM which was trained and tested on a cohort of 60 African American hepatocyte primary cultures. Uniquely, LA-GEM include local ancestry inference in its prediction of gene expression. We compared the performance of LA-GEM to PrediXcan trained the same dataset (with no inclusion of local ancestry) We were able to reliably predict the expression of 2559 genes (1326 in LA-GEM and 1236 in PrediXcan). Of these, 546 genes were unique to LA-GEM, including the CYP3A5 gene which is critical to drug metabolism. We conducted TWAS analysis on two African American clinical cohorts with pharmacogenomics phenotypic information to identity novel gene associations. In our IWPC warfarin cohort, we identified 17 transcriptome-wide significant hits. No gene reached are prespecified significance level in the clopidogrel cohort. We did see suggestive association with RAS3A to P2RY12 Reactivity Units (PRU), a clinical measure of response to anti-platelet therapy. This method demonstrated the need for the incorporation of LA into study in admixed populations.
Collapse
Affiliation(s)
- Mrinal Mishra
- Department of Pharmacology, Center for Pharmacogenomics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA†Contributed equally to the work
| | | | | | | | | | | | | |
Collapse
|
3
|
Kim JS, Lee S, Yee J, Park K, Jang EJ, Chang BC, Gwak HS. Novel Gene Polymorphisms for Stable Warfarin Dose in a Korean Population: Genome-Wide Association Study. Biomedicines 2023; 11:2308. [PMID: 37626805 PMCID: PMC10452379 DOI: 10.3390/biomedicines11082308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/03/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Warfarin has a narrow therapeutic window and high intra- and inter-individual variability. Considering that many published papers on genotype-guided dosing are derived from European populations, the aim of this study was to investigate novel genetic variants associated with the variability of stable warfarin dose in the Korean population with cardiac valve replacement, using the GWAS approach. This retrospective cohort study was performed from January 1982 to December 2020 at the Severance Cardiovascular Hospital of Yonsei University College of Medicine. GWAS was performed to identify associations between genotypes and the warfarin maintenance dose, by comparing the allele frequency of genetic variants between individuals. Then, the extent of genetic and non-genetic factors on the dose variability was determined by multivariable regression analysis. The study enrolled 214 participants, and the most robust signal cluster was detected on chromosome 16 around VKORC1. Followed by VKORC1, three novel variants (NKX2-6 rs310279, FRAS1 rs4386623, and FAM201A rs1890109) showed an association with stable warfarin dose requirement in univariate analysis. The algorithm was constructed by using multivariable analysis that includes genetic and non-genetic factors, and it could explain 58.5% of the variations in stable warfarin doses. In this variability, VKORC1 rs9934438 and FRAS1 rs4386623 accounted for 33.0% and 9.9%, respectively. This GWAS analysis identified the fact that three novel variants (NKX2-6 rs310279, FRAS1 rs4386623, and FAM201A rs1890109) were associated with stable warfarin doses. Additional research is necessary to validate the results and establish personalized treatment strategies for the Korean population.
Collapse
Affiliation(s)
- Jung Sun Kim
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea; (J.S.K.); (J.Y.); (E.J.J.)
| | - Sak Lee
- Department of Thoracic and Cardiovascular Surgery, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea;
| | - Jeong Yee
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea; (J.S.K.); (J.Y.); (E.J.J.)
| | - Kyemyung Park
- Department of Biomedical Engineering, College of Information and Biotechnology, Ulsan National Institute of Science and Technology, Ulsan 44919, Republic of Korea;
| | - Eun Jeong Jang
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea; (J.S.K.); (J.Y.); (E.J.J.)
| | - Byung Chul Chang
- Department of Thoracic and Cardiovascular Surgery, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea;
- Department of Thoracic and Cardiovascular Surgery, Bundang CHA Medical Center, CHA University, Seongnam 13496, Republic of Korea
| | - Hye Sun Gwak
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul 03760, Republic of Korea; (J.S.K.); (J.Y.); (E.J.J.)
| |
Collapse
|
4
|
Laverdière J, Meloche M, Provost S, Leclair G, Oussaïd E, Jutras M, Perreault LPL, Valois D, Mongrain I, Busseuil D, Rouleau JL, Tardif JC, Dubé MP, Denus SD. Pharmacogenomic markers of metoprolol and α-OH-metoprolol concentrations: a genome-wide association study. Pharmacogenomics 2023; 24:441-448. [PMID: 37307170 DOI: 10.2217/pgs-2023-0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Aim: Few genome-wide association studies (GWASs) have been conducted to identify predictors of drug concentrations. The authors therefore sought to discover the pharmacogenomic markers involved in metoprolol pharmacokinetics. Patients & methods: The authors performed a GWAS of a cross-sectional study of 993 patients from the Montreal Heart Institute Biobank taking metoprolol. Results: A total of 391 and 444 SNPs reached the significance threshold of 5 × 10-8 for metoprolol and α-OH-metoprolol concentrations, respectively. All were located on chromosome 22 at or near the CYP2D6 gene, encoding CYP450 2D6, metoprolol's main metabolizing enzyme. Conclusion: The results reinforce previous findings of the importance of the CYP2D6 locus for metoprolol concentrations and confirm that large biobanks can be used to identify genetic determinants of drug pharmacokinetics at a GWAS significance level.
Collapse
Affiliation(s)
- Jean Laverdière
- Faculty of Pharmacy, Université de Montréal, H3T 1J4, Montreal, Quebec, Canada
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| | - Maxime Meloche
- Faculty of Pharmacy, Université de Montréal, H3T 1J4, Montreal, Quebec, Canada
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| | - Sylvie Provost
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| | - Grégoire Leclair
- Faculty of Pharmacy, Université de Montréal, H3T 1J4, Montreal, Quebec, Canada
| | - Essaïd Oussaïd
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| | - Martin Jutras
- Faculty of Pharmacy, Université de Montréal, H3T 1J4, Montreal, Quebec, Canada
| | - Louis-Philippe Lemieux Perreault
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| | - Diane Valois
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| | - Ian Mongrain
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| | - David Busseuil
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| | - Jean Lucien Rouleau
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Faculty of Medicine, Université de Montréal, H3T 1J4, Montreal, Quebec, Canada
| | - Jean-Claude Tardif
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
- Faculty of Medicine, Université de Montréal, H3T 1J4, Montreal, Quebec, Canada
| | - Marie-Pierre Dubé
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
- Faculty of Medicine, Université de Montréal, H3T 1J4, Montreal, Quebec, Canada
| | - Simon de Denus
- Faculty of Pharmacy, Université de Montréal, H3T 1J4, Montreal, Quebec, Canada
- Montreal Heart Institute, H1T 1C8, Montreal, Quebec, Canada
- Université de Montreal Beaulieu-Saucier Pharmacogenomics Centre, H1T 1C8, Montreal, Quebec, Canada
| |
Collapse
|