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Accuracy of various human NAT2 SNP genotyping panels to infer rapid, intermediate and slow acetylator phenotypes

    &
    Mark A Doll

    Department of Pharmacology & Toxicology, University of Louisville Health Sciences Center, 505 South Hancock Street, Clinical & Translational Research Building Room 303, Louisville, KY 40202-1617, USA

    Published Online:https://doi.org/10.2217/pgs.11.122

    Aim: Humans exhibit genetic polymorphism in NAT2 resulting in rapid, intermediate and slow acetylator phenotypes. Over 65 NAT2 variants possessing one or more SNPs in the 870-bp NAT2 coding region have been reported. The seven most frequent SNPs are rs1801279 (191G>A), rs1041983 (282C>T), rs1801280 (341T>C), rs1799929 (481C>T), rs1799930 (590G>A), rs1208 (803A>G) and rs1799931 (857G>A). The majority of studies investigate the NAT2 genotype assay for three SNPs: 481C>T, 590G>A and 857G>A. A tag-SNP (rs1495741) recently identified in a genome-wide association study has also been proposed as a biomarker for the NAT2 phenotype. Materials & methods: Sulfamethazine N-acetyltransferase catalytic activities were measured in cryopreserved human hepatocytes from a convenience sample of individuals in the USA with an ethnic frequency similar to the 2010 US population census. These activities were segregated by the tag-SNP rs1495741 and each of the seven SNPs described above. We assessed the accuracy of the tag-SNP and various two-, three-, four- and seven-SNP genotyping panels for their ability to accurately infer NAT2 phenotype. Results: The accuracy of the various NAT2 SNP genotype panels to infer NAT2 phenotype were as follows: seven-SNP: 98.4%; tag-SNP: 77.7%; two-SNP: 96.1%; three-SNP: 92.2%; and four-SNP: 98.4%. Conclusion: A NAT2 four-SNP genotype panel of rs1801279 (191G>A), rs1801280 (341T>C), rs1799930 (590G>A) and rs1799931 (857G>A) infers NAT2 acetylator phenotype with high accuracy, and is recommended over the tag-, two-, three- and (for economy of scale) the seven-SNP genotyping panels, particularly in populations of non-European ancestry.

    Original submitted 9 June 2011; Revision submitted 9 August 2011

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

    References

    • Evans DA, Manley KA, McKusick VA. Genetic control of isoniazid metabolism in man. Br. Med. J.2,485–491 (1960).
    • Weber WW, Hein DW. N-acetylation pharmacogenetics. Pharmacol. Rev.37,25–79 (1985).
    • Cascorbi I, Brockmoller J, Mrozikiewicz PM, Muller A, Roots I. Arylamine N-acetyltransferase activity in man. Drug Metab. Rev.31,489–502 (1999).
    • Blum M, Demierre A, Grant DM, Heim, M, Meyer UA. Molecular mechanism of slow acetylation of drugs and carcinogens in humans. Proc. Natl Acad. Sci. USA88,5237–5241 (1991).▪ Described the initial report into the functional effects of three common NAT2 SNPs and formed the basis for the historical three-SNP assay.
    • Vatsis KP, Martell KJ, Weber WW. Diverse point mutations in the human gene for polymorphic N-acetyltransferase. Proc. Natl Acad. Sci. USA88,6333–6337 (1991).
    • Boukouvala S, Fakis G. Arylamine N-acetyltransferases: what we learn from genes and genomes. Drug Metab. Rev.37,511–564 (2005).
    • Grant DM, Goodfellow GH, Sugamori K, Durette K. Pharmacogenetics of the human arylamine N-acetyltransferases. Pharmacology61,204–211 (2000).
    • Sim E, Lack N, Wang CJ et al. Arylamine N-acetyltransferases: structural and functional implications of polymorphisms. Toxicology254,170–183 (2008).
    • Hein DW, Doll MA, Fretland AJ et al. Molecular genetics and epidemiology of the NAT1 and NAT2 acetylation polymorphisms. Cancer Epidemiol. Biomarkers Prev.9,29–42 (2000).▪ One of the first comprehensive reviews on the role of NAT2 polymorphisms in cancer risk. The paper also discusses possible genotyping misclassification with the historical three-SNP genotype assay.
    • 10  Agundez JA. Polymorphisms of human N-acetyltransferases and cancer risk. Curr. Drug Metab.9,520–531 (2008).
    • 11  Walraven JM, Zang Y, Trent JO, Hein DW. Structure/function evaluations of single nucleotide polymorphisms in human N-acetyltransferase 2. Curr. Drug Metab.9,471–486 (2008).
    • 12  Hein DW. N-acetyltransferase SNPs: emerging concepts serve as a paradigm for understanding complexities of personalized medicine. Expert Opin. Drug Metab. Toxicol.5,353–366 (2009).▪ Summarizes the functional effects of NAT2 SNPs.
    • 13  Deitz AC, Rothman N, Rebbeck TR et al. Impact of misclassification in genotype-exposure interaction studies: example of N-acetyltransferase 2 (NAT2), smoking, and bladder cancer. Cancer Epidemiol. Biomarkers Prev.13,1543–1546 (2004).▪ Reports NAT2 genotyping misclassification with the historical three-SNP assay and the consequences for gene–environmental interaction analyses.
    • 14  Doll MA, Fretland AJ, Deitz AC, Hein DW. Determination of human NAT2 acetylator genotype by restriction fragment-length polymorphism and allele-specific amplification. Anal. Biochem.231,413–420 (1995).
    • 15  Rothman N, Garcia-Closas M, Chatterjee N et al. A multi-stage genome-wide association study of bladder cancer identifies multiple susceptibility loci. Nat. Genet.42,978–984 (2010).▪▪ Describes the genome-wide association study that identified a new tag-SNP for slow acetylation and increased risk for urinary bladder cancer.
    • 16  Garcia-Closas M, Hein DW, Silverman D et al. A single nucleotide polymorphism tags variation in the arylamine N-acetyltransferase 2 phenotype in populations of European background. Pharmacogenet. Genomics21,231–236 (2011).▪▪ Reported associations between the newly identified tag-SNP and arylamine N-acetyltransferase activities in human hepatocytes from a population of individuals of European ancestry.
    • 17  Doll MA, Zang Y, Moeller T, Hein DW. Codominant expression of N-acetylation and O-acetylation activities catalyzed by N-acetyltransferase 2 in human hepatocytes. J. Pharmacol. Exp. Ther.334,540–544 (2010).
    • 18  Doll MA, Hein, DW. Comprehensive human NAT2 genotype method using single nucleotide polymorphism-specific polymerase chain reaction primers and fluorogenic probes. Anal. Biochem.288,106–108 (2001).
    • 19  Hein DW. N-acetyltransferase 2 genetic polymorphism: effects of carcinogen and haplotype on urinary bladder cancer risk. Oncogene25,1649–1658 (2006).
    • 20  Leff MA, Epstein PN, Doll MA et al. Prostate-specific human N-acetyltransferase 2 (NAT2) expression in the mouse. J. Pharmacol. Exp. Ther.290,182–187 (1999).
    • 21  Chapron DJ, Kramer PA, Mercik SA. Kinetic discrimination of three sulfamethazine acetylation phenotypes. Clin. Pharmacol. Ther.27,104–113 (1980).
    • 22  Chen B, Zhang WX, Cai WM. The influence of various genotypes on the metabolic activity of NAT2 in a Chinese population. Eur. J. Clin. Pharmacol.62,355–359 (2006).
    • 23  Deguchi T, Mashimo M, Suzuki T. Correlation between acetylator phenotypes and genotypes of polymorphic arylamine N-acetyltransferase in human liver. J. Biol. Chem.265,12757–12760 (1990).
    • 24  Parkin DP, Vandenplas S, Botha FJ et al. Trimodality of isoniazid elimination: phenotype and genotype in patients with tuberculosis. Am. J. Respir. Crit. Care Med.155,1717–1722 (1997).
    • 25  Smith CA, Wadelius M, Gough AC, Harrison DJ, Wolf CR, Rane A. A simplified assay for the arylamine N-acetyltransferase 2 polymorphism validated by phenotyping with isoniazid. J. Med. Genet.34,758–760 (1997).
    • 26  Kinzig-Schippers M, Tomalik-Scharte D, Jetter A et al. Should we use N-acetyltransferase type 2 genotyping to personalize isoniazid doses? Antimicrob. Agents Chemother.49,1733–1738 (2005).▪ Describes the importance of NAT2 genotyping in tuberculosis therapy.
    • 27  Ma JJ, Liu CG, Li JH, Cao XM, Sun SL, Yao X. Effects of NAT2 polymorphism on SASP pharmacokinetics in Chinese population. Clin. Chim. Acta407,30–35 (2009).
    • 28  Grant DM, Tang BK, Kalow W. A simple test for acetylator phenotype using caffeine. Br. J. Clin. Pharmacol.17,459–464 (1984).
    • 29  Cascorbi I, Drakoulis N, Brockmoller J, Maurer A, Sperling K, Roots I. Arylamine N-acetyltransferase (NAT2) mutations and their allelic linkage in unrelated Caucasian individuals: correlation with phenotypic activity. Am. J. Hum. Genet.57,581–592 (1995).
    • 30  Hein DW, Trinidad A, Yerokun T, Ferguson RJ, Kirlin WG, Weber WW. Genetic control of acetyl coenzyme A-dependent arylamine N-acetyltransferase, hydrazine N-acetyltransferase, and N-hydroxy-arylamine O-acetyltransferase enzymes in C57BL/6J, A/J, AC57F1, and the rapid and slow acetylator A.B6 and B6.A congenic inbred mouse. Drug Metab. Dispos.16,341–347 (1988).
    • 31  Hein DW, Rustan TD, Bucher KD, Miller LS. Polymorphic and monomorphic expression of arylamine carcinogen N-acetyltransferase isozymes in tumor target organ cytosols of Syrian-hamsters congenic at the polymorphic acetyltransferase locus. J. Pharmacol. Exp. Ther.259,699–704 (1991).
    • 32  Hein DW, Doll MA, Rustan TD, Gray K, Ferguson RJ, Feng Y. Construction of Syrian hamster lines congenic at the polymorphic acetyltransferase locus (NAT2): acetylator genotype-dependent N- and O-acetylation of arylamine carcinogens. Toxicol. Appl. Pharmacol.124,16–24 (1994).
    • 33  Hein DW, Rustan TD, Bucher KD, Martin WJ, Furman EJ. Acetylator phenotype-dependent and -independent expression of arylamine N-acetyltransferase isozymes in rapid and slow acetylator inbred rat liver. Drug Metab. Dispos.19,933–937 (1991).
    • 34  Hein DW, Bendaly J, Neale JR, Doll MA. Systemic functional expression of N-acetyltransferase polymorphism in the F344 Nat2 congenic rat. Drug Metab. Dispos.36,2452–2459 (2008).
    • 35  Grant DM, Blum M, Beer M, Meyer UA. Monomorphic and polymorphic human arylamine N-acetyltransferases: a comparison of liver isozymes and expressed products of two cloned genes. Mol. Pharmacol.39,184–191 (1991).
    • 36  Hein DW, Doll MA, Rustan TD et al. Metabolic activation and deactivation of arylamine carcinogens by recombinant human NAT1 and polymorphic NAT2 acetyltransferases. Carcinogenesis14,1633–1638 (1993).
    • 37  Hein DW, Ferguson RJ, Doll MA, Rustan TD, Gray K. Molecular genetics of human polymorphic N-acetyltransferase: enzymatic analysis of 15 recombinant wild-type, mutant, and chimeric NAT2 allozymes. Hum. Mol. Genet.3,729–734 (1994).
    • 38  Hein DW, Doll MA, Rustan TD, Ferguson RJ. Metabolic activation of N-hydroxyarylamines and N-hydroxyarylamides by 16 recombinant human NAT2 allozymes: effects of 7 specific NAT2 nucleic acid substitutions. Cancer Res.55,3531–3536 (1995).
    • 39  Grant DM, Hughes NC, Janezic SA et al. Human acetyltransferase polymorphisms. Mutat. Res.376,61–70 (1997).
    • 40  Fretland AJ, Leff MA, Doll MA, Hein DW. Functional characterization of human N-acetyltransferase 2 (NAT2) single nucleotide polymorphisms. Pharmacogenetics11,207–215 (2001).
    • 41  Hein DW, Fretland AJ Doll MA. Effects of single nucleotide polymorphisms in human N-acetyltransferase 2 on metabolic activation (O-acetylation) of heterocyclic amine carcinogens. Int. J. Cancer119,1208–1211 (2006).
    • 42  Zang Y, Zhao S, Doll MA, States JC, Hein DW. The T341C (Ile114Thr) polymorphism of N-acetyltransferase 2 yields slow acetylator phenotype by enhanced protein degradation. Pharmacogenetics14,717–723 (2004).
    • 43  Zang Y, Doll MA, Zhao S, States JC, Hein DW. Functional characterization of single-nucleotide polymorphisms and haplotypes of human N-acetyltransferase 2. Carcinogenesis28,1665–1671 (2007).
    • 44  Selinski S, Blaszkewicz M, Lehmann ML et al. Genotyping NAT2 with only two SNPs (rs1041983 and rs1801280) outperforms the tagging SNP rs1495741 and is equivalent to the conventional 7-SNP NAT2 genotype. Pharmacogenet. Genomics21(10),673–678 (2011).
    • 45  Loktionov A, Moore W, Spencer SP et al. Differences in N-acetylation genotypes between Caucasians and black South Africans: implications for cancer prevention. Cancer Detect. Prev.26,15–22 (2002).
    • 46  Sabbagh A, Langaney A, Darlu P, Gerard N, Krishnamoorthy R, Poloni ES. Worldwide distribution of NAT2 diversity: implications for NAT2 evolutionary history. BMC Genet.9,21 (2008).
    • 47  Sabbagh A, Darlu P, Crouau-Roy B, Poloni ES. Arylamine N-acetyltransferase 2 (NAT2) genetic diversity and traditional subsistence: a worldwide population survey. PLoS ONE6,e18507 (2011).
    • 48  Ohno M, Yamaguchi I, Yamamoto I et al. Slow N-acetyltransferase 2 genotype affects the incidence of isoniazid and rifampicin-induced hepatotoxicity. Int. J. Tuberc. Lung Dis.4,256–261 (2000).
    • 49  Hiratsuka M, Kishikawa Y, Takekuma Y et al. Genotyping of the N-acetyltransferase 2 polymorphism in the prediction of adverse drug reactions to isoniazid in Japanese patients. Drug Metab. Pharmacokinet.17,357–362 (2002).
    • 50  Cho HJ, Koh WJ, Ryu YJ et al. Genetic polymorphisms of NAT2 and CYP2E1 associated with antituberculosis drug-induced hepatotoxicity in Korean patients with pulmonary tuberculosis. Tuberculosis87,551–556 (2007).
    • 51  Teslovich TM, Musunuru K, Smith AV et al. Biological, clinical and population relevance of 95 loci for blood lipids. Nature466,7071–7073 (2010).
    • 101  University of Louisville, KY, USA. Department of pharmacology and toxicology. www.n-acetyltransferasenomenclature.louisville.edu▪▪ Official website for consensus human arylamine N-acetyltransferase gene nomenclature.
    • 102  Celsis. Characterization tables. www.celsis.com/ivt/characterization-tables/
    • 103  US Census Burea. Overview of race and Hispanic origin: 2010. www.census.gov/prod/cen2010/briefs/c2010br-02.pdf