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2. Overview of Cytochrome P450 Enzymes: The Role of Polymorphisms
Simon Kung, M.D.
Associate Professor of Psychiatry
Mayo Clinic

3. Liver Cytochrome P450 Enzymes
Zanger, U. M., & Schwab, M. (2013). Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacology & therapeutics, 138(1),

4. P450 Enzyme Polymorphisms
2D6
> 100
2C19
> 30
1A2
> 20

5. Factors Affecting Cytochrome P450 Enzymes
Gender
Age
Disease
Factors Affecting Cytochrome P450 Enzymes
Diurnal
influences
Hormones
Zanger, U. M., & Schwab, M. (2013). Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacology & therapeutics, 138(1),

6. The Cytochrome 2D6 Enzyme
One nucleotide change could significantly affect enzyme performance
Zanger, U. M., & Schwab, M. (2013). Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacology & therapeutics, 138(1),

7. Factors Affecting CYP 450 Enzymes
CYP2C19 (6.8%)
· Polymorphism
· Induction
· Inflammation
· Gender
( )
( )
( )
CYP2D6 (20%)
· Polymorphism
· Inflammation
( )
( )
Zanger, U. M., & Schwab, M. (2013). Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacology & therapeutics, 138(1),

8. Key Points
The cytochrome P450 enzyme system metabolizes many of our oral medications. Many of these enzymes have polymorphisms.
The enzyme activity is affected by nongenetic factors, such as gender, age, and inflammation.

9. Next Presentation CYP2D6 Pharmacogenomics: From Genotype to Phenotype