rs56337013

neutralMag 5.5

This is a variant in the CYP2C19 gene that changes a arginine to an tryptophan.

Key Literature Trait Associations

Drug Metabolism (CYP2C19)

CYP2C19*5 (c.1297C>T, p.Arg433Trp) is a rare loss-of-function allele that produces a non-functional enzyme due to an amino acid substitution in the heme-binding region of CYP2C19. Carriers have reduced capacity to metabolize multiple CYP2C19 substrates including clopidogrel, proton pump inhibitors, and antifungals. CPIC guidelines classify *5 as a no-function allele.

Allele T
OR
p
Major Consortium Study
Allele T
OR
p
Major Consortium Study
multi-ancestry
Mega JL et al. Cytochrome p-450 polymorphisms and response to clopidogrel. The New England Journal of Medicine (2009)
Allele T
OR 1.53
p 1.0e-2
N 1,477
Preliminary work
multi-ancestry

ClinVar annotation

Drug Response★★★★
3 submitters7 publications

CYP2C19: no function; Citalopram response; Clopidogrel response; Escitalopram response; Mephenytoin, poor metabolism of; Sertraline response; Voriconazole response

View on ClinVar →

Research that mentions this SNP (4)

Interindividual Variability in the Hepatic Expression of the Human Breast Cancer Resistance Protein (BCRP/ABCG2): Effect of Age, Sex, and Genotype
AssociationN=1,000Bhagwat Prasad et al.(2013)· Journal of Pharmaceutical Sciences

Case-control study of 1,000 Han Chinese individuals (450 epilepsy cases, 550 controls) examining associations between STX1B polymorphisms and epilepsy treatment response. The rs140820592 variant showed significant association with reduced epilepsy risk (OR=0.542, p=0.004) and drug-resistant epilepsy risk (OR=0.260, p=0.004), with eQTL analysis confirming rs140820592 regulates STX1B expression in brain tissues.

Traits studied:Drug-resistant epilepsyDrug-responsive epilepsyEpilepsyImatinib response in chronic myelogenous leukemiaPraziquantel responseTacrolimus metabolism
Influence of neurexin 1 (NRXN1) polymorphisms in clozapine response
ReviewRenan P. Souza et al.(2010)· Human Psychopharmacology: Clinical and Experimental

This systematic review of 98 studies examined biological predictors of clozapine response in treatment-resistant schizophrenia patients. Of 379 different gene variants investigated across 70 genetic studies, only three variants (DRD3 Ser9Gly rs6280, HTR2A His452Tyr, and GNB3 C825T) achieved independent replication. Non-genetic predictors included higher prefrontal cortical volumes and lower HVA:5-HIAA ratio in cerebrospinal fluid.

Traits studied:Clozapine responseSchizophreniaTreatment-resistant schizophrenia
Association of Cytochrome P450 2C19 Genotype With the Antiplatelet Effect and Clinical Efficacy of Clopidogrel Therapy
AssociationN=656Shuldiner AR et al.(2009)· JAMA

This genome-wide association study identified the CYP2C19*2 loss-of-function variant (rs4244285) as a major determinant of clopidogrel response in 429 Amish individuals. The variant was associated with diminished platelet aggregation response to ADP stimulation (P=4.3×10⁻¹¹) and accounted for 12% of variation in clopidogrel response. In an independent cohort of 227 patients undergoing percutaneous coronary intervention, carriers of CYP2C19*2 had higher cardiovascular event rates (20.9% vs 10.0%, HR=2.42, P=.02).

Traits studied:Acute coronary syndromesCardiovascular ischemic eventsClopidogrel responsePercutaneous coronary intervention outcomesPlatelet aggregation
Lack of association of GPX1 and MnSOD genes with symptom severity and response to clozapine treatment in schizophrenia subjects
ReviewRenan P. Souza et al.(2009)· Human Psychopharmacology: Clinical and Experimental

A systematic review of 98 studies investigating biological predictors of clozapine response in treatment-resistant schizophrenia. Of 70 genetic studies examining 379 variants, only three genetic variants have independently replicated findings: DRD3 Ser9Gly (rs6280), HTR2A His452Tyr, and GNB3 C825T (rs5442/rs5443). Non-genetic predictors include higher prefrontal cortical structural integrity and activity, and lower HVA:5-HIAA ratio in cerebrospinal fluid.

Traits studied:Clozapine responseSchizophreniaTreatment-resistant schizophrenia

Gene information from NCBI Gene. Variant classifications from ClinVar.

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