Protein Information

Name cytochrome P450 4F2
Synonyms CPF 2; CPF2; CYP4F2; CYP4F2 protein; CYPIVF 2; CYPIVF2; Cytochrome P450 4F2; Cytochrome P450 LTB omega…

Compound Information

Name warfarin
CAS

Reference List

PubMed Abstract RScore(About this table)
19794411 Pautas E, Moreau C, Gouin-Thibault I, Golmard JL, Mahe I, Legendre C, Taillandier-Heriche E, Durand-Gasselin B, Houllier AM, Verrier P, Beaune P, Loriot MA, Siguret V: Genetic factors (VKORC1, CYP2C9, EPHX1, and CYP4F2) are predictor variables for warfarin response in very elderly, frail inpatients. Clin Pharmacol Ther. 2010 Jan;87(1):57-64. Epub 2009 Sep 30.
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19270263 Perez-Andreu V, Roldan V, Anton AI, Garcia-Barbera N, Corral J, Vicente V, Gonzalez-Conejero R: Pharmacogenetic relevance of CYP4F2 V433M polymorphism on acenocoumarol therapy. Blood. 2009 May 14;113(20):4977-9. Epub 2009 Mar 6.

A new variant of CYP4F2 (V433M) has recently been related to the required warfarin dose.
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19958090 Lee MT, Chen CH, Chou CH, Lu LS, Chuang HP, Chen YT, Saleem AN, Wen MS, Chen JJ, Wu JY, Chen YT: Genetic determinants of warfarin dosing in the Han-Chinese population. Pharmacogenomics. 2009 Dec;10(12):1905-13.

MATERIALS & METHODS: In this study, we screened for SNPs in 13 genes (VKORC1, CYP2C9, CYP2C18, PROC, APOE, EPHX1, CALU, GGCX, ORM1, ORM2, factor II, factor VII and CYP4F2) and tested their associations with warfarin dosing with univariate and multiple regression analysis.
6(0,0,1,1) Details
20217574 Burmester JK, Sedova M, Shapero MH, Mansfield E: DMET microarray technology for pharmacogenomics-based personalized medicine. Methods Mol Biol. 2010;632:99-124.

In a research study using an earlier four-color version of the assay, it was demonstrated that warfarin dosing can be influenced by a cytochrome P450 (CYP) 4F2 variant.
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20182420 Perini JA, Struchiner CJ, Silva-Assuncao E, Suarez-Kurtz G: Impact of CYP4F2 rs2108622 on the stable warfarin dose in an admixed patient cohort. Clin Pharmacol Ther. 2010 Apr;87(4):417-20. Epub 2010 Feb 24.
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19545555 Babic N, Haverfield EV, Burrus JA, Lozada A, Das S, Yeo KT: Comparison of performance of three commercial platforms for warfarin sensitivity genotyping. Clin Chim Acta. 2009 Aug;406(1-2):143-7. Epub 2009 Jun 21.

BACKGROUND: We performed a 3-way comparison on the Osmetech eSensor, AutoGenomics INFINITI, and a real-time PCR method (Paragonx reagents/Stratagene RT-PCR platform) for their FDA-cleared warfarin panels, and additional polymorphisms (CYP2C9*5, *6, and 11 and extended VKORC1 panels) where available.
The CYP4F2 on Osmetech was validated by bi-directional sequencing.
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19578179 Teichert M, Eijgelsheim M, Rivadeneira F, Uitterlinden AG, van Schaik RH, Hofman A, De Smet PA, van Gelder T, Visser LE, Stricker BH: A genome-wide association study of acenocoumarol maintenance dosage. Hum Mol Genet. 2009 Oct 1;18(19):3758-68. Epub 2009 Jul 4.

After adjustment for these SNPs, the rs2108622 polymorphism within cytochrome P450 4F2 (CYP4F2) gene on chromosome 19 reached genome-wide significance (P = 2.0 x 10 (-8)).
Several genome-wide association studies have been performed on warfarin.
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19540002 Jonas DE, McLeod HL: Genetic and clinical factors relating to warfarin dosing. Trends Pharmacol Sci. 2009 Jul;30(7):375-86. Epub 2009 Jun 17.

Recent studies have reported that polymorphisms in CYP4F2 might account for between 2 and 7% of the variation.
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19348697 Daly AK: Pharmacogenomics of anticoagulants: steps toward personal dosage. Genome Med. 2009 Jan 21;1(1):10.


Warfarin and other coumarin anticoagulants are widely used clinically, but currently dosing is determined individually on the basis of patient response.
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19741565 Zhang JE, Jorgensen AL, Alfirevic A, Williamson PR, Toh CH, Park BK, Pirmohamed M: Effects of CYP4F2 genetic polymorphisms and haplotypes on clinical outcomes in patients initiated on warfarin therapy. Pharmacogenet Genomics. 2009 Oct;19(10):781-9.

CONCLUSION: Although we were unable to demonstrate an association between rs2108622 and stable warfarin dose, our finding of an association between rs2189784 and time-to-therapeutic international normalized ratio is consistent with the recent finding that CYP4F2 plays a role in vitamin K metabolism.
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20072124 Cavallari LH, Langaee TY, Momary KM, Shapiro NL, Nutescu EA, Coty WA, Viana MA, Patel SR, Johnson JA: Genetic and clinical predictors of warfarin dose requirements in African Americans. Clin Pharmacol Ther. 2010 Apr;87(4):459-64. Epub 2010 Jan 13.

The objective of this study was to determine whether, in African-American patients, additional vitamin K oxidoreductase complex subunit 1 (VKORC1), cytochrome P450 2C9 (CYP2C9), CYP4F2, or apolipoprotein E (APOE) polymorphisms contribute to variability in the warfarin maintenance dose beyond what is attributable to the CYP2C9*2 and *3 alleles and the VKORC1 -1639G> A genotype.
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19297519 McDonald MG, Rieder MJ, Nakano M, Hsia CK, Rettie AE: CYP4F2 is a vitamin K1 oxidase: An explanation for altered warfarin dose in carriers of the V433M variant. Mol Pharmacol. 2009 Jun;75(6):1337-46. Epub 2009 Mar 18.

The V433M polymorphism (rs2108622) in CYP4F2 has also been associated with warfarin dose and speculatively linked to altered VK1 metabolism.
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18998206 Glurich I, Burmester JK, Caldwell MD: Understanding the pharmacogenetic approach to warfarin dosing. Heart Fail Rev. 2008 Nov 8.

Polymorphic sites in three genes, cytochrome P450 (CYP) 2C9, vitamin K 2,3 epoxide reductase complex 1 (VKORC1), and CYP4F2, have been shown to affect stable warfarin dose.
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20128861 Lubitz SA, Scott SA, Rothlauf EB, Agarwal A, Peter I, Doheny D, van der Zee S, Jaremko M, Yoo C, Desnick RJ, Halperin JL: Comparative performance of gene-based warfarin dosing algorithms in a multiethnic population. J Thromb Haemost. 2010 Feb 2.

Additional covariates tested with each model included race, concurrent medications, medications known to interact with warfarin, and previously described CYP4F2, CALU, and GGCX variants.
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19207028 Borgiani P, Ciccacci C, Forte V, Sirianni E, Novelli L, Bramanti P, Novelli G: CYP4F2 genetic variant (rs2108622) significantly contributes to warfarin dosing variability in the Italian population. Pharmacogenomics. 2009 Feb;10(2):261-6.
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18250228 Caldwell MD, Awad T, Johnson JA, Gage BF, Falkowski M, Gardina P, Hubbard J, Turpaz Y, Langaee TY, Eby C, King CR, Brower A, Schmelzer JR, Glurich I, Vidaillet HJ, Yale SH, Qi Zhang K, Berg RL, Burmester JK: CYP4F2 genetic variant alters required warfarin dose. Blood. 2008 Apr 15;111(8):4106-12. Epub 2008 Feb 4.
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19300499 Takeuchi F, McGinnis R, Bourgeois S, Barnes C, Eriksson N, Soranzo N, Whittaker P, Ranganath V, Kumanduri V, McLaren W, Holm L, Lindh J, Rane A, Wadelius M, Deloukas P: A genome-wide association study confirms VKORC1, CYP2C9, and CYP4F2 as principal genetic determinants of warfarin dose. PLoS Genet. 2009 Mar;5(3):e1000433. Epub 2009 Mar 20.
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