title: CYP2D6, SULT1A1 and UGT2B17 copy number variation: quantitative detection by multiplex PCR.
abstract: OBJECTIVE
  Among the genes of drug-metabolizing enzymes, CYP2D6 is notoriously difficult to characterize owing to the complexity of gene deletions, duplications, multiplications and the presence of hybrid genes composed of CYP2D6 and CYP2D7. For SULT1A1 up to five gene copies have been reported, while UGT2B17 is known for gene deletions only. Different platforms exist for copy number variation (CNV) detection; however, there are no gold standards. Robust methods are required that address specific challenges to accurately determine gene CNVs in complex gene loci.
  
  
  METHODS
  Quantitative multiplex PCR amplification (MPA) was performed on a diverse set of genomic DNA samples. Resulting PCR fragments were separated on an ABI 3730 instrument and analyzed with GeneMapper. CYP2D6 was targeted at four different gene regions and either normalized against CYP2D8 or UGT2B15 and SULT1A2. Inconsistent observations and CNVs contrasting genotype data were further characterized by long-range PCR and/or DNA sequence analysis. UGT2B17 and SULT1A1 were normalized against UGT2B15 and SULT1A2, respectively.
  
  
  RESULTS
  MPA detected 0-5, 1-5 and 0-2 copies for CYP2D6, SULT1A1 and UGT2B17, respectively. The interrogation of four CYP2D6 regions resulted in robust copy number assignments that were in agreement with genotype, sequencing and extra long PCR-based data. Gene deletions, duplication, and multiplications among known and novel hybrid genes were reliably identified. Novel findings regarding allelic variation include nonfunctional CYP2D6/2D7 hybrids such as CYP2D6*4N and *68, which were consistently identified on a subset of CYP2D6*4 alleles. In addition, a novel variant, designated CYP2D6*83, was discovered. For SULT1A1, we report the first six-copy case and for UGT2B15 and UGT2B17 we have evidence for rare deletion and duplication events, respectively.
  
  
  CONCLUSIONS
  This MPA-based copy number platform not only allowed us to determine CNVs, but also served as a tool for allele discovery and characterization in a diverse panel of samples in a fast and reliable manner.
authors: Division of Pediatric Pharmacology & Medical Toxicology, The Children's Mercy Hospital & Clinics, 2401 Gillham Rd, Kansas City, MO 64108, USA. agaedigk@cmh.edu
authors: Andrea
authors: A
authors: Gaedigk
authors: Greyson P
authors: GP
authors: Twist
authors: J Steven
authors: JS
authors: Leeder
mesh_terms: D000483:Alleles; D015239:Arylsulfotransferase / Q000235:genetics; D001769:Blood; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics; D056915:DNA Copy Number Variations / Q000235:genetics*; D005006:Ethnicity; D005091:Exons; D017353:Gene Deletion; D005838:Genotype; D014453:Glucuronosyltransferase / Q000235:genetics; D006801:Humans; D015778:Minor Histocompatibility Antigens; D016133:Polymerase Chain Reaction / Q000379:methods*; D012463:Saliva; D017422:Sequence Analysis, DNA
chemical_list: D015778:Minor Histocompatibility Antigens; D019389:Cytochrome P-450 CYP2D6; D014453:Glucuronosyltransferase; C500513:UGT2B17 protein, human; D015239:Arylsulfotransferase; C117544:SULT1A1 protein, human