AIRR - ANZCA Institutional Research Repository
Skip navigation
Please use this identifier to cite or link to this item: http://hdl.handle.net/11055/462
Title: Warfarin resistance associated with genetic polymorphism of VKORC1: linking clinical response to molecular mechanism using computational modeling.
Authors: Lewis, Benjamin C
Nair, Pramod C
Heran, Subash S
Somogyi, Andrew A
Bowden, Jeffrey J
Doogue, Matthew P
Miners, John O
Issue Date: Jan-2016
Citation: Pharmacogenetics and genomics 2016-01; 26(1): 44-50
Abstract: The variable response to warfarin treatment often has a genetic basis. A protein homology model of human vitamin K epoxide reductase, subunit 1 (VKORC1), was generated to elucidate the mechanism of warfarin resistance observed in a patient with the Val66Met mutation. The VKORC1 homology model comprises four transmembrane (TM) helical domains and a half helical lid domain. Cys132 and Cys135, located in the N-terminal end of TM-4, are linked through a disulfide bond. Two distinct binding sites for warfarin were identified. Site-1, which binds vitamin K epoxide (KO) in a catalytically favorable orientation, shows higher affinity for S-warfarin compared with R-warfarin. Site-2, positioned in the domain occupied by the hydrophobic tail of KO, binds both warfarin enantiomers with similar affinity. Displacement of Arg37 occurs in the Val66Met mutant, blocking access of warfarin (but not KO) to Site-1, consistent with clinical observation of warfarin resistance.
URI: http://hdl.handle.net/11055/462
DOI: 10.1097/FPC.0000000000000184
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/26513304
Journal Title: Pharmacogenetics and genomics
Type: Case Reports
Journal Article
Appears in Collections:Scholarly and Clinical

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.