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Chlorpropamide 2-hydroxylation is catalysed by CYP2C9 and CYP2C19 in vitro: chlorpropamide disposition is influenced by CYP2C9, but not by CYP2C19 genetic polymorphism.

AIMS: We evaluated the involvement of cytochrome P450 (CYP) isoforms 2C9 and 2C19 in chlorpropamide 2-hydroxylation in vitro and in chlorpropamide disposition in vivo. METHODS: To identify CYP isoforms(s) that catalyse 2-hydroxylation of chlorpropamide, the incubation studies were conducted using human liver microsomes and recombinant CYP isoforms. To evaluate whether genetic polymorphisms of CYP2C9 and/or CYP2C19 influence the disposition of chlorpropamide, a single oral dose of 250 mg chlorpropamide was administered to 21 healthy subjects pregenotyped for CYP2C9 and CYP2C19. RESULTS: In human liver microsomal incubation studies, the formation of 2-hydroxychlorpropamide (2-OH-chlorpropamide), a major chlorpropamide metabolite in human, has been best described by a one-enzyme model with estimated K(m) and V(max) of 121.7 +/- 19.9 microm and 16.1 +/- 5.0 pmol min(-1) mg(-1) protein, respectively. In incubation studies using human recombinant CYP isoforms, however, 2-OH-chlorpropamide was formed by both CYP2C9 and CYP2C19 with similar intrinsic clearances (CYP2C9 vs. CYP2C19: 0.26 vs. 0.22 microl min(-1) nmol(-1) protein). Formation of 2-OH-chlorpropamide in human liver microsomes was significantly inhibited by sulfaphenazole, but not by S-mephenytoin, ketoconazole, quinidine, or furafylline. In in vivo clinical trials, eight subjects with the CYP2C9*1/*3 genotype exhibited significantly lower nonrenal clearance [*1/*3 vs.*1/*1: 1.8 +/- 0.2 vs. 2.4 +/- 0.1 ml h(-1) kg(-1), P < 0.05; 95% confidence interval (CI) on the difference 0.2, 1.0] and higher metabolic ratios (of chlorpropamide/2-OH-chlorpropamide in urine: *1/*3 vs.*1/*1: 1.01 +/- 0.19 vs. 0.56 +/- 0.08, P < 0.05; 95% CI on the difference - 0.9, - 0.1) than did 13 subjects with CYP2C9*1/*1 genotype. In contrast, no differences in chlorpropamide pharmacokinetics were observed for subjects with the CYP2C19 extensive metabolizer vs. poor metabolizer genotypes. CONCLUSIONS: These results suggest that chlorpropamide disposition is principally determined by CYP2C9 activity in vivo, although both CYP2C9 and CYP2C19 have a catalysing activity of chlorpropamide 2-hydroxylation pathway.

Administration, Oral↗

Functional analysis of three genetic polymorphisms in the glucocorticoid receptor gene.

Glucocorticoids are widely used as potent anti-inflammatory drugs. Glucocorticoids exert their pharmacological effects by binding to a glucocorticoid receptor (GR), which promotes expression of its target genes or suppresses transcription mediated by other transcriptional factors, such as nuclear factor-kappaB (NF-kappaB). To identify genetic polymorphisms affecting glucocorticoid responses, the GR gene was sequenced, and two novel single nucleotide alterations, 1510A>T (T504S) and 1952C>T (S651F), were identified in addition to an adenine base insertion at nucleotide 2314 (2314insA). mRNA expression levels of T504S and S651F were comparable with that of the wild type (WT), whereas the mRNA level of 2314insA was reduced to approximately 36% of the WT level. Protein expression was reduced to approximately 66% of WT levels in S651F and to approximately 6% in 2314insA. No significant change was seen in the T504S variant levels. The instability of the 2314insA mRNA, S651F protein, and 2314insA protein was confirmed by time course experiments. The transcriptional activity of S651F and 2314insA was also reduced to approximately 63 and 2% of the WT levels, respectively, in the luciferase reporter assay. Moreover, the inhibitory effect of GR on NF-kappaB transactivation was reduced to approximately 81 and 12% of the WT levels for S651F and 2314insA, respectively. These results indicated that the overall transcriptional activity and inhibitory effect on NF-kappaB transactivation of S651F and 2314insA have partially reduced and almost abrogated, respectively, almost paralleling their reduced protein expression levels caused by mRNA and/or protein instabilities. Thus, these two variations were suggested to influence the response to glucocorticoid treatment.

Animals↗

Genetic polymorphisms of CYP3A4, GSTT1, GSTM1, GSTP1 and NQO1 and the risk of acquired idiopathic aplastic anemia in Caucasian patients.

BACKGROUND AND OBJECTIVES: Various drugs and xenobiotics are involved in the pathogenesis of acquired aplastic anemia. Their harmful potential depends on the amount of exposure to them and on the detoxifying capacity of the recipient. Genetic polymorphisms of some important detoxifying enzymes are associated with low or absent cata-lytic activity of the protein. We assessed whether, in a Caucasian population, low or null activity polymorphisms of CYP3A4, GSTT1, GSTM1, GSTP1 and NQO1 were associated with the risk of developing aplastic anemia and with the response to immunosuppressive therapy. DESIGN AND METHODS: In 77 Caucasian patients with aplastic anemia and in 156 normal controls we evaluated the distribution of the following polymorphisms which are associated with low or no activity of the corresponding enzyme: (i)-290 A-->G of the CYP3A4 gene, deletions of (ii) GSTT1 and (iii) GSTM1 genes, (iv) 313A-->G of the GSTP1 gene and (v) 609 C-->T of the NQO1 gene. RESULTS: The distribution of the genotypes of all tested polymorphisms was not different in patients and controls. No differences were seen among the patients when the group was subdivided by age and severity of the disease. Only the GSTM1 null genotype was significantly more frequent in male patients than in male controls. The frequency of all tested polymorphisms did not differ in patients who did or did not respond to immunosuppressive therapy. INTERPRETATION AND CONCLUSIONS: The low/null activity polymorphisms of the detoxifying enzymes CYP3A4, GSTT1, GSTM1, GSTP1 and NQO1 are not associated with the risk of developing aplastic anemia or to the response to immunosuppressive therapy in Caucasian patients.

Adolescent↗

[Analysis of correlation between body length and genetic polymorphism for loci ESTD-1 and IDHP-3 in the Atlantic salmon Salmo salar].

Correlation between body length and characteristics of genetic polymorphism for loci Me-2, IDHP-3, ESTD-1, and AAT-2 were studied in the Atlantic salmon Salmo salar. The study was based on data on genetic variation in more than 4000 fish grown at the Kandalaksha Hatchery. Of four loci studied, loci ESTD-1 and IDHP-3 were distinguished by the fact that they can be confidently considered body-length markers in the Atlantic salmon. Analysis of mean locus heterozygosity indicates a disturbance of the mechanism of negative heterosis that is characteristic of natural populations. This presumably reflects a change in the genetic diversity of the Atlantic salmon under the influence of breeding.

Alleles↗

Genetic polymorphisms of angiotensin-I converting enzyme, haptoglobin and angiotensinogen and oxidative stress parameters in 12 to 15-year-old adolescents.

BACKGROUND: Angiotensin-converting enzyme (ACE) I/D, haptoglobin (Hp) 1/2 and angiotensinogen (AGT) M235T gene polymorphisms have been associated with the risk of various cardiovascular conditions. Oxidative stress and reactive oxygen species have also been implicated in endothelial injury. In a randomly selected sample of healthy adolescents, we studied the relationship between these genetic polymorphisms and somatic characteristics, blood pressure and certain biochemical markers of oxidative stress. METHODS: A sample of 49 healthy adolescents were genotyped for ACE I/D, Hp 1/2 and AGT M235T polymorphisms. Anthropometric parameters, blood pressure and lipid profile were evaluated using internationally recommended methods. Serum ACE activity and oxidative stress markers were determined either by spectrophotometric methods or with commercially available kits. RESULTS: Males had higher values for ACE activity than females (p < 0.01). The haptoglobin Hp allele 1 and the ACE D allele were associated with higher ACE activity (p < 0.05 and p < 0.001). ACE activity was similar between AGT genotypes. Higher levels of MDA-LDL/Apo B were observed in individuals with both ACE DD and Hp 2-2 genotypes. Carriers of the AGT TT genotype showed higher diastolic blood pressures than other AGT genotypes. CONCLUSION: Carriers of both ACE DD and Hp 2-2 genotypes have a higher pro-oxidant status and AGT TT carriers have higher diastolic blood pressures, which may indicate a higher risk for development of hypertension in these individuals.

Adolescent↗

Early-onset and late-onset depression are independent of the genetic polymorphism of apolipoprotein E.

The recently shown association between apolipoprotein E (APOE) genotype and depressive illness has been challenged by subsequent studies. However, controversial results may derive from the different diagnostic criteria used for depression and from the small numbers of depressed patients included in the studies. We examined the association between depression and the genetic polymorphism of APOE in a large sample of depressed patients, Alzheimer's disease (AD) patients, and healthy controls following clear definitions for late-life depression. The cumulative incidence of depression depending on the age at onset of the first episode was examined by survival analysis. Our data do not disconfirm the hypothesis of depression sharing some common pathophysiologic features with AD, however, it seems very unlikely that the APOE genotype will elucidate the assumed common mechanisms.

Age Factors↗

Cytochrome P4502E1 genetic polymorphisms and risk of nasopharyngeal carcinoma: results from a case-control study conducted in Taiwan.

CYP2E1 is responsible for the metabolic activation of nitrosamines believed to be involved in the pathogenesis of various tumors. Nasopharyngeal carcinoma (NPC) is a tumor thought to be linked to nitrosamine exposure. To investigate the possible role of CYP2E1 genetic polymorphisms in the etiology of this tumor, we investigated 50 histologically confirmed NPC cases from Taiwan and 50 controls matched to cases on age, sex, and residence. Samples were examined for RFLPs in the CYP2E1 gene by PCR amplification followed by digestion with DraI and RsaI. Among healthy controls, the allelic frequency of wild-type and variant forms of CYP2E1 were 79 and 21%, respectively, using DraI enzyme digestion and 82 and 18%, respectively, using RsaI enzyme digestion. As compared with individuals who were homozygous for the wild-type CYP2E1 gene, those found to be homozygous for the variant form of the gene by DraI digestion were at a 5-fold excess risk of disease (95% confidence interval = 0.95-16). Similarly, subjects homozygous for the variant form of the CYP2E1 gene by RsaI digestion were at 7.7-fold excess risk of developing NPC (95% confidence interval = 0.87-68). Individuals found to be heterozygous for the gene were at similar risk of disease compared to those homozygous for the wild-type gene. A strong association was observed between the RFLPs detected by DraI and RsaI digestion of CYP2E1; a correlation coefficient of 0.86 for controls and 0.91 for cases was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Genetic polymorphism of DXS7423, DXS7424, DXS7132, DXS7133, DXS6804 loci on X-chromosome in Ewenke population].

OBJECTIVE: To study the genetic polymorphism of five STR loci on X-chromosome in 98 Ewenke population of China and establish the related genetic database. METHODS: The sequence variation of DXS7423, DXS7424, DXS7132, DXS7133, DXS6804 loci on X-chromosome were analyzed by PCR following PAG electrophoresis and silver staining. RESULTS: The genetic data of the 5 X-chromosome STRs in Ewenke ethnic group of China is in accordance with Hard-Weinberg equilibrium. CONCLUSION: Five X-STR loci could be used in forensic identification and population genetic research.

Chi-Square Distribution↗

Novel alleles of the D16S752 polymorphic genetic marker linked to E-cadherin gene--a potential population marker.

Seven DNA variants that polymorphic genetic marker D16S752 reveals in Croatian population are reported in this paper. The marker is a GATA tetranucleotide repeat linked to human E-cadherin gene (CDH1). Prior studies involving this marker revealed only four DNA allele variants. The reported DNA variants contribute to the collection of hypervariable DNA polymorphisms data useful in the field of anthropological and population genetic and forensic medicine.

Cadherins↗

Micronuclei in blood lymphocytes and genetic polymorphism for GSTM1, GSTT1 and NAT2 in pesticide-exposed greenhouse workers.

The frequency of micronuclei (MN) in cultured peripheral lymphocytes was used as a biomarker of genotoxic effects in 34 Italian pesticide-exposed greenhouse workers and 33 unexposed referents matched with the exposed workers for age and smoking habits. The possible influence of the genetic polymorphisms of xenobiotic metabolizing enzymes glutathione S-transferase M1 (GSTM1), T1 (GSTT1), and N-acetyltransferase 2 (NAT2) was also evaluated. To restrict the analysis primarily to cells that have divided once in vitro, MN were scored only in cells showing label after a 42-h incubation with bromodeoxyuridine (BrdU), as detected by immunofluorescence (anti-BrdU technique). Two different concentrations of BrdU (0.5 and 1 microg/ml) were compared. Individual frequencies of micronucleated cells (MNCs) obtained with the two concentrations of BrdU significantly correlated with each other (r=0.55, P<0.001). Higher mean MNCs frequencies (per 1000 cells) were detected among exposed smokers (9.0 at 0.5 microg/ml BrdU and 7.8 at 1 microg/ml BrdU) than in smoking referents (6.3 and 5.9, respectively). In multiple regression analysis controlling for age, sex, smoking and genotypes, a significant elevation of MNC frequency (P=0.004 at 1 microg/ml BrdU; P=0.052 at 0.5 microg/ml BrdU) was observed in greenhouse workers with a work history of extensive pesticide spraying (n=17). Increased MNC frequencies were also associated with ageing at 0.5 microg/ml BrdU, with the GSTM1-positive genotype at both 1 (P=0.028) and 0.5 (P=0.056) microg/ml BrdU in all subjects, and with the NAT2 fast acetylator genotype in smokers at 0.5 microg/ml BrdU (P=0.043). The results indicate that MN rates are increased in greenhouse workers, especially in those involved in pesticide spraying. The GSTM1 positive and NAT2 fast genotypes appear to be associated with elevated MNC frequencies, which contradicts with earlier results on elevated chromosomal aberration rates in GSTM1 null smokers and NAT2 slow subjects.

Acetyltransferases↗

Genetic polymorphisms of aldehyde dehydrogenase 2, cytochrome p450 2E1 for liver cancer risk in HCV antibody-positive japanese patients and the variations of CYP2E1 mRNA expression levels in the liver due to its polymorphism.

BACKGROUND: Hepatocellular carcinoma (HCC) in persons with liver cirrhosis (LC) arises following hepatitis virus infection. Alcohol may accelerate the risk of development of LC and HCC. Cytochrome p450 2E1 (CYP2E1) oxidizes ethanol to form acetaldehyde and aldehyde dehydrogenase 2 (ALDH2) detoxifies acetaldehyde, which is carcinogenic in humans, and both alcohol-metabolizing enzymes show the genetic polymorphisms in a Japanese population. METHODS: Using polymorphism analysis, we studied the frequency of ALDH2 functional deletion due to the G to A single-bp mutation in exon 12 and CYP2E1 polymorphism in the transcriptional region, both associated with higher levels of acetaldehyde, in 135 patients with LC and/or HCC, including 99 with HCC, and 135 non-cancer controls. The mRNA expression levels of CYP2E1 in the liver were also examined in 55 surgical specimens. RESULTS: The allelic frequency of the homozygous ALDH2 2-2 genotype, coding for the enzyme deletion, was significantly higher compared to that of the homozygous or heterozygous ALDH2 1-1 genotypes in cases with HCC (OR = 5.4, 95% CI 2.1-14.0). There were no differences in the frequencies of specific genotypes of CYP2E1 in cases of HCC, but combined analysis of ALDH2 and CYP2E1 revealed that the odds ratio of occurrence of the C1/C1 homozygosity of CYP2E1 and the ALDH2 2-2 homozygosity was as high as 23.0 (2.9-182). The mRNA levels of CYP2E1 were higher in the liver of patients with the C1/C1 homozygosity of CYP2E1 than in those with other genotypes (P < 0.05). CONCLUSIONS: ALDH2 and CYP2E1 polymorphisms may modify the risk of development of HCC against the background of LC in the Japanese. Polymorphism analysis of alcohol-metabolizing enzymes using molecular techniques may be useful in the risk assessment of liver cancer in patients with hepatitis C virus infection.

Adult↗

A cytochrome P4502E1 genetic polymorphism and tobacco smoking in breast cancer.

Known breast-cancer risk factors account for only part of the variability in breast-cancer incidence. Tobacco smoke is not commonly considered a breast carcinogen, but many of its constituents, such as N-nitrosamines, are carcinogenic in laboratory animal studies. Herein, we assessed a cytochrome P4502E1 (CYP2E1) genetic polymorphism (a Dral restriction enzyme site in intron 6) as a risk factor for breast cancer in both premenopausal and postmenopausal women. Because N-nitrosamines are metabolically activated by CYP2E1, the risk among women smokers was investigated. Caucasian women were enrolled in a case-control study of breast cancer between 1986 and 1991. A subset of the women (219 premenopausal and 387 postmenopausal women) consented to phlebotomy. The allelic frequencies for the premenopausal women (D allele = 0.91 and C allele = 0.09) and postmenopausal women (D allele = 0.93 and C allele = 0.07) were similar to those previously reported. There was no statistically significant association between the CYP2E1 polymorphism and breast-cancer risk for premenopausal or postmenopausal women (adjusted odds ratio (OR) = 1.04, 95% confidence interval (CI) = 0.48, 2.24, and OR = 1.01, 95% CI = 0.55, 1.84, respectively). When the women were categorized as nonsmokers versus smokers (those who smoked more than one cigarette per week for more than 1 yr), premenopausal women with one or two C alleles who had a history of smoking were found to be at increased risk (unadjusted OR = 7.00, 95% CI = 0.75, 14.53, and adjusted OR = 11.09, 95% CI = 1.51, 81.41), although the number of study subjects with those genotypes was small. The small number of study subjects with a C allele precluded meaningful classification by level of smoking, but categorizing the smokers into two groups (above and below the median) also suggested an increased risk. Premenopausal women with the DD genotype and postmenopausal women with any genotype were not at increased risk. Breast-cancer risk was not related to the CYP2E1 genotype in either premenopausal nonsmokers or smokers (adjusted OR = 0.66, 95% CI = 0.20, 2.17, and OR = 2.13, 95% CI = 0.60, 7.59, respectively) or postmenopausal nonsmokers or smokers (OR = 0.90, 95% CI = 0.34, 2.35, and OR = 1.02, 95% CI = 0.46, 2.23, respectively), although the difference in the ORs for premenopausal nonsmokers and smokers suggests an increased risk for smokers. While there are limitations to this study, particularly related to the small number of subjects with the DC and CC genotypes, the study suggests that some women may be susceptible to tobacco smoke because of a CYP2E1 polymorphism. However, these results are preliminary and must be replicated.

Adult↗

Impact of racial genetic polymorphism on the probability of finding an HLA-matched donor.

As successful organ or marrow transplantation correlates with the degree of HLA-compatibility between patient and donor, registries have been developed to facilitate matching. However, racial minority groups have a lower chance of finding a match. We evaluate the impact of the biology of racial genetic polymorphism upon the probability of finding an HLA match for patients of different racial groups. The National Marrow Donor Program has compiled the HLA types of 20,449 patients and 1,625,159 potential volunteer donors. These HLA types were used to estimate the probability of finding an HLA-matched donor for patients of different racial groups. We estimated the HLA haplotype frequencies for different races, and then determined the probability of finding matched donors, given several hypothetical registry sizes. We confirmed that patients of minority races searching the current National Marrow Donor Program registry have low probabilities of finding matches. This was only partly due to the smaller number of donors from these racial minorities, as the observation persisted even when hypothetical donor registry sizes were the same for all racial groups. We demonstrate that African-Americans are more polymorphic with respect to HLA, and are hence less likely to find donors at any given registry size. An increase in the recruitment of minority racial groups for organ and marrow donors will only partially alleviate the problem of equal access to HLA matches for patients belonging to racial minority groups. It will therefore be important to attempt to improve methods for transplantation using HLA-mismatched donors.

HLA Antigens↗

Erythrocyte G-6-PD and 6-PGD genetic polymorphisms in South African Negroes, with a note on G-6-PD and the malaria hypothesis.

Sample of 981 and 998 South African Negroes belonging to seven different ethnic groups were screened for G-6-PD and 6-PGD phenotypes, respectively. The results are discussed in terms of the interethnic variability and the possible adaptive values of these genetic polymorphisms. Particular attention is paid to the geographic co-distribution and interrelationship of G-6-PD deficiency and the occurrence of malaria in South Africa.

Black People↗

Genetic polymorphism among Cryptosporidium parvum isolates: evidence of two distinct human transmission cycles.

We report the results of molecular analysis of 39 isolates of Cryptosporidium parvum from human and bovine sources in nine human outbreaks and from bovine sources from a wide geographic distribution. All 39 isolates could be divided into either of two genotypes, on the basis of genetic polymorphism observed at the thrombospondin-related adhesion protein (TRAP-C2) locus. Genotype 1 was observed only in isolates from humans. Genotype 2, however, was seen in calf isolates and in isolates from a subset of human patients who reported direct exposure to infected cattle or consumed items thought to be contaminated with cattle faces. Furthermore, experimental infection studies showed that genotype 2 isolates were infective to mice or calves under routine laboratory conditions, whereas genotype 1 isolates were not. These results support the occurrence of two distinct transmission cycles of C. parvum in humans.

Amino Acid Sequence↗

[Testing for heterogeneity in genetic polymorphism of N-acetylation using isoniazid by metameters--probit, logit, and arcsine transformation].

To investigate genetic polymorphism of N-acetylation in Japanese population we measured isoniazid (INH) and acetylisoniazid (AcINH) in the urine of 340 unrelated Japanese subjects. For the detection of polymorphism, we used probit analysis, logit analysis, and arcsine transformation of the logarithm of molar acetylation ratio (log (INH/AcINH)). The observed antimodes were -0.85 and -0.325 for the probit, 4.899 and 7.154 for the logit, 43.85 and 71.57 for the arcsine analysis plot. Probit and arcsine analysis were sensitive for the separation of intermediate from slow acetylators, while logit analysis was sensitive for the separation of rapid from intermediate acetylators. Clinically it is important to know to which genetic group the patient belongs because we may have to increase the dosage for the rapid acetylators to achieve the desired therapeutic effect, while we may have to reduce the dosage for slow acetylators in whom the incidence of side effect is high.

Acetylation↗

Genetic polymorphism of the epithelial mucin, PAS-I, in milk samples from the major dairy breeds.

Genetic polymorphism in a mucin of the human milk fat globule arises from variable numbers of a tandemly repeated amino acid sequence. As a consequence, the gene from each parent expresses a variable-sized protein. This is manifest on SDS gels in the form of either one or, more often, two protein bands, which differ among individuals in mobility. Evidence of such polymorphism in the bovine mucin, PAS-I, was first obtained from Holstein milk samples. The objective of this study was to evaluate the other major dairy breeds for polymorphism of their PAS-I. Milk samples from individual Jerseys, Guernseys, Ayrshires, and Brown Swiss were analyzed by SDS-PAGE. Bands of the mucin varying in number and mobility were seen in samples from all four breeds. In three of the breeds (Ayrshire, Brown Swiss, and Jersey), there was evidence that two alleles for PAS-I may have become predominant, possibly through degeneration in the structure of their tandem repeats, one that gives rise to a faster moving mucin (relative molecular weight 170,000) and the other to a slower form (relative molecular weight 200,000). In contrast, the PAS-I band patterns on SDS gels for both Guernseys and Holsteins were characterized in nearly 50% of samples by two close bands near the 205,000-molecular weight marker. This pattern was never seen in the other three breeds. The findings suggest a genetic kinship among the Ayrshire, Brown Swiss, and Jersey, on the one hand, and between the Holstein and Guernsey, on the other.

Alleles↗

Genetic polymorphism within HLA-A*02: significant allelic variation revealed in different populations.

HLA-A2 is present at high frequency in most populations, as identified by serological and biochemical means. The value of these methods is limited by their failure to discriminate between the products of the 14 known allelic HLA-A*02 variants. The great majority of genetic polymorphism which defines the allelic variants is found in exons 2 and 3 of the A*02 genes. These exons encode the alpha-1 and alpha-2 domains of the HLA Class I molecules, and variation within the genes may influence the peptide binding specificity of the gene products of each allele. Failure to accurately assign the allelic types has implications in transplantation, in interpretation of cellular assays and in the understanding of HLA disease associations. We have developed a method for determining the 14 known alleles of HLA-A*02 by use of ARMS-PCR to determine the degree of variation of HLA-A*02 alleles in 3 different population groups. Considerable variation was found in the relative frequencies of particular A*02 alleles between Caucasian, oriental and black individuals. Our results indicate the importance of ethnic origin in terms of the expected HLA-A*02 allelic profile, and emphasize the functional significance of allele specific subtyping of HLA-A*02.

Alleles↗