Single nucleotide substitutions are known to result in a different ami
no acid at one of four sites in cytochrome P4502C9 (CYP2C9) namely: re
sidue 144: Arg/Cys; residue 358: Tyr/Cys; residue 359: Ile/Leu and res
idue 417: Gly/Asp. Polymerase chain reaction (PCR) - based amplificati
on of the nucleotide fragments encompassing the four residues (144, 35
8-359 and 417) in 18 samples of human genomic DNA from a liver bank an
d one sample of DNA extracted from the blood of a known poor metaboliz
er of tolbutamide has been carried out. The products of PCR amplificat
ion were analysed by either allele-specific restriction endonucleases
or probed with radioactively labelled allele-specific oligonucleotides
in dot blot hybridizations. Fourteen individuals were homozygous for
Arg144 and four were heterozygous Arg/Cys144. All individuals analysed
were homozygous for Tyr358 (n = 17) and for Gly417 (n = 18). With the
exception of one heterozygote the other 17 subjects were homozygous f
or Ile359. The genotype of the known poor metabolizer of tolbutamide w
as homozygous for Arg144, Leu359 and Gly417. The relative levels of ex
pression of the Cys and Arg144 alleles was studied in the heterozygote
s. A relative 5- to 10-fold greater expression of the Cys- over the Ar
g144 allele was noted in two heterozygotes. There was no apparent corr
elation of genotype to the hydroxylation of the known CYP2C9 substrate
s phenytoin, tolbutamide, torasemide and diclofenac. Apparent K-m valu
es for the cDNA-expressed Arg144/Ile359, Cys144/Ile359 and Arg144/Leu3
59 variants towards tolbutamide were 91 mu M, 62 mu M and 229 mu M, re
spectively. It is likely that functional changes occurring as a result
of the Ile359Leu transition are responsible for the tolbutamide poor
metabolizer phenotype.