PROJECT SUMMARY
The overarching goal of my research program is to gain a comprehensive understanding of the variability in
drug metabolism to make drug therapies more effective and less toxic. The cytochrome P450 drug-
metabolizing enzymes (dmCYPs) are the main enzymes that metabolize nearly 70% of the drugs currently
used, which are highly variable from person to person, necessitating personalized drug therapy. Genetic
factors significantly affect the drug metabolism, and the variants of some dmCYPs are used as clinical
biomarkers to predict the metabolizer status. However, the underlying principles of their variable
expression/activity are far from clear. Variants that result in altered amino acid sequences have been studied
extensively, but they fail to account for all the differences observed. On the other hand, technical challenges
have thus far limited the studies on factors that affect mRNA and protein expression of dmCYPs. Most
dmCYPs are multi-gene clusters with complex genomic architecture and diverse genetic variations. With
the support of NIGMS funding, we have adopted innovative methodologies and dissected the complex
genomic architecture of multiple gene clusters (e. g., CYP3A) and identified hidden cis-acting regulatory
variants that affect gene expression (e. g., 3A4, 3A5 and 3A43). Our results demonstrate that a single variant
can have opposing effects on two genes in the same locus (e. g, 3A4, and 3A43), while more than one variant
can regulate a single gene in the same or opposite direction (e. g., CYP7A1 and CYP2D6) indicating
complex domain-domain interactions within the gene cluster and epistasis between variants. Such
complexity usually escapes genome wide association study based discovery and warrants a dedicated
approach proposed here. With the success of dissecting the CYP3A cluster, we now plan to expand and
analyze the other dmCYP gene clusters over the next five years. Furthermore, we have recently identified
ligand-free estrogen receptor alpha (ESR1) as a master regulator of CYP3A4 and many other dmCYP genes.
Genetic, epigenetic, and non-genetic factors that affect ESR1-centered regulatory network will likely affect
dmCYP gene expression and enzyme activity via trans-acting mechanisms. We plan to use ESR1-knockout
hepatocytes differentiated from iPSC to characterize ESR1-centered regulatory network and to identify factors
regulating ESR1 and dmCYPs expression. The identified functional cis and trans-acting genetic variants and
epigenetic factors, including non-coding RNAs, will be tested in human liver samples for their impact on
mRNA and protein expression of dmCYPs. The clinical significance of the identified variants will be tested
in clinical cohort via collaboration. With my track record of pharmacogenetics biomarker discovery, insights
gained from studying complex multi-gene clusters, availability of novel technologies, and support from
collaborators with expertise in bioinformatics, proteomics and pharmacogenetics implementation, I am well
positioned to undertake the proposed studies. The outcome will have immediate clinical translation leading to
more accurate biomarkers for guiding personalized drug therapy.