Characterisation of the genetic variation in pharmacogenes involved in anti-tuberculosis drug metabolism across African populations

dc.contributor.authorMalinga, Thandeka Vuyiswa Bongiwe
dc.contributor.supervisorTwesigomwe, David
dc.contributor.supervisorOthman, Houcemeddine
dc.date.accessioned2024-12-09T09:37:37Z
dc.date.available2024-12-09T09:37:37Z
dc.date.issued2024
dc.descriptionA research report submitted in partial fulfillment of the requirements for the Degree of MSc (Med) Genomic Medicine to the Faculty of Health Sciences, School of Pathology, University of the Witwatersrand, February 2024
dc.description.abstractTuberculosis (TB) is a major health burden in Africa. Although TB is treatable, anti-TB drugs are associated with adverse drug reactions (ADRs) which are partly attributed to pharmacogenetic variation. The distribution of star alleles (haplotypes) influencing anti-TB drug metabolism, is unknown in many African populations. This presents challenges in implementing genotype-guided therapy in Africa to decrease the occurrence of ADRs and enhance the efficacy of anti-TB drugs. Therefore, this study aimed to characterise the distribution of star alleles in genes that are involved in anti-TB drug metabolism (mainly isoniazid), namely CYP2E1, NAT1, NAT2, GSTM1 and GSTT1, across diverse African populations. We used 794 high-depth whole genome sequence datasets representative of eight Sub-Saharan African (SSA) population groups. Data sources included the 1000 Genomes Project and H3Africa AWi-Gen. CYP2E1, NAT1, NAT2, GSTM1 and GSTT1 star alleles were called from the WGS data using StellarPGx. Subsequently, novel star alleles were analysed, and their allele defining variants were annotated using the Ensembl Variant Effect Predictor. We present the distribution of both common and rare star alleles influencing anti-TB drug metabolism across various SSA populations, in comparison to other global populations. Various key star alleles were identified in the SSA study populations at relatively high frequencies including NAT1*10, GSTT1*0 (>50%), GSTM1*0 (49%), and NAT2*5B (21%). Additionally, we predicted varying phenotypic proportions for NAT1 and NAT2 (acetylation) and the GST enzymes (detoxification activity) between SSA and other global populations. Fifty potentially novel haplotypes were identified computationally across the five genes. This study provides insight into the distribution of star alleles in genes relevant to isoniazid metabolism across various African populations. The high number of potentially novel star alleles exemplifies the need for pharmacogenomics studies in the African context. Overall, our analysis provides a foundation for implementing pharmacogenetic testing in Africa to reduce the risk of ADRs related to TB treatment.
dc.description.submitterMM2024
dc.facultyFaculty of Health Sciences
dc.identifier.citationMalinga, Thandeka Vuyiswa Bongiwe . (2024). Characterisation of the genetic variation in pharmacogenes involved in anti-tuberculosis drug metabolism across African populations[Master’s dissertation, University of the Witwatersrand, Johannesburg]. WireDSpace.
dc.identifier.urihttps://hdl.handle.net/10539/43198
dc.language.isoen
dc.publisherUniversity of the Witwatersrand, Johannesburg
dc.rights© 2024 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg.
dc.rights.holderUniversity of the Witwatersrand, Johannesburg
dc.schoolSchool of Pathology
dc.subjectTuberculosis (TB)
dc.subjectPharmacogenomics
dc.subjectPrecision medicine
dc.subjectUCTD
dc.subject.otherSDG-3: Good health and well-being
dc.titleCharacterisation of the genetic variation in pharmacogenes involved in anti-tuberculosis drug metabolism across African populations
dc.typeDissertation
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