Fig. 4 a) CYP2D6 locus, aligned reads b) NA18256 and reference haplotypes c) gene conversion
The enzyme CYP2D6 metabolises ~25% of common drugs and its activity between individuals varies widely, due to high levels of polymorphism. To determine an individual’s optimal drug dosage, we need to identify all variants that influence the enzyme’s activity. Long reads help to distinguish between CYP2D6 and its close paralogue, CYP2D7 (Fig. 4a) and between their gene conversion products. Using Cas9 we enriched the region from NA18256, previously shown to have one copy of allele *1 and three copies of allele *10. Previous tests did not distinguish between the *10 and *36 variants, the latter being a gene conversion variant. We identified the expected alleles and obtained reads that captured three copies of CYP2D6 (Fig. 4b). Analysis indicates that the haplotype contains one copy of *10 allele and two copies of *36 (Fig. 4c).
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