CMRES
MCID: CMR002
MIFTS: 48

Coumarin Resistance (CMRES)

Categories: Blood diseases, Cardiovascular diseases, Genetic diseases, Metabolic diseases, Rare diseases

Aliases & Classifications for Coumarin Resistance

MalaCards integrated aliases for Coumarin Resistance:

Name: Coumarin Resistance 58 26 76 38 13 74
Warfarin Resistance 58 54 26 76 56
Warfarin Sensitivity 58 54 26 74
Warfarin Response 26 30 6
Poor Metabolism of Coumarin 26 76
Coumadin Sensitivity 54 26
Drug Resistance 45 3
Coumarin, Poor Metabolism of 58
Cmres 76

Characteristics:

OMIM:

58
Inheritance:
autosomal dominant


HPO:

33
coumarin resistance:
Inheritance autosomal dominant inheritance


Classifications:



External Ids:

OMIM 58 122700
KEGG 38 H01205
MeSH 45 D004351
SNOMED-CT via HPO 70 191124002 263681008 34093004

Summaries for Coumarin Resistance

NIH Rare Diseases : 54 Warfarin resistance is a condition that is characterized by a high tolerance for a "blood-thinning" medication called warfarin. Warfarin is an anticoagulant that is often prescribed to people who are at an increased risk for blood clots. Some people with a warfarin resistance do not respond to the drug at all, while others can achieve the benefits of warfarin treatment at a high dose. In either case, affected people will still be at an elevated risk for blood clots when given the standard dose of warfarin. The metabolism of warfarin and the drug's effects in the body are complex traits that are determined by several genes as well as environmental and lifestyle factors such as gender, age, weight, diet, and other medications. One specific genetic polymorphism in the VKORC1 gene accounts for approximately 20% of variation in the response to warfarin and can be passed on to future generations in an autosomal dominant manner.

MalaCards based summary : Coumarin Resistance, also known as warfarin resistance, is related to atrial fibrillation and multidrug-resistant tuberculosis. An important gene associated with Coumarin Resistance is VKORC1 (Vitamin K Epoxide Reductase Complex Subunit 1), and among its related pathways/superpathways are Drug metabolism - cytochrome P450 and Arachidonic acid metabolism. The drugs Warfarin and Phenprocoumon have been mentioned in the context of this disorder. Affiliated tissues include heart and liver, and related phenotypes are abnormality of metabolism/homeostasis and abnormality of blood and blood-forming tissues

Genetics Home Reference : 26 Warfarin sensitivity is a condition in which individuals have a low tolerance for the drug warfarin. Warfarin is an anticoagulant, which means that it thins the blood, preventing blood clots from forming. Warfarin is often prescribed to prevent blood clots in people with heart valve disease who have replacement heart valves, people with an irregular heart beat (atrial fibrillation), or those with a history of heart attack, stroke, or a prior blood clot in the deep veins of the arms or legs (deep vein thrombosis).

OMIM : 58 Warfarin is a widely prescribed anticoagulant for the prevention of thromboembolic diseases for subjects with deep vein thrombosis, atrial fibrillation, or mechanical heart valve replacement (Yuan et al., 2005). The dose requirement is highly variable, both interindividually and interethnically. Variation in the VKORC1 gene is believed to be the most important individual predictor of warfarin dose, accounting for about 30% of the variance observed in dosing (Ross et al., 2010). (122700)

CDC : 3 Antibiotic resistance is one of the biggest public health challenges of our time. Each year in the U.S., at least 2 million people get an antibiotic-resistant infection, and at least 23,000 people die. Fighting this threat is a public health priority that requires a collaborative global approach across sectors. CDC is working to combat this threat. Find out how you can help.

UniProtKB/Swiss-Prot : 76 Coumarin resistance: A condition characterized by partial or complete resistance to warfarin or other 4-hydroxycoumarin derivatives. These drugs are used as anti-coagulants for the prevention of thromboembolic diseases in subjects with deep vein thrombosis, atrial fibrillation, or mechanical heart valve replacement.

Related Diseases for Coumarin Resistance

Diseases related to Coumarin Resistance via text searches within MalaCards or GeneCards Suite gene sharing:

(show top 50) (show all 533)
# Related Disease Score Top Affiliating Genes
1 atrial fibrillation 29.0 VKORC1 CYP4F2
2 multidrug-resistant tuberculosis 11.5
3 mycobacterium abscessus 11.3
4 ceroid lipofuscinosis, neuronal, 2 11.0
5 leukodystrophy, hypomyelinating, 14 11.0
6 epilepsy occipital calcifications 11.0
7 epilepsy 10.8
8 leukemia 10.7
9 breast cancer 10.6
10 mycobacterium tuberculosis 1 10.6
11 ovarian cancer 10.6
12 human immunodeficiency virus type 1 10.6
13 lung cancer 10.6
14 pulmonary tuberculosis 10.5
15 focal epilepsy 10.5
16 myeloma, multiple 10.5
17 malaria 10.5
18 hepatitis 10.4
19 myeloid leukemia 10.4
20 lymphocytic leukemia 10.4
21 temporal lobe epilepsy 10.4
22 small cell cancer of the lung 10.4
23 gastric cancer 10.4
24 hepatocellular carcinoma 10.4
25 lymphoma 10.4
26 leukemia, acute myeloid 10.3
27 colorectal cancer 10.3
28 typhoid fever 10.3
29 leukemia, acute lymphoblastic 10.3
30 melanoma 10.3
31 ovarian cancer 1 10.3
32 polyarteritis nodosa, childhood-onset 10.3
33 meningitis 10.3
34 immunodysregulation, polyendocrinopathy, and enteropathy, x-linked 10.3
35 hepatitis b 10.3
36 pneumonia 10.3
37 hepatitis c 10.3
38 hypoxia 10.3
39 pancreatic cancer 10.2
40 plasmodium falciparum malaria 10.2
41 hepatitis c virus 10.2
42 noonan syndrome 3 10.2
43 influenza 10.2
44 glioblastoma 10.2
45 human immunodeficiency virus infectious disease 10.2
46 neuroblastoma 10.2
47 burns 10.2
48 leprosy 3 10.2
49 glioma 10.2
50 hansen's disease 10.2

Graphical network of the top 20 diseases related to Coumarin Resistance:



Diseases related to Coumarin Resistance

Symptoms & Phenotypes for Coumarin Resistance

Human phenotypes related to Coumarin Resistance:

33
# Description HPO Frequency HPO Source Accession
1 abnormality of metabolism/homeostasis 33 HP:0001939
2 abnormality of blood and blood-forming tissues 33 HP:0001871

Symptoms via clinical synopsis from OMIM:

58
Heme:
warfarin resistance

Lab:
decreased affinity of liver receptors for coumarin

Clinical features from OMIM:

122700

GenomeRNAi Phenotypes related to Coumarin Resistance according to GeneCards Suite gene sharing:

27 (show all 14)
# Description GenomeRNAi Source Accession Score Top Affiliating Genes
1 Increased shRNA abundance (Z-score > 2) GR00366-A-157 9.5 F9
2 Increased shRNA abundance (Z-score > 2) GR00366-A-164 9.5 F9
3 Increased shRNA abundance (Z-score > 2) GR00366-A-169 9.5 CYP2C9
4 Increased shRNA abundance (Z-score > 2) GR00366-A-176 9.5 F9
5 Increased shRNA abundance (Z-score > 2) GR00366-A-183 9.5 CYP2C9 F9
6 Increased shRNA abundance (Z-score > 2) GR00366-A-199 9.5 CYP2C9
7 Increased shRNA abundance (Z-score > 2) GR00366-A-207 9.5 CYP2C9
8 Increased shRNA abundance (Z-score > 2) GR00366-A-208 9.5 F9
9 Increased shRNA abundance (Z-score > 2) GR00366-A-41 9.5 F9
10 Increased shRNA abundance (Z-score > 2) GR00366-A-44 9.5 F9
11 Increased shRNA abundance (Z-score > 2) GR00366-A-50 9.5 CYP2C9
12 Increased shRNA abundance (Z-score > 2) GR00366-A-73 9.5 CYP2C9
13 Increased shRNA abundance (Z-score > 2) GR00366-A-81 9.5 F9
14 Increased shRNA abundance (Z-score > 2) GR00366-A-88 9.5 F9

Drugs & Therapeutics for Coumarin Resistance

Drugs for Coumarin Resistance (from DrugBank, HMDB, Dgidb, PharmGKB, IUPHAR, NovoSeek, BitterDB):


# Name Status Phase Clinical Trials Cas Number PubChem Id
1
Warfarin Approved Phase 4 81-81-2 6691 54678486
2
Phenprocoumon Approved, Investigational Phase 4 435-97-2 9908 54680692
3
Acenocoumarol Approved, Investigational Phase 4 152-72-7 9052 54676537
4 Anticoagulants Phase 4

Interventional clinical trials:


# Name Status NCT ID Phase Drugs
1 EUropean Pharmacogenetics of AntiCoagulant Therapy - Warfarin Completed NCT01119300 Phase 4
2 EUropean Pharmacogenetics of AntiCoagulant Therapy - Phenprocoumon Completed NCT01119274 Phase 4
3 EUropean Pharmacogenetics of AntiCoagulant Therapy - Acenocoumarol Completed NCT01119261 Phase 4

Search NIH Clinical Center for Coumarin Resistance

Cochrane evidence based reviews: drug resistance

Genetic Tests for Coumarin Resistance

Genetic tests related to Coumarin Resistance:

# Genetic test Affiliating Genes
1 Warfarin Response 30

Anatomical Context for Coumarin Resistance

MalaCards organs/tissues related to Coumarin Resistance:

42
Heart, Liver

Publications for Coumarin Resistance

Articles related to Coumarin Resistance:

# Title Authors Year
1
Warfarin resistance from primidone in patient with essential tremor. ( 29170795 )
2018
2
Low warfarin resistance frequency in Norway rats in two cities in China after 30 years of usage of anticoagulant rodenticides. ( 29667309 )
2018
3
Anticoagulation therapy for a LVAD patient with acquired warfarin resistance. ( 28349222 )
2017
4
gyrB mutations which confer coumarin resistance also affect DNA supercoiling and ATP hydrolysis by Escherichia coli DNA gyrase. ( 1323022 )
1992
5
Coumarin resistance: a diagnostic and therapeutic approach. ( 910171 )
1977
6
Coumarin resistance in a Negro woman. ( 4123117 )
1973

Variations for Coumarin Resistance

UniProtKB/Swiss-Prot genetic disease variations for Coumarin Resistance:

76 (show all 18)
# Symbol AA change Variation ID SNP ID
1 VKORC1 p.Val29Leu VAR_021821 rs104894539
2 VKORC1 p.Val45Ala VAR_021822 rs104894540
3 VKORC1 p.Arg58Gly VAR_021823 rs104894541
4 VKORC1 p.Leu128Arg VAR_021825 rs104894542
5 VKORC1 p.Ala26Thr VAR_065785 rs770703948
6 VKORC1 p.Asp36Gly VAR_065786
7 VKORC1 p.Asp36Tyr VAR_065787 rs61742245
8 VKORC1 p.Ser52Trp VAR_065788
9 VKORC1 p.Ser56Phe VAR_065789
10 VKORC1 p.Trp59Cys VAR_065790
11 VKORC1 p.Trp59Leu VAR_065791
12 VKORC1 p.Val66Gly VAR_065792
13 VKORC1 p.Val66Met VAR_065793 rs72547529
14 VKORC1 p.Gly71Ala VAR_065794
15 VKORC1 p.Asn77Ser VAR_065795
16 VKORC1 p.Asn77Tyr VAR_065796 rs755767348
17 VKORC1 p.Ile123Asn VAR_065797
18 VKORC1 p.Tyr139His VAR_065798

ClinVar genetic disease variations for Coumarin Resistance:

6 (show all 34)
# Gene Variation Type Significance SNP ID Assembly Location
1 CYP2C9 NM_000771.4(CYP2C9): c.1075A= (p.Ile359=) single nucleotide variant no interpretation for the single variant rs1057910 GRCh38 Chromosome 10, 94981296: 94981296
2 CYP2C9 NM_000771.4(CYP2C9): c.1075A= (p.Ile359=) single nucleotide variant no interpretation for the single variant rs1057910 GRCh37 Chromosome 10, 96741053: 96741053
3 CYP2C9 NM_000771.4(CYP2C9): c.430C= (p.Arg144=) single nucleotide variant no interpretation for the single variant rs1799853 GRCh37 Chromosome 10, 96702047: 96702047
4 CYP2C9 NM_000771.4(CYP2C9): c.430C= (p.Arg144=) single nucleotide variant no interpretation for the single variant rs1799853 GRCh38 Chromosome 10, 94942290: 94942290
5 VKORC1 NM_024006.5(VKORC1): c.-226-1413G= single nucleotide variant drug response rs9923231 GRCh37 Chromosome 16, 31107689: 31107689
6 VKORC1 NM_024006.5(VKORC1): c.-226-1413G= single nucleotide variant drug response rs9923231 GRCh38 Chromosome 16, 31096368: 31096368
7 CYP2C9 NM_000771.3(CYP2C9): c.1075A> C (p.Ile359Leu) single nucleotide variant drug response rs1057910 GRCh37 Chromosome 10, 96741053: 96741053
8 CYP2C9 NM_000771.3(CYP2C9): c.1075A> C (p.Ile359Leu) single nucleotide variant drug response rs1057910 GRCh38 Chromosome 10, 94981296: 94981296
9 CYP2C9 NM_000771.3(CYP2C9): c.430C> T (p.Arg144Cys) single nucleotide variant drug response rs1799853 GRCh37 Chromosome 10, 96702047: 96702047
10 CYP2C9 NM_000771.3(CYP2C9): c.430C> T (p.Arg144Cys) single nucleotide variant drug response rs1799853 GRCh38 Chromosome 10, 94942290: 94942290
11 CYP2C9 NM_000771.4(CYP2C9): c.622T> G (p.Leu208Val) single nucleotide variant Pathogenic rs72558191 GRCh37 Chromosome 10, 96707676: 96707676
12 CYP2C9 NM_000771.4(CYP2C9): c.622T> G (p.Leu208Val) single nucleotide variant Pathogenic rs72558191 GRCh38 Chromosome 10, 94947919: 94947919
13 CYP2A6 NM_000762.5(CYP2A6): c.479T> A (p.Leu160His) single nucleotide variant drug response rs1801272 GRCh37 Chromosome 19, 41354533: 41354533
14 CYP2A6 NM_000762.5(CYP2A6): c.479T> A (p.Leu160His) single nucleotide variant drug response rs1801272 GRCh38 Chromosome 19, 40848628: 40848628
15 CYP2A6 CYP2A6*12A deletion drug response GRCh38 Chromosome 19, 40848764: 40881588
16 CYP2A6 CYP2A6*12A deletion drug response GRCh37 Chromosome 19, 41354669: 41387493
17 VKORC1 NM_024006.5(VKORC1): c.174-136C> T single nucleotide variant drug response rs9934438 GRCh37 Chromosome 16, 31104878: 31104878
18 VKORC1 NM_024006.5(VKORC1): c.174-136C> T single nucleotide variant drug response rs9934438 GRCh38 Chromosome 16, 31093557: 31093557
19 VKORC1 NM_024006.5(VKORC1): c.-226-1362dupG insertion drug response rs397509427 GRCh37 Chromosome 16, 31107638: 31107638
20 VKORC1 NM_024006.5(VKORC1): c.-226-1362dupG insertion drug response rs397509427 GRCh38 Chromosome 16, 31096317: 31096317
21 F9 F9, ALA-10VAL undetermined variant Pathogenic
22 F9 F9, ALA-10THR single nucleotide variant Pathogenic
23 VKORC1 NM_024006.5(VKORC1): c.106G> T (p.Asp36Tyr) single nucleotide variant drug response rs61742245 GRCh38 Chromosome 16, 31094624: 31094624
24 VKORC1 NM_024006.5(VKORC1): c.106G> T (p.Asp36Tyr) single nucleotide variant drug response rs61742245 GRCh37 Chromosome 16, 31105945: 31105945
25 VKORC1 NM_024006.4(VKORC1): c.-1639G> A single nucleotide variant Likely benign, drug response, other rs9923231 GRCh38 Chromosome 16, 31096368: 31096368
26 VKORC1 NM_024006.4(VKORC1): c.-1639G> A single nucleotide variant Likely benign, drug response, other rs9923231 GRCh37 Chromosome 16, 31107689: 31107689
27 VKORC1 NM_024006.5(VKORC1): c.383T> G (p.Leu128Arg) single nucleotide variant drug response rs104894542 GRCh38 Chromosome 16, 31091243: 31091243
28 VKORC1 NM_024006.5(VKORC1): c.383T> G (p.Leu128Arg) single nucleotide variant drug response rs104894542 GRCh37 Chromosome 16, 31102564: 31102564
29 VKORC1 NM_024006.5(VKORC1): c.172A> G (p.Arg58Gly) single nucleotide variant Pathogenic rs104894541 GRCh38 Chromosome 16, 31094558: 31094558
30 VKORC1 NM_024006.5(VKORC1): c.172A> G (p.Arg58Gly) single nucleotide variant Pathogenic rs104894541 GRCh37 Chromosome 16, 31105879: 31105879
31 VKORC1 NM_024006.5(VKORC1): c.134T> C (p.Val45Ala) single nucleotide variant Pathogenic rs104894540 GRCh38 Chromosome 16, 31094596: 31094596
32 VKORC1 NM_024006.5(VKORC1): c.134T> C (p.Val45Ala) single nucleotide variant Pathogenic rs104894540 GRCh37 Chromosome 16, 31105917: 31105917
33 VKORC1 NM_024006.5(VKORC1): c.85G> T (p.Val29Leu) single nucleotide variant Pathogenic rs104894539 GRCh38 Chromosome 16, 31094645: 31094645
34 VKORC1 NM_024006.5(VKORC1): c.85G> T (p.Val29Leu) single nucleotide variant Pathogenic rs104894539 GRCh37 Chromosome 16, 31105966: 31105966

Expression for Coumarin Resistance

Search GEO for disease gene expression data for Coumarin Resistance.

Pathways for Coumarin Resistance

Pathways related to Coumarin Resistance according to KEGG:

38
# Name Kegg Source Accession
1 Drug metabolism - cytochrome P450 hsa00982

Pathways related to Coumarin Resistance according to GeneCards Suite gene sharing:

(show all 12)
# Super pathways Score Top Affiliating Genes
1
Show member pathways
11.72 CYP2C9 CYP4F2
2
Show member pathways
11.56 CYP2C9 CYP4F2
3
Show member pathways
11.28 CYP2A6 CYP2C9
4
Show member pathways
11.05 CYP2A6 CYP2C9
5 10.94 CYP2A6 CYP2C9
6
Show member pathways
10.84 CYP2A6 CYP2C9
7
Show member pathways
10.8 CYP2C9 CYP4F2
8 10.7 CYP2A6 CYP2C9
9 10.58 CYP2A6 CYP2C9
10 10.46 CYP2A6 CYP2C9
11 10.07 CYP2A6 CYP2C9
12 9.98 CYP4F2 F9 VKORC1

GO Terms for Coumarin Resistance

Cellular components related to Coumarin Resistance according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 endoplasmic reticulum GO:0005783 9.55 CYP2A6 CYP2C9 CYP4F2 MCFD2 VKORC1
2 intracellular membrane-bounded organelle GO:0043231 9.43 CYP2A6 CYP2C9 CYP4F2
3 organelle membrane GO:0031090 9.13 CYP2A6 CYP2C9 CYP4F2
4 endoplasmic reticulum membrane GO:0005789 9.02 CYP2A6 CYP2C9 CYP4F2 MCFD2 VKORC1

Biological processes related to Coumarin Resistance according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 oxidation-reduction process GO:0055114 9.62 CYP2A6 CYP2C9 CYP4F2 VKORC1
2 steroid metabolic process GO:0008202 9.46 CYP2A6 CYP2C9
3 xenobiotic metabolic process GO:0006805 9.43 CYP2A6 CYP2C9
4 blood coagulation GO:0007596 9.43 CYP4F2 F9 VKORC1
5 exogenous drug catabolic process GO:0042738 9.4 CYP2A6 CYP2C9
6 organic acid metabolic process GO:0006082 9.37 CYP2A6 CYP2C9
7 omega-hydroxylase P450 pathway GO:0097267 9.16 CYP2C9 CYP4F2
8 epoxygenase P450 pathway GO:0019373 9.13 CYP2A6 CYP2C9 CYP4F2
9 drug metabolic process GO:0017144 8.92 CYP2A6 CYP2C9 CYP4F2 VKORC1

Molecular functions related to Coumarin Resistance according to GeneCards Suite gene sharing:

# Name GO ID Score Top Affiliating Genes
1 metal ion binding GO:0046872 9.85 CYP2A6 CYP2C9 CYP4F2 F9 MCFD2
2 oxidoreductase activity GO:0016491 9.62 CYP2A6 CYP2C9 CYP4F2 VKORC1
3 monooxygenase activity GO:0004497 9.43 CYP2C9 CYP4F2
4 heme binding GO:0020037 9.43 CYP2A6 CYP2C9 CYP4F2
5 oxidoreductase activity, acting on paired donors, with incorporation or reduction of molecular oxygen, reduced flavin or flavoprotein as one donor, and incorporation of one atom of oxygen GO:0016712 9.4 CYP2A6 CYP2C9
6 steroid hydroxylase activity GO:0008395 9.37 CYP2A6 CYP2C9
7 iron ion binding GO:0005506 9.33 CYP2A6 CYP2C9 CYP4F2
8 oxidoreductase activity, acting on paired donors, with incorporation or reduction of molecular oxygen GO:0016705 9.13 CYP2A6 CYP2C9 CYP4F2
9 arachidonic acid epoxygenase activity GO:0008392 8.8 CYP2A6 CYP2C9 CYP4F2

Sources for Coumarin Resistance

3 CDC
7 CNVD
9 Cosmic
10 dbSNP
11 DGIdb
17 EFO
18 ExPASy
20 FMA
29 GO
30 GTR
31 HGMD
32 HMDB
33 HPO
34 ICD10
35 ICD10 via Orphanet
36 ICD9CM
37 IUPHAR
38 KEGG
39 LifeMap
41 LOVD
43 MedGen
45 MeSH
46 MESH via Orphanet
47 MGI
50 NCI
51 NCIt
52 NDF-RT
55 NINDS
56 Novoseek
58 OMIM
59 OMIM via Orphanet
63 PubMed
65 QIAGEN
70 SNOMED-CT via HPO
71 SNOMED-CT via Orphanet
72 TGDB
73 Tocris
74 UMLS
75 UMLS via Orphanet
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