Prevalence of polymorphisms in N-acetyltransferase 2 gene among patients of Yakut ethnicity newly diagnosed with pulmonary tuberculosis

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Background. Tuberculosis therapy can lead to considerably dissimilar outcomes among individual patients. Some patients benefit from anti-tuberculosis chemotherapy leading to a desired therapeutic effect, while other patients show insufficient or absent response, or develop adverse side effects. Individual response to isoniazid is affected by mutations in the gene encoding N-acetyltransferase 2 (NAT2). Wide variations were observed in distributions of polymorphic NAT2 alleles in human populations depending on race, ethnicity, or geographical origin. No data are available to date on prevalence of NAT2 gene polymorphic variants and acetylation types in Yakut (Sakha) patients with newly diagnosed pulmonary tuberculosis.

Aims: the frequencies of NAT2 polymorphic SNPs as well isoniazid acetylation phenotypes were evaluated in the patient’s cohort of Yakut ethnicity with newly diagnosed pulmonary tuberculosis (PTB). The comparison with, other ethnic groups of Asian origin was done.

Methods. Cross-sectional study was conducted among Yakut patient cohorts with newly identified pulmonary tuberculosis. Using real-time PCR the following SNPs were explored: NAT2*5 (rs1801280, Т341С), NAT2*6 (rs1799930, G590A), NAT2*7 (rs1799931, G857A), NAT2*11 (rs1799929, C481T), NAT2*12 (rs1208, A803G), NAT2*13 (rs1041983, C282T). Genetically determined metabolic rates were calculated using NATpred online tool.

Results. NAT2 SNPs were assessed, namely *5, *6, *7, *11, *12, and *13. The most frequent in Yakut patients were NAT2*6 and NAT2*13 SNPs (40.9% and 64.4%, respectively). Significant differences were detected in frequencies of NAT2 *5, *11, *12 polymorphisms; all studied NAT2 gene polymorphisms showed meaningful differences in genotype and minor allele prevalence rates after comparison between Yakut population and other Mongoloid ethnic groups (populations of China, Japan, Vietnam). High prevalence of intermediate acetylation type among ethnic Yakuts (58.3%) was established.

Conclusions. Certain distinct differences in allelic variants of NAT2 gene and acetylation type prevalence in patients of Yakut ethnic origin newly diagnosed with pulmonary tuberculosis let conclude that the existing genotyping and phenotyping data from studies among other Mongoloid populations cannot be implicitly extrapolated on Yakut people. Pharmacogenetic data on individual response to drugs in Yakut patients should be made use of in clinical practice, to develop personalized isoniazid administration algorithms, with a final goal to make treatment more effective and safe.

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About the authors

Nataliya M. Krasnova

M.K. Ammosov North-Eastern Federal University, Medical Institute

Author for correspondence.
ORCID iD: 0000-0002-4811-7801
SPIN-code: 8703-8169

Russian Federation, 58, Belinsky Street, Yakutsk, 677000


Elizaveta A. Alekseeva

Republican Hospital no. 3, Center for Personalized Medicine

ORCID iD: 0000-0001-6116-5720
SPIN-code: 8918-7035

Russian Federation, 677027, Sakha Republic (Yakutia), Yakutsk, Gorkogo str., 94


Zoya A. Rudykh

Republican Hospital no. 3, Center for Personalized Medicine, Yakutsk, Russia

ORCID iD: 0000-0001-8212-0150
SPIN-code: 4930-4297

Russian Federation, 677027, Sakha Republic (Yakutia), Yakutsk, Gorkogo str., 94

clinical pharmacologist

Yana V. Chertovskykh

Republican Hospital no. 3, Center for Personalized Medicine

ORCID iD: 0000-0003-0941-8633
SPIN-code: 8485-9530

Russian Federation, 677027, Sakha Republic (Yakutia), Yakutsk, Gorkogo str., 94

clinical pharmacologist, Head of the Center for Personalized Medicine

Tatiana M. Klimova

M.K. Ammosov North-Eastern Federal University, Medical Institute

ORCID iD: 0000-0003-2746-0608
SPIN-code: 2635-0865

Russian Federation, 58, Belinsky Street, Yakutsk, 677000

MD, PhD, associate professor of the Department for pharmacology and pharmacy, Medical Institute

Efrosiniya N. Efremova

Phthisiatry Research-Practice Center

ORCID iD: 0000-0001-6934-2971
SPIN-code: 3688-9742

Russian Federation, 677000, Sakha Republic (Yakutia), Yakutsk, Petra Alekseeva str., 93

TB clinician

Aleksandr F. Kravchenko

Phthisiatry Research-Practice Center

ORCID iD: 0000-0002-9210-3407
SPIN-code: 3188-6796

Russian Federation, 677000, Sakha Republic (Yakutia), Yakutsk, Petra Alekseeva str., 93

MD, PhD, Professor, Director 

Natalia S. Val

Phthisiatry Research-Practice Center

ORCID iD: 0000-0003-2910-1895

Russian Federation, 677000, Sakha Republic (Yakutia), Yakutsk, Petra Alekseeva str., 93

MD, PhD, Deputy director for medical service

Olga A. Suvorova

Russian Medical Academy of Continuous Professional Education

ORCID iD: 0000-0001-9661-7213

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

Salavat Sh. Suleymanov

SAIKO Russian-Japanese Medical Center

ORCID iD: 0000-0002-3176-2716
SPIN-code: 9047-1399

Russian Federation, Khabarovsk

MD, PhD, Professor

Aleksandr I. Vengerovsky

Siberian State Medical University

ORCID iD: 0000-0001-5094-3742
SPIN-code: 8818-0543

Russian Federation, 2, Moscowski Trakt, Tomsk, 634050

MD, PhD, Professor

Dmitry A. Sychev

Russian Medical Academy of Continuous Professional Education

ORCID iD: 0000-0002-4496-3680
SPIN-code: 4525-7556

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

MD, PhD, Professor


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