NAT2

is a	gene
is	mentioned by
Full name	N-acetyltransferase 2 (arylamine N-acetyltransferase)
Related	NAT1
EntrezGene	10
PheGenI	10
VariationViewer	10
ClinVar	NAT2
GeneCards	NAT2
dbSNP	10
Diseases	NAT2
SADR	10
HugeNav	10
wikipedia	NAT2
google	NAT2
gopubmed	NAT2
EVS	NAT2
HEFalMp	NAT2
MyGene2	NAT2
23andMe	NAT2
UniProt	P11245
Ensembl	ENSG00000156006
OMIM	612182
# SNPs	13

	Max Magnitude	Chromosome position
rs1041983	0	18,400,285
rs1208	0	18,400,806
rs1565684	0	18,389,154
rs1799929	0	18,400,484
rs1799930	2.4	18,400,593
rs1799931	0	18,400,860
rs1801279	0	18,400,194
rs1801280	0	18,400,344
rs4271002	0	18,390,758
rs4345600	0	18,390,698
rs4986996	0	18,400,367
rs4986997	0	18,400,414
rs9987109	0	18,393,412

NAT2 may also refer to SLC38A1.

NAT2 is one of only 2 N-acetyltransferase genes in humans; the other, NAT1, shows little variation between individuals, whereas NAT2 is known to have over 23 variants. N-acetyltransferases are enzymes acting primarily in the liver to detoxify a large number of chemicals, including caffeine and several prescribed drugs. The NAT2 acetylation polymorphism is important because of its primary role in the activation and/or deactivation of many chemicals in the body's environment, including those produced by cigarettes as well as aromatic amine and hydrazine drugs used medicinally. In turn, this can affect an individual's cancer risk.

Individuals can be classified as either rapid, or slow, metabolizers (i.e. detoxifiers). In general, slow metabolizers have higher rates of certain types of cancer and are more susceptible to side effects from chemicals metabolized by NAT2.[PMID 10667461] Drugs reported to be metabolized by NAT2 include isoniazid, sulfadimidine, hydralazine, dapsone, procaine amide, sulfapyridine, nitrazepam and some sulfa drugs. [PMID 3712391]

It takes two slow metabolizer alleles to give rise to a slow metabolizer phenotype, or to put it another way, the rapid metabolizer allele is dominant to the slow metabolizer, and you therefore only need one to be a rapid metabolizer.

Prior to removing this information due to FDA actions, Promethease reports evaluated an individual's NAT2 phenotype based on genosets gs138, gs139 and gs140 using a 6 SNP algorithm, and based on genosets gs154 and gs156 using a 2 SNP algorithm.[PMID 21750470]

Generally, with respect to NAT2, individuals are therefore classified as rapid metabolizers if they have one or more NAT2*4 alleles, and slow metabolizers only if they carry two slow metabolizer variants. The alleles themselves are effectively haplotypes composed of several NAT2 SNPs, most typically assigned according to the status of the following seven SNPs:

rs1801279, aka G191A
rs1041983, aka C282T
rs1801280, aka T341C
rs1799929, aka C481T
rs1799930, aka G590A
rs1208, aka A803G
rs1799931, aka G857A

The most common alleles are then defined as follows:

NAT2*4: considered to be the wild-type allele, and the exemplar rapid metabolizer; consists of the first nucleotide shown in the "aka" (also known as) names listed above for these seven NAT2 SNPs, i.e. an allele in question is NAT2*4 if it is rs1801279(G) and rs1041983(C) and rs1801280(T) and ... etc

Almost all of the remaining common alleles are slow metabolizers, such as:

NAT2*5A: 341C + 481T, i.e. rs1801280(C) + rs1799929(T)
NAT2*5B: 341C + 481T + 803G, i.e. rs1801280(C) + rs1799929(T) + rs1208(G)
NAT2*5C: 341C + 803G, i.e. rs1801280(C) + rs1208(G)
NAT2*5D: 341C, i.e. rs1801280(C)
NAT2*5E: 341C + 590A, i.e. rs1801280(C) + rs1799930(A)
NAT2*5G: 282T + 341C + 481T + 803G, i.e. rs1041983(T) + rs1801280(C) + rs1799929(T) + rs1208(G)
NAT2*5J: 282T + 341C + 590A, i.e. rs1041983(T) + rs1801280(C) + rs1799930(A)
NAT2*6A: 282T + 590A, i.e. rs1041983(T) + rs1799930(A)
NAT2*6B: 590A (only), i.e. no variation compared to NAT2*4 except rs1799930(A)
NAT2*6C: 282T + 590A + 803G, i.e. rs1041983(T) + rs1799930(A) + rs1208(G)
NAT2*6E: 481T + 590A, i.e. rs1799929(T) + rs1799930(A)
NAT2*7A: 857A (only), i.e. rs1799931(A)
NAT2*7B: 282T + 857A, i.e. rs1041983(T) + rs1799931(A)
NAT2*14A: 191A, i.e. rs1801279(A)
NAT2*14B: 191A + 282T, i.e. rs1801279(A) + rs1041983(T)
NAT2*14C: 191A + 341C + 481T + 803G, i.e. rs1801279(A) + rs1801280(C) + rs1799929(T) + rs1208(G)
NAT2*14D: 191A + 282T + 590A, i.e. rs1801279(A) + rs1041983(T) + rs1799930(A)
NAT2*14E: 191A + 803G, i.e. rs1801279(A) + rs1208(G)
NAT2*14F: 191A + 341C + 803G, i.e. rs1801279(A) + rs1801280(C) + rs1208(G)
NAT2*14G: 191A + 282T + 803G, i.e. rs1801279(A) + rs1041983(T) + rs1208(G)

However there are also a few rapid (i.e. normal) metabolizer variants as well, such as:

NAT2*11A: 481T, i.e. rs1799929(T)
NAT2*12A: 803G, i.e. rs1208(G)
NAT2*12B: 282T + 803G, i.e. rs1041983(T) + rs1208(G)
NAT2*12C: 481T + 803G, i.e. rs1799929(T) + rs1208(G)
NAT2*13: 282T (only), i.e. rs1041983(T)

As mentioned above, individuals running the Promethease program associated with SNPedia used to be automatically tested for NAT2 genotype via the genosets known as gs138, gs139 and gs140.

Alternatively, NAT2 acetylator phenotype can be inferred from a complex NAT2 genotype (i.e. a combination of SNPs observed in a given individual) using the publicly-accessible web-server NAT2PRED (http://nat2pred.rit.albany.edu). [PMID 19261719]

rs1495741 is reported to tag NAT2 phenotypes with 99% sensitivity and 95% specificity, and may be an alternative classifier to the 7-SNP panel.[PMID 20739907]

The proportion of slow and rapid metabolizers is known to differ between different ethnic populations. In general, the slow metabolizer phenotype is most prevalent (>80%) in Northern Africans and Scandinavians, and lowest (5%) in Canadian Eskimos and Japanese. Intermediate frequencies are seen in Chinese populations (around 20% slow metabolizers), whereas 40 - 60% of African-Americans and most non-Scandinavian Caucasians are slow metabolizers.[PMID 16416399 ]