Gene NAT2

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Also known as

AAC2, PNAT, NAT-2, N-acetyltransferase 2

Overview

NAT2 (N-Acetyltransferase 2) encodes a phase II detoxification enzyme that acetylates aromatic amines, hydrazines, and various drugs. NAT2 metabolizes medications including isoniazid (tuberculosis treatment), hydralazine (antihypertensive), procainamide (antiarrhythmic), and sulfonamide antibiotics.

NAT2 acetylator status is one of the oldest pharmacogenetic traits, recognized since the 1950s when patients showed variable responses to isoniazid. Individuals are classified as slow, intermediate, or rapid acetylators based on NAT2 genotype. Slow acetylators are at increased risk of drug toxicity, including isoniazid-induced hepatotoxicity and drug-induced lupus, while rapid acetylators may need higher drug doses.

NAT2 slow acetylator status has also been associated with increased bladder cancer risk, particularly in individuals with aromatic amine exposure from smoking or occupational sources. Understanding your NAT2 status guides dosing for affected medications and informs cancer risk assessment.

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