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Cytochrome P450 family 4 subfamily F member 2 (CYP4F2) is a microsomal enzyme primarily expressed in the liver, kidney, and intestine, where it catalyzes the omega-hydroxylation of long-chain fatty acids, eicosanoids, and vitamins including vitamin K and vitamin E. Functionally, CYP4F2 initiates the inactivation and breakdown of leukotriene B4, a key inflammatory mediator, and produces 20-hydroxyeicosatetraenoic acid (20-HETE), an important regulator of vascular tone and sodium excretion. Genetic variants in CYP4F2 significantly affect the pharmacokinetics of vitamin K and the dosing of warfarin and related anticoagulants; the most prominent variant, CYP4F2*3 (V433M), exhibits reduced enzymatic activity, resulting in higher hepatic vitamin K levels and increased anticoagulant dose requirements. CYP4F2 activity also modulates vitamin E status, response to drugs such as imatinib and fingolimod, and may influence susceptibility to cardiovascular disease, cancer, and inflammation through its impact on lipid mediator profiles.
CYP4F2 oxidizes vitamin K1 and other lipid substrates, influencing their bioavailability and catabolic rate. Pharmacologic inhibition/modulation alters drug clearance and endogenous mediator levels.
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