What is BCRP (ABCG2) – 421C>A (rs2231142) and Why Does the Cardio Zoomer Test for It?

Drug transport and uric acid regulation transporter variant

BCRP (Breast Cancer Resistance Protein), encoded by the ABCG2 gene, is a membrane transporter that helps move various substances—including medications, metabolic byproducts, and uric acid—out of cells. The 421C>A (rs2231142) genetic variant can reduce transporter activity, influencing drug handling and uric acid levels. Identifying this variant helps contextualize cardiometabolic and pharmacologic risk patterns within the Cardio Zoomer.

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BCRP (ABCG2) – 421C>A (rs2231142)

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About BCRP (ABCG2) – 421C>A (rs2231142)

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About BCRP (ABCG2) – 421C>A (rs2231142)

Overview and History

BCRP, also known as ABCG2, is an ATP-binding cassette (ABC) transporter expressed in the intestine, liver, kidney, placenta, and blood–brain barrier. Its primary function is to export a wide range of endogenous and exogenous compounds from cells, including certain medications, dietary compounds, toxins, and uric acid. The 421C>A (rs2231142) polymorphism results in an amino acid substitution (Q141K) that has been associated with reduced transporter expression and activity. Functionally, this can alter how substrates are absorbed, distributed, and eliminated in the body. Because BCRP participates in drug disposition and uric acid handling, this variant is clinically relevant in cardiometabolic and pharmacogenomic contexts.

Interpreting Highs and Lows

Reduced BCRP activity associated with the 421A allele has been linked in population studies to higher serum uric acid levels and an increased likelihood of hyperuricemia. Elevated uric acid is associated with gout risk and has been studied in relation to cardiometabolic and vascular patterns. In addition, altered transporter activity can influence systemic exposure to certain medications, including some statins and other cardiovascular therapies that are BCRP substrates. These effects are variable and context-dependent. Interpretation should integrate lipid markers, inflammatory biomarkers, uric acid levels, medication use, and other genetic findings within the full Cardio Zoomer profile.

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BCRP does not act in isolation. Its functional impact depends on interactions with other transporters (such as OATP1B1 and P-glycoprotein), liver and kidney function, medication selection, and overall metabolic status. The presence of the 421C>A variant does not determine outcomes on its own but may help explain differences in uric acid levels or drug response patterns. Evaluating this variant alongside lipid particle markers, inflammatory indicators, oxidative stress markers, and other pharmacogenetic findings allows for a more comprehensive understanding of cardiovascular and metabolic physiology.

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BCRP (ABCG2) – 421C>A (rs2231142) FAQs

What is BCRP (ABCG2) – 421C>A (rs2231142) and why is it important?

BCRP (ABCG2) – 421C>A (rs2231142) is a genetic variant in a transporter protein that moves substances such as medications and uric acid out of cells. It is important because reduced transporter activity may influence uric acid levels and the way certain cardiovascular medications are processed. Understanding this variant helps personalize interpretation of metabolic and pharmacologic patterns.

What does it mean if I carry the 421A variant?

Carrying the 421A variant has been associated with reduced BCRP transporter activity. In research studies, this has been linked to higher average uric acid levels and altered handling of certain medications that rely on BCRP for transport. The clinical significance depends on your full laboratory profile, medication use, kidney and liver function, and other genetic factors.

Does this variant mean I will develop gout or cardiovascular disease?

No. The 421C>A variant is a risk modifier, not a diagnosis. While it has been associated with higher uric acid levels in some populations, outcomes depend on many factors including diet, kidney function, metabolic health, inflammation, and additional genetic markers. It should be interpreted within the broader Cardio Zoomer results and clinical context.

Why is BCRP (ABCG2) included in the Cardio Zoomer?

Cardio Zoomer includes BCRP (ABCG2) – 421C>A to provide insight into genetic influences on uric acid regulation and medication transport. Because uric acid metabolism and pharmacologic response can intersect with cardiometabolic risk, this variant helps clinicians integrate genetic transport capacity with lipid, inflammatory, metabolic, and vascular markers for more individualized assessment.

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