ORM1, also known as orosomucoid 1 or alpha-1 acid glycoprotein (AGP), is a plasma drug-binding protein coded by a locus on chromosome 9q31->34.1. It is one of the major acute-phase proteins, with its serum concentration increasing in response to systemic tissue injury, inflammation or infection. ORM1 binds and transports various basic drugs, and its genetic polymorphism could be related to the inter-individual variability in plasma binding of these drugs [2,3].

Studies have explored the role of ORM1 in different medical conditions. In tuberculosis, ORM1 in Mycobacterium tuberculosis antigen-stimulated peripheral blood mononuclear cells showed a high area under the curve value in discriminating active tuberculosis from latent infection, suggesting it could be a potential biomarker [1]. Regarding warfarin therapy, ORM1 rs17650 polymorphism affects the maintenance stable warfarin dosage, with ORM1 S carriers requiring lower doses [2]. Also, different ORM1 phenotypes influence the disposition of quinidine, a basic drug [3]. Moreover, multiallelic copy number variation in ORM1 is associated with plasma cell-free DNA levels, which could contribute to venous thromboembolism risk [4,5].

In conclusion, ORM1 plays important roles in drug-binding and disposition, and shows potential as a biomarker in diseases like tuberculosis. Its polymorphisms and copy number variations are associated with different disease-related factors such as warfarin dosage and venous thromboembolism risk, highlighting the significance of studying ORM1 in understanding disease mechanisms and treatment strategies.