Final answer:
The CYP2D6 enzyme is responsible for converting tramadol to its active metabolite, leading to its pain-relieving effects. This pharmacogenomic aspect is significant for personalized medicine due to the variations in enzyme activity among individuals.
Step-by-step explanation:
The enzyme that converts tramadol to its active metabolite is the CYP2D6 enzyme, choice A). Tramadol is a pro-drug which means it requires metabolic activation to become pharmacologically active. The CYP2D6 enzyme, which is part of the Cytochrome P450 family, plays a crucial role in this process by converting tramadol into O-desmethyltramadol, the substance responsible for its analgesic effects.
It is important to note that the activity of CYP2D6 can vary among individuals due to genetic polymorphisms, which can lead to different levels of tramadol efficacy and safety. Such variability in CYP2D6 activity is a significant consideration in personalized medicine and drug development. Other enzymes like CYP3A4 are involved in the metabolism of tramadol but do not primarily convert it to its active form.