Kudzi W, Adjei G O, Ofori-Adjei D, Dodoo A N O
Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School. P.O. GP 4236, Accra, Ghana.
Ghana Med J. 2011 Jun;45(2):73-80. doi: 10.4314/gmj.v45i2.68932.
Different clinical response of different patients to the same medicine has been recognised and documented since the 1950's. Variability in response of individuals to standard doses of drug therapy is important in clinical practice and can lead to therapeutic failures or adverse drug reactions. Pharmacogenetics seeks to identify individual genetic differences (polymorphisms) in drug absorption, metabolism, distribution and excretion that can affect the activity of a particular drug with the view of improving efficacy and reducing toxicity. Although knowledge of pharmacogenetics is being translated into clinical practice in the developed world, its applicability in the developing countries is low. Several factors account for this including the fact that there is very little pharmacogenetic information available in many indigenous African populations including Ghanaians. A number of genes including Cytochrome P450 (CYP) 2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, MDR1 and TPMT have been genotyped in the Ghanaian population since the completion of the Human genome project. There is however, an urgent need to increase pharmacogenetic research in Ghana to increase availability of data. Introducing Pharmacogenetics into the curriculum of Medical and Pharmacy training institutions will influence translating knowledge of pharmacogenetics into clinical practice. This will also equip health professionals with the skill to integrate genetic information into public health decision making.
自20世纪50年代以来,不同患者对同一种药物的不同临床反应就已得到认识和记录。个体对标准剂量药物治疗反应的变异性在临床实践中很重要,可能导致治疗失败或药物不良反应。药物遗传学旨在识别药物吸收、代谢、分布和排泄方面的个体遗传差异(多态性),这些差异可能影响特定药物的活性,以期提高疗效并降低毒性。尽管在发达国家,药物遗传学知识正在转化为临床实践,但其在发展中国家的适用性较低。造成这种情况的因素有几个,包括在许多非洲本土人群(包括加纳人)中,药物遗传学信息非常少。自人类基因组计划完成以来,加纳人群中已经对包括细胞色素P450(CYP)2A6、CYP2B6、CYP2C8、CYP2C9、CYP2C19、CYP2D6、MDR1和TPMT在内的一些基因进行了基因分型。然而,加纳迫切需要加强药物遗传学研究,以增加数据的可获得性。将药物遗传学纳入医学和药学培训机构的课程,将有助于把药物遗传学知识转化为临床实践。这也将使卫生专业人员具备将遗传信息纳入公共卫生决策的技能。