Landino Joan, Buckley Jane, Roy John M, Villagra David, Gorowski Krystyna, Kocherla Mohan, Windemuth Andreas, Ruaño Gualberto
Integrated Psychiatric Services, Inc., North Haven, Connecticut, USA.
J Am Acad Nurse Pract. 2011 Sep;23(9):459-63. doi: 10.1111/j.1745-7599.2011.00640.x. Epub 2011 Jul 25.
To illustrate the utility of CYP450 genotyping to guide clinical psychopharmacological treatment decisions and minimize or avoid harmful and costly adverse drug reactions (ADRs).
DNA was extracted from a whole blood sample from the case study subject and tested for CYP450 gene polymorphisms in the CLIA certified Laboratory of Personalized Health at Genomas, Inc. Clinical data were obtained from patient records and clinician observations.
We present a case in which the ascertainment of multiple CYP450 isoenzyme deficiencies resulted in a dramatic change in psychotropic treatment approach. Shortly after making these adjustments, the patient saw a significant improvement in most of her debilitating psychiatric symptoms.
In complex cases, CYP450 DNA testing can guide pharmacotherapy by exposing innate hepatic metabolic deficiencies as a result of DNA polymorphism. In such cases, clinicians can favor treatments that target functional isoenzyme pathways rather than deficient or null pathways thus leading to decreased risk of ADRs and improved patient response.
阐述细胞色素P450（CYP450）基因分型在指导临床精神药理学治疗决策以及最小化或避免有害且昂贵的药物不良反应（ADR）方面的作用。
从案例研究对象的全血样本中提取DNA，并在Genomas公司经临床实验室改进修正案（CLIA）认证的个性化健康实验室中检测CYP450基因多态性。临床数据来自患者记录和临床医生观察。
我们呈现了一个案例，其中多种CYP450同工酶缺陷的确定导致了精神药物治疗方法的显著改变。在做出这些调整后不久，患者大部分使人衰弱的精神症状有了显著改善。
在复杂病例中，CYP450 DNA检测可通过揭示因DNA多态性导致的先天性肝脏代谢缺陷来指导药物治疗。在这类病例中，临床医生可倾向于选择针对功能性同工酶途径而非缺陷或无功能途径的治疗方法，从而降低药物不良反应风险并改善患者反应。
