Weber Yvonne G, Nies Anne T, Schwab Matthias, Lerche Holger
Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany,
Neurotherapeutics. 2014 Apr;11(2):324-33. doi: 10.1007/s13311-014-0262-5.
The identification of valid biomarkers for outcome prediction of diseases and improvement of drug response, as well as avoidance of side effects is an emerging field of interest in medicine. The concept of individualized therapy is becoming increasingly important in the treatment of patients with epilepsy, as predictive markers for disease prognosis and treatment outcome are still limited. Currently, the clinical decision process for selection of an antiepileptic drug (AED) is predominately based on the patient's epileptic syndrome and side effect profiles of the AEDs, but not on effectiveness data. Although standard dosages of AEDs are used, supplemented, in part, by therapeutic monitoring, the response of an individual patient to a specific AED is generally unpredictable, and the standard care of patients in antiepileptic treatment is more or less based on trial and error. Therefore, there is an urgent need for valid predictive biomarkers to guide patient-tailored individualized treatment strategies in epilepsy, a research area that is still in its infancy. This review focuses on genomic factors as part of an individual concept for AED therapy summarizing examples that influence the prognosis of the disease and the response to AEDs, including side effects.
识别有效的生物标志物以预测疾病预后、改善药物反应并避免副作用，是医学领域一个新兴的研究热点。在癫痫患者的治疗中，个体化治疗的概念变得越来越重要，因为用于疾病预后和治疗效果预测的标志物仍然有限。目前，选择抗癫痫药物（AED）的临床决策过程主要基于患者的癫痫综合征以及AED的副作用情况，而非有效性数据。尽管使用了AED的标准剂量，并部分辅以治疗监测，但个体患者对特定AED的反应通常无法预测，抗癫痫治疗中患者的标准护理或多或少基于试错法。因此，迫切需要有效的预测性生物标志物来指导癫痫患者的个体化治疗策略，这一研究领域仍处于起步阶段。本综述聚焦于基因组因素，作为AED治疗个体化概念的一部分，总结了影响疾病预后和对AED反应（包括副作用）的实例。
