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抗结核药物的药物不良反应:从药物基因组学角度鉴定宿主遗传标记

Adverse Drug Reactions to Anti-TB Drugs: Pharmacogenomics Perspective for Identification of Host Genetic Markers.

作者信息

Sahu Roshan Kumar, Singh Kan, Subodh Swati

机构信息

Open Source Drug Discovery Unit, Council for Scientific & Industrial Research, Anusandhan Bhawan, 2, Rafi Marg, New Delhi-110001, India.

出版信息

Curr Drug Metab. 2015;16(7):538-52. doi: 10.2174/1389200216666150812123725.

Abstract

Adverse drug reactions (ADRs) are associated with clinical morbidity and, in severe cases, even mortality. Globally billions of dollars are spent on managing these ADRs for common and uncommon diseases. The developing world suffers from a high burden of tuberculosis, which requires 6-8 months of multi-drug treatment. In spite of most cases being treatable the problem persists mainly due to a high attrition rate associated with ADR mediated complications. Due to these reasons drug resistant strains have emerged and are now a serious challenge to TB eradication. To effectively deliver the available treatment regimen and ensure patient compliance it is important to manage ADRs more efficiently. Recent studies have demonstrated that drug outcomes are patient-specific and can, therefore be predicted. A few of these drugs, including a few administered for TB, have shown excellent correlation with response rates and development of ADRs. In this review, we profile information available in public domain for existing anti-TB drugs to understand the genesis of ADRs and patient response. Additionally, human genome variation databases have been used to correlate the frequency of these markers and their genomic variants in different populations.

摘要

药物不良反应(ADR)与临床发病率相关,在严重情况下甚至会导致死亡。全球在管理这些常见和罕见疾病的药物不良反应方面花费了数十亿美元。发展中世界结核病负担沉重,需要进行6至8个月的多药治疗。尽管大多数病例是可治疗的,但问题仍然存在,主要是因为与药物不良反应介导的并发症相关的高损耗率。由于这些原因,耐药菌株已经出现,现在对结核病的根除构成了严重挑战。为了有效地提供可用的治疗方案并确保患者的依从性,更有效地管理药物不良反应非常重要。最近的研究表明,药物疗效是因人而异的,因此是可以预测的。其中一些药物,包括一些用于治疗结核病的药物,已显示出与反应率和药物不良反应的发生有很好的相关性。在这篇综述中,我们梳理了公共领域中现有抗结核药物的可用信息,以了解药物不良反应的成因和患者反应。此外,人类基因组变异数据库已被用于关联这些标记及其在不同人群中的基因组变异的频率。

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