Berinstein Elliot, Levy Andrew
a Technion Faculty of Medicine , Technion Israel Institute of Technology , Haifa , Israel.
Expert Opin Drug Metab Toxicol. 2017 Sep;13(9):973-983. doi: 10.1080/17425255.2017.1363887. Epub 2017 Aug 20.
Cardiovascular disease is still the leading cause of death worldwide. There are many environmental and genetic factors that play a role in the development of cardiovascular disease. The treatment of cardiovascular disease is beginning to move in the direction of personalized medicine by using biomarkers from the patient's genome to design more effective treatment plans. Pharmacogenomics have already uncovered many links between genetic variation and response of many different drugs. Areas covered: This article will focus on the main polymorphisms that impact the risk of adverse effects and response efficacy of statins, clopidogrel, aspirin, β-blockers, warfarin dalcetrapib and vitamin E. The genes discussed include SLCO1B1, ABCB1, CYP3A4, CYP3A5, CYP2C19, PTGS1, PTGS2, ADRB1, ADCY9, CYP2C19, PON1, CES1, PEAR1, GPIIIa, CYP2D6, CKORC1, CYP2C9 and Hp. Expert opinion: Although there are some convincing results that have already been incorporated in the labelling treatment guidelines, most gene-drug relationships have been inconsistent. A better understanding of the relationships between genetic factors and drug response will provide more opportunities for personalized diagnosis and treatment of cardiovascular disease.
心血管疾病仍是全球主要死因。有许多环境和遗传因素在心血管疾病的发展中起作用。心血管疾病的治疗正开始朝着个性化医疗的方向发展，通过利用患者基因组中的生物标志物来设计更有效的治疗方案。药物基因组学已经揭示了基因变异与许多不同药物反应之间的许多联系。涵盖领域：本文将重点关注影响他汀类药物、氯吡格雷、阿司匹林、β受体阻滞剂、华法林、达塞曲匹和维生素E不良反应风险及反应疗效的主要多态性。所讨论的基因包括SLCO1B1、ABCB1、CYP3A4、CYP3A5、CYP2C19、PTGS1、PTGS2、ADRB1、ADCY9、CYP2C19、PON1、CES1、PEAR1、GPIIIa、CYP2D6、CKORC1、CYP2C9和Hp。专家观点：尽管已有一些令人信服的结果被纳入标签治疗指南，但大多数基因与药物的关系并不一致。更好地理解遗传因素与药物反应之间的关系将为心血管疾病的个性化诊断和治疗提供更多机会。
