Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Medical Genetics, Tehran University of Medical Sciences, Tehran, Iran.
Clin Genet. 2018 Mar;93(3):481-497. doi: 10.1111/cge.13186.
For many years, a considerable number of patients with autoimmune diseases (ADs) have suffered from a lack of drug response and drug-related toxicity. Despite the emergence of new therapeutic options such as biological agents, patients continue to struggle with these problems. Unfortunately, new challenges, including the paradoxical effects of biological drugs, have complicated the situation. In recent decades, efforts have been made to predict drug response as well as drug-related side effects. Thanks to the many advances in genetics, evaluation of markers to predict drug response/toxicity before the initiation of treatment may be an avenue toward personalizing treatments. Implementing pharmacogenetics and pharmacogenomics in the clinic could improve clinical care; however, obstacles remain to effective personalized medicine for ADs. The present study attempted to clarify the concept of pharmacogenetics/pharmacogenomics for ADs. After an overview on the pathogenesis of the most common types of treatments, this paper focuses on pharmacogenetic studies related to the selected ADs. Bridging the gap between pharmacogenetics and personalized medicine is also discussed. Moreover, the advantages, disadvantages and recommendations related to making personalized medicine practical for ADs have been addressed.
多年来,相当数量的自身免疫性疾病(AD)患者一直面临药物反应不足和与药物相关的毒性问题。尽管出现了新的治疗选择,如生物制剂,但患者仍在努力应对这些问题。不幸的是,包括生物药物的矛盾效应在内的新挑战使情况更加复杂。近几十年来,人们一直在努力预测药物反应和与药物相关的副作用。由于遗传学的许多进步,在开始治疗之前评估预测药物反应/毒性的标志物可能是实现个体化治疗的一种途径。在临床上实施药物遗传学和药物基因组学可以改善临床护理;然而,AD 的个体化医学仍存在障碍。本研究试图阐明 AD 的药物遗传学/药物基因组学概念。在概述最常见治疗类型的发病机制后,本文重点介绍了与选定 AD 相关的药物遗传学研究。还讨论了在药物遗传学和个体化医学之间架起桥梁的问题。此外,还解决了与 AD 个体化医学实用性相关的优点、缺点和建议。