National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.
The Jackson Laboratory for Mammalian Genetics, Bar Harbor, Maine, USA.
Clin Pharmacol Ther. 2018 May;103(5):778-786. doi: 10.1002/cpt.1048. Epub 2018 Mar 30.
Response to a drug often differs widely among individual patients. This variability is frequently observed not only with respect to effective responses but also with adverse drug reactions. Matching patients to the drugs that are most likely to be effective and least likely to cause harm is the goal of effective therapeutics. Pharmacogenomics (PGx) holds the promise of precision medicine through elucidating the genetic determinants responsible for pharmacological outcomes and using them to guide drug selection and dosing. Here we survey the US landscape of research programs in PGx implementation, review current advances and clinical applications of PGx, summarize the obstacles that have hindered PGx implementation, and identify the critical knowledge gaps and possible studies needed to help to address them.
药物反应在个体患者中往往差异很大。这种变异性不仅表现在有效反应方面,也表现在药物不良反应方面。使患者与最有可能有效且最不可能造成伤害的药物相匹配是有效治疗的目标。药物基因组学(PGx)通过阐明负责药物作用的遗传决定因素,并利用这些因素来指导药物选择和剂量,有望实现精准医疗。在这里,我们调查了美国 PGx 实施研究计划的情况,回顾了 PGx 的当前进展和临床应用,总结了阻碍 PGx 实施的障碍,并确定了帮助解决这些障碍所需的关键知识差距和可能的研究。