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药物不良反应与药物基因组学:最新进展

Adverse drug reactions and pharmacogenomics: recent advances.

作者信息

Alfirevic Ana, Pirmohamed Munir

机构信息

The University of Liverpool, Department of Pharmacology & Therapeutics, Sherrington Building, Ashton Street, Liverpool, Merseyside, L69 3GE, UK.

出版信息

Per Med. 2008 Jan;5(1):11-23. doi: 10.2217/17410541.5.1.11.

Abstract

The concept of pharmacogenomics, the study of how variation in the human genome affects response to drugs, attracts attention from clinicians and the pharmaceutical industry alike. The aim is to distinguish, using appropriate genetic tests, individuals who may be harmed by certain drugs from those who may benefit from them. Adverse drug reactions cause significant morbidity and mortality and incur a large cost to healthcare systems. Pharmacogenomics may help in the prediction and prevention of adverse reactions to drugs. While some recent studies (e.g., abacavir hypersensitivity) have shown strong associations with single genetic factors, whether these represent the exceptions rather than the rule is unclear. Further studies on adverse drug reaction pharmacogenetics are needed - these should be adequately powered and utilize the most appropriate study design that allows for an evaluation of both genetic and environmental factors. For pharmacogenetic testing to become acceptable in clinical practice, it is important that such studies are also able to provide evidence of clinical validity and clinical utility.

摘要

药物基因组学是研究人类基因组变异如何影响药物反应的学科,这一概念引起了临床医生和制药行业的关注。其目的是通过适当的基因检测,区分可能因某些药物而受到伤害的个体和可能从这些药物中受益的个体。药物不良反应会导致严重的发病率和死亡率,并给医疗系统带来巨大成本。药物基因组学可能有助于预测和预防药物不良反应。虽然最近的一些研究(如阿巴卡韦超敏反应)显示与单一遗传因素有很强的关联,但这些是例外还是普遍规律尚不清楚。需要进一步开展药物不良反应药物基因组学研究——这些研究应有足够的样本量,并采用最恰当的研究设计,以便能够评估遗传和环境因素。为使药物基因检测在临床实践中被接受,此类研究还能够提供临床有效性和临床实用性的证据,这一点很重要。

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