Department of Biotechnology, Institute of Biosciences and Biotechnology, Chhatrapati Shahu Ji Maharaj University, Kanpur, Uttar Pradesh, India.
Adv Biochem Eng Biotechnol. 2020;171:369-394. doi: 10.1007/10_2019_110.
Recent advances in Pharmacogenomics have made it possible to understand the reasons behind the different response of a drug. Discovery of genetic variants and its association with the varying response of drug provide the basis for recommending a drug and its dose to an individual patient. Genetic makeup-based prescription, design, and implementation of therapy not only improve the outcome of treatments but also reduce the risk of toxicity and other adverse effects. A better understanding of individual variations and their effect on drug response, metabolism excretion, and toxicity will replace the trial-and-error approach of treatment. Evidence of the clinical utility of pharmacogenetics testing is only available for a few medications, and FDA labels only require pharmacogenetics testing for a small number of drugs. Although there is a great promise, there are not many examples where Pharmacogenomics impacts clinical utility. Some genetic variants related to different diseases have been reported, and many have not been studied yet. The information related to the outcome of treatment with a particular drug and a genetic variant can be used to release a warning/label for the use of that drug. There are many limitations in the way of implementing the goal of personalized medicine. Future advances in the field of genomics, diagnosis approaches, data analysis, clinical decision-making, and sustainable business model for personalization of therapy can speed up the individualization of therapy based on genetic makeup.
药物基因组学的最新进展使得人们能够了解药物反应不同的原因。发现遗传变异及其与药物反应的变化的关联为向个体患者推荐药物及其剂量提供了依据。基于遗传构成的处方、治疗设计和实施不仅可以改善治疗效果,还可以降低毒性和其他不良反应的风险。更好地了解个体差异及其对药物反应、代谢、排泄和毒性的影响,将取代治疗的反复试验方法。药物基因组学检测的临床实用性证据仅适用于少数几种药物,并且 FDA 标签仅要求对少数几种药物进行药物基因组学检测。尽管有很大的前景,但药物基因组学对临床实用性产生影响的例子并不多。已经报道了一些与不同疾病相关的遗传变异,但还有许多尚未研究。与特定药物和遗传变异的治疗结果相关的信息可用于发布该药物使用的警告/标签。在实现个性化医学目标的方式上存在许多限制。基因组学领域、诊断方法、数据分析、临床决策和治疗个性化可持续商业模式的未来进展可以加速基于遗传构成的治疗个体化。