Department of Pharmacology, Sree Balaji Medical College and Hospital, Bharat University, Chennai, Tamil Nadu, India.
Genomic Research Centre, Sree Balaji Medical College and Hospital, Bharat University, Chennai, Tamil Nadu, India.
Indian J Pharmacol. 2021 Jul-Aug;53(4):301-309. doi: 10.4103/ijp.IJP_593_19.
Hypertension is a leading age-related disease in our society and if left untreated, leads to fatal cardiovascular complications. The prevalence of hypertension has increased and becomes a significant global health economic burden, particularly in lower-income societies. Many loci associated with blood pressure and hypertension have been reported by genome-wide association studies that provided potential targets for pharmacotherapy. Pharmacogenetic research had shown interindividual variations in drug efficacy, safety, and tolerability. This could be due to genetic polymorphisms in the pharmacokinetics (genes involved in a transporter, plasma protein binding, and metabolism) or pharmacodynamic pathway (receptors, ion channels, enzymes). Pharmacogenetics promises great hope toward targeted therapy, but challenges remain in implementing pharmacogenetic aided antihypertensive therapy in clinical practice. Using various databases, we analyzed the underlying mechanisms between the candidate gene polymorphisms and antihypertensive drug interactions and the challenges of implementing precision medicine. We review the emergence of pharmacogenetics and its relevance to clinical pharmacological practice.
高血压是我们社会中与年龄相关的主要疾病，如果不加以治疗，会导致致命的心血管并发症。高血压的患病率不断上升，成为一个重大的全球卫生经济负担，特别是在低收入社会。全基因组关联研究已经报道了许多与血压和高血压相关的基因座，为药物治疗提供了潜在的靶点。药物遗传学研究表明，药物的疗效、安全性和耐受性存在个体间的差异。这可能是由于药物代谢动力学（涉及转运体、血浆蛋白结合和代谢的基因）或药效学途径（受体、离子通道、酶）中的遗传多态性所致。药物遗传学为靶向治疗带来了巨大的希望，但在将药物遗传学辅助的降压治疗应用于临床实践方面仍存在挑战。我们使用各种数据库分析了候选基因多态性与降压药物相互作用的潜在机制以及实施精准医学的挑战。我们综述了药物遗传学的出现及其与临床药理学实践的相关性。
