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针对消除与他克莫司免疫抑制治疗相关的个体间差异的理论构建策略:下一代个性化医学的案例研究

Theoretical Formulation Strategies towards Neutralizing Inter-individual Variability Associated with Tacrolimus Immunosuppressant Therapy: A Case Study on Nextgeneration Personalized Medicine.

作者信息

Radhakrishnan Arun, Kuppusamy Gowthamarajan

机构信息

Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Ooty, Nilgris, Tamilnadu, India.

出版信息

Curr Drug Metab. 2021;22(12):939-956. doi: 10.2174/1389200222666211015153317.

Abstract

Individualizing drug therapy and attaining maximum benefits of a drug devoid of adverse reactions is the benefit of personalized medicine. One of the important factors contributing to inter-individual variability is genetic polymorphism. As of now, dose titration is the only followed golden standard for implementing personalized medicine. Converting the genotypic data into an optimized dose has become easier now due to technology development. However, for many drugs, finding an individualized dose may not be successful, which further leads to a trial and error approach. These dose titration strategies are generally followed at the clinical level, and so industrial involvement and further standardizations are not feasible. On the other side, technologically driven pharmaceutical industries have multiple smart drug delivery systems which are underutilized towards personalized medicine. Transdisciplinary research with drug delivery science can additionally support the personalization by converting the traditional concept of "dose titration towards personalization" with novel "dose-cum-dosage form modification towards next-generation personalized medicine"; the latter approach is useful to overcome gene-based inter-individual variability by either blocking, to downregulate, or bypassing the biological protein generated by the polymorphic gene. This article elaborates an advanced approach to implementing personalized medicine with the support of novel drug delivery systems. As a case study, we further reviewed the genetic polymorphisms associated with tacrolimus and customized novel drug delivery systems to overcome these challenges factored towards personalized medicine for better clinical outcomes, thereby paving a new strategy for implementing personalized medicine for all other drug candidates.

摘要

个体化药物治疗并在无不良反应的情况下实现药物的最大效益是个性化医疗的优势。导致个体间差异的重要因素之一是基因多态性。目前,剂量滴定是实施个性化医疗唯一遵循的黄金标准。由于技术发展,现在将基因型数据转化为优化剂量变得更加容易。然而,对于许多药物来说,找到个体化剂量可能并不成功,这进一步导致了试错法。这些剂量滴定策略通常在临床层面遵循,因此工业界的参与和进一步的标准化并不可行。另一方面,技术驱动的制药行业有多种智能药物递送系统,但在个性化医疗方面未得到充分利用。药物递送科学的跨学科研究可以通过将传统的“朝向个性化的剂量滴定”概念转变为新颖的“朝向新一代个性化医疗的剂量及剂型修饰”来进一步支持个性化;后一种方法通过阻断、下调或绕过多态性基因产生的生物蛋白来克服基于基因的个体间差异是有用的。本文阐述了在新型药物递送系统支持下实施个性化医疗的先进方法。作为一个案例研究,我们进一步回顾了与他克莫司相关的基因多态性以及定制的新型药物递送系统,以克服个性化医疗面临的这些挑战,从而为更好的临床结果奠定基础,进而为所有其他候选药物实施个性化医疗开辟一条新策略。

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