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在个性化心血管医疗保健中整合药物-营养-基因组相互作用的挑战与重要性。

The Challenge and Importance of Integrating Drug-Nutrient-Genome Interactions in Personalized Cardiovascular Healthcare.

作者信息

Stouras Ioannis, Papaioannou Theodore G, Tsioufis Konstantinos, Eliopoulos Aristides G, Sanoudou Despina

机构信息

Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, Attikon Hospital Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

出版信息

J Pers Med. 2022 Mar 22;12(4):513. doi: 10.3390/jpm12040513.

Abstract

Despite the rich armamentarium of available drugs against different forms of cardiovascular disease (CVD), major challenges persist in their safe and effective use. These include high rates of adverse drug reactions, increased heterogeneity in patient responses, suboptimal drug efficacy, and in some cases limited compliance. Dietary elements (including food, beverages, and supplements) can modulate drug absorption, distribution, metabolism, excretion, and action, with significant implications for drug efficacy and safety. Genetic variation can further modulate the response to diet, to a drug, and to the interaction of the two. These interactions represent a largely unexplored territory that holds considerable promise in the field of personalized medicine in CVD. Herein, we highlight examples of clinically relevant drug-nutrient-genome interactions, map the challenges faced to date, and discuss their future perspectives in personalized cardiovascular healthcare in light of the rapid technological advances.

摘要

尽管有针对不同形式心血管疾病(CVD)的丰富药物储备,但在其安全有效使用方面仍存在重大挑战。这些挑战包括药物不良反应发生率高、患者反应的异质性增加、药物疗效欠佳,以及在某些情况下依从性有限。饮食因素(包括食物、饮料和补充剂)可调节药物的吸收、分布、代谢、排泄和作用,对药物疗效和安全性有重大影响。基因变异可进一步调节对饮食、药物以及二者相互作用的反应。这些相互作用代表了一个很大程度上未被探索的领域,在CVD个性化医疗领域具有相当大的前景。在此,我们重点介绍临床相关的药物-营养-基因组相互作用的实例,梳理迄今为止面临的挑战,并根据快速的技术进步讨论它们在个性化心血管医疗保健方面的未来前景。

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