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定制抗糖尿病疗法的决定因素:个性化方法

Determinants in Tailoring Antidiabetic Therapies: A Personalized Approach.

作者信息

Rizvi Aliya A, Abbas Mohammad, Verma Sushma, Verma Shrikant, Khan Almas, Raza Syed T, Mahdi Farzana

机构信息

Department of Personalized and Molecular Medicine, Era University, Lucknow, Uttar Pradesh, India.

Department of Biochemistry, Era University, Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.

出版信息

Glob Med Genet. 2022 Jun 13;9(2):63-71. doi: 10.1055/s-0041-1741109. eCollection 2022 Jun.

Abstract

Diabetes has become a pandemic as the number of diabetic people continues to rise globally. Being a heterogeneous disease, it has different manifestations and associated complications in different individuals like diabetic nephropathy, neuropathy, retinopathy, and others. With the advent of science and technology, this era desperately requires increasing the pace of embracing precision medicine and tailoring of drug treatment based on the genetic composition of individuals. It has been previously established that response to antidiabetic drugs, like biguanides, sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide 1 (GLP-1) agonists, and others, depending on variations in their transporter genes, metabolizing genes, genes involved in their action, etc Responsiveness of these drugs also relies on epigenetic factors, including histone modifications, miRNAs, and DNA methylation, as well as environmental factors and the lifestyle of an individual. For precision medicine to make its way into clinical procedures and come into execution, all these factors must be reckoned with. This review provides an insight into several factors oscillating around the idea of precision medicine in type-2 diabetes mellitus.

摘要

随着全球糖尿病患者数量持续增加,糖尿病已成为一种流行病。作为一种异质性疾病,它在不同个体中有不同表现及相关并发症,如糖尿病肾病、神经病变、视网膜病变等。随着科技的出现,这个时代迫切需要加快采用精准医学的步伐,并根据个体的基因组成定制药物治疗。此前已经确定,抗糖尿病药物(如双胍类、磺脲类、二肽基肽酶-4 [DPP-4] 抑制剂、胰高血糖素样肽1 [GLP-1] 激动剂等)的反应取决于其转运基因、代谢基因、参与其作用的基因等的变异。这些药物的反应性还依赖于表观遗传因素,包括组蛋白修饰、微小RNA和DNA甲基化,以及环境因素和个体的生活方式。为使精准医学进入临床程序并得以实施,必须考虑所有这些因素。本综述深入探讨了围绕2型糖尿病精准医学理念的几个因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d7e/9192178/9d1071900347/10-1055-s-0041-1741109-i2100054-1.jpg

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