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药物遗传学的应用能否提高新冠病毒肺炎的治疗效率?

Will the Use of Pharmacogenetics Improve Treatment Efficiency in COVID-19?

作者信息

Franczyk Beata, Rysz Jacek, Miłoński Jarosław, Konecki Tomasz, Rysz-Górzyńska Magdalena, Gluba-Brzózka Anna

机构信息

Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland.

Department of Otolaryngology, Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, 90-549 Lodz, Poland.

出版信息

Pharmaceuticals (Basel). 2022 Jun 13;15(6):739. doi: 10.3390/ph15060739.

Abstract

The COVID-19 pandemic is associated with a global health crisis and the greatest challenge for scientists and doctors. The virus causes severe acute respiratory syndrome with an outcome that is fatal in more vulnerable populations. Due to the need to find an efficient treatment in a short time, there were several drugs that were repurposed or repositioned for COVID-19. There are many types of available COVID-19 therapies, including antiviral agents (remdesivir, lopinavir/ritonavir, oseltamivir), antibiotics (azithromycin), antiparasitics (chloroquine, hydroxychloroquine, ivermectin), and corticosteroids (dexamethasone). A combination of antivirals with various mechanisms of action may be more efficient. However, the use of some of these medicines can be related to the occurrence of adverse effects. Some promising drug candidates have been found to be ineffective in clinical trials. The knowledge of pharmacogenetic issues, which translate into variability in drug conversion from prodrug into drug, metabolism as well as transport, could help to predict treatment efficiency and the occurrence of adverse effects in patients. However, many drugs used for the treatment of COVID-19 have not undergone pharmacogenetic studies, perhaps as a result of the lack of time.

摘要

新冠疫情与全球健康危机相关,是科学家和医生面临的最大挑战。该病毒会引发严重急性呼吸综合征,在较脆弱人群中会导致致命后果。由于需要在短时间内找到有效治疗方法,有几种药物被重新用于治疗新冠。现有多种新冠治疗方法,包括抗病毒药物(瑞德西韦、洛匹那韦/利托那韦、奥司他韦)、抗生素(阿奇霉素)、抗寄生虫药物(氯喹、羟氯喹、伊维菌素)以及皮质类固醇(地塞米松)。作用机制各异的抗病毒药物联合使用可能更有效。然而,使用其中一些药物可能会出现不良反应。一些有前景的候选药物在临床试验中被发现无效。药物遗传学问题,即前体药物转化为药物、代谢以及转运过程中的变异性,其相关知识有助于预测患者的治疗效果和不良反应的发生。然而,许多用于治疗新冠的药物尚未进行药物遗传学研究,这可能是由于时间紧迫。

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