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儿科药物过敏的遗传标志物:现状与前景。

Genetic markers of drug hypersensitivity in pediatrics: current state and promise.

机构信息

Department of Paediatrics Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Department of Physiology and Pharmacology Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

出版信息

Expert Rev Clin Pharmacol. 2022 Jun;15(6):715-728. doi: 10.1080/17512433.2022.2100345. Epub 2022 Jul 21.

Abstract

INTRODUCTION

Drug hypersensitivity reactions (DHRs) represent a great challenge to clinicians due to their unpredictability and severity, notably being potentially fatal. Genetic markers for DHRs have been emerging as potential valuable clinical tools for prediction and diagnosis of DHRs. Dedicated pediatric studies in this field are scarce and many published studies lack key data in this regard.

AREA COVERED

This review briefly covers the current status of the use and validation of genetic markers for drug hypersensitivity in pediatrics. Classification, epidemiology and pathophysiology of DHRs are also briefly described. We searched PubMed, Ovid Medline, Web of Science, Scopus and Google Scholar literature databases for all relevant articles published from their date of commencement to March 2022. We summarized the current existing evidence and discussed the role and potential of pharmacogenomic testing in management of DHRs in pediatrics.

EXPERT OPINION

Several genetic markers for DHRs in children have been identified and proven to be useful tools for prediction, diagnosis, and management of these adverse reactions. However, data in pediatric populations is still limited and confined to specific drugs in specific ethnic groups. Further research is needed to identify and validate more genetic markers to help guide drug therapy in children.

摘要

简介

药物过敏反应(DHRs)由于其不可预测性和严重性,对临床医生来说是一个巨大的挑战,尤其是可能致命的。药物过敏反应的遗传标志物已成为预测和诊断 DHRs 的潜在有价值的临床工具。该领域专门针对儿科的研究很少,许多已发表的研究在这方面缺乏关键数据。

涵盖领域

本文简要介绍了目前在儿科中使用和验证药物过敏遗传标志物的现状。DHRs 的分类、流行病学和病理生理学也作了简要描述。我们检索了 PubMed、Ovid Medline、Web of Science、Scopus 和 Google Scholar 文献数据库,以获取从其开始日期到 2022 年 3 月发表的所有相关文章。我们总结了目前存在的证据,并讨论了药物基因组检测在儿科 DHRs 管理中的作用和潜力。

专家意见

已经确定了几种儿童药物过敏反应的遗传标志物,并且已被证明是预测、诊断和管理这些不良反应的有用工具。然而,儿科人群的数据仍然有限,仅限于特定种族群体的特定药物。需要进一步研究以确定和验证更多的遗传标志物,以帮助指导儿童的药物治疗。

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