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药物遗传学检测在优化青少年抗抑郁药物治疗中的应用:一项叙述性文献综述

Utility of pharmacogenetic testing to optimise antidepressant pharmacotherapy in youth: a narrative literature review.

作者信息

Roberts Bradley, Cooper Zahra, Lu Stephanie, Stanley Susanne, Majda Bernadette T, Collins Khan R L, Gilkes Lucy, Rodger Jennifer, Akkari P Anthony, Hood Sean D

机构信息

The Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.

School of Biological Sciences, University of Western Australia, Crawley, WA, Australia.

出版信息

Front Pharmacol. 2023 Sep 19;14:1267294. doi: 10.3389/fphar.2023.1267294. eCollection 2023.

Abstract

Pharmacogenetics (PGx) is the study and application of how interindividual differences in our genomes can influence drug responses. By evaluating individuals' genetic variability in genes related to drug metabolism, PGx testing has the capabilities to individualise primary care and build a safer drug prescription model than the current "one-size-fits-all" approach. In particular, the use of PGx testing in psychiatry has shown promising evidence in improving drug efficacy as well as reducing toxicity and adverse drug reactions. Despite randomised controlled trials demonstrating an evidence base for its use, there are still numerous barriers impeding its implementation. This review paper will discuss the management of mental health conditions with PGx-guided treatment with a strong focus on youth mental illness. PGx testing in clinical practice, the concerns for its implementation in youth psychiatry, and some of the barriers inhibiting its integration in clinical healthcare will also be discussed. Overall, this paper provides a comprehensive review of the current state of knowledge and application for PGx in psychiatry and summarises the capabilities of genetic information to personalising medicine for the treatment of mental ill-health in youth.

摘要

药物遗传学(PGx)是研究和应用个体基因组差异如何影响药物反应的学科。通过评估个体在与药物代谢相关基因中的遗传变异性,PGx检测有能力使初级保健个性化,并建立一个比当前“一刀切”方法更安全的药物处方模型。特别是,PGx检测在精神病学中的应用已显示出在提高药物疗效以及降低毒性和药物不良反应方面的有力证据。尽管随机对照试验证明了其使用的证据基础,但仍有许多障碍阻碍其实施。这篇综述文章将讨论以PGx为指导的治疗对心理健康状况的管理,重点关注青少年精神疾病。还将讨论PGx检测在临床实践中的应用、在青少年精神病学中实施的相关问题以及一些阻碍其融入临床医疗保健的障碍。总体而言,本文全面回顾了PGx在精神病学中的知识现状和应用,并总结了遗传信息在为青少年精神疾病治疗实现个性化医疗方面的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ad/10545970/4b0bea293df0/fphar-14-1267294-g001.jpg

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