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药物基因组学对心血管治疗的变革:一篇综述

Pharmacogenomics revolutionizing cardiovascular therapeutics: A narrative review.

作者信息

Inshutiyimana Samuel, Ramadan Nagham, Razzak Rawane Abdul, Al Maaz Zeina, Wojtara Magda, Uwishema Olivier

机构信息

Department of Research and Education Oli Health Magazine Organization Kigali Rwanda.

Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy and Health Sciences United States International University-Africa Nairobi Kenya.

出版信息

Health Sci Rep. 2024 Oct 20;7(10):e70139. doi: 10.1002/hsr2.70139. eCollection 2024 Oct.

Abstract

BACKGROUND AND AIM

Among the cardiovascular diseases (CVDs), heart failure, hypertension, and myocardial infarction are associated with the greatest number of disability-adjusted life years due to lifestyle changes and the failure of therapeutic approaches, especially the one-size-fits-all interventions. As a result, there has been advances in defining genetic variants responsible for different responses to cardiovascular drugs such as antiplatelets, anticoagulants, statins, and beta-blockers, which has led to their usage in guiding treatment plans. This study comprehensively reviews the current state-of-the-art potential of pharmacogenomics in dramatically altering CVD treatment. It stresses the applicability of pharmacogenomic technology, the threats associated with its adoption in the clinical setting, and proffers relevant solutions.

METHODS

Literature search strategies were used to retrieve articles from various databases: PubMed, Google Scholar, and EBSCOhost. Articles with information relevant to pharmacogenomics, DNA variants, cardiovascular diseases, sequencing techniques, and drug responses were reviewed and analyzed.

RESULTS

DNA-based technologies such as next generation sequencing, whole genome sequencing, whole exome sequencing, and targeted segment sequencing can identify variants in the human genome. This has played a substantial role in identifying different genetic variants governing the poor response and adverse effects associated with cardiovascular drugs. Thus, this has reduced patients' number of emergency visits and hospitalization.

CONCLUSION

Despite the emergence of pharmacogenomics, its implementation has been threatened by factors including patient compliance and a low adoption rate by clinicians. Education and training programs targeting both healthcare professionals and patients should be established to increase the acceptance and application of the emerging pharmacogenomic technologies in reducing the burden of CVDs.

摘要

背景与目的

在心血管疾病(CVD)中,由于生活方式的改变以及治疗方法的失效,尤其是“一刀切”的干预措施,心力衰竭、高血压和心肌梗死与最多的残疾调整生命年相关。因此,在确定导致对心血管药物(如抗血小板药物、抗凝剂、他汀类药物和β受体阻滞剂)产生不同反应的基因变异方面取得了进展,这使得这些基因变异可用于指导治疗方案。本研究全面综述了药物基因组学在显著改变心血管疾病治疗方面的当前先进潜力。它强调了药物基因组技术的适用性、在临床环境中采用该技术所带来的威胁,并提出了相关解决方案。

方法

采用文献检索策略从多个数据库检索文章:PubMed、谷歌学术和EBSCOhost。对与药物基因组学、DNA变异、心血管疾病、测序技术和药物反应相关的文章进行了综述和分析。

结果

基于DNA的技术,如下一代测序、全基因组测序、全外显子组测序和靶向片段测序,可以识别人类基因组中的变异。这在识别导致对心血管药物反应不佳和不良反应的不同基因变异方面发挥了重要作用。因此,这减少了患者的急诊就诊次数和住院次数。

结论

尽管药物基因组学已经出现,但其实施受到包括患者依从性和临床医生采用率低等因素的威胁。应针对医疗保健专业人员和患者建立教育和培训项目,以提高新兴药物基因组技术在减轻心血管疾病负担方面的接受度和应用。

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