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小儿氟卡尼药物基因组学：为小儿心律失常提供精准医疗的路线图。

Pediatric flecainide pharmacogenomics: a roadmap to delivering precision-based care to pediatrics arrhythmias.

作者信息

Palmen Ronald, Walton Mollie, Wagner Jonathan

机构信息

Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States.

Division of Cardiology, Kansas City, MO, United States.

出版信息

Front Pharmacol. 2024 Dec 16;15:1477485. doi: 10.3389/fphar.2024.1477485. eCollection 2024.

DOI:10.3389/fphar.2024.1477485
PMID:39741635
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11686437/
Abstract

Flecainide acetate is a Class 1c anti-arrhythmic with a potent sodium voltage gated channel blockade which is utilized for the second-line treatment of tachyarrhythmias in children and adults. Given its narrow therapeutic index, the individualization of drug therapy is of utmost importance for clinicians. Despite efforts to improve anti-arrhythmic drug therapy, there remain knowledge gaps regarding the impact of variation in the genes relevant to flecainide's disposition and response. This variability is compounded in developing children whose drug disposition and response pathways may remain immature. The purpose of this comprehensive review is to outline flecainide's disposition and response pathways while simultaneously highlighting opportunities for prospective investigation in the pediatric population.

摘要

醋酸氟卡尼是一种1c类抗心律失常药物，具有强大的钠电压门控通道阻滞作用，用于儿童和成人快速性心律失常的二线治疗。鉴于其治疗指数狭窄，药物治疗的个体化对临床医生至关重要。尽管人们努力改进抗心律失常药物治疗，但关于与氟卡尼处置和反应相关基因变异的影响仍存在知识空白。这种变异性在发育中的儿童中更为复杂，他们的药物处置和反应途径可能仍未成熟。本综述的目的是概述氟卡尼的处置和反应途径，同时突出在儿科人群中进行前瞻性研究的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a8f/11686437/b7f9b7934545/fphar-15-1477485-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a8f/11686437/0aca9c831502/fphar-15-1477485-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a8f/11686437/b7f9b7934545/fphar-15-1477485-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a8f/11686437/0aca9c831502/fphar-15-1477485-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a8f/11686437/b7f9b7934545/fphar-15-1477485-g002.jpg

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本文引用的文献

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Genes (Basel). 2024 Mar 20;15(3):379. doi: 10.3390/genes15030379.
2
Novel SCN5A gene mutation in a patient affected by multifocal ectopic premature Purkinje-related contractions syndrome.患者受多灶性异位过早浦肯野相关收缩综合征影响，存在新型 SCN5A 基因突变。
ESC Heart Fail. 2024 Aug;11(4):2399-2404. doi: 10.1002/ehf2.14677. Epub 2024 Mar 19.
3
Case report: Use of therapeutic drug monitoring and pharmacogenetic testing as opportunities to individualize care in a case of flecainide toxicity after fetal supraventricular tachycardia.
病例报告：胎儿室上性心动过速后氟卡尼中毒病例中，利用治疗药物监测和药物遗传学检测实现个体化治疗
Front Pediatr. 2023 Jun 28;11:1168619. doi: 10.3389/fped.2023.1168619. eCollection 2023.
4
RYR2-ryanodinopathies: from calcium overload to calcium deficiency.RYR2-ryanodinopathies：从钙超载到钙缺乏。
Europace. 2023 Jun 2;25(6). doi: 10.1093/europace/euad156.
5
Familial atrial fibrillation mutation M1875T-SCN5A increases early sodium current and dampens the effect of flecainide.SCN5A 基因 M1875T 突变导致家族性心房颤动，增加早期钠电流并减弱氟卡尼的作用。
Europace. 2023 Mar 30;25(3):1152-1161. doi: 10.1093/europace/euac218.
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