Singam Hareesh, Mossad Sherif
Department of Infectious Diseases, Section of Transplant Infectious Diseases, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Genes (Basel). 2025 Sep 9;16(9):1058. doi: 10.3390/genes16091058.
Azoles are the primary agents for antifungal activity in clinical medicine due to their broad-spectrum efficacy and favorable safety profiles compared to older agents. Triazoles, including fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole, have varied pharmacokinetic and pharmacodynamic properties. This is due to various polymorphisms in hepatic enzymes, necessitating genotype-guided dosing and therapeutic drug monitoring (TDM) to optimize treatment outcomes. This review highlights the clinical relevance of pharmacogenomics in azole therapy, particularly the role of cytochrome P450 (CYP450) enzyme polymorphisms in influencing drug levels, efficacy, and toxicity. Understanding these genetic and metabolic factors is essential for personalized antifungal treatment strategies, improving patient safety and therapeutic outcomes.
由于具有广谱疗效且与旧有药物相比安全性良好，唑类药物是临床医学中抗真菌活性的主要药物。三唑类药物，包括氟康唑、伊曲康唑、伏立康唑、泊沙康唑和艾沙康唑，具有不同的药代动力学和药效学特性。这是由于肝酶存在各种多态性，因此需要进行基因型指导的给药和治疗药物监测（TDM）以优化治疗效果。本综述强调了药物基因组学在唑类治疗中的临床相关性，特别是细胞色素P450（CYP450）酶多态性在影响药物水平、疗效和毒性方面的作用。了解这些遗传和代谢因素对于个性化抗真菌治疗策略至关重要，有助于提高患者安全性和治疗效果。
