{"title":"药物基因组学:新的个性化医学方法","authors":"Khizar Hayat","doi":"10.54393/pbmj.v6i09.950","DOIUrl":null,"url":null,"abstract":"Ineffective treatments and the management of adverse drug reactions are responsible for a large proportion of health resources. Drug response and toxicity are significantly influenced by genetic variations in drug-metabolizing enzymes, transporters, and targets. This information may be used to help in selecting the appropriate drug and dosage. One of the newest methods of precision medicine is pharmacogenomics, which adjusts drug selection and dosage based on a patient's genetic characteristics. Pharmacogenomics can reduce the chances of negative effects of the drugs and increase the chances of successful treatment, as the medicines are only for the targeted individuals. It can also revolutionize the healthcare industry to be more specific.
 The main reason that drugs and their dosages are designed based on individuals’ genetic characteristics is that they have a great influence on drug metabolism and its response. The main evidence is the link between dosage requirements and genetic differences in drug transporters such as p-glycoprotein (ABCB1) and OATP-C (SLC21A6), and drug-metabolizing enzymes such as cytochrome P450 (CYP) 2D6, CYP2C19, and CYP2C9. Polymorphisms in these enzymes can alter the drug metabolism phenotype. As these are all proteins translated from genetic information, any change or point mutation can increase or decrease the effectiveness of the enzymes. This can cause more adverse effects in some individuals. Every individual’s body function is unique, and its right to say that the dosage of drugs depends on that.
 Many pharmacogenomic tests and their outcomes have confirmed the potential to improve therapeutic activities. In the field of oncology, the use of this technique to establish a connection between drug metabolism and genetic biomarkers is more reliable, effective, and precise. PD-L1 expression analysis is an example of pharmacogenomics potential. Expression analysis helps physicians select which cancer patients are suitable for immunotherapy techniques. Survival rates for lung and other cancers have drastically increased by comparing the genetic factors and immunotherapies that trigger the immune response against tumors. Similarly, pharmacogenomics has promising potential in antiviral drugs. It targets the genes that influence such drugs to predict treatment success. Therefore, as our understanding of the genome becomes clearer, the potential of pharmacogenomics will also grow.
 Although this is a very promising technique and many scientific organizations are pursuing this approach, there has been very little success in implementing it in clinical trials. Targeted drugs are very costly, as they require the identification of candidate genes and drug responses to these genes. Acceptance is another matter to focus on as most people are not comfortable with these approaches; they prefer conventional approaches. Implementation, cost, acceptance, defining targeted genes, and defining drug responses are all barriers to pharmacogenomics right now. Physicians and patients must adapt to avoid the side effects of drugs by implementing a personalized medicine approach.
 Despite growing interest, the adoption of pharmacogenomics is still in its early stages of development. Attempts to fully apply pharmacogenomics to enhance health will likely take decades. It is important to find a balance between equality concerns across varied populations and increased healthcare efficiency to successfully implement pharmacogenomics. This can be done more effectively through coordinated studies and worldwide collaboration. This not only makes it possible to better utilize resources and knowledge but also sparks political interest in and support for the personalized medicine approach.
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 The main reason that drugs and their dosages are designed based on individuals’ genetic characteristics is that they have a great influence on drug metabolism and its response. The main evidence is the link between dosage requirements and genetic differences in drug transporters such as p-glycoprotein (ABCB1) and OATP-C (SLC21A6), and drug-metabolizing enzymes such as cytochrome P450 (CYP) 2D6, CYP2C19, and CYP2C9. Polymorphisms in these enzymes can alter the drug metabolism phenotype. As these are all proteins translated from genetic information, any change or point mutation can increase or decrease the effectiveness of the enzymes. This can cause more adverse effects in some individuals. Every individual’s body function is unique, and its right to say that the dosage of drugs depends on that.
 Many pharmacogenomic tests and their outcomes have confirmed the potential to improve therapeutic activities. In the field of oncology, the use of this technique to establish a connection between drug metabolism and genetic biomarkers is more reliable, effective, and precise. PD-L1 expression analysis is an example of pharmacogenomics potential. Expression analysis helps physicians select which cancer patients are suitable for immunotherapy techniques. Survival rates for lung and other cancers have drastically increased by comparing the genetic factors and immunotherapies that trigger the immune response against tumors. Similarly, pharmacogenomics has promising potential in antiviral drugs. It targets the genes that influence such drugs to predict treatment success. Therefore, as our understanding of the genome becomes clearer, the potential of pharmacogenomics will also grow.
 Although this is a very promising technique and many scientific organizations are pursuing this approach, there has been very little success in implementing it in clinical trials. Targeted drugs are very costly, as they require the identification of candidate genes and drug responses to these genes. Acceptance is another matter to focus on as most people are not comfortable with these approaches; they prefer conventional approaches. Implementation, cost, acceptance, defining targeted genes, and defining drug responses are all barriers to pharmacogenomics right now. Physicians and patients must adapt to avoid the side effects of drugs by implementing a personalized medicine approach.
 Despite growing interest, the adoption of pharmacogenomics is still in its early stages of development. Attempts to fully apply pharmacogenomics to enhance health will likely take decades. It is important to find a balance between equality concerns across varied populations and increased healthcare efficiency to successfully implement pharmacogenomics. This can be done more effectively through coordinated studies and worldwide collaboration. This not only makes it possible to better utilize resources and knowledge but also sparks political interest in and support for the personalized medicine approach.
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引用次数: 0
摘要
无效的治疗和药物不良反应的管理造成了很大一部分卫生资源的浪费。药物反应和毒性受到药物代谢酶、转运体和靶点的遗传变异的显著影响。该信息可用于帮助选择适当的药物和剂量。精准医疗的最新方法之一是药物基因组学,它根据患者的遗传特征调整药物选择和剂量。药物基因组学可以减少药物产生负面影响的机会,增加治疗成功的机会,因为药物只针对目标个体。它还可以使医疗保健行业变得更加具体。
根据个体的遗传特征来设计药物及其剂量的主要原因是它们对药物代谢及其反应有很大的影响。主要证据是剂量要求与p-糖蛋白(ABCB1)和ooatp - c (SLC21A6)等药物转运体以及细胞色素P450 (CYP) 2D6、CYP2C19和CYP2C9等药物代谢酶的遗传差异有关。这些酶的多态性可以改变药物代谢表型。由于这些都是由遗传信息翻译而来的蛋白质,任何改变或点突变都可以增加或降低酶的有效性。这可能会对某些人造成更多的不良影响。每个人的身体机能都是独一无二的,药物的剂量取决于这一点,这是正确的。许多药物基因组学测试及其结果证实了改善治疗活性的潜力。在肿瘤学领域,利用该技术建立药物代谢与遗传生物标志物之间的联系更加可靠、有效和精确。PD-L1表达分析是药物基因组学潜力的一个例子。表达分析可以帮助医生选择适合免疫治疗技术的癌症患者。通过比较基因因素和触发肿瘤免疫反应的免疫疗法,肺癌和其他癌症的存活率大幅提高。同样,药物基因组学在抗病毒药物方面也有很大的潜力。它针对影响此类药物的基因来预测治疗成功。因此,随着我们对基因组的理解越来越清晰,药物基因组学的潜力也将增长。
尽管这是一项非常有前途的技术,许多科学组织都在追求这种方法,但在临床试验中实施它的成功很少。靶向药物非常昂贵,因为它们需要鉴定候选基因和对这些基因的药物反应。接受度是另一个需要关注的问题,因为大多数人对这些方法感到不舒服;他们更喜欢传统的方法。实施、成本、接受度、确定目标基因和确定药物反应都是目前药物基因组学的障碍。医生和患者必须通过实施个性化的治疗方法来避免药物的副作用。
尽管越来越多的兴趣,药物基因组学的采用仍处于发展的早期阶段。全面应用药物基因组学来改善健康的尝试可能需要几十年的时间。重要的是要在不同人群的平等问题和提高医疗保健效率之间找到平衡,以成功实施药物基因组学。通过协调研究和全球合作,可以更有效地做到这一点。这不仅使更好地利用资源和知识成为可能,而且还激发了对个性化医疗方法的政治兴趣和支持。
Pharmacogenomics: New Personalized Medicine Approach
Ineffective treatments and the management of adverse drug reactions are responsible for a large proportion of health resources. Drug response and toxicity are significantly influenced by genetic variations in drug-metabolizing enzymes, transporters, and targets. This information may be used to help in selecting the appropriate drug and dosage. One of the newest methods of precision medicine is pharmacogenomics, which adjusts drug selection and dosage based on a patient's genetic characteristics. Pharmacogenomics can reduce the chances of negative effects of the drugs and increase the chances of successful treatment, as the medicines are only for the targeted individuals. It can also revolutionize the healthcare industry to be more specific.
The main reason that drugs and their dosages are designed based on individuals’ genetic characteristics is that they have a great influence on drug metabolism and its response. The main evidence is the link between dosage requirements and genetic differences in drug transporters such as p-glycoprotein (ABCB1) and OATP-C (SLC21A6), and drug-metabolizing enzymes such as cytochrome P450 (CYP) 2D6, CYP2C19, and CYP2C9. Polymorphisms in these enzymes can alter the drug metabolism phenotype. As these are all proteins translated from genetic information, any change or point mutation can increase or decrease the effectiveness of the enzymes. This can cause more adverse effects in some individuals. Every individual’s body function is unique, and its right to say that the dosage of drugs depends on that.
Many pharmacogenomic tests and their outcomes have confirmed the potential to improve therapeutic activities. In the field of oncology, the use of this technique to establish a connection between drug metabolism and genetic biomarkers is more reliable, effective, and precise. PD-L1 expression analysis is an example of pharmacogenomics potential. Expression analysis helps physicians select which cancer patients are suitable for immunotherapy techniques. Survival rates for lung and other cancers have drastically increased by comparing the genetic factors and immunotherapies that trigger the immune response against tumors. Similarly, pharmacogenomics has promising potential in antiviral drugs. It targets the genes that influence such drugs to predict treatment success. Therefore, as our understanding of the genome becomes clearer, the potential of pharmacogenomics will also grow.
Although this is a very promising technique and many scientific organizations are pursuing this approach, there has been very little success in implementing it in clinical trials. Targeted drugs are very costly, as they require the identification of candidate genes and drug responses to these genes. Acceptance is another matter to focus on as most people are not comfortable with these approaches; they prefer conventional approaches. Implementation, cost, acceptance, defining targeted genes, and defining drug responses are all barriers to pharmacogenomics right now. Physicians and patients must adapt to avoid the side effects of drugs by implementing a personalized medicine approach.
Despite growing interest, the adoption of pharmacogenomics is still in its early stages of development. Attempts to fully apply pharmacogenomics to enhance health will likely take decades. It is important to find a balance between equality concerns across varied populations and increased healthcare efficiency to successfully implement pharmacogenomics. This can be done more effectively through coordinated studies and worldwide collaboration. This not only makes it possible to better utilize resources and knowledge but also sparks political interest in and support for the personalized medicine approach.