用于治疗脑部疾病的药物基因组学

IF 1 Q4 PHARMACOLOGY & PHARMACY
R. Cacabelos
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引用次数: 11

摘要

神经精神疾病(npd)(神经发育、精神、神经退行性、神经毒性、复杂疾病)是发达国家的第三大健康问题。大约10-20%的直接费用用于药物治疗;然而,在大多数非传染性疾病中,药物有效性低于30%。药物基因组学解释了60-90%的药代动力学和药效学变异。主要涉及的领域包括(i)药物遗传机制的组织(病原性、机械性、代谢性、转运性、多效性基因);(ii)抗抑郁药、抗精神病药、抗焦虑药、抗癫痫药、抗阿尔茨海默病药、抗帕金森药和抗中风药的药物基因组学;(三)药物不良反应和耐药性。npd的药物基因组学仍然是原始的,但足以帮助医生通过减少不良反应(锥体外系症状、迟发性运动障碍、神经毒性、脑血管损伤)和不必要的费用来优化药物治疗。超过50%的精神药物的处方是错误的。CYP酶参与90%以上npd治疗药物的代谢。只有20%的人群是目前80%精神药物的潜在广泛代谢者。因此,在临床环境中引入药物基因组学程序是提高药物疗效和安全性的迫切需要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pharmacogenomics of drugs used to treat brain disorders
ABSTRACT Introduction Neuropsychiatric disorders (NPDs) (neurodevelopmental, mental, neurodegenerative, neurotoxic, complex disorders) are the third major problem of health in developed countries. About 10-20% of direct costs are attributed to pharmacological treatment; however, drug effectiveness is lower than 30% in most NPDs. Pharmacogenomics accounts for 60-90% variability in pharmacokinetics and pharmacodynamics. Areas covered Main areas covered include (i) organization of the pharmacogenetic machinery (pathogenic, mechanistic, metabolic, transporter, pleiotropic genes); (ii) pharmacogenomics of antidepressants, antipsychotics, anxiolytics, antiepileptics, anti-Alzheimer, anti-Parkinson, and anti-stroke drugs; and (iii) adverse drug reactions and pharmaco-resistance. Expert commentary The pharmacogenomics of NPDs is still primitive, but sufficient to help physicians to optimize pharmacological treatment by reducing ADRs (extrapyramidal symptoms, tardive dyskinesia, neurotoxicity, cerebrovascular damage) and unnecessary costs. Over 50% of psychotropic drugs are incorrectly prescribed. CYP enzymes participate in the metabolism of over 90% of drugs for the treatment of NPDs. Only 20% of the population is potentially extensive metabolizer for 80% of current psychotropic agents. Consequently, the introduction of pharmacogenomic procedures in the clinical setting is an urgent need for improving drug efficacy and safety.
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来源期刊
CiteScore
2.30
自引率
0.00%
发文量
9
期刊介绍: Expert Review of Precision Medicine and Drug Development publishes primarily review articles covering the development and clinical application of medicine to be used in a personalized therapy setting; in addition, the journal also publishes original research and commentary-style articles. In an era where medicine is recognizing that a one-size-fits-all approach is not always appropriate, it has become necessary to identify patients responsive to treatments and treat patient populations using a tailored approach. Areas covered include: Development and application of drugs targeted to specific genotypes and populations, as well as advanced diagnostic technologies and significant biomarkers that aid in this. Clinical trials and case studies within personalized therapy and drug development. Screening, prediction and prevention of disease, prediction of adverse events, treatment monitoring, effects of metabolomics and microbiomics on treatment. Secondary population research, genome-wide association studies, disease–gene association studies, personal genome technologies. Ethical and cost–benefit issues, the impact to healthcare and business infrastructure, and regulatory issues.
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