儿童医学中药物代谢酶和转运体的药物遗传学:研究进展、临床实践和未来展望。

IF 3.4 3区 医学 Q1 PEDIATRICS
Jinxia Zhao, Jialu Bian, Yinyu Zhao, Yuanyuan Li, Boyu Liu, Xu Hao, Shiyu He, Lin Huang
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引用次数: 0

摘要

由于某些药物代谢酶或转运蛋白的活性可能随年龄而变化,个体发生和遗传变异对这些酶活性的影响对于准确预测儿童的治疗结果和毒性至关重要。这使得儿科药物遗传学研究尤为重要和迫切需要,但也具有挑战性。本综述总结了遗传多态性对某些药物在儿科人群中的药代动力学参数和临床结果影响的药物遗传学研究,这些药物通常由综合医院多个治疗领域的临床医生开出,从每个药物类别中儿科证据最多到最少。并进一步讨论了基因引导给药方案及儿科药物遗传学临床应用的研究现状。越来越多的药物-基因相互作用被证明对儿童具有临床有效性,儿科药物基因组学已经显示出基于证据的益处,可以提高一些治疗领域现有药物给药方案的疗效和准确性。然而,实施的最重要的限制是缺乏高质量,严格的儿科前瞻性临床研究,因此仍然需要充分支持药物遗传学纳入儿童护理的介入临床试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pharmacogenetic Aspects of Drug Metabolizing Enzymes and Transporters in Pediatric Medicine: Study Progress, Clinical Practice and Future Perspectives.

As the activity of certain drug metabolizing enzymes or transporter proteins can vary with age, the effect of ontogenetic and genetic variation on the activity of these enzymes is critical for the accurate prediction of treatment outcomes and toxicity in children. This makes pharmacogenetic research in pediatrics particularly important and urgently needed, but also challenging. This review summarizes pharmacogenetic studies on the effects of genetic polymorphisms on pharmacokinetic parameters and clinical outcomes in pediatric populations for certain drugs, which are commonly prescribed by clinicians across multiple therapeutic areas in a general hospital, organized from those with the most to the least pediatric evidence among each drug category. We also further discuss the research status of the gene-guided dosing regimens and clinical implementation of pediatric pharmacogenetics. More and more drug-gene interactions are demonstrated to have clinical validity for children, and pharmacogenomics in pediatrics have shown evidence-based benefits to enhance the efficacy and precision of existing drug dosing regimens in several therapeutic areas. However, the most important limitation to the implementation is the lack of high-quality, rigorous pediatric prospective clinical studies, so adequately powered interventional clinical trials that support incorporation of pharmacogenetics into the care of children are still needed.

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来源期刊
Pediatric Drugs
Pediatric Drugs PEDIATRICS-PHARMACOLOGY & PHARMACY
CiteScore
7.20
自引率
0.00%
发文量
54
审稿时长
>12 weeks
期刊介绍: Pediatric Drugs promotes the optimization and advancement of all aspects of pharmacotherapy for healthcare professionals interested in pediatric drug therapy (including vaccines). The program of review and original research articles provides healthcare decision makers with clinically applicable knowledge on issues relevant to drug therapy in all areas of neonatology and the care of children and adolescents. The Journal includes: -overviews of contentious or emerging issues. -comprehensive narrative reviews of topics relating to the effective and safe management of drug therapy through all stages of pediatric development. -practical reviews covering optimum drug management of specific clinical situations. -systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. -Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in the pediatric population. -original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pediatric Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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