Pharmacogenetics
Genes will tell you which medicine is suitable
The Basis Genotech Group Company, press-release.ru
In the middle of the 20th century, medicine has already clearly established that people react differently to the same medicines. One patient demonstrates a positive recovery dynamics after taking the drug, while the other does not help at all or even causes an allergic reaction. Then the science of pharmacogenetics was born, combining two directions: pharmacology and genetics. It analyzes the relationship between a person's genetic characteristics and his reaction to various medications and medications.
The highest stage in the development of pharmacogenetics occurred at the end of the 20th century, when the human genome was almost completely decoded. This made it possible to compare how polymorphisms of certain genes affect the body's susceptibility to drugs and their doses. On the basis of this knowledge, a new science "pharmacogenomics" was formed. She is already directly engaged in the selection of effective and safe medicines for a certain human genotype. This is a young but promising science that began to be put into practice only in the 21st century. This is a big step towards personalized medicine, which assumes that the main priority of the doctor is to make the individuality and peculiarity of each patient instead of treating all patients according to the same scheme. In the future, pharmacogenomics is capable of upending humanity's idea of medicine, since doctors will no longer prescribe drugs to patients by trial and error.
Pharmacogenomics on the example of hormone therapy
Hormone therapy is quite popular in modern medicine. But, there must be good reasons for its use, since the hormonal balance is a delicate structure that is easy to break and then very difficult to restore. Moreover, hormonal drugs often have a large set of possible side effects. Therefore, the wrong tactics of hormonal treatment can cause damage to health. The science of pharmacogenomics helps the doctor to choose the most effective hormonal drug in a particular case, prescribe ideal dosages and avoid side effects.
The genes of the cytochrome P450 family are responsible for the metabolism and proper assimilation of drugs. The absorption of a hormonal drug, like any other medical drug, in the body goes through two stages. The first stage is the oxidation process. If a person has polymorphisms in the genes of the first phase of hormone biotransformation, then he may form intermediates that will be many times more active than the original ones. Because of this, the effect of excessive oxidized forms of the drug may be increased and this will lead to a negative reaction of the body to the drug, at normal dosages.
The second stage is detoxification, during which the combination of glutathione and oxidized metabolites of the first stage occurs. The genes of the glutathione-S-transferase superfamily encode enzymes of the xenobiotic detoxification system (including hormonal drugs). If there are "breakdowns" in these genes, then this leads to an increase in the circulation cycle of active phase I metabolites in the blood, as a result of which the body becomes more sensitive to the negative effects of the drug.
Pharmacogenomics helps to avoid side effects of the drug
As you know, the main side effect of many hormonal agents is blood thickening. This is dangerous by the formation of blood clots, which in particularly severe stages can lead to death. In addition, a high genetic risk of venous thrombosis in a woman may also entail a predisposition to pregnancy complications.
The activity of the blood coagulation system is genetically inherent in a person. If there are mutations in the genes responsible for blood clotting, then taking hormonal drugs will entail a high risk of thrombophilia, even with normal hormone levels. When prescribing hormone therapy, the doctor will take into account these genetic characteristics of the patient and will not prescribe drugs or dosages that may negatively affect the circulatory system.
Similarly to the above example, pharmacogenomics also applies to all other groups of drugs. Thus, taking into account the genetic characteristics, the doctor can choose the best possible treatment for the patient from the first time and avoid unexpected reactions to the drug.
What else can pharmacogenetics and pharmacogenomics do
1. New generation pharmaceuticals. Based on the knowledge of genotypes, it is possible not only to select medicines for patients, but also to develop more effective drugs with a minimum number of side effects. That is, these sciences can give a powerful impetus to the innovative development of pharmaceuticals.
2. Selection of doses of drugs. For example, each person has the ability to assimilate certain vitamins at the genetic level. For example, the BCMO1 gene is responsible for the concentration of vitamin A in the blood. If a person has a polymorphism in this gene, his vitamin A concentration level will be permanently reduced, especially if he is a vegetarian. Knowing these data, the doctor will be able to conclude that such a patient should be recommended vitamin A in increased doses and in a certain pharmacological form.
3. Improvement of vaccination. Based on deep knowledge of DNA and RNA, the most effective vaccines are being developed. Side effects from them are reduced to zero, but they affect the immune system better than before.
Of course, now pharmacogenetics and pharmacogenomics are still at the stage of development, but in the near future these sciences will show themselves in all their glory, becoming the basis of preventive and personalized medicine of the future.
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