Role of pharmacogenomics in dialysis and transplantation.
Role of pharmacogenomics in dialysis and transplantation.
复制标题
DOI：
10.1097/mnh.0000000000000065
复制
发表时间：
2014-11
影响因子：
3.2
通讯作者：
Birdwell K
中科院分区：
文献类型：
--
作者：
Birdwell K
药物基因组学是以个体遗传背景为基础研究药物反应差异的科学。随着基因组技术的迅速进步和基因分型成本的降低，药物基因组学领域继续发展。肾脏疾病患者的应用为改进药物治疗提供了越来越多的机会。药物基因组学研究在慢性肾脏疾病和透析患者中缺乏，但在肾脏移植领域有丰富的研究。在CYP3A5基因中存在一种临床上可操作的遗传变异，初始他克莫司剂量选择基于CYP3A5基因。尽管许多药物基因组学研究都集中在移植免疫抑制药物动力学上，但越来越多的关于钙调神经磷酸酶抑制剂毒性和新发糖尿病等药效学结果的文献正在为高危患者提供新的信息。需要具有明确表型的适当支持的药物基因组学研究来验证现有研究，并在肾脏疾病患者中发现新的发现，特别是慢性肾脏疾病和透析人群。
Pharmacogenomics is the study of differences in drug response based on individual genetic background. With rapidly advancing genomic technologies and decreased costs of genotyping, the field of pharmacogenomics continues to develop. Application to patients with kidney disease provides growing opportunities for improving drug therapy. Pharmacogenomics studies are lacking in patients with chronic kidney disease and dialysis but are abundant in the kidney transplant field. A clinically actionable genetic variant exists in the CYP3A5 gene, with the initial tacrolimus dose selection optimized based on CYP3A5 genotype. Though many pharmacogenomics studies have focused on transplant immunosuppression pharmacokinetics, an expanding literature on pharmacodynamic outcomes like calcineurin inhibitor toxicity and new onset diabetes is providing new information on patients at risk. Appropriately powered pharmacogenomics studies with well-defined phenotypes are needed to validate existing studies and unearth new findings in patients with kidney disease, especially the chronic kidney disease and dialysis population.