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Pharmacogenics to make patients' lives easier

Pharmacogenics, the study of the relationship between pharmaceuticals and genetics, is finding a niche in today's research world. Experts believe that safer pharmaceutical drugs can emerge from state-of-the-art genetic screening. The European Science Foundation (ESF), together...

Pharmacogenics, the study of the relationship between pharmaceuticals and genetics, is finding a niche in today's research world. Experts believe that safer pharmaceutical drugs can emerge from state-of-the-art genetic screening. The European Science Foundation (ESF), together with the University of Barcelona in Spain, called on leading scientists to join the pharmacogenics trend. At a recent forum in the Spanish coastal region of Costa Brava, experts said the upshot of the use of pharmacogenetics is the emergence of fewer side effects of drugs and an accelerated drug development process. Even more to the point is that it acts like a filter, where scientists can focus solely on the most promising compounds, while placing unsuitable compounds in the bin. At the end of the day, both scientists and patients will benefit. From a patient's perspective, pharmacogenetics is making major headway in a period where scientists are targeting personalised medicine development for those in need. The drugs patients will consume and the treatments they will undergo will be tailored to their circumstances and genetic makeup, according to the ESF. Studying how the actions and reactions to drugs vary according to a patient's genes is vital, the experts said. 'It was confirmed by the conference that we need to ensure we have the appropriate study designs including randomised controlled trials to unravel the complexity of variable drug responses,' explained Professor Munir Pirmohamed from the University of Liverpool, UK. 'We need to embrace the new technologies such as whole genome scans to identify novel and known genetic predisposing factors,' the conference chair added. Professor Pirmohamed commented that a number of factors trigger side effects, including immune response, drug transport and unexpected metabolic pathways. However, he noted that side effects fall into two main categories: type A and type B. 'The majority (80%-90%) of adverse drug reactions are type A - they are predictable from the known pharmacology of the drug, are dose-dependent, and can be alleviated by reducing or identifying the correct dose for the patient,' he said. The University of Liverpool researcher used warfarin, an anti-coagulant, to get his point across. Warfarin is typically used to prevent blood clotting in patients. However, if blood does not clot, it could result in a patient bleeding to death. So a correct dose of warfarin must be given to ensure that the patient does not die from blood clotting or haemorrhaging. Pharmacogenetics makes this possible. 'Genetic factors can be important here,' he commented. The remaining drug reactions are type B. These responses, according to the experts, may be genetically dependent or alternatively shared by patients taking the drug. It has been harder to identify type B reactions when animal testing and other existing methods are used, they said. The role of pharmacogenetics for type B reactions is crucial for recognising which reactions are potentially lethal, even those involving the immune system's memory cells, the ESF said. 'The immune system is important in adverse reactions, and this conference did focus on certain aspects of predisposition to immune mediated reactions,' Professor Pirmohamed explained. The conference also put the Human Leukocyte Antigen (HLA) system in the spotlight. This system not only directs the production and operation of immunity proteins, but is the source of the individual variation in immune response leading to population-wide protection against disease and rejection of incompatible blood, tissue or donated organs, the ESF said. 'It is clear from the conference, and from the findings over the last few years, that the HLA system plays a major role in predisposing to certain immune mediated adverse reactions,' Professor Pirmohamed remarked.

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