The pharmacogenetic – An opportunity to improve prescribing safety and efficacy – Ketan Zota

New Delhi, July 22, 2016: Medicines are those external force that acts as a bandage to your ill-health. Earlier times noticed the making of medicines the traditional way but as the years changed with the influence of technology, the scientists since then have been researching on all the possible cure methods for every kind of health issue. The cultural changes have also been a benefit for the medical institutions to grow in terms of adapting new methods with an ease. It is true that a mother’s care is the most effective medicine but a well-researched method just cures your ill-health in time without leaving any traces of harmful side-effects. The difference in our health is noticed when there are linked series of chemical reactions occurring within a cell. Pharmacogenetics is the study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs, both in terms of therapeutic effect as well as adverse effects. Though the field of pharmacogenetic was established in 1950s, the adoption of new tests for the variants of pharmacogenetic has recently become available to the institutions and clinicians that guide pharmacotherapy. These variants are implicated in inter-individual drug response. Pharmacogenetics is largely used in relation to genes determining drug metabolism. The term pharmacogenetics is often used interchangeably with the term pharmacogenomics, the latter being a broader based term that encompasses all genes in the genome that may determine drug response. Health being the greatest of all possessions, one never fails to rely on the doctor and their medications even if they catch cold. The wider use of pharmacogenetic testing is viewed by many as an outstanding opportunity to improve prescribing safety and efficacy. Thus, scientists and doctors are using this new technology for a variety of things, one being improving the efficacy of drugs.

Talking about its history, the field of pharmacogenetics was not officially recognized until 1959 when the term “pharmacogenetics” was first published by the German physician Friedrich Vogel. One of the most influential discoveries for pharmacogenetics and its potential clinical utility was the identification in 1977 of the hepatic cytochrome P450 oxidase that controls debrisoquine and sparteine metabolism. Since then there have been numerous landmarks that have shaped this field of research, and have led to the current wave of interest. Variation within the human genome is seen about every 500–1000 bases. Variation in the N-acetyltransferase gene divides people into “slow acetylators” and “fast acetylators”, with very different half-lives and blood concentrations of such important drugs asisoniazid (antituberculosis) and procainamide (antiarrhythmic). As part of the inborn system for clearing the body of xenobiotics, the cytochrome P450 oxidases (CYPs) are heavily involved in drug metabolism, and genetic variations in CYPs affect large populations. Importantly, CYP2D6 is also prone to copy number variation, including full gene deletion and duplication, which can significantly influence the interpretation of CYP2D6 sequencing, genotyping, and phenotype prediction. Since the initial discovery of CYP2D6 and its important role in drug metabolism, CYP2D6 genotypes have been correlated with four general metabolism phenotypes: ultra-rapid, extensive, intermediate, and poor. Now that clinical DNA-basedCYP2D6 testing is available, interpretation of a patient’s genotype typically includes one of these predicted metabolism phenotypes. However, it should be emphasized that this is only a prediction and not based on individual pharmacokinetic measurements.

We spend our health in gaining success, respect, money but years down the lane we spend some money to cure our health. With the advancement in the medical field, the practice of pharmacogenetics was at a kick-start. The clinical experiments did not only help the scientists and clinicians to analyse the drug compositions accurately but also helped them in formulating effective combination for curing the genetic variations. One of the earliest tests for a genetic variation resulting in a clinically important consequence was on the enzyme thiopurine methyltransferase (TPMT). TPMT metabolizes 6-mercaptopurine and azathioprine, two thiopurine drugs used in a range of indications, from childhood leukemia to autoimmune diseases. Another performed test was for the polymorphism near a human interferon gene that is predictive of the effectiveness of an artificial interferon treatment for Hepatitis C. For genotype 1 hepatitis C treated with Pegylated interferon-alpha-2a or Pegylated interferon-alpha-2b (brand names Pegasys or PEG-Intron) combined with ribavirin. Moreover, highly multiplexed genotyping assays enriched for important pharmacogenetic genes and functional variants have been commercially developed for both research and clinical use,prompting the possibility of providing individuals with a predicted drug metabolism phenotype profile. As the cost per genetic test decreases, the development of personalized drug therapies will increase.The need to stay modernized along with time is important when it comes to health. Technology now allows for genetic analysis of hundreds of target genes involved in medication metabolism and response in less than 24 hours for under $1,000. This is a huge step towards bringing pharmacogenetic technology into everyday medical decisions.

Spending on your health to be perfect makes more sense than spending money on junk that ruins your health. Medical field is just witnessing a mode of accelerated growth when it comes to the involvement of technology in their clinical experiments and tests. With machines and instruments being well-equipped to increasing the knowledge about a particular drug does not only result in a successful test but the scientists also get a green signal to ask the doctors to perform that particular test on patients as well. Still Pharmacogenetics has become a controversial issue in the area of bioethics. It’s a new topic to the medical field, as well as the public. This new technique will have a huge impact on society, influencing the treatment of both common and rare diseases. Pharmacogenetics is expensive yet controversial because of its elongated process and the high level of risk involved in resulting out a successful test. Since it is a new topic in the field of medical, the ethics of it are not clear but yet few of them have been addressed with proven solutions. Pharmacogenetics is a new process that may increase the benefits of medicine while decreasing the risk.

Corporate Comm India (CCI Newswire)