Pharmacogenomics

Epitranscriptional regulation of TGF-β pseudoreceptor BAMBI by m6A/YTHDF2 drives extrinsic radioresistance

Fri, 2023-12-15 06:00

J Clin Invest. 2023 Dec 15;133(24):e172919. doi: 10.1172/JCI172919.

ABSTRACT

Activation of TGF-β signaling serves as an extrinsic resistance mechanism that limits the potential for radiotherapy. Bone morphogenetic protein and activin membrane-bound inhibitor (BAMBI) antagonizes TGF-β signaling and is implicated in cancer progression. However, the molecular mechanisms of BAMBI regulation in immune cells and its impact on antitumor immunity after radiation have not been established. Here, we show that ionizing radiation (IR) specifically reduces BAMBI expression in immunosuppressive myeloid-derived suppressor cells (MDSCs) in both murine models and humans. Mechanistically, YTH N6-methyladenosine RNA-binding protein F2 (YTHDF2) directly binds and degrades Bambi transcripts in an N6-methyladenosine-dependent (m6A-dependent) manner, and this relies on NF-κB signaling. BAMBI suppresses the tumor-infiltrating capacity and suppression function of MDSCs via inhibiting TGF-β signaling. Adeno-associated viral delivery of Bambi (AAV-Bambi) to the tumor microenvironment boosts the antitumor effects of radiotherapy and radioimmunotherapy combinations. Intriguingly, combination of AAV-Bambi and IR not only improves local tumor control, but also suppresses distant metastasis, further supporting its clinical translation potential. Our findings uncover a surprising role of BAMBI in myeloid cells, unveiling a potential therapeutic strategy for overcoming extrinsic radioresistance.

PMID:38099498 | DOI:10.1172/JCI172919

Categories: Literature Watch

Pharmacogenetic aspects of efficacy and safety of methotrexate treatment in pediatric acute lymphoblastic leukemia

Fri, 2023-12-15 06:00

Drug Metab Pers Ther. 2023 Dec 14. doi: 10.1515/dmpt-2023-0079. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the role of ABCB1 (C3435T rs1045642, rs1128503, rs2032582, rs4148738), SLCO1B1 T521C rs4149056 genetic polymorphisms in the development of major types of methotrexate (MTX) toxicities and the occurrence of a terminal event (death, relapse) in pediatric АLL.

METHODS: The study included 124 patients diagnosed with pediatric ALL. All patients treated according to the protocols of the German BFM group (2002/2009) with high-dose (1,000, 2,000 and 5,000 mg/m2) methotrexate. MTX-related toxicities, including hematologic, hepatic and renal, were evaluated according to the common terminology criteria for adverse events version 5.0 (CTCAE v.5.0). Real-time PCR method was used to investigate polymorphisms of ABCB1 and SLCO1B1 genes. The study material was peripheral blood.

RESULTS: A competitive analysis demonstrated significant relationships between MTX ADRs. The results of the study support the existence of relationships between some ADRs and MTX kinetics. An associative analysis showed association with the development of AEs to methotrexate indicating their clinical significance from different genetic polymorphisms protein-transporters. The available results confirm the associations of the studied genes with the increased risk of high doses MTX toxic ADRs and terminal events.

CONCLUSIONS: Complementing the existing criteria for pediatric ALL risk groups with pharmacogenetic indicators will allow further individualization of therapy.

PMID:38098143 | DOI:10.1515/dmpt-2023-0079

Categories: Literature Watch

LINE-1 global DNA methylation, iron homeostasis genes, sex and age in sudden sensorineural hearing loss (SSNHL)

Fri, 2023-12-15 06:00

Hum Genomics. 2023 Dec 14;17(1):112. doi: 10.1186/s40246-023-00562-9.

ABSTRACT

BACKGROUND: Sudden sensorineural hearing loss (SSNHL) is an abrupt loss of hearing, still idiopathic in most of cases. Several mechanisms have been proposed including genetic and epigenetic interrelationships also considering iron homeostasis genes, ferroptosis and cellular stressors such as iron excess and dysfunctional mitochondrial superoxide dismutase activity.

RESULTS: We investigated 206 SSNHL patients and 420 healthy controls for the following genetic variants in the iron pathway: SLC40A1 - 8CG (ferroportin; FPN1), HAMP - 582AG (hepcidin; HEPC), HFE C282Y and H63D (homeostatic iron regulator), TF P570S (transferrin) and SOD2 A16V in the mitochondrial superoxide dismutase-2 gene. Among patients, SLC40A1 - 8GG homozygotes were overrepresented (8.25% vs 2.62%; P = 0.0015) as well SOD2 16VV genotype (32.0% vs 24.3%; P = 0.037) accounting for increased SSNHL risk (OR = 3.34; 1.54-7.29 and OR = 1.47; 1.02-2.12, respectively). Moreover, LINE-1 methylation was inversely related (r2 = 0.042; P = 0.001) with hearing loss score assessed as pure tone average (PTA, dB HL), and the trend was maintained after SLC40A1 - 8CG and HAMP - 582AG genotype stratification (ΔSLC40A1 = + 8.99 dB HL and ΔHAMP = - 6.07 dB HL). In multivariate investigations, principal component analysis (PCA) yielded PC1 (PTA, age, LINE-1, HAMP, SLC40A1) and PC2 (sex, HFEC282Y, SOD2, HAMP) among the five generated PCs, and logistic regression analysis ascribed to PC1 an inverse association with moderate/severe/profound HL (OR = 0.60; 0.42-0.86; P = 0.0006) and with severe/profound HL (OR = 0.52; 0.35-0.76; P = 0.001).

CONCLUSION: Recognizing genetic and epigenetic biomarkers and their mutual interactions in SSNHL is of great value and can help pharmacy science to design by pharmacogenomic data classical or advanced molecules, such as epidrugs, to target new pathways for a better prognosis and treatment of SSNHL.

PMID:38098073 | DOI:10.1186/s40246-023-00562-9

Categories: Literature Watch

Utilizing plasma drug levels and genetic testing to achieve optimal treatment response in a patient with treatment-resistant schizoaffective disorder

Thu, 2023-12-14 06:00

Bipolar Disord. 2023 Dec 14. doi: 10.1111/bdi.13385. Online ahead of print.

ABSTRACT

We report the case of a Chinese male with schizoaffective disorder, an active smoker and a nonresponder to clozapine (600 mg daily). Therapeutic clozapine monitoring was analyzed, revealing a low concentration-dose ratio. A pharmacogenetic test showed that the patient had the CYP1A2*1F/*1F genotype, indicating an ultra-rapid clozapine metabolizer. In combination with fluvoxamine, a CYP1A2 enzyme inhibitor, clozapine plasma concentrations approached the reference range and achieved clinical improvement. This case demonstrates how pharmacogenetics can help understand the value of therapeutic drug monitoring to enhance the treatment of refractory schizoaffective disorder.

PMID:38097824 | DOI:10.1111/bdi.13385

Categories: Literature Watch

Association of ITPA 94C>A genetic polymorphisms with azathioprine induced adverse effects in the South Indian population

Thu, 2023-12-14 06:00

Drug Metab Pers Ther. 2023 Dec 15. doi: 10.1515/dmpt-2023-0061. Online ahead of print.

ABSTRACT

OBJECTIVES: Azathioprine (AZA) is an effective immunosuppressant commonly used for malignancy and immune-mediated disorders. The association between genetic polymorphisms and AZA-induced adverse effects has not been elucidated. Hence this study aimed to evaluate the relationship between single nucleotide polymorphisms of ITPA (C94A) with azathioprine-induced adverse effects.

METHODS: A cross-sectional study was performed on 120 patients who were on AZA therapy for immunobullous disorders and inflammatory bowel disease (IBD). Eligible patients were enrolled from outpatient Departments of dermatology and medical gastroenterology and five mL of blood was collected after obtaining written informed consent. DNA extraction and genotyping were done by phenol-chloroform method and real-time polymerase chain reaction (RT-PCR), respectively.

RESULTS: The minor allele frequency of ITPA (A allele) was 30.8 %. The mutant genotypes of ITPA (C94A) were found to have no significant association with overall adverse effects in the South Indian patients on AZA therapy.

CONCLUSIONS: We report no significant association between ITPA rs1127354 genetic polymorphism and adverse effects in the South Indian patients on AZA therapy.

PMID:38097396 | DOI:10.1515/dmpt-2023-0061

Categories: Literature Watch

Successful Management of Fetal Torsades de Pointes and Long QT Syndrome by a Cardio-Obstetrical Team

Thu, 2023-12-14 06:00

JACC Case Rep. 2023 Dec 6;27:102110. doi: 10.1016/j.jaccas.2023.102110. eCollection 2023 Dec 6.

ABSTRACT

A 32-week fetus with tachycardia and bradycardia, diagnosed with torsades de pointes, atrioventricular block, and sinus bradycardia due to a de novo KCNH2 mutation was successfully managed by a cardio-obstetrical team. Maternal/fetal pharmacogenomic testing resulted in appropriate drug dosing without toxicity and delivery of a term infant in sinus rhythm.

PMID:38094730 | PMC:PMC10715977 | DOI:10.1016/j.jaccas.2023.102110

Categories: Literature Watch

Ethics Challenges in Pediatric Research

Thu, 2023-12-14 06:00

J Pediatr Pharmacol Ther. 2023;28(8):680-686. doi: 10.5863/1551-6776-28.8.680. Epub 2023 Dec 12.

NO ABSTRACT

PMID:38094679 | PMC:PMC10715381 | DOI:10.5863/1551-6776-28.8.680

Categories: Literature Watch

Global Burden of Cardiovascular Diseases and Risks, 1990-2022

Wed, 2023-12-13 06:00

J Am Coll Cardiol. 2023 Dec 19;82(25):2350-2473. doi: 10.1016/j.jacc.2023.11.007.

NO ABSTRACT

PMID:38092509 | DOI:10.1016/j.jacc.2023.11.007

Categories: Literature Watch

Benchmarking and improving the performance of variant-calling pipelines with RecallME

Wed, 2023-12-13 06:00

Bioinformatics. 2023 Dec 13:btad722. doi: 10.1093/bioinformatics/btad722. Online ahead of print.

ABSTRACT

MOTIVATION: The steady increment of Whole Genome/Exome sequencing and the development of novel NGS-based gene panels requires continuous testing and validation of variant calling pipelines and the detection of sequencing-related issues to be maintained up-to-date and feasible for the clinical settings. State of the art tools are reliable when used to compute standard performance metrics. However, the need for an automated software to discriminate between bioinformatic and sequencing issues and to optimize variant calling parameters remains unmet.The aim of the current work is to present RecallME, a bioinformatic suite that tracks down difficult-to-detect variants as insertions and deletions in highly repetitive regions, thus providing the maximum reachable recall for both single nucleotide variants and small insertion and deletions and to precisely guide the user in the pipeline optimization process.

AVAILABILITY: Source code is freely available under MIT license at https://github.com/mazzalab-ieo/recallme RecallME web application is available at https://translational-oncology-lab.shinyapps.io/recallme/ To use RecallME, users must obtain a license for ANNOVAR by themselves.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:38092052 | DOI:10.1093/bioinformatics/btad722

Categories: Literature Watch

Personalized medicine in a community health system: the NorthShore experience

Wed, 2023-12-13 06:00

Front Genet. 2023 Nov 28;14:1308738. doi: 10.3389/fgene.2023.1308738. eCollection 2023.

ABSTRACT

Genomic and personalized medicine implementation efforts have largely centered on specialty care in tertiary health systems. There are few examples of fully integrated care systems that span the healthcare continuum. In 2014, NorthShore University HealthSystem launched the Center for Personalized Medicine to catalyze the delivery of personalized medicine. Successful implementation required the development of a scalable family history collection tool, the Genetic and Wellness Assessment (GWA) and Breast Health Assessment (BHA) tools; integrated pharmacogenomics programming; educational programming; electronic medical record integration; and robust clinical decision support tools. To date, more than 225,000 patients have been screened for increased hereditary conditions, such as cancer risk, through these tools in primary care. More than 35,000 patients completed clinical genetic testing following GWA or BHA completion. An innovative program trained more than 100 primary care providers in genomic medicine, activated with clinical decision support and access to patient genetic counseling services and digital healthcare tools. The development of a novel bioinformatics platform (FLYPE) enabled the incorporation of genomics data into electronic medical records. To date, over 4,000 patients have been identified to have a pathogenic or likely pathogenic variant in a gene with medical management implications. Over 33,000 patients have clinical pharmacogenomics data incorporated into the electronic health record supported by clinical decision support tools. This manuscript describes the evolution, strategy, and successful multispecialty partnerships aligned with health system leadership that enabled the implementation of a comprehensive personalized medicine program with measurable patient outcomes through a genomics-enabled learning health system model that utilizes implementation science frameworks.

PMID:38090148 | PMC:PMC10713750 | DOI:10.3389/fgene.2023.1308738

Categories: Literature Watch

Medicine Pharmacy Interprofessional Exercise Pilot: Lessons Learned

Wed, 2023-12-13 06:00

MedEdPublish (2016). 2018 Mar 22;7:66. doi: 10.15694/mep.2018.0000066.1. eCollection 2018.

ABSTRACT

This article was migrated. The article was marked as recommended. The Association of American Medical Colleges and the American Association of Colleges of Pharmacy with leaders of other health professions formed the Interprofessional Education Collaborative (IPEC) in 2009. Interprofessional education (IPE) is now a component of accreditation standards for academic programs in both medicine and pharmacy. While geographically separated, the Medical College of Georgia (Augusta University) and the College of Pharmacy (University of Georgia) have over 40 year history of collaboration but never intentionally added joint curricular offerings.To address IPE competencies, we developed and evaluated a medicine pharmacy collaborative exercise. Specifically, to compare the attitudes and perception toward interprofessional education and practice of students from two disciplines. An observational cross sectional study with 208 third year medical (M3) students and 108 third year pharmacy (P3) students was conducted in two consecutive academic years. Groups consisted of 6-8 M3 and 3-4 P3 students from all campuses across the state. The M3 student was to choose a patient they had seen who was taking at least 3 prescription medications. Objectives for students were to discuss the case (medications, side effects, cost, pharmacogenetics, drug-drug interactions, and cost effectiveness). A report of M3-P3 findings was to be submitted for grading by the Pharmacy faculty. Once the exercises were completed surveys were distributed and the de-identified data was analyzed in relation to IPEC competencies. The study was conducted in one academic year and 316 responses were obtained. Within medical students 48.2 % agreed and 21.2 % strongly agreed to consult with Pharm D in the future. Perception of leadership in the groups was shifted more toward pharmacy students (56.5% vs. 27.4%, p<0.0001). Students confidence in working with other professionals was improved more for pharmacy students than medical students (50.0% in P3 and 30.2% in M3 p =0.0014). Communication skills improved more in P3 than M3 (48.2% in P3 and 28.3% in M3, p=0.0043). More research is needed on equal adoption of IPE by medical and pharmacy students. Emphasis should be made on equal state of training (theory vs. clinical) on both sides with focus on working as a team and value of each team member. More direct involvement in patient care is needed with both M3 and P3 having face to face contact with patients and each other.

PMID:38089216 | PMC:PMC10712014 | DOI:10.15694/mep.2018.0000066.1

Categories: Literature Watch

miR-6805-5p as a biomarker of cisplatin-induced nephrotoxicity in patients with head and neck cancer

Wed, 2023-12-13 06:00

Front Pharmacol. 2023 Nov 28;14:1275238. doi: 10.3389/fphar.2023.1275238. eCollection 2023.

ABSTRACT

Introduction: The standard treatment for head and neck squamous cell carcinoma (HNSCC) is cisplatin chemoradiotherapy. One of the main treatment adverse reactions is nephrotoxicity, for which there is currently no adequate specific and sensitive biomarker. Thus, this study aimed to evaluate the use of microRNAs (miRNAs) as renal biomarker candidates. Methods: This was a retrospective cohort study. Nephrotoxicity was assessed through blood samples collected before and 5 days (D5) after chemotherapy. MiRNAs were extracted from urine samples collected at baseline and D5, and RNA sequencing identified miRNAs differentially expressed between participants with and without cisplatin-induced nephrotoxicity. Results: A total of 49 participants were included (n = 49). A significant difference was seen between the two groups for traditional renal markers (serum creatinine and creatinine clearance) and for the acute kidney injury (AKI) categories. Among the six miRNAs evaluated as biomarkers, four were upregulated (hsa-miR-6729-5p, hsa-miR-1238-5p, hsa-miR-4706, and hsa-miR-4322) and two were downregulated (hsa-miR-6805-5p and hsa-miR-21-5p), but only hsa-miR-6805-5p had a significant difference (p < 0.0001). Its receiver operating characteristic curve revealed excellent specificity (0.920) for its expression fluctuation assessment, while its absolute expression in D5 showed greater sensitivity (0.792). Conclusion: So, the integrated use of these two parameters seems to be an interesting approach for AKI.

PMID:38089043 | PMC:PMC10713822 | DOI:10.3389/fphar.2023.1275238

Categories: Literature Watch

Recalculating the Route: Repositioning Antimicrobial Peptides for Cancer Treatment

Wed, 2023-12-13 06:00

Chem Biodivers. 2023 Dec 13:e202301840. doi: 10.1002/cbdv.202301840. Online ahead of print.

ABSTRACT

Resistance to antimicrobial drugs has been considered a public health problem. Likewise, the increasing resistance of cancer cells to drugs currently used in therapy has also become a problem. Therefore, the research and development of synthetic peptides bring a new perspective on the emergence of new drugs for treating this resistance since bioinformatics provides a means to optimize these molecules and save time and costs in research. Peptides have several mechanisms of action, such as forming pores on the cell membrane and inhibiting protein synthesis. Some studies report the use of antimicrobial peptides with the potential for action against cancer cells, suggesting a repositioning of antimicrobial peptides to fight back cancer resistance. There is an alteration in the microenvironment, making its net charge negative for the survival and growth of cancer cells. The changes in glycoproteins favor the membrane to have a more negative charge, favoring the interaction between the cells and the peptide, thus making possible the repositioning of these antimicrobial peptides against cancer. Here, we will discuss the mechanism of action, targets and effects of peptides, comparison between microbial and cancer cells, and proteomic changes caused by the interaction of peptides and cells.

PMID:38088493 | DOI:10.1002/cbdv.202301840

Categories: Literature Watch

Implementing pharmacogenetics in clinical trials: considerations about current methodological, ethical, and regulatory challenges

Wed, 2023-12-13 06:00

Expert Rev Clin Pharmacol. 2023 Dec 13. doi: 10.1080/17512433.2023.2293999. Online ahead of print.

ABSTRACT

INTRODUCTION: The implementation of pharmacogenetic analysis within clinical trials faces methodological, ethical, and regulatory challenges, as well as tackling the difficulty in obtaining actionable information with a sufficient level of evidence to enable its integration into routine clinical practice.

AREAS COVERED: we discuss the current status of pharmacogenetics integration in clinical trials, underscore the associated challenges, and make some suggestions on the aspects to address in any clinical trial including a pharmacogenetic evaluation. We conducted a literature review, thoroughly reviewed the applicable regulations and available guidelines, and assessed the application dossiers submitted for evaluation to the Ethics committee of Hospital La Paz (Madrid, Spain) to extract information related to inclusion of pharmacogenetics evaluations.

EXPERT OPINION: The integration of pharmacogenetics into clinical trials is becoming increasingly common. However, several regulatory, methodological and ethical aspects involved are insufficiently addressed. There is a need for specific and transparent guidelines that establish unified and compliant criteria for methodology, proper handling of samples in compliance with regulations, and the protection of data privacy and confidentiality. Participants should receive complete and appropriate information regarding the purpose, handling, storage, and transfer of their samples and data, and should have the right to decide about their processing.

PMID:38088171 | DOI:10.1080/17512433.2023.2293999

Categories: Literature Watch

Current Perspectives on Data Sharing and Open Science in Pharmacogenomics

Wed, 2023-12-13 06:00

Clin Pharmacol Ther. 2023 Dec 13. doi: 10.1002/cpt.3115. Online ahead of print.

NO ABSTRACT

PMID:38087986 | DOI:10.1002/cpt.3115

Categories: Literature Watch

The associations of PON1 and APOE polymorphisms with plasma lipid levels and the risk for late complications in type 2 diabetes patients

Tue, 2023-12-12 06:00

J Med Biochem. 2023 Oct 27;42(4):675-684. doi: 10.5937/jomb0-43154.

ABSTRACT

BACKGROUND: Besides good glycemic control, also control of lipid levels can effectively prevent or delay late type 2 diabetes (T2D) complications. As apolipoprotein E (APOE) and paraoxonase 1 (PON1) were shown to suppress atherosclerosis, we investigated the associations of common functional PON1 and APOE polymorphisms with plasma lipid levels and the risk for late complications in T2D patients.

METHODS: Our retrospective genetic association study included 181 T2D patients genotyped for PON1 rs622, PON1 rs854560, APOE rs429358 and APOE rs7412.

PMID:38084238 | PMC:PMC10710788 | DOI:10.5937/jomb0-43154

Categories: Literature Watch

Genetic variants in myostatin and its receptors promote elite athlete status

Mon, 2023-12-11 06:00

BMC Genomics. 2023 Dec 11;24(1):761. doi: 10.1186/s12864-023-09869-2.

ABSTRACT

BACKGROUND: While product of the myostatin gene (MSTN) is an important factor influencing muscle growth, which is well confirmed in nonhuman species, it has not been clearly confirmed whether MSTN expression influences interindividual differences in skeletal muscle mass, affects posttraining changes, or plays a role in the age-related loss of muscle mass and function in humans. Although the inconclusive results are usually explained by ethnic differences and the low frequency of some alleles, it is possible that the role of receptors (ACVR2A and ACVR2B) that affect the biological activity of myostatin is crucial. Therefore, we investigated the sequences of the MSTN, ACVR2A, and ACVR2B genes and determined the interaction between allelic variants and athletic performance and competition level in the Caucasian population. One hundred-two athletes were recruited for the sequencing study, and whole-genome sequencing (WGS) was performed. Second, 330 athletes and 365 controls were included, and real-time PCR was performed.

RESULTS: The sequence analysis revealed two polymorphisms relatively common in the athlete cohort, and the alternate allele showed overrepresentation in athletes: MSTN rs11333758 and ACVR2A rs3764955. Regarding the polymorphic site MSTN rs11333758, there was a significant overrepresentation of the -/- genotype in all high-elite and mixed-sport high-elite athletes. Carriers of the ACVR2A rs3764955 CC and GG genotypes were more likely to be elite and high-elite athletes. In addition, carriers of the CC genotype were more likely to be in the mixed-sport subelite group. The gene‒gene interaction analysis revealed that mixed-sport high elite athletes showed significant underrepresentation of the ACVR2A rs3764955 GC - MSTN rs11333758 AA genotype combination. In the same group, we observed a significant overrepresentation of the ACVR2A rs3764955 GC - MSTN rs11333758 -/- and the ACVR2A rs3764955 CC - MSTN rs11333758 -/- genotype combinations.

CONCLUSIONS: We showed that the specific genotypes of the MSTN rs11333758 and ACVR2A rs3764955, either individually or in gene‒gene combination, are significantly associated with athletes' competition level in the Polish population, especially in the mixed-sports athlete group. Thus, although further research is required, these polymorphisms, alone or in combination with other polymorphisms, are among the numerous candidates that could explain individual variations in muscle phenotypes.

PMID:38082252 | DOI:10.1186/s12864-023-09869-2

Categories: Literature Watch

Pain and Opioid Use Following Total Knee Arthroplasty: Psycho-Social Factors Are More Predictive than Pharmacogenomics

Mon, 2023-12-11 06:00

J Arthroplasty. 2023 Dec 9:S0883-5403(23)01203-2. doi: 10.1016/j.arth.2023.12.011. Online ahead of print.

ABSTRACT

BACKGROUND: This prospective, observational study was designed to assess the phenotype variation of the genes associated with pain and opioid use following total knee arthroplasty in comparison to psycho-social elements.

METHODS: Preoperative demographic data and Patient-Reported Outcomes Measurement Information System (PROMIS)-43 scores were obtained on 305 elective total knee arthroplasty patients. Patient visual analog scale (VAS) pain scores and opioid use were extracted from the hospital record. Following discharge, participants completed a daily log of VAS pain score, and medications used over 30 days. Pharmacogenomic testing was performed for three genes, CYP2D6, COMT, and OPRM1, which are involved in the opioid pathway and pain modulation.

RESULTS: Other than increased pain seen in the COMT high activity group while in the hospital, none of the phenotype variations of the three genes were significantly associated with the participants' pain or opioid use. The PROMIS-43 domains of pain interference and anxiety were significantly associated with pain and opioid use using multiple logistic regression.

CONCLUSION: Pharmacogenomic testing in this study was not predictive of pain and opioid use following total knee arthroplasty compared with psycho-social variables.

PMID:38081553 | DOI:10.1016/j.arth.2023.12.011

Categories: Literature Watch

Challenges of pediatric pharmacotherapy: A narrative review of pharmacokinetics, pharmacodynamics, and pharmacogenetics

Mon, 2023-12-11 06:00

Eur J Clin Pharmacol. 2023 Dec 11. doi: 10.1007/s00228-023-03598-x. Online ahead of print.

ABSTRACT

PURPOSE: Personalized pharmacotherapy, including for the pediatric population, provides optimal treatment and has emerged as a major trend owing to advanced drug therapeutics and diversified drug selection. However, it is essential to understand the growth and developmental characteristics of this population to provide appropriate drug therapy. In recent years, clinical pharmacogenetics has accumulated knowledge in pediatric pharmacotherapy, and guidelines from professional organizations, such as the Clinical Pharmacogenetics Implementation Consortium, can be consulted to determine the efficacy of specific drugs and the risk of adverse effects. However, the existence of a large knowledge gap hinders the use of these findings in clinical practice.

METHODS: We provide a narrative review of the knowledge gaps in pharmacokinetics (PK) and pharmacodynamics (PD) in the pediatric population, focusing on the differences from the perspective of growth and developmental characteristics. In addition, we explored PK/PD in relation to pediatric clinical pharmacogenetics.

RESULTS: The lack of direct and indirect biomarkers for more accurate assessment of the effects of drug administration limits the current knowledge of PD. In addition, incorporating pharmacogenetic insights as pivotal covariates is indispensable in this comprehensive synthesis for precision therapy; therefore, we have provided recommendations regarding the current status and challenges of personalized pediatric pharmacotherapy. The integration of clinical pharmacogenetics with the health care system and institution of educational programs for health care providers is necessary for its safe and effective implementation. A comprehensive understanding of the physiological and genetic complexities of the pediatric population will facilitate the development of effective and personalized pharmacotherapeutic strategies.

PMID:38078929 | DOI:10.1007/s00228-023-03598-x

Categories: Literature Watch

Relationship of <em>CYP3A4*1B</em> Single Nucleotide Polymorphism to the Efficiency and Safety Profiles of Haloperidol in Patients Enduring Acute Alcoholic Hallucinosis

Mon, 2023-12-11 06:00

Psychopharmacol Bull. 2023 Dec 4;53(4):8-14.

ABSTRACT

To date, haloperidol has been widely used to treat patients with acute alcoholic hallucinosis. There is strong evidence that haloperidol therapy is commonly associated with adverse drug reactions (ADRs). The 392A > G polymorphism of the CYP3A4*1B gene (rs2740574) is known to affect the metabolism rates of haloperidol; hence it correlates with both therapy efficacy and safety parameters.

OBJECTIVE: The study objective was to investigate the effect of 392A > G polymorphism of the CYP3A4*1B gene (rs2740574) on the efficacy and safety profiles of haloperidol in patients with acute alcoholic hallucinosis.

METHODS: This study enrolled 100 male patients suffering from acute alcoholic hallucinosis (mean age 41.4 ± 14.4 years). The efficacy profile of haloperidol was assessed using the PANSS (Positive and Negative Syndrome Scale) validated psychometric scale. The safety profile of therapy was assessed with the UKU Side-Effect Rating Scale and the SAS (Simpson-Angus Scale for Extrapyramidal Symptoms) scale. Genotyping was performed using the real-time polymerase chain reaction (Real-time PCR).

RESULTS: There were no statistically significant results for the efficacy rates (dynamics of the PANSS score: AA genotype -14.00 [-16.00; -12.00], AG genotype -13.00 [-14.00; -10.50], p = 0.306). Similarly, there was no statistically significant difference in the safety profiles (dynamics of the UKU score: AA genotype - 9.00 [7.00; 13.00], AG genotype - 8.50 [7.25; 10.50], p = 0.620; dynamics of the SAS score: AA genotype -12.00 [10.00; 16.75], AG genotype - 10.00 [10.00; 12.25], p = 0.321).

CONCLUSION: The study demonstrated that the 392A > G polymorphism of the CYP3A4*1B gene (rs2740574) in patients with acute alcoholic hallucinosis does not affect the efficacy and safety rates of haloperidol therapy.

PMID:38076668 | PMC:PMC10698852

Categories: Literature Watch

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