Pharmacogenomics

Editorial: Ovarian cancer targeted medication: PARP inhibitors, anti-angiogenic drugs, immunotherapy, and more, volume II

Tue, 2025-02-25 06:00

Front Pharmacol. 2025 Feb 10;16:1552652. doi: 10.3389/fphar.2025.1552652. eCollection 2025.

NO ABSTRACT

PMID:39995412 | PMC:PMC11848066 | DOI:10.3389/fphar.2025.1552652

Categories: Literature Watch

CYP3A5 and POR gene polymorphisms as predictors of infection and graft rejection in post-liver transplant patients treated with tacrolimus - a cohort study

Mon, 2025-02-24 06:00

Pharmacogenomics J. 2025 Feb 25;25(2):4. doi: 10.1038/s41397-025-00363-4.

ABSTRACT

Liver transplantation is the only curative option for patients with advanced stages of liver disease, with tacrolimus used as the immunosuppressive drug of choice. Genetic variability can interfere with drug response, potentially leading to overexposure or underexposure. This study aims to investigate the association of CYP3A4 (rs2740574, rs2242480, rs35599367), CYP3A5 (rs776746, rs10264272), POR (rs1057868) and ABCB1 (rs1128503, rs2229109, rs9282564) gene polymorphisms with infection, acute rejection, and renal failure. The logistic regression model found an influence of CYP3A5 (rs776746) and POR28 (rs1057868) on the development of acute rejection after liver transplantation (p = 0.028). It also found an association between carriers of the variant allele of the POR*28 gene and infection.

PMID:39994182 | DOI:10.1038/s41397-025-00363-4

Categories: Literature Watch

Integrated Pharmacogenetic Signature for the Prediction of Prostatic Neoplasms in Men With Metabolic Disorders

Mon, 2025-02-24 06:00

Cancer Genomics Proteomics. 2025 Mar-Apr;22(2):285-305. doi: 10.21873/cgp.20502.

ABSTRACT

BACKGROUND/AIM: Oncogenic processes are delineated by metabolic dysregulation. Drug likeness is pharmacokinetically tested through the CYP450 enzymatic system, whose genetic aberrations under epigenetic stress could shift male organisms into prostate cancer pathways. Our objective was to predict the susceptibility to prostate neoplasia, focused on benign prostatic hyperplasia (BPH) and prostate cancer (PCa), based on the pharmacoepigenetic and the metabolic profile of Caucasians.

MATERIALS AND METHODS: Two independent cohorts of 47,389 individuals in total were assessed to find risk associations of CYP450 genes with prostatic neoplasia. The metabolic profile of the first cohort was statistically evaluated and frequencies of absorption-distribution-metabolism-excretion-toxicity (ADMET) properties were calculated. Prediction of miRNA pharmacoepigenetic targeting was performed.

RESULTS: We found that prostate cancer and benign prostatic hyperplasia patients of the first cohort shared common cardiometabolic trends. Drug classes C08CA, C09AA, C09CA, C10AA, C10AX of the cardiovascular, and G04CA, G04CB of the genitourinary systems, were associated with increased prostate cancer risk, while C03CA and N06AB of the cardiovascular and nervous systems were associated with low-risk for PCa. CYP3A4*1B was the most related pharmacogenetic polymorphism associated with prostate cancer susceptibility. miRNA-200c-3p and miRNA-27b-3p seem to be associated with CYP3A4 targeting and prostate cancer predisposition. Metabolomic analysis indicated that 11β-OHT, 2β-OHT, 15β-OHT, 2α-OHT and 6β-OHT had a high risk, and 16α-OHT, and 16β-OHT had an intermediate disease-risk.

CONCLUSION: These findings constitute a novel integrated signature for prostate cancer susceptibility. Further studies are required to assess their predictive value more fully.

PMID:39993800 | DOI:10.21873/cgp.20502

Categories: Literature Watch

The pharmacogenomic landscape in the Chinese: An analytics of pharmacogenetic variants in 206,640 individuals

Mon, 2025-02-24 06:00

Innovation (Camb). 2025 Jan 18;6(2):100773. doi: 10.1016/j.xinn.2024.100773. eCollection 2025 Feb 3.

ABSTRACT

Pharmacogenomic landscapes and related databases are important for identifying the biomarkers of drug response and toxicity. However, these data are still lacking for the Chinese population. In this study, we constructed a pharmacogenomic landscape and an associated database using whole-genome sequencing data generated by non-invasive prenatal testing in 206,640 Chinese individuals. In total, 1,577,513 variants (including 331,610 novel variants) were identified among 3,538 pharmacogenes related to 2,086 drugs. We found that the variant spectrum in the Chinese population differed among the seven major regions. Regional differences also exist among provinces in China. The average numbers of drug enzyme, transporter, and receptor variants were 258, 557, and 632, respectively. Subsequent correlation analysis indicated that the pharmacogenes affecting multiple drugs had fewer variants. Among the 16 categories of drugs, we found that nervous system, cardiovascular system, and genitourinary system/sex hormone drugs were more likely to be affected by variants of pharmacogenes. Characteristics of the variants in the enzyme, transporter, and receptor subfamilies showed specificity. To explore the clinical utility of these data, a genetic association study was conducted on 1,019 lung cancer patients. Two novel variants, AKT2 chr19:40770621 C>G and SLC19A1 chr21:46934171 A>C, were identified as novel platinum response biomarkers. Finally, a pharmacogenomic database, named the Chinese Pharmacogenomic Knowledge Base (CNPKB: http://www.cnpkb.com.cn/), was constructed to collect all the data. In summary, a pharmacogenomic landscape and database for the Chinese population were constructed in this study, which could support personalized Chinese medicine in the future.

PMID:39991480 | PMC:PMC11846038 | DOI:10.1016/j.xinn.2024.100773

Categories: Literature Watch

Harnessing genomics and translational research to improve health in Africa: a report of the 13<sup>th</sup> African Society of Human Genetics meeting in Dar es Salaam, Tanzania

Mon, 2025-02-24 06:00

Pan Afr Med J. 2024 Nov 14;49:79. doi: 10.11604/pamj.2024.49.79.42550. eCollection 2024.

ABSTRACT

The thirteenth conference of the African Society of Human Genetics with the theme "harnessing genomics and translational research to improve health in Africa" was held in Dar es Salaam, Tanzania, in August 2021, using a hybrid in-person and virtual model for participation in the wake of COVID-19 pandemic. During the meeting, African research across various human genetics disciplines was presented, including talks on the genetics of infectious and non-communicable diseases, population genetics, and translational research. The meeting also featured presentations on pharmacogenomics, genetics of developmental disorders, cancer genetics and genetics of rare diseases. In-depth discussions on ethical legal and social issues in genomics research and community and patient engagement were also key sessions of this meeting. The primary focus of the conference and the discussions was how to translate the wealth of genomic research in the continent into improved health outcomes in the continent. In this report, we summarize the key scientific research relevant to Africa presented and discussed during the meeting providing an overview of the progress of human genetics in the continent. We also discuss opportunities and challenges of harnessing genomics for health improvement in Africa.

PMID:39989936 | PMC:PMC11845995 | DOI:10.11604/pamj.2024.49.79.42550

Categories: Literature Watch

Mosaic loss of chromosome Y characterises late-onset rheumatoid arthritis and contrasting associations of polygenic risk score based on age at onset

Sat, 2025-02-22 06:00

Ann Rheum Dis. 2025 Feb 19:S0003-4967(25)00184-0. doi: 10.1016/j.ard.2025.01.034. Online ahead of print.

ABSTRACT

OBJECTIVES: Mosaic chromosomal alterations (mCAs) increase with age and are associated with age-related diseases. The association between mCAs and rheumatoid arthritis (RA), particularly late-onset RA (LORA), has not been explored.

METHODS: mCAs were detected in peripheral blood samples from 2 independent Japanese datasets (Set 1: 2107 RA cases and 86,998 controls; Set 2: 2359 RA cases and 86,998 controls). The associations between mCAs and RA were evaluated in each dataset using logistic regression models and meta-analysis. In each dataset, the effect sizes of mosaic loss of Y (mLOY) and polygenic risk score (PRS) of RA in males was evaluated, and a meta-analysis was subsequently performed. The interaction between mLOY and PRS was assessed. These models were applied separately to RA, LORA, and young-onset RA (YORA).

RESULTS: mLOY increased significantly in LORA (odds ratio [OR] = 1.43, P = .0070). We observed a negative association between mLOY and YORA (OR = 0.66, P = .0034). On the other hand, we found consistently negative associations of autosomal mCAs or mosaic loss of X with RA, LORA, and YORA. The PRS effect sizes were lower for LORA than for YORA. mLOY with a high cell fraction strengthened the association between PRS and LORA (P = .0036), whereas the association with YORA was independent of mLOY.

CONCLUSIONS: LORA was characterised by the presence of a high burden of mLOY. The observed interaction between mLOY and PRS in LORA, but not in YORA, supports different gene-environment interactions between the subsets. These data suggest that distinct pathophysiological mechanisms underlie the development of LORA and YORA.

PMID:39986957 | DOI:10.1016/j.ard.2025.01.034

Categories: Literature Watch

Interactions between the intestinal microbiota and drug metabolism - Clinical implications and future opportunities

Fri, 2025-02-21 06:00

Biochem Pharmacol. 2025 Feb 19:116809. doi: 10.1016/j.bcp.2025.116809. Online ahead of print.

ABSTRACT

The importance of the intestinal microbita in a multitude of physiological processes is well-evidenced. These include metabolism of nutrients and xenobiotics, biosynthesis of vitamin K and vitamin B12, immunomodulation, maintenance of the gut mucosal barrier integrity and protection against some pathogens. Interindividual differences in the intestinal microbiota composition have impacts on health. The bioavailability and activity of some pharmaceuticals are heavily influenced by interindividual variability in metabolism, which has a genetic basis. This variability, primarily occurring in the liver but also in the intestine, has been studied extensively. Despite the advancement of this field - pharmacogenetics - its integration into clinical practice remains limited for reasons discussed herein. This highlights the even greater challenge of applying emerging knowledge on variability in the gut microbiota to drug therapy. However, ignoring these opportunities would be a mistake. While clinical applications of microbiota-guided drug therapy are currently absent and the ideas in this article are largely theoretical, research is uncovering that in cases where a substantial portion of a drug or its metabolites reaches the colon, or where drugs are formulated for colonic delivery, the gut microbiota can significantly affect drug metabolism and activity. Greater focus should be placed on research into how interindividual variability in the intestinal microbiome can modify pharmaceutical bioavailability and activity. This article is deliberately speculative and exploratory but proposes that, though there are still no clinical examples of microbiome-guided drug therapy, these interactions could afford opportunities for improvements in personalised medicine and also for drug design.

PMID:39983848 | DOI:10.1016/j.bcp.2025.116809

Categories: Literature Watch

Comparing the clinical utility of pharmacogenomic genotyping and next generation sequencing in a military health system adult medicine clinic

Fri, 2025-02-21 06:00

Pharmacogenomics. 2025 Feb 21:1-9. doi: 10.1080/14622416.2025.2466413. Online ahead of print.

ABSTRACT

INTRODUCTION: Pharmacogenetic (PGx) screening is intended to optimize drug efficacy and reduce adverse drug reactions. Current screening options include genotyping assays for preselected PGx variants and broader next-generation sequencing panels (NGS). Few studies have directly compared preemptive PGx screening methods.

MATERIALS AND METHODS: The two PGx methods were compared in a cross-sectional study of adult Military Health System (MHS) clinic beneficiaries. Participants had initial targeted CYP2C19/CYP2D6 genotyping at a Military Health System Laboratory. Genotyping was followed by multi-gene NGS testing. Current prescriptions were recorded and potential drug-drug interactions screened to evaluate prescribing risk.

RESULTS: All participants (100%) had at least one clinically actionable NGS panel result compared to 81% with targeted CYP2C19/CYP2D6 genotyping. Participants (n = 162) had an average of 6.6 (range 0-22) prescriptions and 2.7 (range 0-24) drug-drug interactions. Among those with at least one clinically actionable NGS result, 42% were currently taking medication with actionable CPIC guidelines (Level A/B), compared with 24% with CYP2C19/CYP2D6 genotyping. Sixteen participants (10%) had uncertain NGS panel results, with none for CYP2C19/CYP2D6 genotyping.

CONCLUSIONS: Preemptive multi-gene NGS detected more clinically actionable PGx results than targeted CYP2C19/CYP2D6 genotyping. Effective PGx screening in the MHS may decrease preventable adverse effects and improve military readiness.

PMID:39981562 | DOI:10.1080/14622416.2025.2466413

Categories: Literature Watch

Global burden of metabolic dysfunction-associated steatotic liver disease, 2010 to 2021

Fri, 2025-02-21 06:00

JHEP Rep. 2024 Nov 14;7(3):101271. doi: 10.1016/j.jhepr.2024.101271. eCollection 2025 Mar.

ABSTRACT

BACKGROUND & AIMS: This study used the Global Burden of Disease data (2010-2021) to analyze the rates and trends of point prevalence, annual incidence, and years lived with disability (YLDs) for metabolic dysfunction-associated steatotic liver disease (MASLD) in 204 countries.

METHODS: Total numbers and age-standardized rates per 100,000 population for MASLD prevalence, annual incidence, and YLDs were compared across regions and countries by age, sex, and sociodemographic index (SDI). Smoothing spline models were used to evaluate the relationship between the burden of MASLD and SDI. Estimates were reported with uncertainty intervals (UI).

RESULTS: Globally, in 2021, the age-standardized rates per 100,000 population of point prevalence of MASLD were 15,018.1 cases (95% UI 13,756.5-16,361.4), annual incidence rates were 608.5 cases (598.8-617.7), and YLDs were 0.5 (0.3-0.8) years. MASLD point prevalence was higher in men than women (15,731.4 vs. 14,310.6 cases per 100,000 population). Prevalence peaked at ages 45-49 for men and 50-54 for women. Kuwait (32,312.2 cases per 100,000 people; 95% UI: 29,947.1-34,839.0), Egypt (31,668.8 cases per 100,000 people; 95% UI: 29,272.5-34,224.7), and Qatar (31,327.5 cases per 100,000 people; 95% UI: 29,078.5-33,790.9) had the highest prevalence rates in 2021. The largest increases in age-standardized point prevalence estimates from 2010 to 2021 were in China (16.9%, 95% UI 14.7%-18.9%), Sudan (13.3%, 95% UI 9.8%-16.7%) and India (13.2%, 95% UI 12.0%-14.4%). MASLD incidence varied with SDI, peaking at moderate SDI levels.

CONCLUSIONS: MASLD is a global health concern, with the highest prevalence reported in Kuwait, Egypt, and Qatar. Raising awareness about risk factors and prevention is essential in every country, especially in China, Sudan and India, where disease incidence and prevalence are rapidly increasing.

IMPACT AND IMPLICATIONS: This research provides a comprehensive analysis of the global burden of MASLD, highlighting its rising prevalence and incidence, particularly in countries with varying sociodemographic indices. The findings are significant for both clinicians and policymakers, as they offer critical insights into the regional disparities in MASLD burden, which can inform targeted prevention and intervention strategies. However, the study's reliance on modeling and available data suggests cautious interpretation, and further research is needed to validate these findings in clinical and real-world settings.

PMID:39980749 | PMC:PMC11840544 | DOI:10.1016/j.jhepr.2024.101271

Categories: Literature Watch

Genetic markers of early response to lurasidone in acute schizophrenia

Thu, 2025-02-20 06:00

Pharmacogenomics J. 2025 Feb 20;25(2):3. doi: 10.1038/s41397-024-00360-z.

ABSTRACT

Prediction of treatment response by genetic biomarkers has potential for clinical use and contributes to the understanding of pathophysiology and drug mechanism of action. The purpose of this study is to detect genetic biomarkers possibly associated with response to lurasidone, during the first four weeks of treatment. One-hundred and seventy-one acutely psychotic patients from two placebo-controlled clinical trials of lurasidone were included. Genetic associations with changes in Positive and Negative Syndrome Scale total score at weeks one, two, and four were examined. Genotyping was done with the Affymetrix 6.0 microarray and associations were computed using PLINK regression model. Although genome-wide significance was not reached with a limited sample size, signals of potential interest for further studies were with genes important for neurogenesis. Possible week one marker, rs6459950 (p = 7.05 × 10-7), was close to the sonic hedgehog gene (SHH), involved in neuronal differentiation and neurogenesis. Possible week two marker, rs7435958, was a SNP of GABRB1, encoding the GABAA Receptor β1. Notably, possible week four signals included a SNP within PTCH1, a specific receptor for the SHH, the possible week one marker. Pathway analysis supported the possibility that neurogenesis might be involved in early antipsychotic response. Tissue enrichment analysis suggested that potential signals were enriched in anterior cingulate cortex, reported to be relevant in antipsychotic action. This is the first study to examine genes possibly associated with very early response to lurasidone. Further replication studies in larger sample size should be required.

PMID:39979276 | DOI:10.1038/s41397-024-00360-z

Categories: Literature Watch

Medical policy determinations for pharmacogenetic tests among US health plans

Thu, 2025-02-20 06:00

Am J Manag Care. 2025 Feb 1;31(2):e47-e55. doi: 10.37765/ajmc.2025.89683.

ABSTRACT

OBJECTIVES: To evaluate medical policy determinations for pharmacogenetic (PGx) testing for 65 clinically relevant drug-gene pairs and evidence cited to support determinations across major US health plans and laboratory benefit managers (LBMs).

STUDY DESIGN: Landscape analysis of available PGx medical policies to determine coverage status of certain drug-gene pairs.

METHODS: PGx medical policies as of February 1, 2024, were ascertained through Policy Reporter for top national insurers, LBMs, and the Palmetto GBA Molecular Diagnostic Services (MolDX) Program, which determines whether a molecular diagnostic test is covered by Medicare. Data elements included date of last policy update, coverage status for each drug-gene pair, and evidence cited for or against coverage. A drug-gene pair was considered covered if the policy indicated that a PGx test was deemed medically necessary and/or meets coverage criteria.

RESULTS: Policies from 8 insurers, 3 LBMs, and MolDX were available and reviewed. MolDX covered all 65 individual drug-gene pairs, followed by Avalon Healthcare Solutions (n = 50) and UnitedHealthcare (n = 45); these 3 also covered multigene panels. Eight policies covered 10 or fewer drug-gene pairs. HLA-B*57:01 testing prior to abacavir initiation and HLA-B*15:02 testing prior to carbamazepine initiation were covered across all policies. Drug-gene pairs with Clinical Pharmacogenetics Implementation Consortium guidelines and/or included in the FDA's Table of Pharmacogenetic Associations Section 1 were more commonly covered. Society guidelines were the most frequently cited evidence (413 times), and cost-effectiveness studies were infrequently cited (43 times).

CONCLUSIONS: We found significant variability in medical policy determinations and evidence cited for clinically relevant PGx tests among major US health insurers and LBMs. A collaborative effort between payers and the PGx community to standardize evidence evaluation may lead to more consistent coverage and improve patient access to PGx tests meeting evidence requirements.

PMID:39977287 | DOI:10.37765/ajmc.2025.89683

Categories: Literature Watch

Pharmacogenomics-based subtype decoded implications for risk stratification and immunotherapy in pancreatic adenocarcinoma

Wed, 2025-02-19 06:00

Mol Med. 2025 Feb 19;31(1):62. doi: 10.1186/s10020-024-01049-6.

ABSTRACT

BACKGROUND: With fatal malignant peculiarities and poor survival rate, outcomes of pancreatic adenocarcinoma (PAAD) were frustrated by non-response and even resistance to therapy due to heterogeneity across clinical patients. Nevertheless, pharmacogenomics has been developed for individualized-treatment and still maintains obscure in PAAD.

METHODS: A total of 964 samples from 10 independent multi-center cohorts were enrolled in our study. With drug response data from the profiling of relative inhibition simultaneously in mixtures (PRISM) and genomics of drug sensitivity in cancer (GDSC) databases, we established and validated multidimensionally three pharmacogenomics-classified subtypes using non-negative matrix factorization (NMF) and nearest template prediction (NTP) algorithms, separately. The heterogenous biological characteristics and precision medicine strategies among subtypes were further investigated.

RESULTS: Three pharmacogenomics-classified subtypes after stable and reproducible validation, distinguished in six aspects of prognosis, biological peculiarities, immune landscapes, genomic variations, immunotherapy and individualized management strategies. Subtype 2 was close to immunocompetent phenotype and projected to immunotherapy; Subtype 3 held most favorable outcomes and metabolic pathways distinctively, promising to be treated with first-line agents. Subtype 1 with worst prognosis, was anticipated to chromosome instability (CIN) phenotype and resistant to chemotherapeutic agents. In addition, ITGB6 contributed to subtype 1 resistance to 5-fluorouracil, and knockdown of ITGB6 enhanced sensitivity to 5-fluorouracil in in vitro experiments. Ultimately, appropriate clinical stratified treatments were assigned to corresponding subtypes according to pharmacogenomic transcripts. Some limitations were not taken into account, thus needs to be supported by more research.

CONCLUSION: A span-new molecular subtype exploited for PAAD uncovered an insight into precise medication on ground of pharmacogenomics, and highly refined multiple clinical management strategies for specific patients.

PMID:39972282 | DOI:10.1186/s10020-024-01049-6

Categories: Literature Watch

Lessons learned from a candidate gene study investigating aromatase inhibitor treatment outcome in breast cancer

Wed, 2025-02-19 06:00

NPJ Breast Cancer. 2025 Feb 19;11(1):18. doi: 10.1038/s41523-025-00733-y.

ABSTRACT

The role of germline genetics in adjuvant aromatase inhibitor (AI) treatment efficacy in ER-positive breast cancer is poorly understood. We employed a two-stage candidate gene approach to examine associations between survival endpoints and common germline variants in 753 endocrine resistance-related genes. For a discovery cohort, we screened the Breast Cancer Association Consortium database (n ≥ 90,000 cases) and retrieved 2789 AI-treated patients. Cox model-based analysis revealed 125 variants associated with overall, distant relapse-free, and relapse-free survival (p-value ≤ 1E-04). In validation analysis using five independent cohorts (n = 8857), none of the six selected candidates representing major linkage blocks at CELA2B/CASP9, NR1I2/GSK3B, LRP1B, and MIR143HG (CARMN) were validated. We discuss potential reasons for the failed validation and replication of published findings, including study/treatment heterogeneity and other limitations inherent to genomic treatment outcome studies. For the future, we envision prospective longitudinal studies with sufficiently long follow-up and endpoints that reflect the dynamic nature of endocrine resistance.

PMID:39971965 | DOI:10.1038/s41523-025-00733-y

Categories: Literature Watch

Systematic identification of cancer pathways and potential drugs for intervention through multi-omics analysis

Wed, 2025-02-19 06:00

Pharmacogenomics J. 2025 Feb 19;25(2):2. doi: 10.1038/s41397-025-00361-6.

ABSTRACT

The pathogenesis of cancer is complicated, and different types of cancer often exhibit different gene mutations resulting in different omics profiles. The purpose of this study was to systematically identify cancer-specific biological pathways and potential cancer-targeting drugs. We collectively analyzed the transcriptomics and proteomics data from 16 common types of human cancer to study the mechanism of carcinogenesis and seek potential treatment. Statistical approaches were applied to identify significant molecular targets and pathways related to each cancer type. Potential anti-cancer drugs were subsequently retrieved that can target these pathways. The number of significant pathways linked to each cancer type ranged from four (stomach cancer) to 112 (acute myeloid leukemia), and the number of therapeutic drugs that can target these cancer related pathways, ranged from one (ovarian cancer) to 97 (acute myeloid leukemia and non-small-cell lung carcinoma). As a validation of our method, some of these drugs are FDA approved therapies for their corresponding cancer type. Our findings provide a rich source of testable hypotheses that can be applied to deconvolute the complex underlying mechanisms of human cancer and used to prioritize and repurpose drugs as anti-cancer therapies.

PMID:39971899 | DOI:10.1038/s41397-025-00361-6

Categories: Literature Watch

Predictive Biomarkers and Personalized Therapy: Use of Pharmacogenetic Testing in a Scandinavian Perspective

Wed, 2025-02-19 06:00

Basic Clin Pharmacol Toxicol. 2025 Mar;136(3):e70009. doi: 10.1111/bcpt.70009.

ABSTRACT

Precision medicine has significantly advanced through the development of predictive biomarkers based on pharmacogenetic (PGx) testing. These tests identify interactions between drugs and genetic variants that influence patient responses to treatments. Understanding genetic variations in drug-metabolizing enzymes, receptors and transporters and their impact on pharmacokinetics and pharmacodynamics allows for the prediction of drug effects and side effects, enabling tailored treatments for different patient groups. This review focuses on drugs metabolized by cytochrome P450 (CYP450) enzymes, for example, citalopram and clopidogrel or transported by the solute carrier organic anion transporter family member 1B1 (SLCO1B1), for example, atorvastatin and simvastatin, with PGx dosing guidelines, in the context of consumption in Scandinavian countries. A major barrier to the widespread adoption of PGx tests in clinical practice has been healthcare professionals' uncertainty about their efficacy, complexity in result interpretation and questions regarding the evidence base. However, recent studies have demonstrated PGx testing has the potential to improve treatment outcomes, reduce adverse drug reactions and achieve cost savings. These findings underscore the potential of PGx testing as a valuable tool in clinical decision making, promoting its use in a pre-emptive manner to enhance patient care.

PMID:39971612 | DOI:10.1111/bcpt.70009

Categories: Literature Watch

A United Kingdom nationally representative survey of public attitudes towards pharmacogenomics

Wed, 2025-02-19 06:00

QJM. 2025 Feb 20:hcaf035. doi: 10.1093/qjmed/hcaf035. Online ahead of print.

ABSTRACT

BACKGROUND: Variation in DNA is known to contribute to medication response, impacting both medicine effectiveness and incidence of adverse drug reactions (ADRs). However, clinical implementation of pharmacogenomics (PGx) has been slow, and the views of the public are not well understood.

AIM: To assess UK national public attitudes around pharmacogenetics.

DESIGN AND METHODS: The survey was co-designed with the Participant Panel at Genomics England and the data were collected by the National Centre for Social Research, using its nationally representative panel of UK adults. Multivariable logistic regression analyses were used to analyse relationships between selected survey reported variables, controlled for age and sex.

RESULTS: The survey response rate was 58%. Two thousand seven hundred and nineteen responses were obtained. Most respondents (59%) had experienced either no benefit or a side effect. Forty-five per cent of respondents reported having experienced no benefit and 46% of respondents reported having experienced a side effect, with female respondents more likely to be in both groups (P < 0.0001). Despite variability in interindividual medicine response being well understood (89%), the involvement of DNA in predicting benefit or risk of a side effect is not (understood by 52% and 48%, respectively). Eighty-nine per cent would complete a PGx test, with 91% wanting direct access to this information. Eighty-five per cent of UK adults think that the NHS should offer PGx to those regularly taking many medicines. Respondents were not more worried overall about misuse of PGx data compared with other routine medical data. Experience with prescription medication impacted on views with those who were prescribed medication almost twice as likely to want a PGx test for any reason.

CONCLUSION: Most respondents reported experience with either a medication not working for them or ADRs. There was a high level of understanding of variable medication response but a relatively low level of awareness of the role genetics plays in that variability. Most respondents would want a PGx test, to have direct access to results, and think the NHS should offer this form of testing. Importantly, respondents were not more concerned about PGx data use than that of any other routinely generated medical data. Notably, this study highlights a relationship between individuals' experiences with prescription medications and their interest in PGx testing, underscoring the potential for personalized medicine to address public healthcare needs.

PMID:39971322 | DOI:10.1093/qjmed/hcaf035

Categories: Literature Watch

A naturalistic retrospective evaluation of the utility of pharmacogenetic testing based on CYP2D6 e CYP2C19 profiling in antidepressants treatment in a cohort of patients with major depressive disorder

Wed, 2025-02-19 06:00

Prog Neuropsychopharmacol Biol Psychiatry. 2025 Feb 17:111292. doi: 10.1016/j.pnpbp.2025.111292. Online ahead of print.

ABSTRACT

Response to antidepressants (ADs) is highly variable and partly genetically driven, but the utility of pharmacogenetic testing in guiding ADs treatment is still controversial. We conducted a retrospective, naturalistic study to explore the utility of CYP2C6 and CYP2C19 genotyping in ADs treatment in a sample of 156 patients diagnosed with major depressive disorder from South Sardinia (Italy). Clinical data, including history of medication regimens, adverse reactions, and response to ADs, were collected over the last five years preceding recruitment. Patients received pharmacogenetic testing at recruitment and were classified depending on whether their history of treatment regimen followed the recommendations of the Clinical Pharmacogenetics Implementation Consortium (CPIC)). Non-responders to ADs had a larger number of therapeutic regimens and of medication changes due to lack of response compared to responders. Patients with at least one incongruent regimen had a larger number of total therapeutic changes and fewer congruent regimens. Metabolizing phenotypes of CYP2D6 were not associated with response to ADs or changes in regimen of any kind. However, the group of ultra-rapid metabolizers for CYP2C19 showed significantly smaller improvement in symptoms while the poor-metabolizers showed a larger number of medication changes for side effects compared to normal, intermediate and rapid metabolizers. Our findings suggest that the implementation of pharmacogenetic testing based on CYP2C19 could be clinically useful in guiding AD treatment, but further studies are warranted to investigate the clinical implications of implementing PGx testing in depression.

PMID:39971121 | DOI:10.1016/j.pnpbp.2025.111292

Categories: Literature Watch

Causal relationship between Faecalibacterium abundance and risk of Faecalibacterium-related diseases: a two-sample bi-directional Mendelian randomisation study

Wed, 2025-02-19 06:00

Benef Microbes. 2025 Feb 12:1-14. doi: 10.1163/18762891-bja00058. Online ahead of print.

ABSTRACT

Faecalibacterium is an essential probiotic in the human gut; changes in its abundance are associated with various disease states in many studies. However, the causal nature of such associations remains obscure. Therefore, we aimed to thoroughly investigate the causal relationships between Faecalibacterium and its related diseases. A two-sample bi-directional Mendelian randomisation analysis was conducted using publicly available genome-wide association studies summary statistics for Faecalibacterium and its related diseases. We found that Faecalibacterium was negatively correlated with the risk of ankylosing spondylitis (odds ratio [OR] = 0.526, 95% confidence interval [CI]:0.304-0.908, P = 0.021), atopic dermatitis (OR = 0.484, 95%CI: 0.261-0.898, P = 0.021) and heart failure (OR = 0.657, 95%CI: 0.467-0.924, P = 0.016), while Faecalibacterium was positively associated with autism spectrum disorder risk (OR = 2.529, 95%CI: 1.012-6.319, P = 0.047). The results of reverse Mendelian randomisation analysis showed that acute sinusitis (OR = 0.902, 95%CI: 0.839-0.970, P = 0.005) and Alzheimer's disease (OR = 0.976, 95%CI: 0.958-0.993, P = 0.008) was causally associated with lower Faecalibacterium abundance, respectively, while cirrhosis (OR = 1.154, 95%CI: 1.028-1.295, P = 0.015) and multiple myeloma (OR = 2.619 × 1012, 95%CI: 2.492-2.754 × 1024, P = 0.043) was causally associated with higher Faecalibacterium abundance. Our findings firstly showed that changes in Faecalibacterium abundance may contribute to the risk of ankylosing spondylitis, atopic dermatitis, heart failure and autism spectrum disorders, and potentially as a result of acute sinusitis, Alzheimer's disease, cirrhosis and multiple myeloma.

PMID:39970929 | DOI:10.1163/18762891-bja00058

Categories: Literature Watch

Pharmacogenomics of Chemotherapies for Childhood Cancers in Africa: A Scoping Review

Wed, 2025-02-19 06:00

Pharmgenomics Pers Med. 2025 Feb 14;18:55-69. doi: 10.2147/PGPM.S502355. eCollection 2025.

ABSTRACT

BACKGROUND: Pharmacogenomics holds significant promise in improving the efficacy and safety of chemotherapy for childhood cancers. However, the field remains underexplored in Africa, where high genetic diversity and substantial disease burdens, including cancers, create unique challenges. This review investigates the current state of pharmacogenomics research in childhood cancer chemotherapies across Africa, focusing on genetic variations influencing chemotherapy efficacy and adverse drug reactions. It also highlights critical gaps, such as limited infrastructure and insufficient healthcare worker knowledge, and emphasizes the importance of capacity-building initiatives in the region.

METHODS: A scoping review was conducted encompassing studies published up to September 2024 that examined pharmacogenomic variations associated with chemotherapies in childhood cancer patients across Africa. The review included laboratory genetic analyses and surveys assessing healthcare workers' knowledge, attitudes, and perceptions regarding pharmacogenomics, particularly in the context of pediatric oncology.

RESULTS: A total of 12 genes were identified across eight studies, including TPMT, CYP3A5, MDR1, MAPT, NUDT15, ITPA, IMPDH1, SLC29A1, SLC28A2, SLC28A3, ABCC4, and MTHFR. The most studied genes were TPMT and CYP3A5, which are involved in the metabolism of 6-mercaptopurine (6-MP) and vincristine, respectively. These studies spanned five African countries, including Kenya, Egypt, Zimbabwe, Nigeria, Tunisia, and Libya, and focused primarily on childhood cancers, particularly acute lymphoblastic leukemia. Chemotherapies frequently studied were 6-MP (reported in five studies), vincristine, cyclophosphamide, and methotrexate. Knowledge of pharmacogenomics among healthcare workers in Africa remains low, though a positive attitude towards its clinical applications was observed.

CONCLUSION: Pharmacogenomic variants, such as TPMT*3A, 3C, and CYP3A53, *6, significantly impact drug metabolism in African children with cancer. However, research remains regionally limited, and gaps in infrastructure and healthcare worker training persist. Expanding research efforts and improving pharmacogenomics capacity through pharmacist training and capacity-building initiatives are essential to advancing personalized medicine in Africa, ultimately improving treatment outcomes for pediatric cancer patients.

PMID:39968370 | PMC:PMC11834739 | DOI:10.2147/PGPM.S502355

Categories: Literature Watch

The mental health implication of mpox: Enhancing care with genetic insights

Wed, 2025-02-19 06:00

J Public Health Afr. 2025 Jan 24;16(1):786. doi: 10.4102/jphia.v16i1.786. eCollection 2025.

ABSTRACT

The intersection of mpox and mental health is a critical concern, particularly for individuals with pre-existing mental disorders, who face heightened psychological stress and exacerbation of symptoms. This study explores the potential of genetic testing, such as Polygenic Risk Scores and pharmacogenetics, in enhancing mental disorders and mpox management. By tailoring treatment and prevention strategies to an individual's genetic profile, clinicians can provide more personalised care, reducing adverse effects and improving outcomes. Furthermore, genetic insights can inform the development of safer vaccines and early interventions, particularly for vulnerable populations. The study underscores the importance of integrating mental and public health strategies, advocating for targeted research and fostering interdisciplinary collaboration to effectively address these complex health challenges.

PMID:39968354 | PMC:PMC11830839 | DOI:10.4102/jphia.v16i1.786

Categories: Literature Watch

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