在非洲背景下临床使用的表型尾酒的批判性评估
Machel Leuschner1, Allan Duncan Cromarty1
1Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa.
Journal of personalized medicine
|July 29, 2023
概括
开发具有成本效益的药物代谢表型化方法对于个性化医学至关重要,特别是在南非. 目前的方法面临局限性,但使用毛细血管血液的更简单,非侵入性方法对常规临床使用有希望.
科学领域:
- 药物基因组学 药物基因组学
- 临床药理学 临床药理学
- 药物新陈代谢 药物新陈代谢
背景情况:
- 细胞染色体P450 (CYP450) 代谢和P-葡萄糖蛋白 (P-gp) 运输的个体间变异影响药物的有效性和安全性.
- 药物不良反应,相互作用和治疗失败是常见的临床问题.
- 个性化药物治疗需要具有成本效益的表型,特别是在像南非这样的资源有限的环境中.
研究的目的:
- 批判性地评估在南非背景下使用现有的体内药物表型化尾酒的可行性.
- 确定阻碍当前表型化策略临床实施的局限性.
- 提出一种改进的,具有成本效益的表型化方法.
主要方法:
- 进行了关于第一阶段代谢和P-gp传输的体内表型化尾酒的文献搜索.
- 专注于人类研究和临床实践中使用的探针药物.
- 分析了与药物管理,可用性,副作用,采样和分析程序相关的限制.
主要成果:
- 目前的表型化方法受到多种管理途径,药物的可用性,副作用,广泛的采样和复杂的分析程序的限制.
- 分析挑战包括难以处理样本,低检测极限和敏感性/特异性差.
- 现有的方法不适合常规,经济高效的临床应用.
结论:
- 建议采用简化,非侵入性的表型化方法,采用单一时间点毛细血管采样和低剂量探针药物尾酒.
- 该方法旨在提高常规临床表型的可行性和成本效益.
- 需要进一步的研究来验证毛细血管血液生物分析与标准血/血清矩阵的相关性.
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