药物基因组学在脏移植后对白人和土著美国人的价值
Alexandra Brady1, Suman Misra1, Mina Abdelmalek1
1Department of Nephrology and Hypertension, Mayo Clinic, Scottsdale, AZ 85259, USA.
Pharmacy (Basel, Switzerland)
|August 25, 2023
概括
在移植受体中进行的药物基因组 (PGx) 测试显示,超过三分之一的患者有临床可行的药物基因相互作用. 与白人患者相比,美洲原住民在药物代谢中表现出明显的遗传变异.
科学领域:
- 药物基因组学 药物基因组学
- 移植医学 移植医学 移植医学
- 遗传学 遗传学 是一个
背景情况:
- 有限的证据证明了对移植患者的药物遗传学 (PGx) 测试的价值.
- 美国土著人和白人之间PGx结果的差异尚未得到充分理解.
研究的目的:
- 根据移植患者的PGx结果来确定药物改变的频率.
- 为了比较PGx发现和原住民美国人和白人移植接受者之间的患者看法.
主要方法:
- 对31名美国原住民和50名白人脏移植接受者的前性研究.
- 使用OneOme RightMed的PGx测试对27个基因进行检测.
- 收集了测试前和后的定性患者调查.
主要成果:
- 在21.5%的患者中发现了临床可行的药物基因相互作用,其中12.7%的患者建议进行监测.
- 与白人患者相比,美国土著人表现出不同的CYP2C19,CYP2D6,CYP4F2和VKORC活动.
- 影响抗抑郁药代谢的SLC6A4变异在美国原住民患者 (45%) 和白人患者 (20%) 中更为普遍.
结论:
- 接受脏移植的人经常有可操作的药物基因相互作用,这表明超过三分之一的人可能会从PGx引导的药物调整中受益.
- 在土著美国人和白人脏移植接受者之间存在药物代谢酶和输送物的显著遗传差异.
相关概念视频
Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29
Analysis of Population Pharmacokinetic Data
293
Analysis of population pharmacokinetic data involves studying the behavior of drugs within diverse populations to understand their pharmacokinetic parameters. Traditional pharmacokinetic methods typically involve collecting samples from a few individuals and estimating these parameters. While these methods are commonly used, they have limitations in capturing the variability in drug response among individuals or heterogeneous populations. Population pharmacokinetics is employed to address these...
293
Factors Affecting Renal Clearance: Drug Distribution and Drug Interactions
162
Renal clearance plays a pivotal role in drug elimination from the body and can be influenced by drug distribution and interactions. Understanding these factors is crucial in pharmacology as they impact the effectiveness and duration of drug therapy.
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
One important factor is the relationship between renal clearance and the apparent volume of distribution. Renal clearance tends to be inversely proportional to the apparent volume of distribution. Drugs with an extensive distribution volume or those...
162
Renal Drug Excretion: Overview
183
As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules...
183
Renal Drug Clearance: Overview
247
Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
247
Kidney Transplant III: Nursing Management
39
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
39


