药物遗传学和变现:对精神病患者体验的副作用的影响
Manon G den Uil1, Hannelotte W Hut1, Kay R Wagelaar1,2
1Division Laboratories, Pharmacy and Biomedical Genetics, Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, Netherlands.
Frontiers in genetics
|September 11, 2023
概括
由于同时服用药物而导致药物代谢的变化 - - 现象转化 (phenoconversion) 影响精神病患者. 这项研究强调了它在预测更好的精神药物治疗副作用方面的作用.
科学领域:
- 药物遗传学 药物遗传学
- 精神病学是一个精神病学.
- 临床药理学 临床药理学
背景情况:
- 预防心理药物治疗的副作用对于患者的坚持至关重要.
- 对CYP2C19和CYP2D6的药物遗传学 (PGx) 分析会影响药物代谢.
- 由于同时服用药物而导致的预测代谢表型的转变,即转换,可以改变药物反应.
研究的目的:
- 为了研究PGx配置文件和phenoconversion对精神病患者副作用的影响.
- 评估CYP2C19和CYP2D6转化现象和不良事件之间的关系.
主要方法:
- 对117名精神病室门诊患者进行了回顾性队列研究.
- 使用精神病学PGx小组对CYP2C19和CYP2D6.6进行基因型鉴定.
- 使用 Udvalg for Kliniske Undersølgelser (UKU) 的副作用评级尺度进行副作用评价.
主要成果:
- 现象转化发生在10.3% (CYP2C19) 和9.4% (CYP2D6) 的患者中.
- 具有转化CYP2C19 (IM/PM) 患者的恶心/吐率 (75%) 与NM/UM (9.1%,p=0.033) 相比较高.
- 具有转化CYP2D6 (IM/PM) 的患者报告了更多的抑郁症 (64%) 与NM/UM (30.4%,p=0.020).
结论:
- 转化显著影响精神病患者出现恶心,吐和抑郁等特定副作用的发生.
- 考虑到与基因型一起的表观转换对于准确的表型预测和预防与精神药物治疗相关的不良事件至关重要.
- 通过CYP2D6代谢的中间体和弱代谢者表现出更高的药物度-剂量比率,这表明药物处理发生了改变.
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