HLA基因测试在预测药物副作用方面的作用不断扩大
Natasha Petry1, Kennedy Forest2, Russell A Wilke2
1School of Pharmacy, North Dakota State University, Fargo, ND 58102, USA.
The American journal of the medical sciences
|October 14, 2023
概括
奇异的药物不良反应,通常是免疫介导的,可以通过人类白细胞抗原 (HLA) 基因变异来预测. 本综述探讨了HLA介导的对常见药物的药物反应.
科学领域:
- 药物基因组学 药物基因组学
- 免疫学 免疫学 免疫学
- 药品安全 药品安全
背景情况:
- 药物不良反应 (ADR) 被分为剂量依赖 (A型) 或特异性 (B型).
- B型ADRs是罕见的,不可预测的,并且经常是免疫介导的,包括严重的皮肤反应和药物诱导的肝损伤.
- 人类白细胞抗原 (HLA) 基因的变异性影响了许多常见药物的特异性ADRs风险,如抗生素.
研究的目的:
- 审查有关HLA介导药物不良反应的现有文献.
- 确定特定的药物基因关系,在这些情况下,先发性HLA基因型定型可能是有益的.
- 突出自动化临床决策支持在管理这些风险方面的潜力.
主要方法:
- 对调查HLA与药物诱导的不良反应相关的研究进行系统性文献综述.
- 报告的病例和遗传数据分析,将特定的HLA基因组与药物过敏性联系起来.
- 综合与常见药物类别及其相关的HLA类型相关的发现.
主要成果:
- 几种常见的药物,特别是抗生素,与特定的HLA等位基因有明确的关联.
- 这些由HLA介导的反应可能是严重的和潜在的致命的,强调需要进行风险评估.
- 鉴定的药物基因关系为有针对性的基因查提供了基础.
结论:
- HLA基因型鉴定可以识别特定药物诱导不良反应的高风险个体.
- 预防性基因查和临床决策支持系统对于提高药物安全至关重要.
- 了解HLA介导的副作用对于个性化医疗和预防严重药物过敏至关重要.
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