精准医学策略,以改善结核病患者的异化治疗
Levin Thomas1, Arun Prasath Raju1, Surulivelrajan Mallayasamy1
1Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India.
European journal of drug metabolism and pharmacokinetics
|August 17, 2024
概括
使用异化治疗结核病的精密治疗包括根据个体患者的遗传学,新陈代谢和病原体特征量身定制剂量. 这种方法优化药物水平,减少不良反应和耐药性,以获得更好的治疗结果.
科学领域:
- 药物基因组学和精准医学
- 传染病治疗方法 传染病治疗方法
- 药物代谢和药理动力学
背景情况:
- 结核病的标准异化剂量可能是低于最佳的,因为药物代谢和药理动力学的个体差异.
- 这种变化可能导致毒性药物度,不良反应,治疗失败或药物耐药性.
研究的目的:
- 在结核病治疗中探索异化的精密治疗方法.
- 整合宿主药物基因组学,病原体基因组学和临床因素,以实现个性化剂量.
主要方法:
- 利用分子诊断来进行宿主药基因组分析,重点关注N-乙转移酶2 (NAT2) 代谢.
- 分析Mycobacterium结核病基因组的药物耐药突变.
- 整合基于omics的方法 (微生物组,表观基因组学,蛋白质组学,代谢组学,脂管组学).
- 使用治疗药物监测和人口药动力学建模.
主要成果:
- 主体药物基因组学 (特别是NAT2) 和Mycobacterium结核病基因组学显著影响异化的药物动力学和疗效.
- 基于Omics的方法提供了对药物动力学变异性和药物不良反应的机制性见解.
- 宿主/病原体基因组学,药理动力学数据和患者因素的整合使得量身定制的异化治疗成为可能.
结论:
- 对于异尼的精密治疗,需要采用多方面的方法,将宿主和病原体的分子数据与临床信息相结合.
- 个性化的异化剂量可以优化药物暴露,最大限度地减少毒性,并对抗药物耐药性.
- 为了广泛的临床应用,需要在不同患者群体中进一步验证.
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