药物遗传学以优化系统性红斑狼的免疫抑制疗法:一个范围审查
Alim Khodimul Rahmat1,2, Irmasari2, Zahrotun Nafiah2
1Doctor's Program in Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
遗传变异会影响免疫抑制剂在系统性红斑狼 (SLE) 中的作用. 了解这些遗传差异可以个性化治疗并改善SLE患者的治疗结果.
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
- 自免疫性疾病 自免疫性疾病
背景情况:
- 系统性红斑狼 (SLE) 是一种复杂的自身免疫性疾病,可以用免疫抑制剂治疗.
- 个人对这些药物的反应因遗传因素而有很大差异.
研究的目的:
- 审查遗传多态度对免疫抑制剂药理动力学和SLE治疗反应的影响.
- 确定关键基因及其对SLE患者药物代谢,疗效和毒性的影响.
主要方法:
- 综合审查37项研究,重点关注用于SLE的免疫抑制剂.
- 对诸如UGT1A9,UGT2B7,CYP3A5,ABCB1,ABCC2和TPMT等基因中的遗传变异进行分析.
主要成果:
- 在UGT1A9,UGT2B7,CYP3A5,ABCB1,ABCC2,TPMT,CYP2C19和CYP2B6中的遗传多态性显著影响了免疫抑制剂的新陈代谢,疗效和毒性,如mycophenolic acid,tacrolimus,azathioprine,glucocorticoids和cyclophosphamide.
- ABCB1变种影响药物运输,ABCC2影响菌酸清除,UGT变种影响菌酸代谢,CYP3A5对塔克罗利斯剂量至关重要,TPMT对阿扎西奥普林代谢至关重要,CYP2C19/CYP2B6影响循环胺加工.
结论:
- 遗传变异需要针对SLE患者个性化治疗策略,以优化免疫抑制疗法.
- 迫切需要更多的SLE特异性药物遗传学研究,特别是在多种人群中,以推进精准医学并改善患者的治疗结果.
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