Have you ever wondered why certain medications work wonders for some people, but not for others? The answer lies in our genes. That's right, our genetic makeup can determine how we respond to certain drugs - and this fascinating field is known as pharmacogenomics.
In this blog, we will discuss the basics of pharmacogenomics, its potential impact on healthcare, and the challenges that still lie ahead.
Did You Know Your DNA Could Impact Your Medication's Effectiveness?
Pharmacogenomics is a crucial aspect of precision medicine, a field that aims to individually or collectively modify medical care for each patient. Pharmacogenomics looks at the role that heredity plays in how you respond to drugs. Sometimes, a drug's effectiveness for you—or even whether it has any impact at all—can be influenced by your DNA.
Pharmacogenomics can assist you in knowing beforehand whether a medication is likely to be advantageous to you and safe for you to take, which can enhance your health. With this knowledge, your doctor can find the drug that will benefit you the most.
Delving into the Inner Workings of Pharmacogenomics
Drugs can interact with your body in a variety of ways, depending on how you take them and where they function in your body. After you swallow a drug, your body must digest it in order to transport it to the intended site. This process can be affected by your genes at different points, which will affect how you respond to the medication. To mention few, of these interactions include
- Drug Receptors: Only when they can bind to receptors—proteins that are present on the surface of cells—do some medicines work as intended. Your DNA determines what kinds and how many receptors you have, which may affect how you respond to the medication. You might need a different medication or a higher or lower dosage than most people do.
- Example: T-DM1 and breast cancer. Certain breast tumors overproduce the receptor HER2, which aids in the growth and spread of the disease. This form of breast cancer can be treated with T-DM1, a medication that kills malignant cells by binding to their HER2 receptor. Your doctor may test a piece of your tumor if you have breast cancer to see if T-DM1 is the best course of action for you. Your doctor might advise T-DM1 if your tumor is HER2 positive (high HER2 content). T-DM1 won't help you if your tumor lacks enough HER2 (is HER2 negative).
- Drug Uptake: Certain medications need to be actively ingested by the tissues and cells where they work. The absorption of some medications may be impacted by your DNA. Reduced uptake may indicate that the medicine is not working as well or that it is building up in other areas of your body, both of which might be problematic. Also, your DNA can influence how quickly some medications leave the cells where they work. Drugs may not have enough time to act if they are taken out of the cell too soon.
- Example: Muscle issues and statins. An example of a medication that works in the liver to decrease cholesterol is statins. Statins must first enter the liver in order to function properly. A protein produced by the SLCO1B1 gene is responsible for delivering statins to the liver. The simvastatin statin is taken up less readily by the liver in some persons due to a specific mutation in this gene. Simvastatin can build up in the blood when taken in large amounts, which can lead to muscle problems like weakness and soreness. Your doctor may suggest genetic testing for the SLCO1B1 gene prior to the prescription of simvastatin in order to assess whether simvastatin is the best statin for you or what dosage would be most effective.
- Drug Breakdown: How quickly your body breaks down drugs depends in part on your genes. You could require more of the drug or a different drug if you break down the drug more quickly than the majority of individuals do. You could require less of the medicine if your body breaks it down more slowly.
- Example: Amitriptyline and depression. Amitriptyline, an antidepressant medication, is broken down by two genes named CYP2D6 and CYP2C19. If you are given amitriptyline by your doctor, the dosage of the medication you require may be determined by genetic testing for the CYP2D6 and CYP2C19 genes. You may need to use a different medication or take a bigger dose of amitriptyline if your body breaks it down too quickly. To prevent a negative response, you will need to take a smaller amount of amitriptyline or another medication if your body breaks down the medicine slowly.
How is Pharmacogenomics Shaping the Future of Drug Design, Development, and Personalized Prescribing Guidelines?
Drug safety in the US is monitored by the Food and Drug Administration (FDA). The labels of about 200 drugs now contain pharmacogenomic data. By offering advice on a dose, potential side effects, or differences in effectiveness for persons with particular gene variants, this information can assist clinicians in customizing medicine prescriptions for individual patients.
Pharmacogenomics is also being used by pharmaceutical companies to create and sell medications for patients with particular genetic profiles. Drug companies may be able to accelerate the development of medicine and enhance its therapeutic benefit by only testing it in patients who are likely to benefit from it.
Additionally, if researchers are able to pinpoint genes that result in harmful side effects, doctors might only recommend those medications to those who do not possess those genes. This would make it possible for some persons to get potentially life-saving medications that might otherwise be prohibited because they present a risk to others.
Can Pharmacogenomics Change the Face of Medicine Forever?
When considering its possible usefulness in the future, pharmacogenomics is still a very new field of study and its current application in practice is quite limited.
In order to create medications that are customized for specific people with particular genetic compositions, extensive research is now being conducted in this area. As a result, the market for pharmacogenomics is likely to reach a valuation of USD 33.1 billion by 2030, as per estimates by Extrapolate. Genes for metabolic enzymes that modify a drug's activity or a person's propensity to get a disease are of particular interest.