So aduru a wɔrekyerɛw ama wo no fata wo? Momma yɛnka Pharmacogenomics ho asɛm!

Ebia woate sɛ aduru koro no ara a wɔde sa yare koro no ara yɛ adwuma ma nnipa binom, ɛnyɛ adwuma mma afoforo, na ɛwɔ nkɛntɛnso bɔne ma afoforo. Dɛn nti na ɛte saa? So ɛsono yɛn nipadua nti? Yiw, ɛno yɛ ade biako nti a ɛte saa. Ɛno yɛ asɛmti a ɛfa ho, ɛyɛ den kakra, nanso ɛho hia paa a yɛbɛka ho asɛm nnɛ. Wɔfrɛ eyi sɛ pharmacogenomics.

Dɛn ne Pharmacogenomics?

Sɛ yɛbɛka no tiawa a, pharmacogenomics yɛ sɛnea yɛyɛ yɛn ade wɔ nnuru ho a egyina yɛn awosu mu nkwaadɔm so. Kae sɛ nnuruyɛ ho adesua yɛ nnuru a wɔde di dwuma ne nea efi mu ba ho nhwehwɛmu. Genomics yɛ awosu mu nkwaadɔm ne ne dwumadi ho adesua. Wɔfrɛ abien no nyinaa a wɔaka abom no pharmacogenomics. Ɛtɔ mmere bi a wɔfrɛ no pharmacogenetics.

Eyi hyɛ ‘Precision Medicine’ afuw kɛse no ase ankasa . Ɛne sɛ, wɔbɛma wo ayaresa nhyehyɛe a ɛfata a egyina nneɛma te sɛ w’awosu mu nkwaadɔm, nneɛma a atwa wo ho ahyia, ne w’asetra kwan so. Pharmacogenomics betumi aboa wo duruyɛfo ma wapaw aduru a enni nsunsuanso bɔne pii anaasɛ ɛyɛ adwuma yiye ma wo .

Nanso ɛsɛ sɛ yɛhyɛ no nsow sɛ wonnya mfaa saa kwan yi nni dwuma wɔ yare biara anaa aduru biara ho. Mprempren, wɔde di dwuma kɛse ma tebea horow ne nnuru kakraa bi, te sɛ HIV, kokoram ahorow bi, adwenemhaw, ne komayare. Nanso saa afuw yi renya nkɔso ntɛmntɛm yiye. Nhwehwɛmufo wɔ anidaso sɛ ɛrenkyɛ na saa kwan yi aboa ma wɔapaw nnuru a eye ma nyarewa a ɛtaa ba mpo.

Ɔkwan bɛn so na awosu mu nneɛma ka ɔkwan a nnuru fa so yɛ adwuma?

Susuw ho saa kwan yi so: yɛn awosu mu nkwaadɔm te sɛ akwankyerɛ ahorow a wɔahyehyɛ ama nkwammoaa a ɛwɔ yɛn nipadua mu no. Saa awosu mu nkwaadɔm yi boa yɛn ma yɛyɛ protein molecule ahorow a wɔfrɛ no enzymes . Enzymes wɔ nnwuma ɔpepem biako wɔ yɛn nipadua mu. Emu biako ne sɛ wɔbɛpaapae nnubɔne a ɛwɔ nipadua no mu, anaasɛ wɔbɛsakra no . Sɛ nnipa binom nyɛ wɔn ade wɔ nnubɔne ho sɛnea wɔhwɛɛ kwan a, ebetumi aba sɛ esiane nsakrae bi wɔ wɔn awosu mu nti. Saa nsakrae yi betumi ama enzymes no anyɛ adwuma yiye anaasɛ enzymes no anyɛ adwuma yiye.

Afei susuw ho hwɛ, sɛ wo nipadua bubu nnubɔne bi ntɛmntɛm dodo, anaa brɛoo dodo, anaasɛ ɛntetew koraa a, dɛn na ɛbɛba? Afei na aduru a wɔde ma wɔ dodow a wɔtaa de ma no rennyɛ adwuma sɛnea wɔhwɛ kwan no. Aduru no betumi de ɔhaw ahorow a emu yɛ den aba , anaasɛ entumi nnya yare a ɛwɔ hɔ mprempren no so nkɛntɛnso biara.

Sɛ nhwɛso no, nnipa binom nna ntɛm bere a wɔanom kɔfe awie no, na ebinom nso ntumi nna. Ade biako nti a ɛte saa ne sɛ yɛn awosu mu nkwaadɔm nya sɛnea yɛn nipadua no sɛe caffeine ntɛmntɛm no so nkɛntɛnso. Saa ara na ebetumi aba wɔ nnuru ho.

Dɛn ne saa pharmacogenomic sɔhwɛ yi?

Pharmacogenomic nhwehwɛmu yɛ awosu mu nhwehwɛmu. Ebetumi ahwɛ awosu mu nkwaadɔm biako anaa nea ɛboro saa, titiriw de ahwehwɛ awosu mu nkwaadɔm pɔtee bi a ɛka aduru bi a ɛpaapae. Ɛte sɛ nea yɛrehwɛ sɛ mfomso bi wɔ yɛn nipadua ‘akwankyerɛ nhoma’ mu.

Nnuruyɛfo taa de mogya anaa anom aduru di dwuma de yɛ eyi. Wɔfa saa nhwɛsoɔ yi firi wo hɔ na wɔde kɔ lab. Ɛhɔ no, mfiridwuma ho nimdefo bi hwɛ wo DNA mu hwɛ sɛ nsakrae pɔtee bi wɔ hɔ anaa. Awosu mu abɔde anaa awosu mu nkwaadɔm a wɔhwehwɛ no begyina nhwehwɛmu a wo duruyɛfo ahyɛ sɛ wɔnyɛ, tebea a wɔrebɔ mmɔden sɛ wɔbɛsa, ne nnuru a wɔayɛ nhyehyɛe sɛ wɔde bɛma wo no so.

Bere bɛn na ɛsɛ sɛ meyɛ pharmacogenomic nhwehwɛmu?

Sɛ worenom nnuru ama ayaresa tebea horow bi a, ebia wobɛfata nso sɛ wɔyɛ pharmacogenomic nhwehwɛmu. Nhwɛso ahorow bi ni (na ebia pii nso wɔ hɔ):

Cholesterol a ɛdɔɔso

Esiane ``SLCO1B1 gene`` a ɛwɔ yɛn nipadua mu no ahorow bi nti, sɛ wofa nnuru bi a wɔfrɛ no statins ma srade a ɛkɔ soro a, ebia wobɛte ntini mu yaw ne mmerɛwyɛ. Saa statin ahorow yi ho nhwɛso ne:

• Atorvastatin (sɛ nhwɛso no, Lipitor®) .
• Fluvastatin (sɛ nhwɛso no, Lescol®) .
• Lovastatin (sɛ nhwɛso no, Altoprev®) .
• Pitavastatin (sɛ nhwɛso no, Livalo®) .
• Pravastatin (sɛ nhwɛso no, Pravachol®) .
• Rosuvastatin (sɛ nhwɛso no, Crestor®) .
• Simvastatin (sɛ nhwɛso no, Zocor®) .

Enti ansa na wubefi ase anom aduru bi a ɛte sɛɛ, anaasɛ sɛ wuhyia ɔhaw bi bere a wode redi dwuma a, wo duruyɛfo betumi ne wo akasa afa nhwehwɛmu a ɛte sɛɛ ho.

Hahaahayɔ

Nsonsonoe a ɛba awosu mu nkwaadɔm CYP2D6 ne CYP2C19 mu no betumi aka sɛnea wo nipadua no sɛe nnuru bi a ekum adwenemhaw ntɛmntɛm no. Nnuru yi ho nhwɛso bi ne:

• Amitriptyline (e.g. Elavil®) - Eyi yɛ aduru bi a wɔde kum adwenemhaw a ɛwɔ akwan abiɛsa so .
• `SSRI` nnuru kuw : `Citalopram` (sɛ nhwɛso no, `Celexa®`), `Escitalopram` (sɛ nhwɛso no, `Lexapro®`), `Sertraline` (sɛ nhwɛso no, `Zoloft®`), `Paroxetine` (sɛ nhwɛso no, `Paxil®`) ne `Fluvoxamine` (sɛ nhwɛso no, `Luvox®`).
• Venlafaxine (e.g. Effexor®) - Eyi yɛ SNRI bi.

Saa sɔhwɛ yi betumi ayɛ nea mfaso wɔ so bere a worefi nnuru a ɛte sɛɛ ase, anaasɛ bere a aduru biako ntumi nyɛ adwuma na worebɔ mmɔden sɛ wobɛdan akɔ foforo so no.

Kokoram ahorow

Sɛ worenom nnuru a wɔde sa kokoram pɔtee bi a, ebia wubenya mfaso afi pharmacogenomic nhwehwɛmu mu. Nhwɛso ahorow bi ni:

• Nufu mu kokoram: Aduru trastuzumab (e.g. Herceptin®) yɛ adwuma wɔ nnipa a wɔwɔ nufu mu kokoram a HER2 wom nkutoo mu . Eyi kyerɛ sɛ kokoram nkwammoaa no wɔ awosu mu nsakrae bi a ɛma wɔyɛ HER2 protein no pii dodo.
• Acute Lymphoblastic Leukemia (ALL): Nnipa a enzyme Thiopurine Methyltransferase (TPMT) dodow sua no betumi anya nsunsuanso bɔne a emu yɛ den na sɛ wɔma wɔn Mercaptopurine dodow a wɔtaa de ma (e.g. Purinethol®) a, asiane a ɛwɔ hɔ sɛ wobenya ɔyare no akɔ soro.
• Kokoram a ɛwɔ akyi berɛmo mu: Nnipa a enzyme UGT1A1 sua no betumi anya asiane kɛse sɛ wobenya akisikuru a emu yɛ den na wɔanya ɔyare mmoawa sɛ wɔma wɔn aduru Irinotecan (e.g. Camptosar®).

Afei nso, aduru a ɛko tia kokoram a wɔfrɛ no fluorouracil, `5-FU` (e.g. Adrucil® - `Adrucil®`), betumi de nsunsuanso bɔne a emu yɛ den aba sɛ wɔde ma nnipa a enzyme dihydropyrimidine dehydrogenase (`Dihydropyrimidine Dehydrogenase - DPD`) sua no dodow a ɛfata. Ebia nnuruyɛfo akyerɛw saa aduru yi ama kokoram a ɛwɔ akyi berɛmo mu, nufu, yafunu ne dwensɔtwaa mu kokoram.

Mogya a ɛtwetwe no ano a wosiw

Ɛsɛ sɛ nnipa a wɔwɔ awosu mu nsakrae ahorow bi nom aduru a ekum mogya a ɛtwetwe mogya a wɔfrɛ no warfarin (e.g. Coumadin®) no dodow a ɛba fam . Sɛ ɛboro so a, ebetumi ama mogya atu.

Afei nso, nsakrae a ɛba CYP2C19 enzyme a ɛwɔ wo mmerɛbo mu no betumi asiw aduru a ekum mogya nkwammoaa a wɔfrɛ no clopidogrel (e.g. Plavix®) no kwan sɛ ɛnyɛ adwuma yiye . Eyi yɛ aduru a wɔde siw nneɛma te sɛ komayare ne akisikuru ano.

HIV a ɛma obi nya ɔyare mmoawa

HLA-B awosu mu abɔde bi a ɛyɛ soronko betumi ama honam ani ayɛ adwuma denneennen wɔ aduru Abacavir (e.g. Ziagen®) ho.

Afei nso, CYP2B6 awosu mu abɔde mu nkwaadɔm no mu nsakrae bi betumi ama asiane a ɛwɔ hɔ sɛ ebenya nsunsuanso bɔne te sɛ ntini mu nsakrae a efi aduru efavirenz (e.g. Sustiva®) mu no ayɛ kɛse.

Nsɛm a ɛfa nipadua mu ahoɔden a ɛko tia nyarewa ho

Sɛ worenom nnuru a ɛma nipadua no tumi ko tia nyarewa a, ebia wubenya mfaso afi pharmacogenomic nhwehwɛmu mu:

• Esiane nsakraeɛ a ɛwɔ protein `TPMT` ne `NUDT15` mu nti, sɛ wofa aduru `Azathioprine` (e.g. `Imuran®`) wɔ asaabo a wɔde ma akyi anaasɛ wo nipadua no mu tumi a ɛko tia nyarewa tebea te sɛ multiple sclerosis akyi a, wobetumi asiw nnompe mu ntini dwumadi ano.
• Esiane nsakrae a ɛwɔ CYP3A5 enzyme no mu nti, sɛ wofa tacrolimus (e.g. Prograf®) bere a wode akwaa foforo ama wo akyi a, asiane a ɛwɔ hɔ sɛ wobɛpo akwaa a wɔde bɛma wo no betumi ayɛ kɛse.

Mfaso bɛn na ɛwɔ pharmacogenomics so?

Bere a nhwehwɛmufo ne nnuruyɛfo kɔ so sua nnuru a ɛma nipadua no yɛ adwuma ho ade na wɔde di dwuma no, ebetumi de mfaso pii aba. Hwɛ:

• Ahobammɔ a ɛkɔ anim: Nnuruyɛfo betumi akwati sɛ wɔbɛkyerɛw nnuru a ɛde ɔhaw bɔne ba nnipa binom so, anaasɛ sɛ wɔnom boro so a ebetumi de ɔhaw aba. Eyi kyerɛ sɛ ɛho renhia sɛ wuhu amane a ɛho nhia.
• Akwahosan ho ka a wɔyɛ no yiye na wɔtew so: Sɛ nnuruyɛfo tumi di kan hu nnuru a ɛyɛ adwuma ne nea ɛnyɛ adwuma a, wobetumi adi kan akyerɛw nnuru a etu mpɔn sen biara , na wɔakora sika ne bere so .
• Nnuru a wɔde wɔn ani asi so: Nsakrae pɔtee bi (a ɛsono) a ɛba awosu mu abɔde bi mu na ɛde nyarewa bi ba. Pharmacogenomics ma nhwehwɛmufo nya nnuru foforo denam saa awosu mu nsakrae a wɔde wɔn ani si so tẽẽ no so. Te sɛ nea wɔbɔ aduru bi a ɛfata yare no ara pɛ.

Dɛn ne anohyeto/mfomso ahorow a ɛwɔ pharmacogenomics mu?

Bere a w’awosu mu nneɛma ho hia wɔ ayaresa a eye sen biara a wobɛkyerɛ mu ma tebea horow pii no, ɛnkyerɛkyerɛ sɛnea wo nipadua no yɛ nnuru ho adwuma no mu yiye. Ɛsɛ sɛ nnuruyɛfo da so ara susuw nneɛma afoforo ho bere a wɔrepaw aduru a ɛfata no. Nhwɛsoɔ:

• Nnuru afoforo: Nnuru a wonom mprempren no betumi asiw nnuru foforo a etu mpɔn no kwan.
• Akwahosan ho nsɛm afoforo: Nyarewa bi betumi asakra ɔkwan a wo nipadua no fa so di nnuru ho dwuma. Sɛ nhwɛso no, sɛ w’asaabo ntumi nyɛ adwuma yiye a, nnuru bi bɛkɔ wo nipadua mu.
• Asetra kwan: Nneɛma te sɛ nea wudi, apɔw-mu-teɛteɛ dodow a woyɛ, ne tawa ne nsa a wonom betumi aka sɛnea w’aduru no sɛe yiye.

Nsɛnnennen afoforo a ɛwɔ pharmacogenomics a wɔyɛ ne nea wɔde di dwuma mu ne:

• Ɛka: Ɛwom sɛ ɛka a wɔbɔ wɔ nnuru a wɔde yɛ nhwehwɛmu ho no so retew nkakrankakra de, nanso ɛka a wɔbɔ wɔ onipa biara ho, anaasɛ ɛka a wɔbɔ wɔ kotoku mu no taa gu ahorow a egyina insurance a wɔde tua ho ka so. Ebia sɔhwɛ yi rentumi mma obiara.
• Sɛnea wobetumi akɔ hɔ:Ɛdenam baabi a wote ne oduruyɛfo ko a ɔresa wo yare so no, ebia awosu mu nhwehwɛmu ahorow bi a wubenya no sua.

Mprempren, nnuruyɛfo betumi de pharmacogenomics adi dwuma ama tebea horow ne nnuru kakraa bi pɛ. Nanso, ‘aduruyɛ a wɔde di dwuma pɛpɛɛpɛ’ ho adwuma a ɛyɛ anigye yi renya nkɔso ntɛmntɛm. Wo ne wo duruyɛfo nkasa mfa sɛnea pharmacogenomics betumi aboa w’akwahosan ne mfaso horow a ebetumi de aba no ho. Wubetumi nso abisa nnuruyɛ mu sɔhwɛ ahorow a wɔyɛ wɔ saa asɛm yi mu ho asɛm.

Awiei koraa no, awiei koraa no, kae eyi.

Okay, enti, ɛwom sɛ asɛmfua pharmacogenomics a yɛkaa ho asɛm nnɛ no yɛ nea ɛyɛ den kakra de, nanso nea ɛkyerɛ ne sɛ ɛboa yɛn ma yɛpaw aduru a ɛfata yɛn yiye na ɛwɔ nsunsuanso bɔne kakraa bi, a egyina yɛn awosu mu nkwaadɔm so.

Yɛn awosu mu nkwaadɔm yɛ ade titiriw nti a aduru koro no ara nyɛ adwuma wɔ ɔkwan koro so mma obiara. Pharmacogenomics yɛ mmɔden a wɔbɔ sɛ wɔbɛte saa ahintasɛm no ase na wɔama yɛn ayaresa a ɛfa yɛn ankasa ho, na etu mpɔn kɛse.

Ɛwom sɛ eyi da so ara yɛ adwuma a ɛrenya nkɔso de, nanso ebetumi asakra ɔkwan a wɔfa so sa nyarewa pii daakye. Sɛ wowɔ nsɛmmisa bi fa aduru pɔtee bi ho, titiriw sɛ ebia ɛbɛyɛ adwuma ama wo anaasɛ ɛde ɔhaw ahorow bɛba a, nsuro sɛ wo ne wo duruyɛfo bɛkasa afa saa pharmacogenomic nhwehwɛmu ahorow yi ho. Ebia wɔbɛboa wo paa.

Kae sɛ w’awosu yɛ w’akwahosan ho asɛm no fã titiriw biako pɛ. Aduan pa a wubedi, apɔw-mu-teɛteɛ, ne wo duruyɛfo afotu a wubedi so ho hia saa ara!

` Pharmacogenomics, awosu mu nkwaadɔm, nnuru, nnuru, nnuru a wɔde di dwuma pɛpɛɛpɛ, awosu mu nhwehwɛmu, nea efi mu ba