Cov tshuaj uas koj tau txais puas yog rau koj? Cia peb tham txog Pharmacogenomics!

Tej zaum koj twb tau hnov ​​​​tias cov tshuaj kho mob zoo ib yam rau qee tus neeg, tsis ua haujlwm rau lwm tus, thiab muaj cov kev mob tshwm sim rau lwm tus. Vim li cas ho yog li ntawd? Puas yog vim peb lub cev txawv? Yog lawm, qhov ntawd yog ib qho laj thawj. Qhov ntawd yog ib qho kev sib txuas, nyuaj me ntsis, tab sis tseem ceeb heev uas peb yuav tham txog hnub no. Qhov no hu ua pharmacogenomics.

Pharmacogenomics yog dab tsi?

Hais yooj yim xwb, pharmacogenomics yog kev kawm txog peb cov tshuaj teb li cas raws li peb cov noob caj noob ces. Nco ntsoov tias, pharmacology yog kev kawm txog kev siv thiab cov teebmeem ntawm cov tshuaj. Genomics yog kev kawm txog cov noob caj noob ces thiab lawv txoj haujlwm. Kev sib xyaw ua ke ntawm ob qho no hu ua pharmacogenomics. Qee zaum nws hu ua pharmacogenetics.

Qhov no yeej poob rau hauv thaj chaw loj dua ntawm 'Precision Medicine' . Uas yog, muab rau koj ib txoj kev npaj kho mob raws li tej yam xws li koj cov noob caj noob ces, ib puag ncig koj nyob, thiab koj txoj kev ua neej. Pharmacogenomics tuaj yeem pab koj tus kws kho mob xaiv cov tshuaj uas muaj tsawg dua cov kev mob tshwm sim lossis ua haujlwm zoo tshaj plaws rau koj .

Tiamsis yuav tsum nco ntsoov tias txoj kev no tseem tsis tau siv rau txhua yam kab mob lossis txhua yam tshuaj. Tam sim no, feem ntau nws siv rau qee yam mob thiab tshuaj, xws li HIV, qee hom mob qog noj ntshav, kev nyuaj siab, thiab kab mob plawv. Tab sis qhov kev tshawb fawb no tab tom txhim kho sai heev. Cov kws tshawb fawb vam tias txoj kev no yuav pab xaiv cov tshuaj zoo dua rau txawm tias cov kab mob feem ntau.

Cov noob caj noob ces cuam tshuam li cas rau txoj kev ua haujlwm ntawm cov tshuaj?

Xav txog nws li no: peb cov noob caj noob ces zoo li ib pawg lus qhia rau cov cell hauv peb lub cev. Cov noob caj noob ces no pab peb ua cov protein molecules hu ua enzymes . Cov enzymes muaj ib lab txoj haujlwm hauv peb lub cev. Ib qho ntawm lawv yog rhuav tshem cov tshuaj hauv lub cev, lossis ua rau lawv zom zaub mov . Yog tias qee tus neeg tsis teb rau cov tshuaj raws li xav tau, nws yuav yog vim lawv muaj qee qhov kev hloov pauv hauv lawv cov noob caj noob ces. Cov kev hloov pauv no tuaj yeem ua rau cov enzymes tsis ua haujlwm zoo lossis cov enzymes tsis ua haujlwm zoo.

Tam sim no xav txog, yuav ua li cas yog tias koj lub cev zom cov tshuaj sai dhau, lossis qeeb dhau, lossis tsis ua li ntawd? Ces cov tshuaj, uas muab rau ntawm qhov koob tshuaj ib txwm, yuav tsis ua haujlwm raws li xav tau. Yog tias cov tshuaj ntawd tuaj yeem ua rau muaj kev phiv loj heev , lossis nws yuav tsis muaj txiaj ntsig rau tus mob tam sim no.

Piv txwv li, qee tus neeg tsis tsaug zog sai tom qab haus kas fes, thaum lwm tus tsis tsaug zog. Ib qho laj thawj rau qhov no yog vim peb cov noob caj noob ces cuam tshuam rau qhov sai npaum li cas peb lub cev zom cov caffeine. Tib yam tuaj yeem tshwm sim nrog cov tshuaj.

Qhov kev sim tshuaj pharmacogenomic no yog dab tsi?

Kev kuaj tshuaj pharmacogenomic yog kev kuaj noob caj noob ces. Nws tuaj yeem saib ib lossis ntau lub noob caj noob ces, tshwj xeeb yog nrhiav cov kev hloov pauv noob caj noob ces tshwj xeeb uas cuam tshuam rau kev tawg ntawm cov tshuaj. Nws zoo li kuaj xyuas seb puas muaj qhov yuam kev hauv peb lub cev 'phau ntawv qhia'.

Feem ntau cov kws kho mob siv cov qauv ntshav lossis daim ntaub so ntswg los ua qhov no. Cov qauv no raug coj los ntawm koj thiab xa mus rau chav kuaj mob. Nyob ntawd, tus kws kho mob kuaj xyuas koj cov DNA rau cov kev hloov pauv tshwj xeeb. Cov noob caj noob ces lossis cov noob caj noob ces uas lawv nrhiav yuav nyob ntawm qhov kev kuaj mob uas koj tus kws kho mob tau xaj, qhov mob uas lawv tab tom sim kho, thiab cov tshuaj uas lawv npaj yuav muab rau koj.

Thaum twg kuv thiaj xav tau kev kuaj mob pharmacogenomic?

Yog tias koj noj tshuaj rau qee yam mob, koj kuj tseem yuav tsim nyog rau kev kuaj mob pharmacogenomic. Nov yog qee qhov piv txwv (thiab tej zaum yuav muaj ntau dua):

Cov roj cholesterol ntau

Vim muaj qee yam kev hloov pauv ntawm "SLCO1B1 gene" hauv peb lub cev, yog tias koj noj qee yam tshuaj hu ua statins rau cov roj cholesterol siab, koj yuav mob nqaij thiab tsis muaj zog. Piv txwv ntawm cov statins no yog:

• Atorvastatin (piv txwv li Lipitor®)
• Fluvastatin (piv txwv li Lescol®)
• Lovastatin (piv txwv li Altoprev®)
• Pitavastatin (piv txwv li Livalo®)
• Pravastatin (piv txwv li Pravachol®)
• Rosuvastatin (piv txwv li Crestor®)
• Simvastatin (piv txwv li Zocor®)

Yog li ntawd, ua ntej koj pib noj tshuaj zoo li no, lossis yog tias koj muaj teeb meem thaum siv nws, koj tus kws kho mob tuaj yeem tham nrog koj txog kev kuaj mob zoo li no.

Kev Nyuaj Siab

Kev hloov pauv ntawm cov noob caj noob ces CYP2D6 thiab CYP2C19 tuaj yeem cuam tshuam rau qhov sai npaum li cas koj lub cev zom qee cov tshuaj antidepressants. Piv txwv ntawm cov tshuaj no suav nrog:

• Amitriptyline (piv txwv li Elavil®) - Qhov no yog ib hom tshuaj tricyclic antidepressant .
• Cov tshuaj `SSRI` : `Citalopram` (piv txwv li `Celexa®`), `Escitalopram` (piv txwv li `Lexapro®`), `Sertraline` (piv txwv li `Zoloft®`), `Paroxetine` (piv txwv li `Paxil®`) thiab `Fluvoxamine` (piv txwv li `Luvox®`).
• Venlafaxine (piv txwv li Effexor®) - Qhov no yog ib hom SNRI.

Qhov kev kuaj no yuav pab tau thaum pib noj tshuaj zoo li no, lossis thaum ib yam tshuaj tsis ua haujlwm thiab koj tab tom sim hloov mus rau lwm yam.

Mob qog noj ntshav

Yog tias koj noj tshuaj rau ib hom mob qog noj ntshav tshwj xeeb, koj yuav tau txais txiaj ntsig los ntawm kev kuaj mob pharmacogenomic. Nov yog qee qhov piv txwv:

• Mob qog noj ntshav hauv lub mis: Cov tshuaj trastuzumab (piv txwv li Herceptin®) tsuas yog ua haujlwm rau cov neeg uas muaj mob qog noj ntshav hauv lub mis HER2 xwb . Qhov no txhais tau tias cov hlwb qog noj ntshav muaj kev hloov pauv caj ces uas ua rau lawv tsim cov protein HER2 ntau dhau.
• Kab mob ntshav dawb Acute Lymphoblastic Leukemia (ALL): Cov neeg uas muaj cov enzyme Thiopurine Methyltransferase (TPMT) tsawg yuav muaj cov kev mob tshwm sim hnyav thiab muaj kev pheej hmoo ntawm kev kis kab mob yog tias muab cov tshuaj Mercaptopurine li niaj zaus (piv txwv li Purinethol®).
• Mob qog nqaij hlav plab hnyuv: Cov neeg uas muaj cov enzyme UGT1A1 tsawg yuav muaj feem yuav mob raws plab thiab kis kab mob ntau dua yog tias noj cov tshuaj Irinotecan (piv txwv li Camptosar®).

Tsis tas li ntawd xwb, cov tshuaj tiv thaiv kab mob qog noj ntshav fluorouracil, '5-FU' (piv txwv li Adrucil® - 'Adrucil®'), tuaj yeem ua rau muaj kev phiv loj heev yog tias muab rau cov neeg uas muaj cov enzyme dihydropyrimidine dehydrogenase tsawg ('Dihydropyrimidine Dehydrogenase - DPD'). Cov kws kho mob yuav sau ntawv kom siv cov tshuaj no rau mob qog noj ntshav hauv plab hnyuv, mob qog noj ntshav hauv lub mis, mob qog noj ntshav hauv plab thiab mob qog noj ntshav hauv lub qog pancreatic.

Kev tiv thaiv cov ntshav txhaws

Cov neeg uas muaj qee yam kev hloov pauv ntawm caj ces yuav tsum noj tshuaj warfarin uas tiv thaiv kev ntshav khov tsawg dua (piv txwv li Coumadin®). Noj ntau dhau yuav ua rau los ntshav.

Tsis tas li ntawd xwb, kev hloov pauv ntawm CYP2C19 enzyme hauv koj lub siab yuav ua rau cov tshuaj tiv thaiv cov ntshav txhaws clopidogrel (piv txwv li Plavix®) tsis ua haujlwm zoo . Qhov no yog ib yam tshuaj siv los tiv thaiv tej yam xws li mob plawv thiab mob hlwb.

Kev kis tus kab mob HIV

Ib qho variant ntawm HLA-B gene tuaj yeem ua rau tawv nqaij tsis haum tshuaj hnyav rau cov tshuaj Abacavir (piv txwv li Ziagen®).

Tsis tas li ntawd xwb, ib qho kev hloov pauv hauv CYP2B6 gene yuav ua rau muaj kev pheej hmoo ntawm cov kev mob tshwm sim xws li kev hloov pauv ntawm lub paj hlwb los ntawm cov tshuaj efavirenz (piv txwv li Sustiva®).

Teeb meem ntawm lub cev tiv thaiv kab mob

Yog tias koj noj tshuaj immunosuppressant, koj yuav tau txais txiaj ntsig los ntawm kev kuaj mob pharmacogenomic:

• Vim muaj kev hloov pauv ntawm cov protein 'TPMT' thiab 'NUDT15', kev ua haujlwm ntawm cov pob txha yuav raug txo qis yog tias koj noj cov tshuaj 'Azathioprine' (piv txwv li 'Imuran®') tom qab hloov raum lossis rau cov mob ntawm lub cev tiv thaiv kab mob xws li multiple sclerosis.
• Vim muaj kev hloov pauv ntawm CYP3A5 enzyme, yog tias koj noj tacrolimus (piv txwv li Prograf®) tom qab hloov cev, qhov kev pheej hmoo ntawm kev tsis lees txais hloov cev yuav nce ntxiv.

Cov txiaj ntsig ntawm pharmacogenomics yog dab tsi?

Thaum cov kws tshawb fawb thiab cov kws kho mob txuas ntxiv kawm thiab siv cov tshuaj pharmacogenomics, nws tuaj yeem ua rau muaj ntau yam txiaj ntsig. Saib seb:

• Kev nyab xeeb zoo dua: Cov kws kho mob yuav zam tau kev sau tshuaj uas ua rau muaj kev phiv tsis zoo rau qee tus neeg, lossis uas tuaj yeem ua rau muaj teeb meem thaum noj ntau dhau. Qhov no txhais tau tias koj yuav tsis tas yuav raug kev txom nyem yam tsis tsim nyog.
• Kev ua haujlwm tau zoo thiab txo cov nqi kho mob: Yog tias cov kws kho mob paub ua ntej tias cov tshuaj twg ua haujlwm thiab cov twg tsis ua haujlwm, lawv tuaj yeem sau cov tshuaj zoo tshaj plaws ua ntej , txuag nyiaj thiab sijhawm .
• Kev tsim tshuaj uas tsom mus rau: Qee cov kab mob yog tshwm sim los ntawm kev hloov pauv tshwj xeeb (variant) hauv ib lub noob caj noob ces. Pharmacogenomics tso cai rau cov kws tshawb fawb nrhiav cov tshuaj tshiab los ntawm kev tsom mus rau qhov kev hloov pauv ntawm noob caj noob ces ntawd. Ib yam li kev tsim cov tshuaj uas haum rau tus kab mob.

Cov kev txwv / qhov tsis zoo ntawm pharmacogenomics yog dab tsi?

Txawm hais tias koj cov noob caj noob ces tseem ceeb rau kev txiav txim siab qhov kev kho mob zoo tshaj plaws rau ntau yam mob, nws tsis piav qhia tag nrho tias koj lub cev ua cov tshuaj li cas. Cov kws kho mob tseem yuav tsum xav txog lwm yam thaum xaiv cov tshuaj zoo. Piv txwv li:

• Lwm cov tshuaj: Cov tshuaj uas koj tab tom noj tam sim no yuav cuam tshuam rau qhov ua tau zoo ntawm cov tshuaj tshiab.
• Lwm yam mob nkeeg: Qee yam mob tuaj yeem hloov txoj kev uas koj lub cev ua cov tshuaj. Piv txwv li, yog tias koj lub raum tsis ua haujlwm zoo, qee cov tshuaj yuav raug tso tawm ntawm koj lub cev.
• Txoj Kev Ua Neej: Tej yam xws li koj noj dab tsi, koj ua si nawv ntau npaum li cas, thiab koj haus luam yeeb thiab haus dej cawv tuaj yeem cuam tshuam rau koj cov tshuaj zom tau zoo npaum li cas.

Lwm yam teeb meem hauv kev tsim thiab kev siv pharmacogenomics suav nrog:

• Tus nqi: Txawm hais tias tus nqi ntawm kev kuaj mob pharmacogenomic maj mam txo qis, tus nqi rau ib tus neeg, lossis cov nqi them tawm ntawm koj lub hnab tshos, feem ntau sib txawv nyob ntawm seb koj pov hwm them nqi li cas. Qhov kev kuaj no yuav tsis muaj rau txhua tus.
• Kev Nkag Tau:Nyob ntawm seb koj nyob qhov twg thiab hom kws kho mob uas kho koj, koj txoj kev nkag mus rau qee qhov kev kuaj noob caj ces yuav raug txwv.

Tam sim no, cov kws kho mob tsuas yog siv tau pharmacogenomics rau qee yam mob thiab tshuaj xwb. Txawm li cas los xij, qhov kev tshawb fawb zoo siab no ntawm 'kev kho mob meej' tab tom loj hlob sai. Tham nrog koj tus kws kho mob txog seb pharmacogenomics tuaj yeem pab koj txoj kev noj qab haus huv li cas thiab nws yuav muaj txiaj ntsig dab tsi. Koj tuaj yeem nug txog kev sim tshuaj hauv daim teb no.

Thaum kawg, thaum kawg, nco ntsoov qhov no.

Zoo, yog li ntawd, txawm hais tias lo lus pharmacogenomics uas peb tau tham txog hnub no nyuaj me ntsis, nws txhais li cas yog tias nws pab peb xaiv cov tshuaj uas haum rau peb tshaj plaws thiab muaj cov kev mob tshwm sim tsawg tshaj plaws, raws li peb cov noob caj noob ces.

Peb cov noob caj noob ces yog ib qho laj thawj loj uas ua rau tib yam tshuaj tsis ua haujlwm zoo ib yam rau txhua tus. Pharmacogenomics yog ib qho kev sim nkag siab txog qhov zais cia ntawd thiab muab kev kho mob zoo dua rau peb.

Txawm hais tias qhov no tseem yog ib qho kev tshawb fawb uas tseem tab tom txhim kho, nws muaj peev xwm hloov pauv txoj kev kho mob ntawm ntau yam kab mob yav tom ntej. Yog tias koj muaj lus nug txog ib yam tshuaj tshwj xeeb, tshwj xeeb tshaj yog seb nws puas yuav ua haujlwm rau koj lossis nws puas yuav ua rau muaj kev phiv, tsis txhob ntshai tham nrog koj tus kws kho mob txog cov kev kuaj mob pharmacogenomic no. Lawv yuav pab tau koj heev.

Nco ntsoov tias, koj cov noob caj ces tsuas yog ib feem tseem ceeb ntawm koj zaj dab neeg kev noj qab haus huv xwb. Kev noj zaub mov zoo, kev tawm dag zog, thiab kev ua raws li koj tus kws kho mob cov lus qhia kuj tseem ceeb ib yam!

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