Dɔktɔ dɔn ɛva gi yu mɛrɛsin, bɔt i nɔ wok fɔ yu, pan ɔl we i wok fɔ yu padi? Ɔ yu dɔn ɛva gɛt sayd ɛfɛkt dɛn we na yu nɔmɔ kin gɛt frɔm sɔm mɛrɛsin dɛn we ɔda pipul dɛn nɔ kin gɛt? Yu go dɔn de wɔnda se, "Wetin mek dis mɛrɛsin nɔ de wok fɔ mi?" Yu dɔn ɛva tink se di rizin fɔ dis kin bi yu jin? Yu nɔ tink se i wɔndaful? Yɛs, dɛn smɔl smɔl jin dɛn ya we de insay wi bɔdi kin chenj di we aw wan mɛrɛsin we wi de tek kin wok kpatakpata. Tide wi de tok boht wan pan di nyu en impotant fild dem fo medisin. Dat na Famakojinɔmiks.
Fɔ tɔk am simpul wan, wetin na Famakojinɔmiks?
Dis wɔd lɔng smɔl ɛn i tan lɛk se i at, nɔto so? Bɔt lɛ wi brok am dɔŋ. Dɔn i rili izi. I mek wit tu wɔd dɛn we dɛn put togɛda.
1. Famakɔlɔji: Dis de tɔk bɔt di stɔdi bɔt mɛrɛsin . Dat min se, aw dɛn de yuz mɛrɛsin, wetin i de du to di bɔdi, ɛn wetin i de du.
2. Jɛnomiks: Dis de tɔk bɔt di stɔdi bɔt di jin dɛn ɛn aw dɛn de wok .
So we dɛn tu ya kam togɛda, Pharmacogenomics na di stɔdi bɔt aw wi jin dɛn de ansa di mɛrɛsin dɛn we wi de tek. Fɔ tɔk am simpul wan, na fɔ no aw wan mɛrɛsin we dɛn gi yu go wok fayn, ɔ if i kin mek yu gɛt sayd ɛfɛkt, bay di we aw yu mek yu jɛnɛtiks.
Dis na fɔ wan nyu fild fɔ mɛrɛsin we dɛn kɔl "Precision Medicine." I min "spɛsifi k mɛrɛsin." Bifo i gi ɔlman di sem mɛrɛsin, i de tek tɛm tink bɔt tin dɛn lɛk yu jin, di we aw yu de liv yu layf, ɛn di say we yu de, ɛn i de pik di tritmɛnt we go fayn fɔ yu . Tink bɔt am lɛk fɔ go na stɔ ɛn bay wan dres we gɛt di sem saiz fɔ ɔlman, instead fɔ go to tayla ɛn mek dɛn mek wan dres fɔ yu yon mɛzhɔmɛnt. Dis na di sem tin.
Naw, na smɔl sik dɛn ɛn mɛrɛsin dɛn nɔmɔ dɛn kin yuz dis we. Fɔ ɛgzampul, dɛn kin yuz dis teknɔlɔji fɔ HIV, sɔm kayn kansa, pwɛl hat, ɛn sɔm mɛrɛsin fɔ at sik. Bɔt dis fil de divɛlɔp kwik kwik wan. Risach pipul dɛn biliv se insay shɔt tɛm, famakɔjinɔmiks go ɛp dɔktɔ dɛn fɔ pik di mɛrɛsin dɛn we fit fɔ ivin di sik dɛn we bɔku pipul dɛn kin gɛt.
Aw wi jin dɛn kin afɛkt di mɛrɛsin dɛn?
Fɔ ɔndastand dis, wi nid fɔ luk fɔs wetin di jin dɛn de du na wi bɔdi. Tink bɔt wi jin dɛn as kɔmplit instrɔkshɔn buk fɔ bil ɛn ɔpreshɔn wi bɔdi. Di sɛl dɛn na wi bɔdi de wok akɔdin to di instrɔkshɔn dɛn we de na dis instrɔkshɔn manyual.
di men tin we fכ du wit dεn instrכkshכn ya na di εnzym dεm.fכ mek protin mכlikul dεm we dεn kכl εnzym. Enzym dɛn tan lɛk smɔl smɔl wokman dɛn na wi bɔdi. Dɛn wokman dɛn ya gɛt bɔku bɔku wok dɛn. Wan pan di impɔtant tin dɛn we wi kin du na fɔ brok, ɔ fɔ mek di mɛrɛsin dɛn we wi kin tek, ɔ fɔ mek wi ebul fɔ chenj di we aw wi de du tin.
Imajin se yu tek wan pil. I nɔ de go stret fɔ mɛn di sik. dat pil fכs fכ go na di fכktri dεm we de insay wi bכdi (fכ egzampl, di liva), usay di wokman dεm de (i.e. εnzym dεm) de brok am dכn, brok am dכn, εn mek di bכdi yuz am.
naw imajin, wetin go apin if dεn εnzym dεm ya nכ de wok fayn biכs fכ chenj dεm na sכm pipul dεm in jin dεm?
- If di enzym dεm wok tu fast: Di mεdisin we yu tek, bifo i go abzכp εn afekt di sik, de brok dכn εn kכmכt na di bכdi kwik kwik wan. Dɔn di nɔmal doz nɔ go du fɔ yu. Di mɛrɛsin go fil lɛk se i nɔ de wok.
- If di enzym dεm de wok tu fast: Di mεdisin we yu de tek de brok tu fast na yu bכdi. Dɔn di mɛrɛsin kin bɔku na yu bɔdi we i gɛt bɔku bɔku mɛrɛsin. Dis kin mek yu ɔvados pan ivin di nɔmal doz ɛn gɛt siriɔs sayd ɛfɛkt .
- if di εnzym nכ de wok atכl: sכmtεm, bikoz fכ wan jεnεtik mכtεshכn, di bכdi kin stכp fכ prodyuz di εnzym we dεn de kכwεshכn. Dɔn di mɛrɛsin nɔ go wok fɔ yu atɔl.
Na so ivin smɔl chenj dɛn na wi jin kin gɛt big impak pan di mɛrɛsin dɛn we wi de tek.
Us tɛst dɛn kin yuz fɔ no dɛn jɛnɛtik chenj ya?
Wi kɔl dis wan famakojɛnomik tɛst . Dis na tɛst bak we dɛn kin du fɔ tɛst pɔsin in jɛnɛtiks. I de luk yu DNA ɛn luk fɔ ɛni chenj we de na wan ɔ mɔ patikyula jin dɛn we de afɛkt aw wan mɛrɛsin de brok.
Dis tɛst kin yuz blɔd sɛmpul ɔ bukal swab . I rili simpul. Yu dɔktɔ kin sɛn dis sampul to lɛbɔtri. Teknishian dɛn we de de kin chɛk yu DNA fɔ si if di jin dɛn we gɛt fɔ du wit am chenj.
Yu dɔktɔ go disayd us jin fɔ tɛst bay yu mɛrɛsin ɛn di kayn mɛrɛsin we dɛn plan fɔ gi yu.
Insay us sityueshɔn dɛn i nid fɔ du fɔ mek dɛn du famakɔjɛnomik tɛst?
Dis test nɔr de du naw fɔ ɛvri sik ɔr ɛvri mɛrɛsin. Bɔt yu dɔktɔ kin tɛl yu fɔ du dis tɛst we yu de trit sɔm patikyula sik dɛn. Lɛ wi luk sɔm ɛgzampul dɛn. Fɔ ɔndastand dis infɔmeshɔn klia wan, luk di tebul we de dɔŋ ya.
| Mɛdikal kɔndishɔn | Rilevεnt jin/εnzym | Impekt ɛn simpul ɛksplen |
|---|---|---|
| Kɔlestɔl we bɔku | SLCO1B1 jin | Pipul dεm we gεt sכm vεryכnt dεm fכ dis jin kin gεt siriכs mכsul pen εn wik we dεn de tek statin dεm (e.g., Simvastatin, Atorvastatin) fכ lכs kכlestכl. If dɛn no dis kwik kwik wan we dɛn de du di tɛst , yu dɔktɔ go ebul fɔ gi yu ɔda mɛrɛsin. |
| Pwɛl at | CYP2D6 ɛn CYP2C19 jin dɛn | dis jin vεryushכn dεm de chenj di rεt we sכm antidipreshכn dεm de brok dכn na di bכdi. Fɔ sɔm, di mɛrɛsin kin wok fayn fayn wan. Fɔ ɔda pipul dɛn, i kin mek dɛn gɛt mɔ sayd ɛfɛkt dɛn. Dis tɛst kin ɛp fɔ pik di mɛrɛsin we go wok fayn pas ɔl wit di smɔl sayd ɛfɛkt dɛn . |
| Kansa dɛn we gɛt kansa | difrεn jin dεm (e.g. HER2, TPMT, UGT1A1, DPD) |
|
| Fɔ mek blɔd nɔ klɔt | CYP2C19 jin ɛn ɔda wan dɛn | Di blɔd tina warfarin nid fɔ gi pan rili smɔl dos to pipul dɛn we gɛt sɔm jɛnɛtik we dɛn de chenj. כlso, di dכg we dεn kכl klopidogrεl (Plavix®) kin nכ wok atכl pan sכm pipul dεm bikoz fכ di vεryushכn na di CYP2C19 εnzym. |
| HIV infɛkshɔn | HLA-B ɛn CYP2B6 jin dɛn | Pipul dεm we gεt wan spεsifi k vεryכnt fכ di HLA-B jin kin gεt siriכs skin riakshכn if dεn gi dεm di drog Abacavir. So, dis tɛst na mandatory bifo yu gi dis drɔg. |
| Prɔblɛm dɛn we de na di imyun sistɛm | TPMT, NUDT15, CYP3A5, ɛn di ɔda wan dɛn | afta dεn transplant כgan, lεk we dεn transplant di kidni, di ifektiv we di imyun supεshכn drog dεm (e.g., Azathioprine, Tacrolimus) de dipכnt pan dεn jin dεm ya. di chenj dεm na dεn jin dεm ya kin mek di bכdi rεjεkt di כgan we dεn transplant . |
Wetin na di bɛnifit dɛn we dis we ya de du?
As di fild fɔ Famakojinɔmiks de divɛlɔp, wi go bɛnifit bɔku.
- Tritmɛnt dɛn we sef: Dɔktɔ dɛn kin no di mɛrɛsin dɛn we kin mek sɔm pipul dɛn gɛt siriɔs sayd ɛfɛkt ɔ we dɛn kin tek pasmak, so dɛn kin avɔyd dɛn mɛrɛsin dɛn de ɛn gi yu di mɛrɛsin we nɔ gɛt wan prɔblɛm .
- Efyushɔn ɛn kɔst fɔ ridyus di tritmɛnt: Imajin, yu fɔ chenj 3-4 mɛrɛsin fɔ wan sik, ɛn dɔn fɔ fɛn di rayt mɛrɛsin. Te da tɛm de go, yu tɛm, mɔni, ɛn tray we yu de tray kin west. Ɛn yu de sɔfa te di sik bɛtɛ. Bɔt if dis tɛst go ebul fɔ mɛn di sik wit di fɔs mɛrɛsin we dɛn gi am , aw dat go bi?
- Targeted drug development: Sɔm sik kin kam bikɔs ɔf chenj na wan patikyula jin. So di wan dɛn we de stɔdi bɔt dis kin mek nyu mɛrɛsin dɛn we de tɔch di chenj dɛn we de apin na da jin de dairekt wan . Dis na impɔtant tin fɔ trit sik dɛn lɛk kansa.
Bɔt dis gɛt in limit...
I nɔ mata aw dis we fɔ du tin fayn, i nɔ de sɔlv ɔltin. We dɔktɔ de pik wan mɛrɛsin, i nɔ jɔs de tink bɔt di jin dɛn. Bɔku ɔda tin dɛn de we wi fɔ tink bɔt.
Di impɔtant tin na dat, yu jin na jɔs pat pan di stori. Bɔku ɔda tin dɛn de we kin afɛkt aw wan mɛrɛsin de wok.
Dɔktɔ fɔ wɔri bak bɔt ɔda tin dɛn lɛk:
- Ɔda mɛrɛsin dɛn we yu de tek naw: Wan mɛrɛsin we yu de tek fɔ wan sik ɛn ɔda wan fɔ ɔda sik kin afɛkt yu bɔdi di kayn we we go mek i brok.
- Ɔda mɛrɛsin dɛn we yu gɛt: Fɔ ɛgzampul, if yu gɛt prɔblɛm wit yu liva ɔ kidni, i kin afɛkt di we aw dɛn kin pul di mɛrɛsin kɔmɔt na yu bɔdi.
- Di we aw yu de liv yu layf: Wetin yu de it ɛn drink, ilɛksɛf yu de du ɛksɛsayz ɔ yu nɔ de du ɛksasaiz, ɛn ivin tin dɛn lɛk fɔ smok ɛn fɔ drink rɔm kin afɛkt aw yu mɛrɛsin kin pwɛl.
Apat frɔm dat, bɔku ɔda prɔblɛm dɛn de:
- Di kɔst: Pan ɔl we di kɔst fɔ dɛn jenɛtik tɛst ya de go dɔŋ smɔl smɔl, dɛn kin stil tu dia fɔ sɔm pipul dɛn fɔ pe fɔ am.
- Nɔ akses: Fasiliti fɔ du dɛn tɛst ya nɔ de yet ɔlsay na Sri Lanka. Na smɔl say dɛn nɔmɔ dɛn kin gɛt dɛn.
Bɔt dis fild fɔ "Precision Medicine" de divɛlɔp rili kwik. If yu gɛt ɛni kwɛstyɔn bɔt dis, nɔ fred fɔ tɔk to yu dɔktɔ . Aks am if ɛni bɛnifit de fɔ du dis kayn tɛst fɔ yu sik.
Mɛsej we dɛn kin kɛr go na os
- Famakojinɔmiks na jɔs fɔ stɔdi aw yu jin dɛn kin afɛkt di mɛrɛsin dɛn we yu de tek.
- Tru dis we, yu dɔktɔ kin pik di mɛrɛsin we sef ɛn we go wok fɔ yu.
- Dis stil na fild we de divɛlɔp. Naw dɛn kin yuz am fɔ mɛn sɔm patikyula sik dɛn lɛk HIV, kansa, ɛn pwɛl hat.
- Nɔto jɔs yu jin dɛn de sho if wan mɛrɛsin go wok fɔ yu. Di we aw yu de liv yu layf, ɔda mɛrɛsin dɛn we yu de tek, ɛn ɔda mɛrɛsin dɛn bak kin ɛp yu.
- If yu gɛt ɛni kwɛstyɔn bɔt dis, di bɛst ɛn fayn pɔsin fɔ tɔk to na yu dɔktɔ.
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