Di mɛrɛsin we dɛn de gi yu rayt fɔ yu? Mek wi tok abaut Pharmacogenomics!

Yu go dɔn yɛri se di sem mɛrɛsin fɔ di sem sik kin woke fɔ sɔm pipul dɛm, nɔr kin woke fɔ ɔda pipul dɛm, ɛn gɛt sayd ɛfɛkt fɔ ɔda pipul dɛm. Wetin mek na so i bi? Na bikɔs wi bɔdi difrɛn? Yɛs, na wan rizin dat. Dat na rilet, somtin komplikayt, bot rili impotant topik we wi go tok abaut tide. Dɛn kɔl dis famakojinɔmiks.

Wetin na Famakojinɔmiks?

Fɔ tɔk am simpul wan, famakojinɔmiks na di stɔdi bɔt aw wi de ansa to drɔgs bays pan wi jin dɛm. Mɛmba se, famakɔlɔji na di stɔdi bɔt aw dɛn de yuz ɛn aw drɔgs kin afɛkt dɛn. Jɛnomiks na di stɔdi bɔt di jin dɛm ɛn di wok we dɛn de du. di kכmbaynshכn fכ di tu dεm dεn kכl am fכmakojεnomiks. Sɔntɛnde dɛn kin kɔl am famakojɛnɛtiks.

Dis rili fɔdɔm ɔnda di big fild fɔ ‘Prɛsishɔn Mɛdisin’ . Dat min se, fɔ gi yu wan pɔrsin in tritmɛnt plan we de bays pan tin dɛm lɛk yu jin, di say we yu de liv, ɛn aw yu de liv yu layf. Famakojinɔmiks kin ɛp yu dɔktɔ fɔ pik wan mɛrɛsin we nɔ gɛt bɔku sayd ɛfɛkt ɔ we go wok fayn fɔ yu .

Bɔt wi fɔ no se dɛn nɔ de yuz dis we yet fɔ ɔl sik ɔ fɔ ɛni mɛrɛsin. Naw, dɛn kin yuse am mɔ fɔ sɔm kayn sik ɛn drɔgs, lɛk HIV, sɔm kayn kansa, pwɛl hat, ɛn at sik. Bɔt dis fil de divɛlɔp kwik kwik wan. Risach pipul dɛn op se i nɔ go te igen dis we ya go ɛp fɔ pik bɛtɛ mɛrɛsin fɔ ivin di sik dɛn we bɔku pipul dɛn kin gɛt.

Aw di jin dɛn kin afɛkt di we aw drɔgs kin wok?

Tink bɔt dis we: wi jin dɛn tan lɛk wan sɛt fɔ instrɔkshɔn fɔ di sɛl dɛn na wi bɔdi. Dɛn jin ya de ɛp wi fɔ mek prɔtin mɔlyul dɛn we dɛn kɔl ɛnzaym . Enzym dεm gεt wan miliכn wok dεm na wi bכdi. Wan pan dɛn na fɔ brok di drɔgs dɛn na di bɔdi, ɔ fɔ mek dɛn chenj dɛn . If sɔm pipul nɔr de ansa to drɔgs lɛk aw dɛn bin de ɛkspɛkt, e kin bi bikɔs dɛn gɛt sɔm chenj na dɛn jin. dis chenj dεm kin mek di εnzym dεm nכ de wok bכku כ di εnzym dεm nכ de wok fayn.

Naw imajin, wetin go apin if yu bɔdi brok wan drɔg tu kwik, ɔ tu slo, ɔ nɔ brok atɔl? Dɔn di mɛrɛsin we dɛn kin gi di mɛrɛsin we dɛn kin gi am, nɔ go wok lɛk aw dɛn bin de tink. Either de drug kin cause serious side effects , or e kin nor kin get eni effekt pan di sik wae de sik naw.

Fɔ ɛgzampul, sɔm pipul dɛn nɔ kin slip kwik afta dɛn dɔn drink kɔfi, ɛn ɔda wan dɛn nɔ kin slip. Wan rizin fɔ dis na bikɔs wi jin dɛn kin afɛkt aw wi bɔdi kin brok di kafin kwik kwik wan. Na di sem tin kin apin to mɛrɛsin dɛn.

Wetin na dis famakojenomik tɛst?

Famakojεnomik tεst na jεnεtik tεst. I kin luk wan ɔ mɔ jin, spɛshal wan fɔ luk fɔ spɛshal jɛnɛtik we de afɛkt di we aw wan drɔg brok. I tan lεk we wi de chεk fכ tayp na wi bכdi in 'instrכkshכn mεnyual'.

Dɔktɔ dɛn kin yuz blɔd sɛmpul ɔ bukal swab fɔ du dis. Dɛn tek dis sampul frɔm yu ɛn sɛn am na lab. Na de, wan tɛknishian kin chɛk yu DNA fɔ si if sɔm patikyula chenj dɛn de. Di jin ɔ jin dɛm we dɛn de luk fɔ go dipen pan di tɛst we yu dɔktɔ dɔn ɔda, di sik we dɛn de tray fɔ trit, ɛn di mɛrɛsin dɛm we dɛn plan fɔ gi yu.

Ustɛm a nid fɔ gɛt famakojinɔmik tɛst?

If yu de tek mɛrɛsin fɔ sɔm kayn mɛrɛsin, yu kin fit bak fɔ gɛt famakojinɔmik tɛst. Na sɔm ɛgzampul dɛn ya (ɛn i kin bi se ɔda wan dɛn de):

Kɔlestɔl we bɔku

biכs fכ sכm vεryכnt dεm fכ di ``SLCO1B1 jin`` na wi bכdi, if yu tek sכm mεdikeshכn dεm we dεn kכ l statin fכ hεy kכlestכl, yu kin gεt mכsul pen εn wik. Sɔm ɛgzampul dɛn fɔ dɛn statin ya na:

• Atorvastatin (fɔ ɛgzampul, Lipitor®) .
• Fluvastatin (e.g. Lεskol®) .
• Lovastatin (fɔ ɛgzampul, Altoprev®) .
• Pitavastatin (fɔ ɛgzampul, Livalo®) .
• Pravastatin (fɔ ɛgzampul, Pravachol®) .
• Rosuvastatin (e.g. Krεstɔr®) .
• Simvastatin (ɛgz. Zokɔr®) .

So bifo yu bigin fɔ tek mɛrɛsin lɛk dis, ɔ if yu gɛt ɛni prɔblɛm we yu de yuz am, yu dɔktɔ kin tɔk to yu bɔt tɛst lɛk dis.

Pwɛl at

difrεns na di jin dεm CYP2D6 εn CYP2C19 kin afekt aw yu bכdi de brok dכn sכm antidipreshan dεm kwik kwik wan. Sɔm ɛgzampul dɛn bɔt dɛn mɛrɛsin ya na:

• Amitriptyline (e.g. Elavil®) - Dis na wan kayn trisayklik antidipreshan .
• `SSRI` klas ɔf drɔgs : `Citalopram` (e.g. `Celexa®`), `Escitalopram` (e.g. `Lexapro®`), `Sertraline` (e.g. `Zoloft®`), `Paroxetine` (e.g. `Paxil®`) ɛn `Fluvoxamine` (e.g. `Luvox®`).
• Venlafaxine (e.g. Effexor®) - Dis na wan kayn SNRI.

Dis tɛst kin fayn we yu bigin fɔ tek mɛrɛsin lɛk dis, ɔ we wan mɛrɛsin nɔ de wok ɛn yu de tray fɔ chenj to ɔda wan.

Kansa dɛn we gɛt kansa

If yu de tek mɛrɛsin fɔ wan patikyula kayn kansa, yu kin bɛnifit frɔm famakojɛnomik tɛst. Na sɔm ɛgzampul dɛn ya:

• Brest kansa: Di drɔg trastuzumab (e.g. Herceptin®) de wok nɔmɔ pan pipul dɛn we gɛt HER2-positiv breast cancer . dis min se di kεnsar sεl dεm gεt jεnεtik mכtεshכn we de mek dεn prodyuz tu mכch pan di HER2 protin.
• Acute Lymphoblastic Leukemia (ALL): Pipul dεm we gεt lכw lεvεl fכ di εnzym Thiopurine Methyltransferase (TPMT) kin gεt siriכs sayd ifekt εn inkrεs risk fכ infεkshכn if dεn gi dεm di usual doz fכ Mercaptopurine (e.g. Purinethol®).
• Kכlon kεnsar: Pipul dεm we gεt lכw lεvεl fכ di εnzym UGT1A1 kin gεt bכku risk fכ siriכs dayariya εn infεkshכn if dεn gi dεm di drog Irinotecan (e.g. Camptosar®).

כlso, di antikansa drog fluorouracil, `5-FU` (e.g. Adrucil® - `Adrucil®`), kin mek siriכs sayd ifekt if dεn gi am nכmal dos to pipul dεm we gεt lכw lεvεl fכ di εnzym dihydropyrimidine dehydrogenase (`Dihydropyrimidine Dehydrogenase - DPD`). Dɔktɔ dɛn kin gi dis mɛrɛsin fɔ kɔlorektal kansa, brɔst, bɛlɛ ɛn pankrias kansa.

Fɔ mek blɔd nɔ klɔt

Pipul dεm we gεt sכm jεnεtik vεryכnt dεm nid fכ tek lכw dכz fכ di antikoagulant dכg warfarin (e.g. Coumadin®). If yu du am tumɔs, dat kin mek yu blɔd.

כlso, if yu chenj di CYP2C19 εnzym na yu liva i kin mek di antiplatelet mεdikeshכn klopidogrεl (e.g. Plavix®) nכ wok fayn . Dis na mɛrɛsin wae dɛn kin yuse fɔ mek yu nɔr gɛt tin lɛk at atak ɛn strok.

HIV infɛkshɔn

wan sכm vεryכnt fכ di HLA-B jin kin mek wan siriכs skin riakshכn to di drog Abacavir (e.g. Ziagen®).

כlso, wan vεryכnt na di CYP2B6 jin kin inkrεs di risk fכ sayd ifekt dεm lεk nyurolכjik chenj frכm di dכg efavirenz (e.g. Sustiva®).

Di prɔblɛm dɛn we de apin na di imyun sistɛm

If yu de tek wan immunosuppressant, yu kin bɛnifit frɔm pharmacogenomic testing:

• biכs fכ di vεryushכn dεm na di protin dεm `TPMT` εn `NUDT15`, bon mכro fכnshכn kin sכpres if yu tek di dכg `Azathioprine` (e.g. `Imuran®`) afta yu transplant kidni כ fכ imyun sistεm kכndishכn dεm lεk mכltipl sklεrosis.
• biכs fכ di vεryushכn dεm na di CYP3A5 εnzym, if yu tek tacrolimus (e.g. Prograf®) afta yu gεt כgan transplant, di risk fכ rijek כgan transplant kin inkrεs.

Wetin na di bɛnifit dɛn we famakɔjinɔmiks gɛt?

As di wan dɛn we de du risach ɛn dɔktɔ dɛn de kɔntinyu fɔ stɔdi ɛn yuz di famakɔjinɔmiks, i kin gi bɔku bɛnifit dɛn. Tek wan luk:

• Impruv sef: Dɔktɔ dɛn go ebul fɔ avɔyd fɔ gi mɛrɛsin we de mek sɔm pipul dɛn gɛt bad bad sayd ɛfɛkt, ɔ we kin mek prɔblɛm we dɛn tek am pasmak. Dis min se yu nɔ go nid fɔ sɔfa we yu nɔ nid fɔ sɔfa.
• Efyushɔn ɛn ridyus di kɔst fɔ wɛlbɔdi biznɛs: If dɔktɔ dɛn ebul fɔ no bifo tɛm us mɛrɛsin dɛn de wok ɛn uswan nɔ de wok, dɛn kin gi dɛn di mɛrɛsin dɛn we go wok fayn fɔs , we go sev mɔni ɛn tɛm .
• Targeted drug development: Sɔm sik dɛn kin kam bikɔs ɔf wan patikyula chenj (variant) na wan jin. Famakojinɔmiks de alaw di wan dɛn we de du risach fɔ fɛn nyu mɛrɛsin dɛn bay we dɛn de tɔch da jɛnɛtik chenj de dairekt wan. Jɔs lɛk fɔ mek wan mɛrɛsin we fit di sik.

Wetin na di limiteshɔn/disavantej dɛm fɔ famakojinɔmiks?

Pan ɔl we yu jenɛtik mek-ap impɔtant fɔ no di bɛst tritmɛnt fɔ bɔku sik dɛn, i nɔ de ɛksplen gud gud wan aw yu bɔdi de prosɛs di mɛrɛsin dɛn. Dɔktɔ dɛn stil gɛt fɔ tink bɔt ɔda tin dɛn we dɛn de pik di rayt mɛrɛsin. Fɔ ɛgzampul:

• Ɔda mɛrɛsin dɛn: Di mɛrɛsin dɛn we yu de tek naw kin ambɔg di wok we nyu mɛrɛsin dɛn de du.
• Ɔda wɛl bɔdi prɔblɛm: Sɔm sik kin chenj di we aw yu bɔdi de prosɛs di mɛrɛsin. Fɔ ɛgzampul, if yu kidni nɔ de wok fayn, sɔm mɛrɛsin dɛn go kɔmɔt na yu bɔdi.
• Di we aw yu de liv yu layf: Tin dɛn lɛk wetin yu de it, aw yu de du ɛksɛsayz, ɛn aw yu de drink tabak ɛn rɔm kin afɛkt aw yu mɛrɛsin kin pwɛl.

Ɔda chalenj dɛn we de na di divɛlɔpmɛnt ɛn aplikeshɔn fɔ famakojinɔmiks na:

• Kɔst: Pan ɔl we di kɔst fɔ tɛst fɔ di famakɔjinɔmik de go dɔŋ smɔl smɔl, di kɔst fɔ ɛni pɔsin, ɔ di kɔst fɔ wan pɔsin we kɔmɔt na in poket, kin difrɛn bɔku tɛm dipen pan di inshɔrans kɔvarej. Dis tɛst nɔ kin de fɔ ɔlman.
• Di we aw pɔsin kin ebul fɔ go de:Dipen pan usay yu de ɛn di kayn dɔktɔ we de trit yu, yu nɔ go ebul fɔ du sɔm tɛst dɛn fɔ yu jɛnɛtiks.

Naw, dɔktɔ dɛn kin jɔs yuz famakojɛnomik fɔ sɔm kayn sik ɛn mɛrɛsin dɛn. Bɔt dis fayn fayn fil fɔ ‘prɛsishɔn mɛrɛsin’ de gro kwik kwik wan. Tɔk to yu dɔktɔ bɔt aw famakojinɔmiks kin ɛp yu wɛlbɔdi ɛn us bɛnifit dɛn i kin briŋ. Yu kin aks bak bɔt klinik trial dɛm na dis fil.

Fɔ dɔn, fɔ dɔn, mɛmba dis.

Okay, so, pan ɔl we di wɔd famakojinɔmiks we wi bin de tɔk bɔt tide na kɔmplikɛt smɔl, wetin i min na dat i de ɛp wi fɔ pik di mɛrɛsin we go fayn fɔ wi ɛn we gɛt di smɔl sayd ɛfɛkt dɛn, bays pan wi jin dɛm.

Wi jin na big rizin we mek di sem mɛrɛsin nɔ de wok di sem we fɔ ɔlman. Famakojinɔmiks na fɔ tray fɔ ɔndastand da sikrit de ɛn gi wi mɔ pɔrsin in yon tritmɛnt, we go wok fayn.

Pan ɔl we dis stil na tin we de divɛlɔp, i ebul fɔ chenj di we aw dɛn de trit bɔku sik dɛn tumara bambay. If yu gɛt ɛni kwɛstyɔn bɔt wan patikyula mɛrɛsin, mɔ if i go wok fɔ yu ɔ if i go mek yu gɛt sayd ɛfɛkt, nɔ fred fɔ tɔk to yu dɔktɔ bɔt dɛn famakɔjinɔmik tɛst ya. Dɛn kin rili ɛp yu.

Mɛmba se yu jin na jɔs wan impɔtant pat pan yu wɛlbɔdi stori. Fɔ it gud it, fɔ du ɛksɛsayz, ɛn fɔ fala yu dɔktɔ in advays na tin dɛn we impɔtant jɔs lɛk dat!

` Famakojinomiks, jin, drɔg, mɛrɛsin, prɛsishɔn mɛrɛsin, jɛnɛtik tɛst, sayd ifɛkt