Damdawi an pek che hi i tan a tha em? Pharmacogenomics chungchang hi han sawi ila!

Natna inang damdawi inang hian mi thenkhat tan hna a thawk a, midang tan a thawk lo va, midang tan pawh side effect a nei tih i hre tawh ngei ang. Engvangin nge chu chu? Kan taksa a danglam vang em ni? Ni e, chu chu a chhan pakhat a ni. Chu chu thupui inzawm, eng emaw chen buaithlak tak, mahse pawimawh tak, vawiinah hian kan sawi dawn a ni. Hei hi pharmacogenomics an ti a.

Pharmacogenomics chu eng nge ni?

A awlsam zawngin sawi ila, pharmacogenomics chu kan genes hmanga damdawi kan dawn dan zirchianna a ni. Pharmacology hi damdawi hman dan leh a nghawng dan zirchianna a ni tih hre reng ang che. Genomics hi genes leh an hnathawh dan zir chianna a ni. An pahnih inzawmkhawm hi pharmacogenomics an ti a. A chang chuan pharmacogenetics an ti bawk.

Hei hi ‘Precision Medicine’ field lian zawk hnuaiah a tla tak zet a ni. Chu chu i genes, i awmna hmun leh i nunphung ang chi thilte hmanga mimal enkawlna ruahmanna siamsak che tihna a ni. Pharmacogenomics hian i doctor chu damdawi side effect tlem zawk nei emaw i tana tha ber emaw thlang turin a pui thei a ni .

Mahse hriat tur chu he method hi natna zawng zawngah emaw, damdawi zawng zawngah emaw hman a la ni lo. Tunah hian natna leh damdawi tlemte, HIV, cancer chi thenkhat, lungngaihna, leh thinlung natna te tan hman a ni ber. Mahse he field hi a thang chak hle a ni. Zirchiangtute chuan he hmanrua hian natna tlanglawn ber berte tan pawh damdawi tha zawk thlan theihna a pui thuai an beisei.

Engtin nge genes hian damdawi hnathawh dan a nghawng?

Hetiang hian han ngaihtuah teh: kan genes te hi kan taksa chhunga cells te tana instruction set ang mai a ni. Heng genes te hian protein molecule enzyme an tih siam turin min pui thin . Enzyme hian kan taksaah hna maktaduai khat a nei a. Chumi zinga pakhat chu taksaa damdawi awmte tihchhiat, a nih loh leh metabolize . Mi thenkhatin beisei angin ruihhlo an dawn loh chuan an genes-ah inthlak danglamna engemaw zat an neih vang pawh a ni thei. Heng inthlak danglamna te hian enzyme te chu a tichak lo thei a, enzyme te chu a thawk tha lo thei bawk.

Tunah chuan han ngaihtuah teh, i taksain damdawi a tihchhiat rang lutuk, emaw, zawi lutuk emaw, a tichhia lo emaw a nih chuan eng nge thleng ang? Tichuan damdawi, a dose pangngaia pek chu beisei angin a thawk thei dawn lo. Either the drug could cause serious side effects , a nih loh leh tuna natna awm mek ah hian nghawng a nei lo thei bawk.

Entirnan, mi thenkhat chuan coffee an in zawhah an muhil vat lova, thenkhat erawh chuan an muhil lo thung. Hei hi a chhan pakhat chu kan genes hian kan taksain caffeine a tihchhiat rang dan a nghawng vang a ni. Damdawi chungchangah pawh chutiang bawk chu a thleng thei.

He pharmacogenomic test hi eng nge ni?

Pharmacogenomic test hi genetic test a ni. Gene pakhat emaw a aia tam emaw a en thei a, a bik takin damdawi pakhat tihchhiatna tichhe thei genetic variant bik zawng turin a ni. Kan taksa ‘instruction manual’-a typo awm leh awm loh enfiah ang mai a ni.

Hetiang ti tur hian doctor-te chuan thisen sample emaw, buccal swab emaw an hmang tlangpui. He sample hi i hnen atangin lak a ni a, lab-ah thawn a ni. Chutah chuan technician pakhat chuan i DNA-ah thil danglam bik a awm leh awm loh a enfiah a. An gene emaw gene emaw an zawn chu i doctor-in a tih test, an enkawl tumna leh damdawi an pek che danah a innghat ang.

Engtikah nge pharmacogenomic test ka mamawh ang?

Damdawi lam harsatna thenkhat atana damdawi i ei a nih chuan pharmacogenomic testing pawh i nei thei bawk. Entirna thenkhat (a dang pawh a awm thei) chu hetiang hi a ni:

Cholesterol sang tak a ni

Kan taksaa ``SLCO1B1 gene`` chi hrang hrang avang hian cholesterol sang damdawi statin an tih thenkhat i ei chuan taksa ruh na leh chak lohna i nei thei a ni. Heng statin te entirnan:

• Atorvastatin (e.g. Lipitor®) hman tur a ni.
• Fluvastatin (e.g. Lescol®) hman a ni.
• Lovastatin (e.g. Altoprev®) hman a ni.
• Pitavastatin (e.g. Livalo®) hman a ni.
• Pravastatin (e.g. Pravachol®) hman a ni.
• Rosuvastatin (e.g. Crestor®) hman a ni.
• Simvastatin (e.g. Zocor®) hman a ni.

Chuvangin hetiang damdawi hi i ei tan hmain emaw, i hman laiin harsatna i neih chuan i doctor chuan hetiang test chungchang hi a sawipui thei ang che.

Lungngaihna

CYP2D6 leh CYP2C19 gene hrang hrang hian i taksain antidepressant thenkhat a tihchhiat rang dan a nghawng thei a ni. Heng damdawi entirnan:

• Amitriptyline (e.g. Elavil®) - Hei hi tricyclic antidepressant chi khat a ni a .
• `SSRI` class of drugs : `Citalopram` (e.g. `Celexa®`), `Escitalopram` (e.g. `Lexapro®`), `Sertraline` (e.g. `Zoloft®`), `Paroxetine` (e.g. `Paxil®`) leh `Fluvoxamine` (e.g. `Luvox®`) te hi a ni.
• Venlafaxine (e.g. Effexor®) - Hei hi SNRI chi khat a ni.

He test hi hetiang damdawi ei tan tirh hian a tangkai thei a, damdawi pakhat a thawk tha lo a, damdawi dang i thlak tum lai pawhin a tangkai thei bawk.

Cancer natna vei te

Cancer chi khat damdawi i ei a nih chuan pharmacogenomic testing hmangin i hlawkpui thei ang. Entirna thenkhat chu hetiang hi a ni:

• Breast cancer: Damdawi trastuzumab (e.g. Herceptin®) hian HER2-positive breast cancer vei te tan chauh hna a thawk a ni . Chumi awmzia chu cancer cell-te hian genetic mutation an nei a, chu chuan HER2 protein chu a siam tam lutuk tihna a ni.
• Acute Lymphoblastic Leukemia (ALL): Enzyme Thiopurine Methyltransferase (TPMT) level hniam nei te chuan Mercaptopurine dose pangngai (e.g. Purinethol®) pek an nih chuan side effect na tak an nei thei a, natna kai theihna a sang thei bawk.
• Colon cancer: Enzyme UGT1A1 level hniam nei te chu damdawi Irinotecan (e.g. Camptosar®) pek an nih chuan ril\am na tak leh natna kai theihna a sang thei hle.

Tin, cancer dona damdawi fluorouracil, `5-FU` (e.g. Adrucil® - `Adrucil®`) hi enzyme dihydropyrimidine dehydrogenase (`Dihydropyrimidine Dehydrogenase - DPD`) level hniam nei te tan a dose pangngaia pek a nih chuan side effect na tak a thlen thei bawk. Doctor ten he damdawi hi colorectal cancer, hnute, pum leh pancreatic cancer te tan an pe thei a ni.

Thisen zam venna

Genetic variant thenkhat nei te chuan anticoagulant drug warfarin (e.g. Coumadin®) dose hniam zawk an ei a ngai a ni. A tam lutuk chuan thisen a chhuak thei.

Tin, i liver-a CYP2C19 enzyme inthlak danglamna chuan antiplatelet damdawi clopidogrel (e.g. Plavix®) chu a thawk tha thei lo thei bawk . Hei hi heart attack leh stroke ang chi thil venna atana hman thin damdawi a ni.

HIV hrik kai

HLA-B gene chi khat hian damdawi Abacavir (e.g. Ziagen®) lakah vun natna nasa tak a thlen thei a ni.

Tin, CYP2B6 gene-a variant pakhat hian damdawi efavirenz (e.g. Sustiva®) atanga neurological changes ang chi side effects a thlen theihna a tipung thei bawk.

Immune system chungchangah harsatna a awm

Immunosuppressant i ei a nih chuan pharmacogenomic testing hmangin i hlawkpui thei ang:

• Protein `TPMT` leh `NUDT15` inthlak danglamna avang hian kidney transplant hnua damdawi `Azathioprine` (e.g. `Imuran®`) i ei chuan emaw, immune system condition, multiple sclerosis ang chi tan emaw i ei chuan bone marrow function a titawp thei a ni.
• CYP3A5 enzyme danglamna avang hian organ transplant hnua tacrolimus (e.g. Prograf®) i ei chuan organ transplant rejection hlauhawmna a sang thei hle.

Pharmacogenomics hian eng nge a thatna?

Researcher leh doctor-te’n pharmacogenomics an zir leh an hman chhunzawm zel chuan hlawkna tam tak a chhuah thei a ni. En teh:

• Hriselna tihchangtlun: Doctor-te chuan mi thenkhata side effect tha lo thlen thei, emaw, ei tam lutuk a nih chuan harsatna thlen thei damdawi an pe lo thei ang. Chumi awmzia chu tul lovah i tuar a ngai dawn lo tihna a ni.
• Efficiency and reduced healthcare costs: Doctor-te chuan eng damdawi nge hna thawk tih leh eng nge thawk lo tih an hriat lawk theih chuan damdawi tha ber ber an pe hmasa thei ang , sum leh pai leh hun a humhim thei ang
• Targeted drug development: Natna thenkhat hi gene pakhata inthlak danglamna (variant) bik avanga lo awm a ni. Pharmacogenomics hian zirchiangtute chu chu genetic variation chu direct-a target-in damdawi thar a zawng thei a ni. Natna nena inmil damdawi siam ang maiin.

Pharmacogenomics hian engte nge a tihkhawtlai/that lohna?

I genetic makeup hi natna tam tak enkawlna tha ber tur hriatnaah a pawimawh laiin, i taksain damdawi a process dan a sawifiah kim lo. Doctor-te chuan damdawi dik an thlan hunah thil dang an la ngaihtuah a ngai a ni. Entir nan:

• Damdawi dang: Tuna i ei mek hian damdawi thar thatna a tibuai thei a ni.
• Hriselna dang: Natna thenkhat chuan i taksain damdawi a process dan a tidanglam thei a ni. Entirnan, i kal (kidney) a thawk tha lo a nih chuan damdawi thenkhat chu i taksa atangin a chhuak ang.
• Nunphung: I ei leh in te, exercise i tih tam dan te, zuk leh hmuam leh zu i hman dan te hian i damdawi a chhiat dan a nghawng thei a ni.

Pharmacogenomics siam leh hmanna kawnga harsatna dangte chu:

• Cost: Pharmacogenomic testing man hi a tlahniam zauh zauh nachungin, mi pakhat tan senso emaw, out-of-pocket costs emaw hi insurance coverage a zirin a danglam fo thin. He test hi mi zawng zawng tan a awm lo mai thei.
• A thlen theihna: 1.1.I awmna hmun leh doctor enkawltu chi hrang hrang a zirin, genetic test thenkhat i neih theihna chu a tlem thei hle.

Tunah hian doctor-te chuan pharmacogenomics hi natna leh damdawi tlemte atan chauh an hmang thei a ni. Mahse, he ‘precision medicine’ field ngaihnawm tak hi a thang chak hle a ni. Pharmacogenomics hian i hriselna a puih theih dan leh eng hlawkna nge a thlen theih tih doctor nen sawiho rawh. Hemi kawngah hian clinical trial chungchang pawh i zawt thei bawk.

A tawp berah chuan, a tawp berah chuan hei hi hre reng ang che.

Okay, chuti a nih chuan, vawiin a kan sawi pharmacogenomics tih thumal hi a buaithlak deuh nachungin, a awmzia chu kan genes atanga thlirin, kan tan a tha ber leh side effects tlem ber damdawi kan thlan theih nan min pui a ni.

Damdawi pakhat hian mi zawng zawng tan hna a thawh dan inang lo chhan lian tak chu kan genes hi a ni. Pharmacogenomics chu chu thuruk chu hriatthiam tumna leh mimal zawk, enkawlna tha zawk min pek tumna a ni.

Hei hi a la thang chho zel a, mahse, nakin lawkah natna tam tak enkawl dan tur thlak danglam theihna a nei a ni. Damdawi pakhat chungchangah zawhna i neih chuan, a bik takin i tan a thawk tha ang em tih leh a side effect a thlen dawn em tih zawhna i neih chuan heng pharmacogenomic test chungchangah hian i doctor nen inbiakna neih hlau suh. An ṭangkai hle mai thei che.

I genes hi i hriselna chanchina thil pawimawh tak pakhat chauh a ni tih hre reng ang che. Ei leh in tha, exercise leh doctor thurawn zawm te pawh chutiang bawk chuan a pawimawh!

` Pharmacogenomics, genes, damdawi, damdawi, precision medicine, genetic testing, side effects te