Toward Individualized Pharmaceutical Care of East Asians


Research into the relationship between genetics and drug response has focused on polymorphisms, or variations, in genes that encode drug-metabolizing enzymes, particularly the genes that affect the clearance of the anticoagulant warfarin, proton pump inhibitors, tricyclic antidepressants, and many other clinically relevant drugs. Much of this work has targeted East Asians, a genetically distinguishable and populous group. Researchers have identified polymorphisms that inactivate gene function, compared polymorphism frequencies in East-Asian and Caucasian populations, and determined the effects on the pharmacokinetic parameters of drugs. Detection in an individual of polymorphisms known to inactivate a drug-metabolizing enzyme is predictive of poor metabolism of drugs processed by that pathway, which itself may be predictive of an atypical drug response. Genetic tests can be used to screen for individuals who are poor metabolizers, with the ultimate goal of better predicting the clinical effects of drugs.