Ethos Ho, BSc Pharm Candidate
“It is more important to know what sort of person has a disease than to know what sort of disease a person has. “ – Hippocrates
The Building Block of Drug Therapy
You may have heard that DNA is the building block of all life. Our DNA is made up of four unique molecules called nucleic acids, and every single one of us is defined by the “code” that’s made up by these molecules, which helps decide our weight, appearance, eye colour, height, and the way we respond to medications.
It’s often well recognized that people’s health may be influenced by their age, gender, organ function, and disease state. However, despite it being the backbone of all life, the impact of our genetic code is something we don’t always consider when thinking about medications. As clinicians realize the importance of genetics in determining how individuals respond to medications, an exciting new area of medicine – known as pharmacogenomics – is helping decipher the code of personalized therapy.
What is Pharmacogenomics?
Pharmacogenomics is the study of genetic differences between individuals, and the impact these differences have on medications.1 To do this, researchers and clinicians study small parts of our DNA, known as genes. More specifically, there are certain medication-related genes that are often different between individuals.1 Some genes may be more common, while others are rarer. To visualize how this plays out, imagine this scenario:
100 patients of the same race, age, and gender are diagnosed with cancer. They’re all given the same medications. However, only 80% of patients get healthier, while the remaining 20% either don’t improve or experience side effects. Unfortunately for this 20%, the window of opportunity for controlling their disease has already passed during this time, and their cancer is no longer curable.
In this scenario, all patients were given the same treatment, but some did much better, while others didn’t. Situations like these are due to individual differences in DNA. Therefore, the idea behind pharmacogenomics is to understand peoples’ DNA beforehand, to help choose the medications that are the safest, and best suited just for them.
How do our genes affect medication, and which drugs are most affected?
Our DNA determines how our bodies absorb, distribute, metabolize and get rid of medications, which all play a big role in how well they work, and if they’ll cause any side effects.1 These differences are all it takes for a drug to make one person feel great, and make the next person feel sick.
Codeine is a prime example of a medication that isn’t consistent among different people. To learn more about this, check out our previous article here.
Currently, research is focusing on the effect of our genes on cancer, heart disease, depression and other psychological disorders.2 Hopefully, soon, we’ll be able to create tailored, individualized drug-therapy that delivers the best results, with little to no side effects.
What are the challenges with pharmacogenomics?
Currently, there are no guidelines on integrating pharmacogenomics, as it’s still such a new science. Also, it’s not always practical to screen every individual out there, given the time, cost, and equipment required to obtain results.3 Hopefully, as technology improves, we may find a way to overcome these obstacles.
The Bottom Line
Pharmacogenomics is a promising new field of healthcare that can improve the well-being of countless people. Although there are still barriers to bringing this science into reality, we can be sure that the future of healthcare will soon become much more individualized.
We hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.
RESOURCES
- Lexicomp
- Olivier, C., & Williams-Jones, B. (2014). Global pharmacogenomics: Where is the research taking us?. Global Public Health, 9(3), 312-324. http://dx.doi.org/10.1080/17441692.2014.887137
- Mooney, S. (2014). Progress towards the integration of pharmacogenomics in practice. Human Genetics, 134(5), 459-465. http://dx.doi.org/10.1007/s00439-014-1484-7
