From Pharmacokinetics to Pharmacogenomics

A New Approach to Tailor Immunosuppressive Therapy

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

One of the main tasks in the management of organ transplantation is the optimization of immunosuppressive therapy, in order to provide therapeutic efficacy limiting drug-related toxicity. In the past years major efforts have been carried out to define therapeutic windows based on blood/plasma levels of each immunosuppressant relating those concentrations to drug dosing and clinical events. Although this traditional approach is able to identify environmental and nongenetic factors that can influence drug exposure during the course of treatment, it presents limitations. Therefore, complementary strategies are advocated. The advent of the genomic era gives birth to pharmacogenomics, a science that studies how the genome as a whole, including single genes as well as gene-to-gene interactions, may affect the action of a drug. This science is of particular importance for drugs characterized by a narrow therapeutic index, such as the immunosuppressants. Preliminary studies focused on polymorphisms of genes encoding for enzymes actively involved in drug metabolism, drug transport and pharmacological target. Pharmacogenomics holds promise for improvement in the ability to individualize immunosuppressive therapy based on the patient's genetic profile, and can be viewed as a support to traditional therapeutic drug monitoring. However, the clinical applicability of this approach is still to be proven.

Original languageEnglish
Pages (from-to)299-310
Number of pages12
JournalAmerican Journal of Transplantation
Volume4
Issue number3
DOIs
Publication statusPublished - Mar 2004

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Pharmacogenetics
Immunosuppressive Agents
Pharmacokinetics
Pharmaceutical Preparations
Genes
Therapeutics
Drug Monitoring
Organ Transplantation
Drug-Related Side Effects and Adverse Reactions
Parturition
Genome
Pharmacology
Enzymes

Keywords

  • Genomics
  • Immunosuppressive agents
  • Pharmacogenetics
  • Therapeutic drug monitoring

ASJC Scopus subject areas

  • Immunology

Cite this

From Pharmacokinetics to Pharmacogenomics : A New Approach to Tailor Immunosuppressive Therapy. / Cattaneo, Dario; Perico, Norberto; Remuzzi, Giuseppe.

In: American Journal of Transplantation, Vol. 4, No. 3, 03.2004, p. 299-310.

Research output: Contribution to journalArticle

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