Pharmacogenetics

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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History
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Bird, 1959

Definition
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Science of the knowledge of hereditary variants in the reaction to drugs and other externally supplied substances. Pharmacogenetics thus stands for the relationship and interplay between the genetic make-up of a person and his or her individual reaction to drugs (see also drug reaction, adverse drug reactions).

General information
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All humans agree with each other in their genetic information to 99.9%. There are differences (polymorphisms) in about 3 million of the approximately 3 billion bases of our genetic information. Such polymorphisms are usually limited to 1 base within a gene. If the exchange of a base occurs in > 1% of the population, this is called a "single nucleotide polymorphism" or SNP. "Single nucleotide polymorphism" are, for example, partly responsible for the different efficacy and tolerability of drugs (see also degradation by cytochrome P450 enzymes).

Occurrence
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  • The first observation of a polymorphic difference in the effect of a drug concerned the muscle relaxant suxamethonium, which is metabolised by pseudocholinesterase. Polymorphisms of the coding gene of this enzyme led in rare cases (1:3500 in people with white skin colour) to a delay in the degradation of suxamethonium and thus to a prolongation of the muscle relaxant effect.
  • Further dermatologically relevant examples:
    • Thiopyrin-S-methytransferase polymorphism. This enzyme plays a role in the metabolism of azathioprine. Patients with this gene polymorphism are at increased risk of developing life-threatening leukopenia.
    • Glucose-6-phosphate dehydrogenase polymorphism can lead to delayed degradation of DADPS and thus to increased methemoglobin formation.

Literature
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  1. Merk HF (2010) Pharmacogenetics. dermatologist 61: 650-653
  2. Vogel F (1959) Modern problems of human genetics. Result Inn Med Kinderheilkd 12: 52-125

Incoming links (1)

Cytochrome p450 enzymes;

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Last updated on: 29.10.2020