Pharmacogenetic DNA test explained

Pharmacogenetic

The iGene pharmacogenetic profile

Thanks to the iGene pharmacogenetic profile, it is possible to take the preventive step of identifying drugs to which you may not respond well. Such a profile makes it easier for a doctor or pharmacist to decide on the right drug and the right dose. In this blog we explain what pharmacogenetics involves and what you can do with your pharmacogenetic profile.

What is pharmacogenetics?

Pharmacogenetics is the scientific field within which research is carried out into variations in DNA and how these relate to an individual’s response to a drug.

Genetic variations, which occur naturally, may mean that drugs are processed more slowly or more quickly than average. This not only has an impact on the efficacy of the drug, but can also affect the extent and severity of any side effects.

A pharmacogenetic DNA test is therefore an important tool for a doctor or pharmacist when it comes to deciding on the right drug and the right dose. That means pharmacogenetics is an important step forward in terms of tailoring medication to the individual.

Processing drugs

(Liver) enzymes, receptors and transport proteins, amongst other things, play a role in the processing of drugs within the human body. For the most part drugs are metabolised in our bodies by enzymes in the liver. The enzyme CYP2D6, for example, is involved in breaking down 20-30% of all drugs. Other important enzymes include CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP3A4, CYP3A5, BChE, DPD, TPMT and VKORC1. Different enzymes are important for each individual drug. Transport proteins such as SLCO1B1 and genotypes such as HLA and IL28B also play a key role in processing drugs.

Not everyone processes drugs in the same way

We are not all the same. The ability to process drugs differs from one person to another. This is because genetic variations influence how the above-mentioned enzymes, transport proteins and receptors act. Consequently, amitriptyline or codeine, for example, are not metabolised at the same speed by everyone. Nevertheless, for the most part, people are prescribed the same initial dose of a drug. If a drug does not seem to be having an effect or is causing (too many) side effects, the dose will be adjusted or another drug may be chosen. A pharmacogenetic profile allows you to take differences in enzyme activity into account in advance, which means an effective treatment can be chosen from the outset.

What can you do with a pharmacogenetic profile?

If you have your DNA analysed, it is possible to produce a personal pharmacogenetic profile. You will receive an overview of potentially abnormal activity for more than 15 different enzymes, transport proteins and receptors. In a list of over 50 different drugs you will also see whether you may have an abnormal response to these medications*. 

You can share these results with your doctor or pharmacist, who can then translate this information into an adapted treatment, where necessary. 

*Based on information from the Royal Dutch Association for the Advancement of Pharmacy - Pharmacogenetics Working Group (DPWG) and Clinical Pharmacogenetics Implementation Consortium (CPIC); only drugs for which an active dosing policy is currently recommended have been included.

 

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Find out more about this subject in the following blog:

Pharmacogenetic DNA test explained: Part II

Sources:

- R.H.N van Schaik, I. Houwink, T. van Gelder "Farmacogenetisch testen op CYP450-enzymen." Ned Tijdschr Geneeskd 160 (2016): A9404Q

- Website Farmacotherapeutisch Kompas: https://www.farmacotherapeutischkompas.nl/farmacologie/farmacogenetica , geraadpleegd op 10-02-2020

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