基因多态性与药品不良反应的相关性  

Relationship between Genetic Polymorphisms and Adverse Drug Reaction

作　　者：孙雪林[1] 胡欣[1] 徐巧玲[2] 

机构地区：[1]北京医院药学部/国家老年医学研究中心/药物临床风险与个体化应用评价北京市重点实验室,北京100730 [2]解放军第305医院药局,北京100017

出　　处：《中国药房》2016年第32期4469-4472,共4页China Pharmacy

基　　金：卫生计生委保健局保健重点科研项目(No.W2016ZD01)

摘　　要：目的:为临床精准用药、预防和减少药品不良反应(ADR)的发生提供参考。方法:收集近年来国内外有关药物基因组学与ADR的研究文献,对基因多态性与ADR的相关性进行归纳和总结。结果与结论:目前已发现多种ADR相关基因。人类白细胞抗原基因多态性与双氯芬酸、阿莫西林克拉维酸钾等药物致肝损伤,卡马西平、阿巴卡韦等药物致皮肤过敏反应有关;肝脏药物转运体1B1基因多态性与他汀类药物致肌病有关;N-乙酰基转移酶2基因多态性与异烟肼致肝损伤有关;一氧化氮合酶1调酶基因、心脏钠离子通道5A基因和钾离子通道E1基因多态性与药物致QT间期延长有关等。基因多态性研究可为预防ADR提供新的参考依据,临床可在药物治疗前对患者进行基因型检测,以降低ADR的发生率。OBJECTIVE： To provide reference for precision medication in the clinic, preventing and reducing the occurrence of adverse drug reaction （ADR）. METHODS： Foreign and domestic literatures about pharmacogenomics and ADR were collected to summarize the relationship of genetic polymorphisms with ADR. RESULTS＆CONCLUSIONS： At present, many ADR-related genes are identified. The polymorphisms of human leukocyte antigen genes are associated with liver injury induced by diclofenac, amoxicillin clavulanate potassium and other drugs, and allergic reaction induced by carbamazepine, abacavir and other drugs. The polymorphisms of liver drug transporter 1B1 genes are associated with myopathy induced by statins. The polymorphisms of N-acety- lase 2 genes are associated with liver injury induced by isoniazid. The polymorphisms of NOS1AP, SCN5A and KCNE1 genes are associated with drug-induced QT prolongation. Gene polymorphism study can provide a new reference for the prevention of ADR. Gene detection can be conducted before drug treatment to reduce the incidence of ADR.

关 键 词：药品不良反应 药物基因组学 基因多态性 精准用药 

分 类 号：R969.3[医药卫生—药理学]