Pharmacogenetic effects on pharmacokinetics and pharmacodynamics

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Presentation transcript:

Pharmacogenetic effects on pharmacokinetics and pharmacodynamics Evans & McLeod, NEJM 2003

Genetic polymorphisms of enzymes involved in drugs’ metabolic inactivation or drug receptors influence treatment bioavailability and efficacy Relling & Evans, Science 1999

DNA polymorphisms can influences protein function Feero et al., NEJM 2010

Epigenetic effects modulate the association of DNA variants with protein function Feero et al., NEJM 2010

Elements of human genetic variation Feero et al., NEJM 2010

Relevance of germline and somatic variants in oncology Paugh et al., Clin Pharm Ther 2011

In infectious diseases, genetic variation can affect a pathogen's sensitivity to antimicrobial drugs Huges and Andresson Nat Rev Genet 2015

Nomenclatura delle regioni genomiche Goodman and Gilman, 2011

Meccanismi molecolari di polimorfismi genetici Goodman and Gilman, 2011

Codice genetico Codice genetico

Nomenclatura delle regioni genomiche Goodman and Gilman, 2011

How different is the genome (DNA) between individuals? ~ 1 nucleotide every 150-1000 nucleotides For a total of: ~ 60 million small elements of varitiation ~ 17 million SNPs ~ 8000 copy number variations Chakravarti et al Nature 409, 822 – 823, 2001 The International HapMap Consortium Nature 449, 851-861. 2007 The International HapMap Consortium Nature 437, 1299-1320. 2005 Conrad et al Nature 2009

How many genes contain variations in each individual DNA genomic studies by exome sequencing and copy number variation interrogation show: 46 non-sense coding SNPs/person 52 frameshift indel/person 274 geni alterati by CNV Therefore ~372 genes/person have substantial defects Nature. 2009; 461:272-6. Ng ….Nickerson DA, Shendure J. Nature. 2009. WTCC CNV Conrad DF et al

What is the importance of inherited genomic variability? Common vs rare variants—still unclear if variability is so diverse that it’s not tenable to discover or utilize What proportion of variability in clinical phenotypes (e.g. cancer risk, response to medications) is inherited?

Common variants vs Rare variants