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Barlas İÖ, Sezgin O, Dandara C, Türköz G, Yengel E, Cindi Z, Ankaralı H, Şardaş S. Harnessing Knowledge on Very Important Pharmacogenes CYP2C9 and CYP2C19 Variation for Precision Medicine in Resource-Limited Global Conflict Zones. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2017; 20:604-609. [PMID: 27726640 DOI: 10.1089/omi.2016.0133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Pharmacogenomics harnesses the utility of a patient's genome (n = 1) in decisions on which therapeutic drugs and in what amounts should be administered. Often, patients with shared ancestry present with comparable genetic profiles that predict drug response. However, populations are not static, thus, often, population mobility through migration, especially enmasse as is seen for refugees, changes the pharmacogenetic profiles of resultant populations and therefore observed responses to commonly used therapeutic drugs. For example, in the aftermath of the Syrian civil war since 2011, millions have fled their homes to neighboring countries in the Middle East. The growing permanence of refugees and mass migrations is a call to shift our focus in the life sciences community from old models of pharmaceutical innovation. These seismic social changes demand faster decisions for "population-to-population bridging," whereby novel drugs developed in or for particular regions/countries can meet with rational regulatory decisions/approval in world regions impacted by migrant/refugee populations whose profiles are dynamic, such as in the Eastern Mediterranean region at present. Thus, it is important to characterize and report on the prevalence of pharmacogenes that affect commonly used medications and predict if population changes may call for attention to particular differences that may impact health of patients. Thus, we report here on four single-nucleotide polymorphism (SNP) variations in CYP2C9 and CYP2C19 genes among Mersin-Turkish healthy volunteers in the Mersin Province in the Eastern Mediterranean region that is currently hosting a vast number of migrant populations from Syria. Both CYP2C9 and CYP2C19 are very important pharmacogene molecular targets. We compare and report here on the observed SNP genetic variation in our sample with data on 12 world populations from dbSNP and discuss the feasibility of forecasting the pharmacokinetics of drugs utilized by migrant communities in Mersin and the Eastern Mediterranean region. This study can serve as a catalyst to invest in research in Syrian populations currently living in the Eastern Mediterranean. The findings have salience for rapid and rational regulatory decision-making for worldwide precision medicine and, specifically, "pharmacogenovigilance-guided bridging of pharmacokinetics" across world populations in the current era of planetary scale migration.
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Affiliation(s)
- İbrahim Ömer Barlas
- 1 Department of Medical Biology and Genetics, Faculty of Medicine, Mersin University , Mersin, Turkey
| | - Orhan Sezgin
- 2 Department of Gastroenterology, Medical Faculty of Mersin University , Mersin, Turkey
| | - Collet Dandara
- 3 Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, Institute for infectious Disease and Molecular Medicine, University of Cape Town , Cape Town, South Africa
| | - Gözde Türköz
- 1 Department of Medical Biology and Genetics, Faculty of Medicine, Mersin University , Mersin, Turkey
| | - Emre Yengel
- 2 Department of Gastroenterology, Medical Faculty of Mersin University , Mersin, Turkey
| | - Zinhle Cindi
- 3 Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, Institute for infectious Disease and Molecular Medicine, University of Cape Town , Cape Town, South Africa
| | - Handan Ankaralı
- 4 Department of Biostatistics and Medical Informatics, Düzce University 81620, Düzce, Turkey
| | - Semra Şardaş
- 5 Pharmacogenetics and Drug Safety Unit, Department of Toxicology, Faculty of Pharmacy, Marmara University , Istanbul, Turkey
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8
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Dove ES, Barlas IÖ, Birch K, Boehme C, Borda-Rodriguez A, Byne WM, Chaverneff F, Coşkun Y, Dahl ML, Dereli T, Diwakar S, Elbeyli L, Endrenyi L, Eroğlu-Kesim B, Ferguson LR, Güngör K, Gürsoy U, Hekim N, Huzair F, Kaushik K, Kickbusch I, Kıroğlu O, Kolker E, Könönen E, Lin B, Llerena A, Malhan F, Nair B, Patrinos GP, Şardaş S, Sert Ö, Srivastava S, Steuten LMG, Toraman C, Vayena E, Wang W, Warnich L, Özdemir V. An Appeal to the Global Health Community for a Tripartite Innovation: An "Essential Diagnostics List," "Health in All Policies," and "See-Through 21(st) Century Science and Ethics". OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2015; 19:435-42. [PMID: 26161545 DOI: 10.1089/omi.2015.0075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Diagnostics spanning a wide range of new biotechnologies, including proteomics, metabolomics, and nanotechnology, are emerging as companion tests to innovative medicines. In this Opinion, we present the rationale for promulgating an "Essential Diagnostics List." Additionally, we explain the ways in which adopting a vision for "Health in All Policies" could link essential diagnostics with robust and timely societal outcomes such as sustainable development, human rights, gender parity, and alleviation of poverty. We do so in three ways. First, we propose the need for a new, "see through" taxonomy for knowledge-based innovation as we transition from the material industries (e.g., textiles, plastic, cement, glass) dominant in the 20(th) century to the anticipated knowledge industry of the 21st century. If knowledge is the currency of the present century, then it is sensible to adopt an approach that thoroughly examines scientific knowledge, starting with the production aims, methods, quality, distribution, access, and the ends it purports to serve. Second, we explain that this knowledge trajectory focus on innovation is crucial and applicable across all sectors, including public, private, or public-private partnerships, as it underscores the fact that scientific knowledge is a co-product of technology, human values, and social systems. By making the value systems embedded in scientific design and knowledge co-production transparent, we all stand to benefit from sustainable and transparent science. Third, we appeal to the global health community to consider the necessary qualities of good governance for 21st century organizations that will embark on developing essential diagnostics. These have importance not only for science and knowledge-based innovation, but also for the ways in which we can build open, healthy, and peaceful civil societies today and for future generations.
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Affiliation(s)
- Edward S Dove
- 1 J. Kenyon Mason Institute for Medicine, Life Sciences and the Law, University of Edinburgh School of Law , Edinburgh, United Kingdom
| | - I Ömer Barlas
- 2 Faculty of Medicine, Department of Medical Biology and Genetics, Mersin University , Mersin, Turkey
| | - Kean Birch
- 3 Department of Social Science, Faculty of Liberal Arts and Professional Studies, York University , Toronto, Ontario, Canada
| | - Catharina Boehme
- 4 Foundation for Innovative New Diagnostics (FIND) , Campus Biotech, Chemin des Mines, Geneva, Switzerland
| | - Alexander Borda-Rodriguez
- 5 Secretaría Nacional de Educación Superior , Ciencia, Tecnología e Innovación, Quito, Ecuador .,6 Development Policy and Practice Group, The Open University , Milton Keynes, United Kingdom
| | - William M Byne
- 7 Departments of Psychiatry, The Icahn School of Medicine at Mount Sinai, New York, NY and The James J. Peters VA Medical Center , Bronx, New York
| | - Florence Chaverneff
- 8 Department of Neuroscience and Physiology, NYU Langone Medical Center , New York, New York
| | - Yavuz Coşkun
- 9 Office of the President, Gaziantep University , Gaziantep, Turkey
| | - Marja-Liisa Dahl
- 10 Division of Clinical Pharmacology, Karolinska Institute , Stockholm, Sweden
| | - Türkay Dereli
- 11 Department of Industrial Engineering, Faculty of Engineering, Gaziantep University , Gaziantep, Turkey
| | - Shyam Diwakar
- 12 Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham (Amrita University) , Amritapuri, Clappana P.O., Kollam, Kerala, India
| | - Levent Elbeyli
- 13 Faculty of Medicine, Gaziantep University , Gaziantep, Turkey
| | - Laszlo Endrenyi
- 14 Department of Pharmacology, Faculty of Medicine, University of Toronto , Ontario, Canada
| | | | - Lynnette R Ferguson
- 16 Discipline of Nutrition, The University of Auckland , Auckland, New Zealand
| | - Kıvanç Güngör
- 17 Faculty of Health Sciences, Gaziantep University , Gaziantep, Turkey
| | - Ulvi Gürsoy
- 18 Department of Periodontology, Institute of Dentistry, University of Turku , Turku, Finland
| | - Nezih Hekim
- 19 School of Medicine, Beykent University , Istanbul, Turkey
| | - Farah Huzair
- 20 Science, Technology and Innovation Studies, School of Social and Political Science, University of Edinburgh , Edinburgh, United Kingdom
| | | | - Ilona Kickbusch
- 22 Global Health Program, Graduate Institute of International and Development Studies , Geneva, Switzerland
| | - Olcay Kıroğlu
- 23 Department of Pharmacology, Faculty of Medicine, Çukurova University , Adana, Turkey
| | - Eugene Kolker
- 24 Bioinformatics and High-Throughput Analysis Laboratory, Seattle Children's Research Institute and CDO Analytics , Seattle Children's, Seattle, Washington.,25 Departments of Biomedical Informatics and Medical Education and Pediatrics, and University of Washington , Seattle, Washington.,26 Data-Enabled Life Sciences Alliance (DELSA Global) , Seattle, Washington.,27 Department of Chemistry and Chemical Biology, College of Science, Northeastern University , Boston, Massachusetts
| | - Eija Könönen
- 18 Department of Periodontology, Institute of Dentistry, University of Turku , Turku, Finland
| | - Biaoyang Lin
- 28 Department of Urology, University of Washington , Seattle, Washington.,29 Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang University , Hangzhou, China
| | - Adrian Llerena
- 30 Extremadura University Hospital and Medical School , Badajoz, Extremadura, Spain
| | - Faruk Malhan
- 31 Istanbul Design Foundation , Istanbul, Turkey
| | - Bipin Nair
- 12 Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham (Amrita University) , Amritapuri, Clappana P.O., Kollam, Kerala, India
| | - George P Patrinos
- 32 Department of Pharmacy, University of Patras School of Health Sciences , Patras, Greece
| | - Semra Şardaş
- 33 Faculty of Pharmacy, Marmara University , Istanbul, Turkey
| | - Özlem Sert
- 34 Urban Studies Center and the Department of History, Hacettepe University , Beytepe, Ankara, Turkey
| | - Sanjeeva Srivastava
- 35 Proteomics Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay , Powai, Mumbai, India
| | - Lotte M G Steuten
- 36 PANAXEA bv , Enschede, The Netherlands .,37 School of Pharmacy, University of Washington , Seattle, Washington
| | - Cengiz Toraman
- 38 Faculty of Communications and Department of Management Sciences, Gaziantep University , Gaziantep, Turkey
| | - Effy Vayena
- 39 Institute of Biomedical Ethics, University of Zurich , Zurich, Switzerland
| | - Wei Wang
- 40 School of Medical Sciences, Edith Cowan University , Perth, Australia .,41 Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University , Beijing, China
| | - Louise Warnich
- 42 Faculty of Science, Stellenbosch University , Stellenbosch, South Africa
| | - Vural Özdemir
- 9 Office of the President, Gaziantep University , Gaziantep, Turkey .,11 Department of Industrial Engineering, Faculty of Engineering, Gaziantep University , Gaziantep, Turkey .,12 Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham (Amrita University) , Amritapuri, Clappana P.O., Kollam, Kerala, India .,26 Data-Enabled Life Sciences Alliance (DELSA Global) , Seattle, Washington.,38 Faculty of Communications and Department of Management Sciences, Gaziantep University , Gaziantep, Turkey
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