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Chen K, Xiao P, Li G, Wang C, Yang C. Distributive characteristics of the CYP2C9 and AGTR1 genetic polymorphisms in Han Chinese hypertensive patients: a retrospective study. BMC Cardiovasc Disord 2021; 21:73. [PMID: 33541272 PMCID: PMC7863246 DOI: 10.1186/s12872-021-01895-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 01/28/2021] [Indexed: 01/01/2023] Open
Abstract
Background There is an individual variation in response to antihypertensive effect of the angiotensin II receptor antagonist. This study aimed to determine the allele and genotype frequencies of CYP2C9 and AGTR1 genetic polymorphisms and explore the potential role of these polymorphisms in guiding the selection of angiotensinIIreceptor antagonist in Han Chinese hypertensive patients. Methods Totally 2419 Han Chinese hypertensive patients and 126 normotensive controls were recruited in this study. Venous blood samples were collected from each patient, and the genetic polymorphisms of CYP2C9 and AGTR1 were assessed using a gene chip platform. The allele and genotype frequency of each gene and the combined genotypes in this study were analyzed respectively. Results The gene chip analysis identified an allelic frequency of 96.51% for CYP2C9*1 and 3.49% for CYP2C9*3 in the cohort of Han Chinese hypertensive patients. Statistical analysis showed that the frequency of wild-type homozygous for CYP2C9*1/*1 was 93.30%, while the frequency of heterozygous for *1/*3 or mutant homozygous for *3/*3 was 6.41% or 0.29%. Meanwhile, we detected allelic frequencies of 95.06% and 4.94% for the A and C allele of AGTR1, respectively. While the genotype frequency of wild-type homozygous for AA was 90.41%, the frequency of heterozygous for AC or mutant homozygous for CC was 9.30% or 0.29%. Notably, we observed that 84.66% (2048/2419) of the subjects exhibited a combined genotype of CYP2C9 and AGTR1 as *1/*1 + AA, while the combined genotypes *3/*3 + AC or *3/*3 + CC were not detected in hypertension patients. Besides, no significant association was found between normotensive controls and hypertensive patients, or among the three grades of hypertensive patients. Conclusions These data revealed the polymorphisms characteristics of CYP2C9 and AGTR1 in Han Chinese hypertensive patients, providing valuable information for genotype-based antihypertension therapy in prospective clinical studies in the future.
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Affiliation(s)
- Keping Chen
- Clinical Laboratory, Zhongda Hospital, School of Medicine, Southeast University, Dingjiaqiao Road 87, Nanjing, 210009, China.
| | - Peng Xiao
- Clinical Laboratory, Zhongda Hospital, School of Medicine, Southeast University, Dingjiaqiao Road 87, Nanjing, 210009, China
| | - Guochun Li
- Nanjing Central Hospital, Nanjing Municipal Government Hospital, Nanjing, 210009, China
| | - Chunling Wang
- Clinical Laboratory, Zhongda Hospital, School of Medicine, Southeast University, Dingjiaqiao Road 87, Nanjing, 210009, China
| | - Chuankun Yang
- Clinical Laboratory, Zhongda Hospital, School of Medicine, Southeast University, Dingjiaqiao Road 87, Nanjing, 210009, China
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2
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Cozma A, Fodor A, Orasan OH, Vulturar R, Samplelean D, Negrean V, Muresan C, Suharoschi R, Sitar-Taut A. Pharmacogenetic Implications of eNOS Polymorphisms ( Glu298Asp, T786C, 4b/4a) in Cardiovascular Drug Therapy. In Vivo 2019; 33:1051-1058. [PMID: 31280192 DOI: 10.21873/invivo.11573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/09/2019] [Accepted: 06/19/2019] [Indexed: 12/17/2022]
Abstract
Endothelial nitric oxide synthase (NOS3 or eNOS) is the enzyme responsible for the highest production of nitric oxide, with the greatest impact on the cardiovascular system, encoded by the eNOS gene, which presents various polymorphisms. ENOS gene polymorphisms play an important role in the response to drugs affecting nitric oxide (NO) signaling. This review discusses the pharmacogenetic impact of eNOS polymorphisms on the response to drugs affecting NO activity: angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, calcium blockers, beta-blockers, diuretics, phosphodiesterase inhibitors, and statins. The identification of biomarkers that accurately predict particular phenotypes is a challenge that needs additional large studies, in different populations. Efforts should be oriented towards a more accurate evaluation of the effects of eNOS genetic variants on biochemical parameters reflecting eNOS gene expression and enzymatic activity, in different diseases, as well as following drug treatment. This approach will allow for a better understanding of the role of eNOS genetic variants in cardiovascular disease progression and for cardiovascular drug therapy optimization.
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Affiliation(s)
- Angela Cozma
- University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,4th Internal Medicine Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Adriana Fodor
- University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,Clinical Center of Diabetes, Nutrition and Metabolic Disease, Cluj-Napoca, Romania
| | - Olga Hilda Orasan
- University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,4th Internal Medicine Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Romana Vulturar
- University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,Department of Cell Biology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Dorel Samplelean
- University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,4th Internal Medicine Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Vasile Negrean
- University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,4th Internal Medicine Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Crina Muresan
- University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Faculty of Food Science &Technology, Cluj-Napoca, Romania
| | - Ramona Suharoschi
- University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Faculty of Food Science &Technology, Cluj-Napoca, Romania
| | - Adela Sitar-Taut
- University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.,4th Internal Medicine Department, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
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Tsapakis EM, Basu A, Aitchison KJ. Clinical relevance of discoveries in psychopharmacogenetics1. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.10.6.455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Individual genetic variation accounts for some of the variability in response to drugs used routinely in clinical psychiatry. Psychopharmacogenetics focuses on how polymorphisms in genes affecting the mechanism of action of a drug's effect and/or metabolism (both peripheral and central) can influence an individual's clinical response to the drug, in terms of both therapeutic efficacy and adverse effects. Pharmacogenetics promises to be of substantial help in the field of psychiatric pharmacotherapy, but before research findings can be applied to clinical practice, ethical and methodological problems have to be addressed and overcome. This review summarises the most robust findings in the field and outlines how psychopharmacogenetic studies could lead to treatment individualisation.
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4
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Flaten HK, Monte AA. The Pharmacogenomic and Metabolomic Predictors of ACE Inhibitor and Angiotensin II Receptor Blocker Effectiveness and Safety. Cardiovasc Drugs Ther 2017; 31:471-482. [PMID: 28741243 PMCID: PMC5727913 DOI: 10.1007/s10557-017-6733-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Hypertension (HTN) is the most common chronic disease in the USA. Hypertensive patients frequently require repeat primary care visits to find an effective drug or drug combination to control their disease. Currently, patients are prescribed drugs for HTN based on race, age, and comorbidities and although the current guidelines are reasonable starting points for prescribing, 50% of hypertensive patients still fail to achieve target blood pressures. Despite numerous strategies to improve compliance, drug effectiveness, and optimization of initial drug choice, effectiveness has remained largely unchanged over the past two decades. Therefore, it is important to pursue alternative strategies to more effectively treat patients and to decrease medical costs. Additional precision medicine work is needed to identify factors associated with effectiveness of commonly used antihypertensive medications. The objective of this manuscript is to present a comprehensive review of the pharmacogenomic and metabolomic factors associated with ACEI and ARB effectiveness and safety.
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Affiliation(s)
- Hania K Flaten
- Department of Emergency Medicine, University of Colorado School of Medicine, Leprino Building, 7th Floor Campus Box B-215, 12401 E. 17th Avenue, Aurora, CO, 80045, USA.
| | - Andrew A Monte
- Department of Emergency Medicine, University of Colorado School of Medicine, Leprino Building, 7th Floor Campus Box B-215, 12401 E. 17th Avenue, Aurora, CO, 80045, USA
- Center for Bioinformatics & Personalized Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Skaggs School of Pharmacy, University of Colorado, Aurora, CO, USA
- Rocky Mountain Poison & Drug Center, Denver Health and Hospital Authority, Denver, CO, USA
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5
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Polimanti R, Iorio A, Piacentini S, Manfellotto D, Fuciarelli M. Human pharmacogenomic variation of antihypertensive drugs: from population genetics to personalized medicine. Pharmacogenomics 2014; 15:157-67. [DOI: 10.2217/pgs.13.231] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aim: To investigate the human pharmacogenetic variation related to antihypertensive drugs, providing a survey of functional interpopulation differences in hypertension pharmacogenes. Materials & methods: The study was divided into two stages. In the first stage, we analyzed 1249 variants located in 57 hypertension pharmacogenes. This first-stage analysis confirmed that geographic origin strongly affects hypertension pharmacogenomic variation and that 31 pharmacogenes are geographically differentiated. In the second stage, we focused our attention on the ethnic-differentiated pharmacogenes, investigating 55,521 genetic variants. In silico analyses were performed to predict the effect of genetic variation. Results: Our analyses indicated functional interpopulation differences, suggesting insight into the mechanisms of antihypertensive drug response. Moreover, our data suggested that rare variants mainly determine the functionality of genes related to antihypertensive drugs. Conclusion: Our study provided important knowledge about the genetics of the antihypertensive drug response, suggesting that next-generation sequencing technologies may develop reliable pharmacogenetic tests for antihypertensive drugs. Original submitted 19 September 2013; Revision submitted 14 November 2013
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Affiliation(s)
- Renato Polimanti
- Department of Biology, University of Rome “Tor Vergata”, Via della Ricerca Scientifica 1, Rome, Italy
| | - Andrea Iorio
- Clinical Pathophysiology Center, AFaR – “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Sara Piacentini
- Department of Biology, University of Rome “Tor Vergata”, Via della Ricerca Scientifica 1, Rome, Italy
| | - Dario Manfellotto
- Clinical Pathophysiology Center, AFaR – “San Giovanni Calibita” Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Maria Fuciarelli
- Department of Biology, University of Rome “Tor Vergata”, Via della Ricerca Scientifica 1, Rome, Italy
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Marcano ACB, Onipinla AK, Caulfield MJ, Munroe PB. Recent advances in the identification of genes for human hypertension. Expert Rev Cardiovasc Ther 2014; 3:733-41. [PMID: 16076282 DOI: 10.1586/14779072.3.4.733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
It is a well-established fact that genes are involved in the etiology of hypertension. However, identification of the gene variants still remains a challenge. Over the years, different approaches and technologies, including genome-wide scans, case-control association studies, experiments on inbred rodent models and expression profiling, have been utilized to elucidate hypertension susceptibility genes, but so far the results have been equivocal. During the last year, further chromosomal regions harboring blood pressure loci have been identified, and transcriptomics has been applied to aid the identification of disease genes. There are great expectations for the future with regards to further advancements in transcriptomics and proteomics. This review reports primarily on work that has been carried out in the last 12 months in the field, and considers its contribution towards a better understanding of the genetic mechanisms involved in blood pressure regulation and hypertension.
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Affiliation(s)
- Ana C B Marcano
- Clinical Pharmacology and The Genome Centre, The William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Charterhouse Square, London, EC1M 6BQ, UK.
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Sun Y, Liao Y, Yuan Y, Feng L, Ma S, Wei F, Wang M, Zhu F. Influence of autoantibodies against AT1 receptor and AGTR1 polymorphisms on candesartan-based antihypertensive regimen. ACTA ACUST UNITED AC 2014; 8:21-7. [DOI: 10.1016/j.jash.2013.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 08/08/2013] [Accepted: 08/12/2013] [Indexed: 11/28/2022]
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Turner ST, Bailey KR, Schwartz GL, Chapman AB, Chai HS, Boerwinkle E. Genomic association analysis identifies multiple loci influencing antihypertensive response to an angiotensin II receptor blocker. Hypertension 2012; 59:1204-11. [PMID: 22566498 DOI: 10.1161/hyp.0b013e31825b30f8] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
To identify genes influencing blood pressure response to an angiotensin II receptor blocker, single nucleotide polymorphisms identified by genome-wide association analysis of the response to candesartan were validated by opposite direction associations with the response to a thiazide diuretic, hydrochlorothiazide. We sampled 198 white and 193 blacks with primary hypertension from opposite tertiles of the race-sex-specific distributions of age-adjusted diastolic blood pressure response to candesartan. There were 285 polymorphisms associated with the response to candesartan at P<10(-4) in whites. A total of 273 of the 285 polymorphisms, which were available for analysis in a separate sample of 196 whites, validated for opposite direction associations with the response to hydrochlorothiazide (Fisher χ(2) 1-sided P=0.02). Among the 273 polymorphisms, those in the chromosome 11q21 region were the most significantly associated with response to candesartan in whites (eg, rs11020821 near FUT4, P=8.98 × 10(-7)), had the strongest opposite direction associations with response to hydrochlorothiazide (eg, rs3758785 in GPR83, P=7.10 × 10(-3)), and had the same direction associations with response to candesartan in the 193 blacks (eg, rs16924603 near FUT4, P=1.52 × 10(-2)). Also notable among the 273 polymorphisms was rs11649420 on chromosome 16 in the amiloride-sensitive sodium channel subunit SCNN1G involved in mediating renal sodium reabsorption and maintaining blood pressure when the renin-angiotensin system is inhibited by candesartan. These results support the use of genomewide association analyses to identify novel genes predictive of opposite direction associations with blood pressure responses to inhibitors of the renin-angiotensin and renal sodium transport systems.
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Affiliation(s)
- Stephen T Turner
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, College of Medicine, Rochester, MN 55905, USA.
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9
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Williams PJ, Morgan L. The role of genetics in pre-eclampsia and potential pharmacogenomic interventions. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2012; 5:37-51. [PMID: 23226061 PMCID: PMC3513227 DOI: 10.2147/pgpm.s23141] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Indexed: 01/23/2023]
Abstract
The pregnancy-specific condition pre-eclampsia not only affects the health of mother and baby during pregnancy but also has long-term consequences, increasing the chances of cardiovascular disease in later life. It is accepted that pre-eclampsia has a placental origin, but the pathogenic mechanisms leading to the systemic endothelial dysfunction characteristic of the disorder remain to be determined. In this review we discuss some key factors regarded as important in the development of pre-eclampsia, including immune maladaptation, inadequate placentation, oxidative stress, and thrombosis. Genetic factors influence all of these proposed pathophysiological mechanisms. The inherited nature of pre-eclampsia has been known for many years, and extensive genetic studies have been undertaken in this area. Genetic research offers an attractive strategy for studying the pathogenesis of pre-eclampsia as it avoids the ethical and practical difficulties of conducting basic science research during the preclinical phase of pre-eclampsia when the underlying pathological changes occur. Although pharmacogenomic studies have not yet been conducted in pre-eclampsia, a number of studies investigating treatment for essential hypertension are of relevance to therapies used in pre-eclampsia. The pharmacogenomics of antiplatelet agents, alpha and beta blockers, calcium channel blockers, and magnesium sulfate are discussed in relation to the treatment and prevention of pre-eclampsia. Pharmacogenomics offers the prospect of individualized patient treatment, ensuring swift introduction of optimal treatment whilst minimizing the use of inappropriate or ineffective drugs, thereby reducing the risk of harmful effects to both mother and baby.
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10
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Zhang Y, Hong X, Liu H, Huo Y, Xu X. Arg347Cys polymorphism of alpha1A-adrenoceptor gene is associated with blood pressure response to nifedipine GITS in Chinese hypertensive patients. J Hum Genet 2009; 54:360-4. [PMID: 19444285 DOI: 10.1038/jhg.2009.42] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Our objectives were to evaluate whether polymorphisms in the alpha1A- and beta2-adrenoceptor genes influence blood pressure response to nifedipine gastrointestinal therapeutic system (GITS). Hypertensive patients received daily treatment with an oral dosage of 30 mg nifedipine GITS for 16 days. Genotypes of the Arg347Cys polymorphism in the alpha1A-adrenoceptor gene and the Arg16Gly and Gln27Glu polymorphisms in the beta2-adrenoceptor gene were determined by TaqMan single-nucleotide polymorphism genotyping assay. The sixteenth-day steady-state plasma concentration of nifedipine was measured using HPLC with UV detection. Multivariate linear regression was performed in a total of 447 patients to evaluate the effects of these polymorphisms on blood pressure response to nifedipine GITS. Patients carrying the Cys347 allele of the alpha1A-adrenoceptor gene had a greater systolic blood pressure reduction than did those carrying two Arg347 alleles of the alpha1A-adrenoceptor gene (32.5+/-14.0 versus 27.3+/-15.5 mm Hg, respectively, P=0.006). However, diastolic blood pressure reduction was not associated with the Arg347Cys polymorphism in the alpha1A-adrenoceptor gene. In addition, no significant associations were observed between blood pressure reduction and two polymorphisms in the beta2-adrenoceptor gene. Our data suggest that the Arg347Cys polymorphism in the alpha1A-adrenoceptor gene may be used to predict blood pressure response to nifedipine GITS in Chinese hypertensive patients.
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Affiliation(s)
- Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
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11
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Genotyping single nucleotide polymorphisms by multiplex minisequencing using tag-arrays. Methods Mol Biol 2009; 529:215-29. [PMID: 19381977 DOI: 10.1007/978-1-59745-538-1_14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The need for multiplexed methods for SNP genotyping has rapidly increased during the last decade. We present here a flexible system that combines highly specific genotyping by minisequencing single-base extension with the advantages of a microarray format that allows highly multiplexed and parallel analysis of any custom selected SNPs.Cyclic minisequencing reactions with fluorescently labeled dideoxynucleotides (ddNTPs) are performed in solution using multiplex PCR product as template and detection primers, designed to anneal immediately adjacent and upstream of the SNP site. The detection primers carry unique Tag-sequences at their 5' ends and oligonucleotides complementary to the Tag-sequence, cTags, are immobilized on a microarray. After extension, the tagged detection primers are allowed to hybridize to the cTags, and the fluorescent signals from the array are measured and the genotypes are deduced by cluster analysis of the incorporated labels. The "array of arrays" format of the system, accomplished by a silicon rubber grid to form separate reaction chambers, allows either 80 or 16 samples to be analyzed for up to 200 or 600 SNPs, respectively on a single microscope slide.
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Khoschnau S, Melhus H, Jacobson A, Rahme H, Bengtsson H, Ribom E, Grundberg E, Mallmin H, Michaëlsson K. Type I collagen alpha1 Sp1 polymorphism and the risk of cruciate ligament ruptures or shoulder dislocations. Am J Sports Med 2008; 36:2432-6. [PMID: 18669982 DOI: 10.1177/0363546508320805] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cruciate ligament ruptures and shoulder dislocations are often caused by trauma, but predisposing intrinsic factors might also influence the risk. These injuries are more common in those with a previously injured sibling, an observation that might indicate a genetic predisposition. It is well known that polymorphisms in the collagen I gene are associated not only with osteoporosis and osteoporotic fracture risk, but also with osteoarthritis. HYPOTHESIS Because collagen I is abundant in ligaments and tendons, the authors hypothesized that collagen I alpha1 Sp1 polymorphism also was related to the occurrence of cruciate ligament ruptures and shoulder dislocations. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS A total of 358 patients and 325 randomly selected population-based female controls were included in the study. Of the cases, 233 had a cruciate ligament rupture and 126 had had a shoulder dislocation. Age-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) estimated by unconditional logistic regression were used as measures of association. RESULTS Compared with the homozygous SS category, the heterozygous participants displayed a similar risk (OR, 1.06; 95% CI, 0.76-1.49), whereas the ss genotype was underrepresented in the injured population compared with the controls (OR, 0.15; 95% CI, 0.03-0.68). This latter estimate was similar for both cruciate ligament ruptures and shoulder dislocations, and was furthermore not modified by general joint laxity. CONCLUSION The authors found a substantially decreased risk of these injuries associated with collagen type I alpha1 Sp1 polymorphism. The study might encourage other investigators to consider further research in the area of genes and soft tissue injuries.
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Affiliation(s)
- Shwan Khoschnau
- Department of Surgical Sciences, Section of Orthopedics, University Hospital, Uppsala, Sweden.
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The relationship between the plasma concentration of irbesartan and the antihypertensive response is disclosed by an angiotensin II type 1 receptor polymorphism: results from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation vs. Atenolol (SILVHIA) Trial. Am J Hypertens 2008; 21:836-9. [PMID: 18464745 DOI: 10.1038/ajh.2008.190] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effect of the plasma concentration of irbesartan, a specific angiotensin II type 1 receptor (AT1R) antagonist, and the blood pressure response in relation to AT1R gene polymorphisms. METHODS Plasma irbesartan was analyzed in 42 patients with mild-to-moderate hypertension and left ventricular hypertrophy from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation vs. Atenolol (SILVHIA) trial, who were treated with irbesartan as monotherapy for 12 weeks. Blood pressure and irbesartan concentration were measured at trough, i.e., 24 +/- 3 h after the last dose. Five AT1R gene polymorphisms were analyzed by minisequencing. RESULTS Neither the plasma concentration of irbesartan, nor any of the AT1R polymorphisms were associated with the blood pressure response to irbesartan treatment. However, the interaction term between the plasma concentration of irbesartan and the AT1R C5245T polymorphism was related to the reduction in systolic blood pressure after 12 weeks of treatment (P = 0.025). Furthermore, the plasma concentration of irbesartan was related to the change in systolic blood pressure in individuals homozygous for the AT1R 5245 T allele (r = -0.56, P = 0.030), but not for other genotypes. CONCLUSIONS There was an association between plasma concentrations of irbesartan and the blood pressure response for hypertensive patients with AT1R 5245 TT. Because of the small sample size, this study needs to be viewed as hypothesis generating. This is the first study, to our knowledge, indicating that the concentration-response relationship of an antihypertensive drug may be genotype dependent.
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Marteau JB, Gambier N, Jeannesson E, Siest G, Visvikis-Siest S. Pharmacogenomics and antihypertensive drugs: a path toward personalized medicine. Per Med 2007; 4:393-412. [DOI: 10.2217/17410541.4.4.393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pharmacogenomics focuses on genes and the transcriptome and proteome. It has the potential to enhance healthcare management by improving disease diagnosis and implementing treatments adapted to each patient. Previously, pharmacogenetics of candidate genes focused on clinical research. It is now extended by using genome-wide approaches to elucidate the inherited basis of differences between individuals in their response to drugs. We summarize relevant polymorphisms of genes involved in the pharmacokinetics and pharmacodynamics of antihypertensive drugs and we give an overview of the state of pharmacogenomic research in hypertension medicine. Even if things are getting better, current pharmacogenetic studies still lack power, adequate selection of candidate genes and knowledge of their functions at the physiological level. Finally, some specific end point phenotypes (i.e., peptides or proteins related to the metabolic cycle targeted by the drug) should be integrated to propose data that are easily applicable to personalized medicine.
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Affiliation(s)
- Jean-Brice Marteau
- Équipe INSERM, Génétique Cardiovasculaire, du CIC 9501, Univ Nancy I, Nancy, F-54000, France
| | - Nicolas Gambier
- Équipe INSERM, Génétique Cardiovasculaire, du CIC 9501, Univ Nancy I, Nancy, F-54000, France
| | - Elise Jeannesson
- Équipe INSERM, Génétique Cardiovasculaire, du CIC 9501, Univ Nancy I, Nancy, F-54000, France
| | - Gérard Siest
- Équipe INSERM, Génétique Cardiovasculaire, du CIC 9501, Univ Nancy I, Nancy, F-54000, France
| | - Sophie Visvikis-Siest
- Équipe Inserm, Génétique Cardiovasculaire, du CIC 9501, Faculté de Pharmacie, Université Henri Poincaré, Nancy I, 30 rue Lionnois, 54000 Nancy, France
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15
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Effect of renin-angiotensin-aldosterone system gene polymorphisms on blood pressure response to antihypertensive treatment. Chin Med J (Engl) 2007. [DOI: 10.1097/00029330-200705010-00009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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16
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Consolandi C, Palmieri L, Doveri S, Maestri E, Marmiroli N, Reale S, Lee D, Baldoni L, Tosti N, Severgnini M, De Bellis G, Castiglioni B. Olive variety identification by ligation detection reaction in a universal array format. J Biotechnol 2007; 129:565-74. [PMID: 17350706 DOI: 10.1016/j.jbiotec.2007.01.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2006] [Revised: 01/09/2007] [Accepted: 01/22/2007] [Indexed: 11/26/2022]
Abstract
Molecular methodologies are increasingly being developed to assess the origin and authenticity of raw organic materials and processed food products. Here we describe the application of a microarray-based assay for single nucleotide polymorphisms (SNPs) identification in olive cultivars. The assay distinguishes alleles in a ligation detection reaction (LDR), with subsequent fluorescent detection by hybridization on a universal array (UA). The LDR-UA approach was used to detect 17 SNPs in olive genomic sequences previously amplified by PCR from fresh olive leaves. Genotype calls obtained with the LDR-UA were in full agreement with those determined by direct sequencing. The panel of 17 SNPs is sufficient to discriminate 49 olive varieties selected among the most widely cultivated for olive oil production in the Mediterranean area.
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Affiliation(s)
- Clarissa Consolandi
- Institute of Biomedical Technologies, National Research Council, LITA, Via Fratelli Cervi 93, I-20090 Segrate (MI), Italy.
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Chessa S, Chiatti F, Ceriotti G, Caroli A, Consolandi C, Pagnacco G, Castiglioni B. Development of a Single Nucleotide Polymorphism Genotyping Microarray Platform for the Identification of Bovine Milk Protein Genetic Polymorphisms. J Dairy Sci 2007; 90:451-64. [PMID: 17183114 DOI: 10.3168/jds.s0022-0302(07)72647-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this study was to develop and validate a fast method for typing the main mutations of bovine milk protein genes by using microarray technology. An approach based on the ligation detection reaction (LDR) and a universal array (UA) was used. Polymorphisms in both the coding and noncoding sequences of alpha(S1)-casein, beta-casein, kappa-casein, and beta-lactoglobulin genes were considered because of their well-known effects on milk composition and cheese production. A total of 22 polymorphic sites, corresponding to 21 different variants, were included in the diagnostic microarray. First, a multiplex PCR was developed to amplify all the DNA target sequences simultaneously. Second, the LDR-UA assay was implemented. The method was validated by analyzing 100 Italian Friesian DNA samples, which were also genotyped by conventional methods both at the protein level by means of milk isoelectrofocusing and at the molecular level using PCR-RFLP and PCR-single strand conformation polymorphism techniques. The genotypes obtained using the LDR-UA approach were in full agreement with those obtained by the conventional analyses. An important result of the LDR-UA assay was a more accurate genotyping of the different milk protein alleles than was found with conventional typing methods. At the kappa-casein gene, in fact, 4 samples were heterozygous (3 reference samples and 1 validation sample) for an allele coding for Thr(136) and Ala(148). This variant, which can be considered as the wild type of the genus Bos, is not usually identifiable by the conventional typing methods used. The multiplex PCR-LDR-UA approach developed provides for an accurate, inexpensive, and high-throughput assay that does not exhibit false positive or false negative signals, thus making it highly suitable for animal genotyping.
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Affiliation(s)
- S Chessa
- Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, Università degli Studi di Milano, Via Trentacoste 2, Milano 20134 Italy.
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18
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Chavan P, Joshi K, Patwardhan B. DNA microarrays in herbal drug research. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2006; 3:447-57. [PMID: 17173108 PMCID: PMC1697755 DOI: 10.1093/ecam/nel075] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Accepted: 09/19/2006] [Indexed: 12/18/2022]
Abstract
Natural products are gaining increased applications in drug discovery and development. Being chemically diverse they are able to modulate several targets simultaneously in a complex system. Analysis of gene expression becomes necessary for better understanding of molecular mechanisms. Conventional strategies for expression profiling are optimized for single gene analysis. DNA microarrays serve as suitable high throughput tool for simultaneous analysis of multiple genes. Major practical applicability of DNA microarrays remains in DNA mutation and polymorphism analysis. This review highlights applications of DNA microarrays in pharmacodynamics, pharmacogenomics, toxicogenomics and quality control of herbal drugs and extracts.
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Arnett DK, Claas SA, Glasser SP. Pharmacogenetics of antihypertensive treatment. Vascul Pharmacol 2006; 44:107-18. [PMID: 16356784 DOI: 10.1016/j.vph.2005.09.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2005] [Accepted: 09/01/2005] [Indexed: 11/21/2022]
Abstract
Hypertension is a common disorder associated with increased cardiovascular morbidity and mortality. Unfortunately, in the US only about one-third of those who are aware of their hypertensive status have their blood pressure adequately controlled. One reason for this is the variable and unpredictable response individuals have to pharmacologic treatment. Clinicians often resort to "trial-and-error" to match patients with effective drug treatment. Hypertension pharmacogenetics seeks to find genetic predictors of drug response. To date, more than forty studies have investigated associations between genetic polymorphisms and response to antihypertensive drugs. Angiotensin-converting enzyme inhibitors and beta blockers have been most frequently studied, followed by angiotensin II blockers, diuretics, adrenergic alpha-agonists, and calcium channel blockers. Renin-angiotensin-aldosterone system genes have been the most widely studied, with the angiotensin-converting enzyme I/D variant being typed in about one-half of all hypertension pharmacogenetic studies. In total, 160 possible gene polymorphism-drug interactions have been explored, with about one-quarter of these showing that genes predict drug response. However, disparate and conflicting findings have been the rule rather than the exception, and the discovery of clinically relevant antihypertensive drug-response genes remains elusive. While there is a growing enthusiasm that pharmacogenetics of hypertension is important, the translation of pharmacogenetic findings to clinical practice in the future will depend on additional studies to enhance our pharmacogenetics knowledge base, the availability of pharmacogenetic screening tests that are affordable and easy to implement in clinical practice, a cohort of clinicians who are trained to interpret genetic test results, and health care systems that pay for them. Caution regarding the future of hypertension pharmacogenetics is warranted.
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Affiliation(s)
- Donna K Arnett
- Department of Epidemiology, University of Alabama, RPHB 220E, 1530 3rd Avenue South, Birmingham, 55294-0022, USA.
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Abstract
Hypertension is a multifactorial disorder that probably results from the inheritance of a number of susceptibility genes and involves multiple environmental determinants. Existing evidence suggests that the genetic contribution to blood pressure variation is about 30-50%. Although a number of candidate genes have been studied in different ethnic populations, results from genetic analysis are still inconsistent and specific causes of hypertension remain unclear. Furthermore, the abundance of data in the literature makes it difficult to piece together the puzzle of hypertension and to define candidate genes involved in the dynamic of blood pressure regulation. In this review, we attempt to highlight the genetic basis of hypertension pathogenesis, focusing on the most important existing genetic variations of candidate genes and their potential role in the development of this disease. Our objective is to review current knowledge and discuss limitations to clinical applications of genotypic information in the diagnosis, evaluation and treatment of hypertension. Finally, some principles of pharmacogenomics are presented here along with future perspectives of hypertension.
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Affiliation(s)
- Jean-Brice Marteau
- INSERM U525, Equipe 4, Faculté de Pharmacie, Université Henri Poincare, Nancy, France
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Siest G, Marteau JB, Maumus S, Berrahmoune H, Jeannesson E, Samara A, Batt AM, Visvikis-Siest S. Pharmacogenomics and cardiovascular drugs: need for integrated biological system with phenotypes and proteomic markers. Eur J Pharmacol 2005; 527:1-22. [PMID: 16316654 DOI: 10.1016/j.ejphar.2005.10.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Revised: 09/23/2005] [Accepted: 10/05/2005] [Indexed: 01/22/2023]
Abstract
Personalized medicine is based on a better knowledge of biological variability, considering the important part due to genetics. When trying to identify involved genes and their products in differential cardiovascular drug responses, a five-step strategy is to be followed: 1) Pharmacokinetic-related genes and phenotypes (2) Pharmacodynamic targets, genes and products (3) Cardiovascular diseases and risks depending on specific or large metabolic cycles (4) Physiological variations of previously identified genes and proteins (5) Environment influences on them. After summarizing the most well-known genes involved in drug metabolism, we will take as example of drugs, the statins, considered as very important drugs from a Public-Health standpoint, but also for economical reasons. These drugs respond differently in human depending on multiple polymorphisms. We will give examples with common ApoE polymorphisms influencing the hypolipemic effects of statins. These drugs also have pleiotropic effects and decrease inflammatory markers. This illustrates the need to separate clinical diseases phenotypes in specific metabolic pathways, which could propose other classifications, of diseases and related genes. Hypertension is also a good example of clinical phenotype which should be followed after various therapeutic approaches by genes polymorphisms and proteins markers. Gene products are under clear environmental expression variations such as age, body mass index and obesity, alcohol, tobacco and dietary interventions which are the first therapeutical actions taken in cardiovascular diseases. But at each of the five steps, within a pharmacoproteomic strategy, we also need to use available information from peptides, proteins and metabolites, which usually are the gene products. A profiling approach, i.e., dealing with genomics, but now also with proteomics, is to be used. In conclusion, the profiling, as well as the large amount of data, will more than before render necessary an organized interpretation of DNA, RNA as well as proteins variations, both at individual and population level.
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Affiliation(s)
- Gérard Siest
- Inserm U525 Equipe 4, Université Henri Poincaré Nancy I, 30 rue Lionnois Faculté de Pharmacie, 54000 Nancy, France.
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Abstract
UNLABELLED PURPOSE IDENTIFICATION: Inter-individual variability in blood pressure response to treatment is well documented, but a clinically useful means to distinguish responders from non-responders has been elusive. With the advent of new technologies and genomic knowledge, more investigators are seeking to identify genetic determinants of blood pressure response to therapy. STUDY SELECTION We identified studies of candidate polymorphisms from an initial PubMed search using the MESH terms 'Hypertension: Drug Therapy' and 'Genetics' or 'Pharmacogenetics', limiting results to English-language publications on studies in human adults. We further identified specific polymorphisms of interest noted in earlier reviews and performed additional PubMed searches based on these candidate genes. Pertinent studies were further extracted from the references of studies already identified. We focused on clinical trials that measured blood pressure response to a medication or class of medications over a minimum of 4 weeks. DATA EXTRACTION We evaluated studies looking at blood pressure response to commonly used classes of antihypertensive medications by major genetic variants. RESULTS OF ANALYSIS: Although many studies show that blood pressure response to a given class of antihypertensive medications varies by genotype for different polymorphisms, none of the genotypes identified consistently predicted blood pressure response. CONCLUSIONS Common variants may influence response to diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers, but studies of polymorphisms have generally yielded conflicting results. The inclusion of pharmacogenomic studies in large clinical trials and other more innovative investigative methods may provide greater clarity of the potential role for genotyping in the treatment of patients with hypertension.
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Affiliation(s)
- Philip B Mellen
- Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA
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Consolandi C, Frosini A, Pera C, Ferrara GB, Bordoni R, Castiglioni B, Rizzi E, Mezzelani A, Bernardi LR, De Bellis G, Battaglia C. Polymorphism analysis within the HLA-A locus by universal oligonucleotide array. Hum Mutat 2005; 24:428-34. [PMID: 15459953 DOI: 10.1002/humu.20098] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Human leukocyte antigen (HLA) class I genes present some of the most complex single nucleotide polymorphism (SNP) patterns in the human genome. HLA typing is therefore extremely challenging. In this article, we use the ligation detection reaction (LDR) combined with a universal array (UA) as a robust and efficient method to analyze SNPs within the HLA-A region that includes HLA-A alleles of interest for immunotherapy in tumor diseases. The LDR, combined with a UA platform, has been optimized for the detection of 27 alleles distributed within exons 2 and 3 of HLA-A. The assay involves the amplification by PCR of the HLA-A genomic region (1,900 bp), the cycled ligation reaction, followed by the capture of ligated products through hybridization onto a UA. Each slide was designed to allow the detection of up to eight samples in parallel. The PCR/LDR/UA HLA-A assay was evaluated by analyzing 62 individuals (31 homozygous and 31 heterozygous) previously typed by direct sequencing. We demonstrate that the microarray genotyping procedure described here is a robust and efficient method for unambiguous detection of HLA alleles. HLA genotyping by PCR/LDR/UA is in perfect agreement with typing obtained by direct sequencing. Our results clearly demonstrate that the combination of enzymatic processing (LDR) and a demultiplexing hybridization onto a UA is a robust tool for SNP discrimination within the highly polymorphic HLA region. We demonstrate the specificity and efficiency of such an approach, suggesting the feasibility of a PCR/LDR/UA low resolution HLA typing procedure.
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Affiliation(s)
- Clarissa Consolandi
- Dipartimento di Scienze e Tecnologie Biomediche and CISI, Università degli Studi di Milano, Segrate, Italy
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Abstract
Increasingly, detailed characterization of human molecular genetic variation will facilitate the use of genetic information in preventing, diagnosing, and treating common diseases. One promising application is the identification of genetic variants influencing responses to drugs used to lower blood pressure (BP) and prevent target-organ complications of hypertension. This update on gene markers to guide antihypertensive therapy highlights polymorphisms recently reported to predict interindividual differences in response to antihypertensive medications. However, single-site variation in most genes makes only a small contribution to differences in BP response, and, after all known genetic and environmental predictors have been considered, most variation in responses still remains unexplained. Advancing beyond our current "trial-and-error" approach to selecting drug therapy in individual patients will undoubtedly require whole-genome approaches to discover additional, novel genetic pathways influencing drug response. In addition, larger samples will be required to more fully characterize genetic variation within candidate genes and to consider the joint effects of gene-gene and gene-environment interactions. Eventually, knowledge of genetic variants that influence BP responses may allow more individualized tailoring of therapy to optimally reduce BP and target-organ damage.
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Affiliation(s)
- Stephen T Turner
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
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Liljedahl U, Kahan T, Malmqvist K, Melhus H, Syvänen AC, Lind L, Kurland L. Single nucleotide polymorphisms predict the change in left ventricular mass in response to antihypertensive treatment. J Hypertens 2005; 22:2321-8. [PMID: 15614026 DOI: 10.1097/00004872-200412000-00014] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Our aim was to determine whether the change in left ventricular (LV) mass in response to antihypertensive treatment could be predicted by multivariate analysis of single nucleotide polymorphisms (SNPs) in candidate genes reflecting pathways likely to be involved in blood pressure control. METHODS Patients with mild to moderate primary hypertension and LV hypertrophy were randomized in a double-blind fashion to treatment with either the angiotensin II type 1 receptor antagonist irbesartan (n = 48) or the beta1 adrenoreceptor blocker atenolol (n = 49). A microarray-based minisequencing system was used for genotyping 74 SNPs in 25 genes. These genotypes were related to the change in LV mass index by echocardiography, after 12 weeks treatment as monotherapy, using stepwise multiple regression analysis. RESULTS The blood pressure reductions were similar and significant in both treatment groups. Two SNPs in two separate genes (the angiotensinogen T1198C polymorphism, corresponding to the M235T variant and the apolipoprotein B G10108A polymorphism) for those treated with irbesartan, and the adrenoreceptor alpha2A A1817G for those treated with atenolol, significantly predicted the change in LV mass. The predictive power of these SNPs was independent of the degree of blood pressure reduction. CONCLUSION SNPs in the angiotensinogen, apolipoprotein B, and the alpha2 adrenoreceptor gene predicted the change in LV mass during antihypertensive therapy. These results illustrate the potential of using microarray-based technology for SNP genotyping in predicting individual drug responses.
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27
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Yu H, Lin S, Liu G, Zhang Y, Deng C, Ma W. T1198C Polymorphism of the Angiotensinogen Gene and Antihypertensive Response to Angiotensin-Converting Enzyme Inhibitors. Hypertens Res 2005; 28:981-6. [PMID: 16671337 DOI: 10.1291/hypres.28.981] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the association between T1198C polymorphism of the angiotensinogen (AGT) gene and the blood pressure response to ACE inhibitors in a Chinese hypertensive cohort. After a 2-week single-blind placebo run-in period, benazepril (10-20 mg/day) or imidapril (5-10 mg/day) was administered for 6 weeks to 509 patients with mild-to-moderate essential hypertension. Polymerase chain reaction combined with restriction enzyme digestion was used to detect the polymorphism, and the patients were classified as having the TT, TC, or CC genotype. The achieved changes in systolic and diastolic blood pressure (SBP and DBP) were analyzed to determine their association with genotypes at the AGT gene locus. In the total 509 patients, the TT genotype was observed in 44 patients (8.7%), the TC genotype in 214 patients (42.0%), and the CC genotype in 251 patients (49.3%). The SBP reductions in patients with the TT genotype, TC genotype, and CC genotype were -15.3+/-12.7 mmHg, -14.0+/-12.7 mmHg, and -14.4+/-12.4 mmHg, respectively (p=0.809). The DBP reductions in patients with the TT genotype, TC genotype, and CC genotype were -8.5+/-8.1 mmHg, -8.3+/-7.5 mmHg, and -8.9+/-6.6 mmHg, respectively (p=0.638). There were no significant differences in the changes in SBP or DBP after treatment among the three genotype groups. In conclusion, these results suggest that the AGT genotype does not predict the blood pressure-lowering response to antihypertensive treatment with ACE inhibitors in Chinese hypertensive patients.
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Affiliation(s)
- Huimin Yu
- Department of Cardiology, Guangdong Provincial People's Hospital and Guangdong Cardiovascular Institute, Guangzhou, P.R. China
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28
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Schelleman H, Stricker BHC, De Boer A, Kroon AA, Verschuren MWM, Van Duijn CM, Psaty BM, Klungel OH. Drug-gene interactions between genetic polymorphisms and antihypertensive therapy. Drugs 2004; 64:1801-16. [PMID: 15301563 DOI: 10.2165/00003495-200464160-00006] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Genetic factors may influence the response to antihypertensive medication. A number of studies have investigated genetic polymorphisms as determinants of cardiovascular response to antihypertensive drug therapy. In most candidate gene studies, no such drug-gene interactions were found. However, there is observational evidence that hypertensive patients with the 460 W allele of the alpha-adducin gene have a lower risk of myocardial infarction and stroke when treated with diuretics compared with other antihypertensive therapies. With regard to blood pressure response, interactions were found between genetic polymorphisms for endothelial nitric oxide synthase and diuretics, the alpha-adducin gene and diuretics, the alpha-subunit of G protein and beta-adrenoceptor antagonists, and the ACE gene and angiotensin II type 1 (AT(1)) receptor antagonists. Other studies found an interaction between ACE inhibitors and the ACE insertion/deletion (I/D) polymorphism, which resulted in differences in AT(1) receptor mRNA expression, left ventricular hypertrophy and arterial stiffness between different genetic variants. Also, drug-gene interactions between calcium channel antagonists and ACE I/D polymorphism regarding arterial stiffness have been reported. Unfortunately, the quality of these studies is quite variable. Given the methodological problems, the results from the candidate gene studies are still inconclusive and further research is necessary.
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Affiliation(s)
- Hedi Schelleman
- Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam, The Netherlands
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29
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Abstract
Left ventricular (LV) hypertrophy is very common, particularly among hypertensives. The presence of LV hypertrophy profoundly affects morbidity and mortality from cardiovascular diseases and stroke, and is now recognized as the most important predictor of chronic heart failure. Hypertension, obesity, and diabetes are important determinants of LV hypertrophy, but they fail to identify many individuals with the condition, suggesting that other factors, likely genetic in origin, play a role. Although much research has been undertaken to understand the causes of hypertrophy and the medical treatments that can lead to its regression, much remains unknown about its genetic basis. LV hypertrophy is considered a complex genetic disease, likely representing an interaction of several genes with the environment. The heritability of LV mass, measured as a quantitative trait, falls between 0.3 and 0.7 in different populations, suggesting it has a familial component. Genes encoding proteins involved in LV structure, as well as genes encoding cell signal transduction, hormones, growth factors, calcium homeostasis, substrate metabolism, and blood pressure are likely candidates for the development of common forms of LV hypertrophy. An overview of the pathophysiology of LV hypertrophy and dysfunction is provided, in addition to evidence of the genetic basis for LV hypertrophy in humans and animal models.
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Affiliation(s)
- Donna K Arnett
- Division of Epidemiology, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA.
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30
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Abstract
Pharmacogenetics is a discipline of molecular medicine that investigates the genetic basis of individual variation of drug responses. Before the era of the human genome project and the subsequent progress in genomic research, this field was primarily restricted to the investigation of the genetics of drug-metabolizing enzymes as they account for individual differences in pharmacokinetics and tolerability of drugs. In the current genomic era, pharmacogenetic research is applied to all fields of drug treatment in clinical medicine, including hypertension research. In contrast to the traditional approach, however, the influence of individual genetic variation on the efficacy of a drug (ie, the pharmacodynamic response) is the major focus of pharmacogenetic research and its clinical applicability. Therefore, the identification of individual genetic variation influencing the blood pressure-lowering effect of an antihypertensive compound and the implementation of this knowledge into clinical practice is the major goal of pharmacogenetic research in the field of hypertension. In this article, some important, recent research work and progress on the pharmacogenetics of antihypertensive drug responses are reviewed and evaluated.
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Affiliation(s)
- Reinhold Kreutz
- Department of Clinical Pharmacology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany.
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Detecting imbalanced expression of SNP alleles by minisequencing on microarrays. BMC Biotechnol 2004; 4:24. [PMID: 15500681 PMCID: PMC529269 DOI: 10.1186/1472-6750-4-24] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2004] [Accepted: 10/22/2004] [Indexed: 11/25/2022] Open
Abstract
Background Each of the human genes or transcriptional units is likely to contain single nucleotide polymorphisms that may give rise to sequence variation between individuals and tissues on the level of RNA. Based on recent studies, differential expression of the two alleles of heterozygous coding single nucleotide polymorphisms (SNPs) may be frequent for human genes. Methods with high accuracy to be used in a high throughput setting are needed for systematic surveys of expressed sequence variation. In this study we evaluated two formats of multiplexed, microarray based minisequencing for quantitative detection of imbalanced expression of SNP alleles. We used a panel of ten SNPs located in five genes known to be expressed in two endothelial cell lines as our model system. Results The accuracy and sensitivity of quantitative detection of allelic imbalance was assessed for each SNP by constructing regression lines using a dilution series of mixed samples from individuals of different genotype. Accurate quantification of SNP alleles by both assay formats was evidenced for by R2 values > 0.95 for the majority of the regression lines. According to a two sample t-test, we were able to distinguish 1–9% of a minority SNP allele from a homozygous genotype, with larger variation between SNPs than between assay formats. Six of the SNPs, heterozygous in either of the two cell lines, were genotyped in RNA extracted from the endothelial cells. The coefficient of variation between the fluorescent signals from five parallel reactions was similar for cDNA and genomic DNA. The fluorescence signal intensity ratios measured in the cDNA samples were compared to those in genomic DNA to determine the relative expression levels of the two alleles of each SNP. Four of the six SNPs tested displayed a higher than 1.4-fold difference in allelic ratios between cDNA and genomic DNA. The results were verified by allele-specific oligonucleotide hybridisation and minisequencing in a microtiter plate format. Conclusions We conclude that microarray based minisequencing is an accurate and accessible tool for multiplexed screening for imbalanced allelic expression in multiple samples and tissues in parallel.
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Weston CFM. Pharmacogenetics and cardiovascular disease management. HOSPITAL MEDICINE (LONDON, ENGLAND : 1998) 2004; 65:594-8. [PMID: 15524338 DOI: 10.12968/hosp.2004.65.10.16608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Patients differ in their response to drugs. Part of this variability may reflect genetically-determined characteristics of target genes or metabolizing enzymes. A knowledge of an individual's genetic makeup could allow drug therapy to be targeted at those most likely to benefit.
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Siest G, Jeannesson E, Berrahmoune H, Maumus S, Marteau JB, Mohr S, Visvikis S. Pharmacogenomics and drug response in cardiovascular disorders. Pharmacogenomics 2004; 5:779-802. [PMID: 15469403 DOI: 10.1517/14622416.5.7.779] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
There are a total of 17 families of drugs that are used for treating the heterogeneous group of cardiovascular diseases. We propose a comprehensive pharmacogenomic approach in the field of cardiovascular therapy that considers the five following sources of variability: the genetics of pharmacokinetics, the genetics of pharmacodynamics (drug targets), genetics linked to a defined pathology and its corresponding drug therapies, the genetics of physiologic regulation, and environmental–genetic interactions. Examples of the genetics of pharmacokinetics are presented for phase I (cytochromes P450) and phase II (conjugating enzymes) drug-metabolizing enzymes and for phase III drug transporters. The example used to explain the genetics of pharmacodynamics is glycoprotein IIIa and the response to antiplatelet effects of aspirin. Genetics linked to a defined pathology and its corresponding drug therapies is exemplified by ADRB1, ACE, CETP and APOE and drug response in metabolic syndrome. The examples of cytochrome P450s, APOE and ADRB2 in relation to ethnicity, age and gender are presented to describe genetics of physiologic regulation. Finally, environmental–genetic interactions are exemplified by CYP7A1 and the effects of diet on plasma lipid levels, and by APOE and the effects of smoking in cardiovascular disease. We illustrate this five-tiered approach using examples of cardiovascular drugs in relation to genetic polymorphism.
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Affiliation(s)
- G Siest
- Université Henri Poincaré, INSERM U525, Nancy I, Faculté de Pharmacie, 30 rue Lionnois, 54000 Nancy, France.
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Liljedahl U, Lind L, Kurland L, Berglund L, Kahan T, Syvänen AC. Single nucleotide polymorphisms in the apolipoprotein B and low density lipoprotein receptor genes affect response to antihypertensive treatment. BMC Cardiovasc Disord 2004; 4:16. [PMID: 15453913 PMCID: PMC524175 DOI: 10.1186/1471-2261-4-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Accepted: 09/28/2004] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dyslipidemia has been associated with hypertension. The present study explored if polymorphisms in genes encoding proteins in lipid metabolism could be used as predictors for the individual response to antihypertensive treatment. METHODS Ten single nucleotide polymorphisms (SNP) in genes related to lipid metabolism were analysed by a microarray based minisequencing system in DNA samples from ninety-seven hypertensive subjects randomised to treatment with either 150 mg of the angiotensin II type 1 receptor blocker irbesartan or 50 mg of the beta1-adrenergic receptor blocker atenolol for twelve weeks. RESULTS The reduction in blood pressure was similar in both treatment groups. The SNP C711T in the apolipoprotein B gene was associated with the blood pressure response to irbesartan with an average reduction of 19 mmHg in the individuals carrying the C-allele, but not to atenolol. The C16730T polymorphism in the low density lipoprotein receptor gene predicted the change in systolic blood pressure in the atenolol group with an average reduction of 14 mmHg in the individuals carrying the C-allele. CONCLUSIONS Polymorphisms in genes encoding proteins in the lipid metabolism are associated with the response to antihypertensive treatment in a drug specific pattern. These results highlight the potential use of pharmacogenetics as a guide for individualised antihypertensive treatment, and also the role of lipids in blood pressure control.
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Affiliation(s)
- Ulrika Liljedahl
- Department of Medical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 3floor, 751 85 Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 3floor, 751 85 Uppsala, Sweden
- Astra Zeneca Research & Development Mölndal, 431 83 Mölndal, Sweden
| | - Lisa Kurland
- Department of Medical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 3floor, 751 85 Uppsala, Sweden
| | - Lars Berglund
- Uppsala Clinical Research Center (UCR), Uppsala University, 751 85 Uppsala, Sweden
| | - Thomas Kahan
- Division of Internal Medicine, Karolinska Institute, Danderyd Hospital, 182 88 Stockholm, Sweden
| | - Ann-Christine Syvänen
- Department of Medical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 3floor, 751 85 Uppsala, Sweden
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36
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Bukaveckas BL, Valdes R, Linder MW. Pharmacogenetics as related to the practice of cardiothoracic and vascular anesthesia. J Cardiothorac Vasc Anesth 2004; 18:353-65. [PMID: 15232819 DOI: 10.1053/j.jvca.2004.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bonny L Bukaveckas
- Department of Pathology and Laboratory Medicine, University of Louisville, Louisville, KY, USA
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Abstract
Genetic factors play a significant role in predicting an individual's response to a drug. The response may be the desired therapeutic effect of the drug and also may be the undesirable development of adverse effects. This relationship between genes and drug response interests the pharmacogeneticist. This article aims to give an overview of the exciting discoveries made so far in the field of psychiatry, particularly concerning the response to antidepressants and antipsychotics, as well as to mention some of the more recent findings. The ultimate goal of pharmacogenetics is to provide medication "tailored" to the individual based on their genetic profile, and although this may currently seem a distant target, it has already begun to raise ethical questions, which also are discussed.
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Affiliation(s)
- Amlan Basu
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Denmark Hill, London SE5 8AF, UK
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38
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Santorini Biologie Prospective Conference 2004 “From Human Genetic Variations to Prediction of Risks and Responses to the Environment”, Santorini, Greece, September 30–October 4, 2004. Clin Chem Lab Med 2004. [DOI: 10.1515/cclm.2004.42.8.a22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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39
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Abstract
The extent of blood pressure lowering by anti-hypertensive agents is difficult to predict for individual patients, even when evaluated in the context of biochemical or demographic information. Genetic predictors (mainly single nucleotide polymorphisms, SNPs) have been the focus of several recent studies and are gaining much attention. We have conducted a literature search for studies in which the lowering of ambient blood pressure by specific drugs or drug classes in humans was related to specific genotypes. Twenty-eight studies were identified, of which six had a single-dose design, and the remaining 22 studied drug effects after more than 4 weeks of drug administration. Virtually all were association studies. Prospective trials that compared the prognostic value of genetic methods to routine clinical practice were not identified. Almost all studies used a candidate-gene design, usually with a very small number of SNPs (typically one). Gene-gene and gene-environment interactions were studied only rarely. Only one study targeted genes involved in drug metabolism. Most candidate-genes were part of the renin-angiotensin system. By far the most extensively studied has been the angiotensin-converting enzyme insertion/deletion polymorphism (15 studies) but, to date, no clear picture has emerged for this or other genetic variants. Thus, the potential for utility of genetic characterization of individual patients as a predictor of anti-hypertensive response has yet to be realized.
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Affiliation(s)
- Richard P Koopmans
- Department of Pharmacology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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40
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Bianchi G, Staessen JA, Patrizia F. Pharmacogenomics of primary hypertension--the lessons from the past to look toward the future. Pharmacogenomics 2003; 4:279-96. [PMID: 12718719 DOI: 10.1517/phgs.4.3.279.22694] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A number of recent reviews have addressed the issue of the pharmacogenomics of primary hypertension and related complications by considering the data on the genotype-drug response relationship. Here we mainly discuss the methodological aspects of this issue, trying to integrate 'traditional' clinical and experimental pathophysiology and therapy-pharmacology with the 'new' genetics. Such integration is indispensable to: a). define the appropriate 'context' (genetic background, environment, age, gender, phase of hypertension, previous therapy etc.) in which a given genotype-drug response relationship should be tested (it is indeed likely that many discrepancies among published data originate from context's interference); b). assign the correct clinical meaning to the results obtained by statistics and functional genetics methodologies; c). define a novel clinical entity caused by a disease favoring allele, alone or in combination with other alleles, with a consistent clinical picture, prognosis and responsiveness to the appropriate drug; d). estimate the size of the population target amenable to benefit from a therapeutic intervention developed according to the pharmacogenomics' principles; e). develop a novel drug that selectively interferes with the sequence of events triggered by the genetic mechanism(s) underlying the clinical entity. Peculiar to this strategy is to look for consistency among findings gathered from different 'contexts' after having properly accounted for the context's dependency of the results.
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Affiliation(s)
- Giuseppe Bianchi
- Division of Nephrology and Hypertension, University 'Vita Salute', San Raffaele Hospital, Via Olgettina, 60, 20132 Milano, Italy.
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41
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Affiliation(s)
- Claes Wahlestedt
- Center for Genomics and Bioinformatics, Karolinska Institutet, Stockholm, Sweden.
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