What medicines are used to treat you after getting sick, and it is related to your genes?
Recently, Aunt Wu, who had two sudden cerebral infarctions in half a year, found out that she belonged to an intermediate metabolic patient through drug genetic testing, and had poor metabolism of clopidogrel (a drug that prevents cerebral infarction), and the doctor immediately replaced it with another drug that was less affected by genes. After finding the right medicine for herself, Aunt Wu quickly recovered and was discharged from the hospital.
What is "drug genetic testing"? What's so magical about it?
It is understood that genetic testing is a method of detecting DNA through blood, other body fluids and cells, analyzing the type of genes it contains and whether the gene defects and their expression function are normal, so that people can understand their own genetic information, clarify the cause or predict the risk of a certain disease in the body.
The "Drug Genetic Testing" project can detect some genes related to drug efficacy or adverse reactions, explain the differences in the efficacy of different patients from a genetic point of view, get rid of the situation of continuous trial and change of drugs in the traditional drug mode, stratify patients, and find more suitable drugs for patients faster due to drug selection, so as to achieve high efficiency and low side effects of medication and reduce medical costs.
Zhong Tiantian, deputy director of the Pharmacy Department of Yunfu People's Hospital, said that it is not uncommon for clopidogrel intermediate metabolite genes like Aunt Wu to be tested for clopidogrel CYP2C19 in 2021, and more than 400 people belong to the intermediate metabolite population and need to adjust the dose of clopidogrel or switch to other antiplatelet drugs.
In fact, not only are there individual differences in drug metabolism, but there are also individual differences in alcohol metabolism. Why do some people have a red face after tasting fine wine, even alcoholism and stomach bleeding? "Drug genetic testing" can also easily reveal "secrets hidden in genes".
The metabolic process of alcohol in the human body is: ethanol acetaldehyde acetate. Among them, ethanol and acetic acid are relatively safe, and the trouble is this intermediate product "acetaldehyde", because the long-term accumulation of acetaldehyde in the body may lead to cirrhosis and even liver cancer. The "ALDH2 gene" in the human body can metabolize acetaldehyde into acetic acid, thereby preventing the toxic accumulation of acetaldehyde.
Therefore, by testing the ALDH2 gene, you can see which type of alcohol metabolism you belong to. If the ALDH2 gene is a normal wild type, alcohol can be drunk in moderation (small drinks, large drinks hurt the body); if it is a mutant type, it is not recommended to drink alcohol.
So, which groups of people need to do genetic testing for drugs? It mainly includes the following five categories.
1. People who intend to use drugs that may induce serious adverse reactions (eg allopurinol, carbamazepine) - before taking the drug
2. People who have a history of adverse drug reactions or a family history of adverse drug reactions - before taking drugs
3. People with chronic diseases who need to take drugs for a long time - before and after medication
4. People whose current drug treatment effect is not good or ineffective - after medication
5. People who attach importance to safe medication, the elderly, children, etc. - before medication
"At present, there are hundreds of hospitals in the country to carry out genetic testing projects, our hospital can detect genes related to 40 drugs, involving infection, cardiovascular, digestion and other multidisciplinary fields, and the scope of testing can be expanded according to clinical needs." Clock astronomical representation.
[Nanfang Daily, Nanfang + reporter] Wang Xie Siqi
[Correspondent] Chen Min
【Author】 Wang Xie Siqi
【Source】 Southern Press Media Group South + client