What Is the Importance of Pharmacogenomics in Gastroenterology and Hepatology?
If you feel sick, doctors mainly use medicines to treat you. This is known as pharmacotherapy. Here, medicines target particular molecules in our body. A change in the form and function of these different molecules is responsible for our cure from illness. Over the years, doctors have identified different levels or areas in the body where these drugs work. Among different regions, some medicines act on our genes. The scientific study of the medications that affect our genes is known as pharmacogenetics.
Doctors prescribe medications based on several factors, including age, sex, and the severity of the disease. However, doctors have observed that in some cases, the medicines are not effective for others. Researchers have noted that our genes play a role in this. Changes in our genes regulate the effectiveness and metabolism of drugs in our bodies. Even one individual can have different variations of the same gene in their body. Such a thing is known as genetic pleomorphism. It is caused by a change in the DNA (deoxyribonucleic acid) sequencing.
The importance of pharmacogenomics in gastrointestinal and liver health is as follows;
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In the new era of medical practice, doctors focus on the effectiveness of the drugs at an individual level. Gastric diseases, which are often related to family history or genetics, require special attention.
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In some cases, due to genetic factors, medicines may not target specific molecules. Instead, they react with some other molecules that do not cause your disease. As a result, doctors find it difficult to treat gut diseases. In these instances, pharmacogenomics helps to identify genetic variations that affect drug targets and improve drug efficacy.
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Due to changes in your genes, medicines can cause unnatural reactions or side effects in your body. These reactions are not typical medicine-related side effects, but rather linked to your genetic makeup. In such cases, pharmacogenomics plays a vital role by preventing or reducing adverse drug reactions.
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Pharmacogenomics also plays a vital role in helping tailor drug doses to the individual. For example, certain UGT1A1 gene variants make people more prone to side effects from the colon cancer drug irinotecan, so they often need lower doses to stay safe.
What Are the Applications of Pharmacogenetics in Gastroenterology?
Some of us suffer from long-term gut issues. Such issues can cause problems such as irregular bowel movements, diarrhea, acid reflux, belching, and abdominal cramping. Doctors call these functional gastrointestinal disorders. Different health issues like GERD or gastroesophageal reflux disease, inflammatory bowel disease, and irritable bowel syndrome belong to this category. If you are experiencing any such issues, your genes may affect the medications you are taking.
Effects of pharmacogenetics on GERD:
In GERD, the contents from the stomach move up into the esophagus. As a result, it irritates your foodpipe and damages its lining. This causes regular acidity, burping, and heartburn. In severe cases, you may have ulcers in your gut. Doctors commonly give you proton pump inhibitors (PPIs) for this. However, if you have some genetic alterations, these drugs may not be effective.
Genetic changes in your body cause a change in the functionality of Cytochrome P450 enzymes. These tiny helper proteins speed up the transformation of these PPIs. Any change in those helper chemicals does not result in the transformation of PPIs. This reduces the effectiveness of your medicines. Such things are associated with genes. However, these genetic changes are observed in a small subset of the Caucasian population.
Pharmacogenetics in inflammatory bowel disease:
Inflammatory bowel syndrome causes many gut issues. Doctors use Azathioprine (AZA) for this gut problem. This medicine can help alleviate your gut problems and inflammation without the need for steroids. As a result, you do not face the side effects of steroids. However, if you have a genetic alteration in your 6th gene, it can cause certain issues. It will hamper the functioning of Thiopurine-S-methyltransferase (TPMT). This helper chemical or enzyme aids in the processing of AZA. However, due to abnormality, abnormal byproducts such as 6-mercaptopurine (6-MP) are produced. This byproduct can harm your bones and bone marrow. Apart from this, you may experience flu-like symptoms or rashes after taking AZA. An alteration in chromosome number 20 is related to it. These alterations can produce 6-thioinosine triphosphate (ITP).
Infliximab is a widely known biological therapy used to treat inflammatory bowel disease. This medication targets tumor necrosis factor-alpha to decrease inflammation levels. However, your genetic changes can reduce the effectiveness of this medicine.
Pharmacogenetics of irritable bowel syndrome:
Irritable bowel syndrome can cause issues such as bloating, gut pain, cramping, constipation, and diarrhea, as well as changes in gut sensation, movement, and secretion. Doctors use Alosetron to treat such an abnormality. However, if you have a genetic issue that causes alterations in the SLC6A4 gene, it can hamper the function of these medicines. As a result, you will not see the desired results.
What Are the Applications of Pharmacogenetics in Hepatology?
If someone is having liver failure or liver cancer, a new liver is an effective treatment option. That is why liver transplantation is needed. In such cases, doctors prescribe Cyclosporine and Tacrolimus to prevent infection. Cytochrome P450 3A4 enzymes in our body process these medicines. However, if you have alterations in your CYP3A4 gene on the seventh chromosome, those medicines can not be very effective. Due to a change in your body's processing, you might need a higher dose of those medicines.
Apart from these, changes in your genes can turn regular medicines into harmful ones for your liver. If you have alterations in your Major histocompatibility complex (MHC) genes, it can affect the processing of different medicines. As a result, toxic products made from these medicines lead to liver damage. This is one of the main reasons for drug-induced liver injury.
Conclusion
Taking the right medicines is essential for your gut diseases. However, you must remember that how well the drug functions will depend on different factors. Apart from factors such as sex, age, pregnancy, and disease severity, genetics also play a significant role. If you have a few genetic alterations, the medication may not yield the desired results. Additionally, it can harm your body. That is why the knowledge of pharmacogenetics is important. For any issues related to your gut health and pharmacogenetics, you can talk to a gastro health specialist online.
Key Takeaways
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Pharmacogenetics examines the impact of genes on the effectiveness of medicines.
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A change in your genes can hamper the function of medicines in your body.
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If you have issues like GERD or irritable bowel syndrome, genetic changes can affect the functions of your medicines.
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Some genetic changes can be linked to abnormal medical effects.
