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Revision notes for 6103BCBMOL exam
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Notes for personalised medicine, with questions about issues/impact of tailored healthcare.
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Personalised medicineGenetics play an important role in disease susceptibility
Genetic variation affects gene expression or function and hence pharmacology and drug effect
Genes that influence disease susceptibility or progression can affect drug effect
Pharmacodiagnostics A.K.A theranostics
Pharmacogenomics – take a patient’s blood sample, look at their genetic variations determine which
variations may cause adverse drug reactions or limited potency and prescribe a drug that will be
effective to them – can also help to predict correct dosing not just which drug to use
“As an example, if a company knows ahead of time that someone has a genetic variation that will cause an
adverse reaction to a drug or that will make a drug ineffective, those patients can be excluded from the clinical
trial. This may speed up the clinical trial process and target the specific population that can be helped by any
one medication.” - Vogenberg, F. R., Isaacson Barash, C., & Pursel, M. (2010). Personalized
medicine: part 1: evolution and development into theranostics. P & T : a peer-reviewed journal for
formulary management, 35(10), 560–576.
- Interesting comment to make, if those people are excluded this poses a risk of someone
prescribed a drug by a GP that has not done the correct tests or is not properly educated this
could be catastrophic – people with genetic variations should be included if the drug dosage
can be tailored to their genetic variation
Concerns
How reliable are the tests?
Are health care providers prepared to use this information?
Will Insurance companies pay for the tests?
Will tailor made medicine lead to discrimination?
Will ethnic biases in science bias treatment developments?
Will this affect people’s privacy?
Case studies
https://www.sciencedirect.com/science/article/abs/pii/S2468125319303401
- Crohns disease
Samec, M., Liskova, A., Koklesova, L. et al. Flavonoids against the Warburg
phenotype—concepts of predictive, preventive and personalised medicine to cut
the Gordian knot of cancer cell metabolism. EPMA Journal 11, 377–398 (2020).
https://doi.org/10.1007/s13167-020-00217-y
- Anticancer therapy targeting Warburg effect
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