title: Pharmacogenetics of inflammatory bowel disease.
abstract: The therapeutic efficacy and toxicity of many commonly employed drugs show interindividual variations that relate to several factors, including genetic variability in drug-metabolizing enzymes, transporters or targets. The study of the genetic determinants influencing interindividual variations in drug response is known as pharmacogenetics. The ability to identify, through preliminary genetic screening, the patients most likely to respond positively to a medication should facilitate the best choice of treatment for each patient; drugs likely to exhibit low efficacy or to give negative side-effects can be avoided. Among the medications used for inflammatory bowel disease, the best studied pharmacogenetically is azathioprine. The hematopoietic toxicity of azathioprine is due to single nucleotide polymorphisms in the thiopurine S-methyltransferase enzyme. Additionally, likely gene targets have been investigated to predict the response to glucocorticoids and infliximab, a monoclonal antibody against tumour necrosis factor that induces remission in approximately 30-40% of patients. However, no genetic predictor of response has been identified in either case.
authors.affiliation: 1st Department of Medicine, Christian-Albrechts-Universtität Kiel, Schittenhelmstr. 12, Kiel D-24105, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Mascheretti
authors.forename: Peter J P
authors.initials: PJ
authors.lastname: Croucher
authors.forename: Stefan
authors.initials: S
authors.lastname: Schreiber
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000235:genetics*; D003424:Crohn Disease / Q000188:drug therapy* / Q000235:genetics*; D004351:Drug Resistance / Q000235:genetics; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D007166:Immunosuppressive Agents