Pharmacogenomics and end-organ susceptibility to injury in the perioperative period.
Genomic medicine has provided new mechanistic understanding for many complex diseases over the last 5-10 years. More recently genomic approaches have been applied to the perioperative paradigm, facilitating identification of patients at high risk for adverse events, as well as those who will respond better/worse to specific pharmacologic therapies. The consistent biological theme emerging is that while inflammation is important in healing from surgical trauma, patients who are too robustly proinflammatory appear to be at higher risk for adverse perioperative events. Precise predictors of each adverse event are being elucidated so that corrective therapeutics can be instituted to improve outcomes in high-risk patients. While the field of perioperative genomics could be considered in its infancy, such approaches are the wave of the future.
Schwinn
Debra A
DA
Box 356540, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195-6540, USA. dschwinn@u.washington.edu
Podgoreanu
Mihai
M
D000758:Anesthesia / Q000009:adverse effects*; D014644:Genetic Variation; D023281:Genomics / Q000639:trends*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control; D019990:Perioperative Care / Q000379:methods / Q000639:trends*; D010597:Pharmacogenetics / Q000639:trends*; D020641:Polymorphism, Single Nucleotide; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors