Pharmacogenomics in the treatment of inflammatory bowel disease.
In recent years, the benefits of early aggressive treatment paradigms for inflammatory bowel disease have emerged. Symptomatic improvement is no longer considered adequate; instead, the aim of treatment has become mucosal healing and altered natural history. Nonetheless, we still fail to achieve these end points in a large number of our patients. There are many reasons why patients fail to respond or develop toxicity when exposed to drugs used for inflammatory bowel disease, but genetic variation is likely to account for a significant proportion of this. Some examples, notably thiopurine methyltransferase polymorphism in thiopurine treatment, are already established in clinical practice. We present a review of the expanding literature in this field, highlighting many interesting developments in pharmacogenomics applied to inflammatory bowel disease and, where possible, providing guidance on the translation of these developments into clinical practice.
Smith
Melissa A
MA
Department of Gastroenterology, 1st Floor, College House, St Thomas' Hospital, Lambeth Palace Road, London, SE1 7EH, UK.
Marinaki
Anthony M
AM
Sanderson
Jeremy D
JD
D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics / Q000378:metabolism; D000305:Adrenal Cortex Hormones / Q000493:pharmacokinetics / Q000627:therapeutic use; D001379:Azathioprine / Q000493:pharmacokinetics / Q000627:therapeutic use; D016207:Cytokines / Q000235:genetics / Q000378:metabolism; D016903:Drug Monitoring; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000235:genetics* / Q000378:metabolism; D019804:Mesalamine / Q000493:pharmacokinetics / Q000627:therapeutic use; D008780:Methyltransferases / Q000235:genetics / Q000378:metabolism; D010597:Pharmacogenetics; D011755:Pyrophosphatases / Q000235:genetics / Q000378:metabolism; D011965:Receptors, Glucocorticoid / Q000235:genetics / Q000378:metabolism; D012460:Sulfasalazine / Q000493:pharmacokinetics / Q000627:therapeutic use; D000097630:Inosine Triphosphatase
D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000305:Adrenal Cortex Hormones; D001379:Azathioprine; D016207:Cytokines; D007166:Immunosuppressive Agents; D019804:Mesalamine; D008780:Methyltransferases; D011755:Pyrophosphatases; D011965:Receptors, Glucocorticoid; D012460:Sulfasalazine; D000097630:Inosine Triphosphatase; C513055:ABCB1 protein, human; C022745:thiopurine methyltransferase