July 5, 2017 | Genetic Foresight, Inc.
When describing what we do to the average person and insisting that our new field, pharmacogenomics, will be the future, a typical reaction is withdrawal into a glazed, distant look. Drawing the connection between the genome and drug metabolism appears intimidating, and the average person (maybe even the average physician) may become overwhelmed.
However, in general terms, understanding how genes mostly affect which drugs we can use is fairly simple. Pharmacogenomics, our work at Genetic Foresight, and the impending paradigm shift in medicine, is quite simple and we’re here to make it accessible to anyone.
Genes and Enzymes
Our responses to drugs mostly vary in proportion to how much particular enzyme-producing genes are expressed. The less a particular gene is expressed, the less the corresponding enzymes it codes for are produced. As a result, certain drugs are broken down and metabolized slower. For a given gene, someone with this low level of expression is called a poor metabolizer. On the other side of the spectrum, the more a particular gene is expressed, the more the corresponding enzymes it codes for are produced, and the more rapidly a drug is broken down. Someone with this level of gene expression is called an ultra-rapid metabolizer.
For example, the enzyme superfamily Cytochrome P-450 (CYPs) is responsible for metabolizing the common drug codeine. If someone has a duplicate of the gene CYP2D6, which produces these enzymes, then they will produce more enzymes to break down codeine into the active form, morphine. This can lead to respiratory depression — severely decreased rate of breathing — and potentially death.
Among the most severe cases of poor metabolism, on the other hand, are people with genetic mutations in the Cytochrome P-450 gene system. Because sufficient enzymes are not produced, certain drugs pass through the liver unprocessed and unmetabolized. They become toxic as they continue circulating throughout the body resulting in nausea, headaches, or vomit. In some cases, this toxicity can even lead to death. The Psychiatric Times reported an autopsy for a boy treated for turrets with Prozac. As a poor metabolizer, the blood levels of Prozac continued building in the boy before he passed away. Had his genome been analyzed prior, an alternative therapy could have been used.
Genetic Foresight Implications
By analyzing how much critical genes are expressed in a person’s genome, Genetic Foresight can understand the metabolism of each individual and allow physicians to give personalized prescriptions. Currently, 25% of adults in America take at least one psychiatric drug and the average 65-year-old uses at least seven different medications daily. With such a high number of drugs and possible interactions, it’s nearly impossible for physicians to avoid adverse drug reactions. This often results in hazardous consequences. Genetic Foresight believes in getting medication right, the first time.
Through pharmacogenomics, physicians will understand the individual patient’s metabolic specificities and prescribe the correct medications to eliminate illness as effectively and quickly as possible. While preventative health is also encouraged through diet, exercise, and stress management, the necessity for prescription drugs is here to stay. By increasing our knowledge of the human genome and its interaction with drugs, we can do our best to mitigate side effects of medications.
Join us at Genetic Foresight as we empower formerly sick patients to return to their normal, healthy lives.