Pharmacogenetics: The Future of Personalised Medicine

What is pharmacogenetics?

Different people respond in different ways to medication. There are several factors that affect how an individual responds to a drug, one of which being their genetic makeup. Pharmacogenetics refers to the study of genes in order to predict people’s responses to certain medications. 

 

By studying someone’s genes, it’s possible to gain certain information about how they might respond to a certain medication. 

Pharmacogenetics The Future of Personalised Medicine

The Royal College of Physicians has stated that the ultimate goal is to “make pharmacogenomic-based prescribing a reality for all.” At ROC Clinic we couldn’t agree more. We’ve been working with genomics since 2016 and believe pharmacogenetics plays a key role in providing our patients with personalised medicine.

Drugs work differently in different people

As humans, our genetic makeup differs. Our genes affect the way we look, the way we think, and even the way we respond to medications.

Medications work by targeting certain processes in the body, and changing them in some way. But variations in our genes can mean that drugs might not work in the way they were intended.

For example, did you know that some painkillers might not work very well for certain people? Let’s take a look at codeine…

In order for codeine to work it has to be metabolised (transformed) into morphine which acts as a strong painkiller. In order for this metabolism to take place the body needs an enzyme called CYP2D6. The expression of this enzyme is controlled by gene CYP2D6. However, people with non-functioning variations of this gene may not be able to produce enough of the enzyme to metabolise codeine. These people will therefore not experience the same reduction in pain as people who have fully functioning variations of the gene.1

If the prescriber knew which version of the gene their patient had, they could use this to decide whether codeine would be an effective painkiller. This is an example of how pharmacogenetics could be used to make more informed decisions on drug treatments.

How does pharmacogenetics work?

Pharmacogenetics requires the following:

  1. An understanding of how the drug works
  2. An understanding of which genes can alter the way the drug works
  3. The ability to test patients for those genes

With all three, healthcare professionals can use pharmacogenetics to make better-informed decisions about which drugs to prescribe patients

What are the benefits of pharmacogenetics?

Pharmacogenetics can tell us:

  • Whether a certain patient is likely to respond to a certain drug
  • What dose of drug the patient needs for treatment
  • Whether the patient is at risk of certain dangerous reactions to the drug

When can pharmacogenetics be used?

Pharmacogenetics can play a valuable role in successful treatment of conditions. Currently, pharmacogenetics are used in the NHS in a few select conditions such as the treatment of breast cancer. Unfortunately, on the whole, the use of pharmacogenetics in clinical practice is relatively poor.2

As the evidence in favour of pharmacogenetics grows we hope that its use will become a standard part of clinical practice.

How is genetic testing carried out?

In order to gain information about your genetic makeup, certain healthcare providers offer a process called genome sequencing. 

At ROC Clinic we work with New Amsterdam Genomics to offer our patients the latest cutting edge technology in genome sequencing. 

To provide you with your genome sequence we simply take a small sample of saliva and send it to our labs. Our experienced doctors will then talk you through your genome sequencing results, explaining to you what each of the findings mean. 

In addition to providing you with information about the effectiveness of certain drugs, genomic testing offers a range of other benefits. 

To learn more about genome sequencing, click here or give our friendly team a call on 01224 515254.

References

  1. Taylor C, Crosby I, Yip V, Maguire P, Pirmohamed M, Turner RM. A Review of the Important Role of CYP2D6 in Pharmacogenomics. Genes (Basel). 2020;11(11):1295. Published 2020 Oct 30. doi:10.3390/genes11111295

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692531/

  1. Cecchin E, Stocco G. Pharmacogenomics and Personalized Medicine. Genes (Basel). 2020;11(6):679. Published 2020 Jun 22. doi:10.3390/genes11060679

https://pubmed.ncbi.nlm.nih.gov/32580376/

Flu SeasonWith the end of Summer and the sudden chill in the morning air, it is inevitable that our thoughts turn to Winter health needs, more specifically the flu!

So, let’s talk more about the flu or influenza, to give it its proper name.

What is the flu?

Influenza or the flu, (as we will call it) is an infectious respiratory disease caused by influenza viruses that contaminate the nose, throat, and occasionally the lungs. Symptoms of flu can be mild to more serious and at times may be fatal.

How do I know I have the flu?

With the advent of Covid 19, and the general increase in cold cases during the chillier months, it can be confusing to know if you have the flu or something else.

Covid 19, the common cold and the flu are all caused by viruses which attack the respiratory system (the nose, mouth, throat, and lungs) and they all have similar symptoms. With the common cold, symptoms tend to be less severe than with the flu, however, Covid 19 and the flu do have comparable symptoms although, Covid 19 spreads more easily and it is more common for sufferers to have changes to their sense of taste and smell. The symptom table below gives you a simple breakdown of common symptoms associated with all three viral conditions (1):

How does the flu spread?

With the increase public health notifications and campaigns, more people are aware that the flu is infection and that it is spread from person to person. Typically, the flu is spread via airborne droplets, meaning that when someone is infected, they can pass on the flu to other’s when they cough, sneeze, or talk, even from as far away as six feet. An infected person can spread the flu up to a day before they feel unwell, and up to a week after they feel ill. Naturally, the young, the old and people who have lowered immunity (resistance) to disease will be more susceptible to contracting the flu and may be contagious longer.

What to do if you have the flu

We’ve all heard the old adage “Feed a cold, starve a fever” but this advice likely came about when people thought that only two types of illness existed, those which caused low temperature and those which cause high temperatures. Eating more food was encouraged to raise the body temperature and dispel the cold symptoms, while by starving, the temperature of the body would drop and the fever break.  Now we have a better understanding of viruses and nutritional needs when we are unwell.  Feeding a fever is now thought to be more important than feeding a cold, as symptoms of sweating, diarrhoea and vomiting increase loss of body fluids leading to dehydration. If tolerated hot soup and herbal drinks are good to keep mucous thin and helping remove unwanted substances from the nose and throat.

The most important thing is to stay hydrated, rest, keep comfortable and remain at home until recovered.

How do we protect ourselves?

We know that the flu is a contagious disease, spread through the population by contact with infected people. Protecting ourselves is key to stopping infection and the best way to do this is by getting

vaccinated.

Getting vaccinated is the safest and most efficient form of protection against contracting the flu. Unfortunately, even when vaccinated, some people can still develop the flu, albeit that symptoms are likely to be milder and the duration of infection shorter. Vaccination can help reduce the spread of flu to vulnerable people; those likely to become seriously ill and who may have more complications if they contract the flu.

It is important to get immunised every year, this is due to the flu virus continually changing and a drop in immunity which happens naturally over time.

The vaccination will not give you the flu, but you may develop mild flu symptoms.

Vaccination for the worforce

Every year in the UK the winter season brings with it absence from work due to cold and flu related illness. In comparison to overall sickness absence rates, the flu accounts for a small percentage of workdays lost; however, this absence can be reduced by organising a vaccination programme for the workforce.

ROC Healthcare Services and your flu vaccination needs

At ROC Healthcare Services we aim to provide best practice and client healthcare whilst considering the requirements of your business. We pride ourselves on delivering exceptional, patient centred care and will help plan and deliver a flu vaccination service to meet your business needs. To discuss this or any other Occupational Health business requirements please contact: –

Address: Aberdeen

Westhill Business Park

Peregrine Road

Aberdeen

AB32 6JL

Telephone: +44 01224 515 254

FAX: +44 01224 418 254

Email: aberdeen@rochealthservices.com

Address: London

45 Queen Anne Street

Marylebone

London

W1G 9JF

Telephone: +44 0207 935 0606

FAX: +44 0207 935 06 07

E-mail: london@rochealthservices.com

References

https://www.nia.nih.gov/health/flu-and-older-adults

https://www.nhsinform.scot/winter-vaccines/the-flu-vaccine/flu-vaccine

https://www.cdc.gov/flu/prevent/vaccine-selection.htm

https://www.health.com/condition/cold/feed-a-cold-starve-a-fever

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