Utjecaj genetskih čimbenika na terapijsku učinkovitost psihofarmaka

master's thesis

• Title (english): Genetic modifiers of psychopharmacological treatment response
• Author: Ivan Mitreković
• Mentor: Neven Henigsberg (mentor)
• Committee member: Dubravka Kalinić (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Neven Henigsberg (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Pharmacology

Abstract

Trenutačne su farmakoterapije za psihijatrijske poremećaje uglavnom nepotpuno učinkovite. Mnogi pacijenti ne reagiraju dobro ili pate od nuspojava ovih lijekova, što može rezultirati lošom suradljivošću pacijenta i lošim ishodom liječenja. Zbog potrebe razumijevanja razlika između pojedinaca u odgovoru na lijek razvila se farmakogenomika, znanost koja proučava ulogu genoma u odgovoru na lijek. Ovome preglednom radu cilj je obraditi dosege farmakogenomike u razumijevanju koji to genetski čimbenici, te kako, utječu na terapijsku učinkovitost psihofarmaka. U uvodu je pobliže objašnjena farmakogenomika. Zatim su u početku razrade rada spomenuti neki od glavnih receptora, odnosno enzima čiji se različiti fenotipi dovode u svezu s drugačijim odgovorom na psihofarmak. Kako se šire spoznaje farmakogenomike, tako se širi i popis aktera koji isto sudjeluju u neočekivanom odgovoru pacijenta na lijek, a oni su spominjani kroz tekst. Nadalje, rad obrađuje četiri glavne skupine psihofarmaka (antidepresivi, antipsihotici, stabilizatori raspoloženja te anksiolitici, sedativi i hipnotici), odnosno njihove predstavnike koji su odabrani zbog svoje važnosti, ali i zbog toga što precizno oslikavaju kako sve na njih mogu utjecati genetski polimorfizmi. Na kraju rad prikazuju se dvije bitne teme farmakogenomike. Izazovi, socioekonomski i etički, farmakogenomike te teškoće uvođenja genetskih testova u svakodnevnu kliničku praksu, no isto tako i tema o obećavajućoj budućnosti koja bi mogla donijeti personaliziranu, po pacijentu skrojenu, medicinu.

Abstract (english)

Current pharmacotherapy for psychiatric disorders is partially effective. Many patients do not respond well to therapy and suffer from adverse effects, which results in poor patient compliance and poor treatment outcomes. Because of the need to understand the differences between individuals in response to drug pharmacogenomics has developed, a science that studies the role of the genome in response to a drug. This review paper aims to address the achievements of pharmacogenomics in understanding which genetic factors, and how, affect the therapeutic efficacy of psychopharmaceuticals. Pharmacogenomics is explained in more detail in the introduction. Then, at the beginning of the elaboration of the paper, some of the main receptors, ie enzymes whose different phenotypes are associated with a different response to the psychopharmaceutical, were mentioned. As the knowledge of pharmacogenomics expands, so does the list of actors who also participate in the patient's unexpected response to the drug, and they are mentioned throughout the text. Furthermore, the paper deals with four main groups of psychopharmaceuticals (antidepressants, antipsychotics, mood stabilizers, and anxiolytics & sedatives & hypnotics), ie their representatives who were selected because of their importance, but also because they accurately depict how genetic polymorphisms can affect them. Finally, the paper discusses two important topics of pharmacogenomics. Challenges, socio-economic and ethical, of pharmacogenomics and the difficulty of introducing genetic tests into everyday clinical practice, but also of a promising future that could bring personalized, patient-tailored medicine.

• Keywords: farmakogenomika; psihofarmak; polimorfizam; personalizirana medicina
• Keywords (english): pharmacogenomics; psychopharmaceutical; polymorphism; personalized medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:419879
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-17 10:43:00