జర్నల్ ఆఫ్ ఫార్మకోజెనోమిక్స్ & ఫార్మాకోప్రొటోమిక్స్

నైరూప్య

Pharmacogenetics and Perinatal Clinical Pharmacology: Tool or Toy?

Karel Allegaert

The concept of personalized medicine and pharmacogenetics reflects the notion that a specific (side) effect or risk is not at random distributed in a (sub) population. This obviously holds also promises for personalized medicine in perinatal life. There are observations on the impact of pharmacogenetics on in vivo cytochrome P450 (CYP) CD6, C219 and N-Acetyl Transferase (NAT) 2 activity in early life. However, these observations are still based on genotype-phenotype concordances described in adults and – to a certain extent – still approach the infant as ‘a small adult’ (when does genotype-phenotype concordance appears ?). In addition to such ‘adult driven’ approach, there are also potential age-specific concordances between genotype and phenotype that are only present in perinatal life: pharmacogenetic polymorphisms as predicting covariate limited to periods during development in which a genotype-phenotype concordance still exists. Such an approach holds the promise of further individualized medicine in perinatal life, but needs simultaneous availability of clinical characteristics, pharmacologic observations and polymorphisms (mother, fetus, child).