人类基因组在医学上的应用

It’s been more than a decade since the human genome was published. And some critics have wondered where the promised medical applications are. Well, a review article in the current issue of The New England Journal of Medicine talks about how knowledge of a patient’s genome is allowing doctors to pick the best drug for that patient, along with dosage and duration of treatment. [Liewei Wang, Howard McLeod and Richard Weinshilboum, "Genomics and Drug Response"]

For example, last year the FDA added a warning to the prescribing info for the widely used anticlotting drug clopidogrel. Because patients with a particular genetic variant might not respond well to that drug. Another example is the antibiotic floxacillin. The drug helps treat most people’s staph infections. But it’s associated with liver problems in rare individuals carrying another specific gene set.

Unfortunately, it’s still uncommon for docs to get genome info about patients, so that wealth of knowledge isn’t often put into practice. Insurers don’t want to cover widespread pharmacogenomic testing without lots of evidence that it’s applicable. Which slows the accumulation of whatever drug-gene interaction evidence would be useful. Here’s hoping that ever-cheaper genome analysis accelerates the use of genetic information.

—Steve Mirsky