Many people have experience in getting medical treatment: Before a doctor prescribes a prescription, you will usually be asked if you have a drug allergy. But except for a few people who have already developed drug allergies, most people check it out. The doctor will write in the medical drug allergy column: not found. This situation will change with the popularity of drug genetic testing. Through the detection of a tube of blood or a saliva, modern genetic testing technology can already find the tolerance and metabolism of individuals to different drugs, so as to avoid serious adverse reactions such as "one shot". This technology is entering the public top three hospitals in China and has a profound impact on the clinician's diagnosis and treatment. However, industry insiders also said that the requirements for the laboratory and kits for drug genetic testing are very high, and the cost problem has also caused many drugs to enter the detection range. It will take time for this technology to enter the public.
"no effect" drug
The 65-year-old Mr. Wang started taking an anti-platelet aggregation drug, clopidogrel, after a heart-stent surgery. Clopidogrel is a platelet aggregation inhibitor widely used in acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI) for antithrombotic therapy. It is the most commonly used anticoagulant. Under normal circumstances, Mr. Wang taking clopidogrel can greatly reduce the risk of thrombosis. However, during the 4 years after stenting, Mr. Wang had several adverse events such as stenosis and thrombosis, and had to undergo stent surgery. Drug genetic testing found that a mutation in the body called CYP2C9 in Mr. Wang was the cause of the disease. This gene is involved in the metabolism of clopidogrel. Under normal circumstances, clopidogrel is required to be metabolized to active product by CYP2C19. However, Mr. Wang’s genetic mutations have reduced the metabolic activity of clopidogrel and the drug is difficult to take effect. According to the results of drug genetic testing, the attending doctor used another alternative drug, and Mr. Wang’s situation gradually improved.
Professor Xu Bangqiang, director of the Inspection Department of the First People's Hospital of Guangzhou, said that the hospital has established a “individualized drug therapy genetic testing service platform†since 2015, and has been able to provide genetic testing for more than 10 commonly used drugs to provide clinicians with A clear medication guide is very popular among doctors.
"The drug enters the body to be metabolized. Some enzymes in the body participate in the process of drug metabolism. The enzyme belongs to the protein and is encoded by the human gene. The activity of this enzyme in each human body is determined by the gene. This is the theoretical basis of drug gene detection. Professor Xu Bangqiang said that when doctors prescribe, the traditional practice is to pay attention to the patient's height, weight, sex, age, whether to take other drugs, etc., and the most important genetic factors are often ignored.
Behind the "durian with wine"
Another more interesting case is related to drinking. There have been news reports that a young man ate a lot of durian while traveling in Thailand, and then drank alcohol, which caused a sudden death from heart disease, only 28 years old. Thailand has a clear rule that after eating a lot of durian, it is not allowed to drink alcohol within 8 hours. Durian with wine = life defrosting cream! Why does this happen? Can be explained by genes.
The study found that the human ALDH2 gene can encode two enzymes, one is acetaldehyde dehydrogenase 2, which is a key enzyme in alcohol metabolism, which can metabolize aldehydes in the diet; the other is nitrate esterase, and The efficacy of the life-saving drug nitroglycerin is related, mainly in the liver, lungs, and heart and brain.
After drinking alcohol, the ALDH2 "acetaldehyde dehydrogenase 2" secreted by the body will decompose the alcohol and excrete it. A compound containing sulfur in durian, which inhibits the production of "acetaldehyde dehydrogenase 2" and reduces the activity of this enzyme, that is, it cannot completely metabolize alcohol into acetic acid which is harmless to the human body. After eating durian and drinking, people are more likely to get drunk and even cause alcoholism. In other words, both the amount of alcohol and the ability to hangover are actually affected by genes. "Acetaldehyde dehydrogenase 2" activity affects the efficiency of human alcohol metabolism. People with high activity have strong ability to metabolize alcohol. People with low activity have poor ability to metabolize alcohol. This can explain why some people do not have a thousand cups. Drunk, some people are drunk.
The nitrate esterase activity encoded by ALDH2 is related to the efficacy of the life-saving drug nitroglycerin. Therefore, if ALDH2 is mutated, nitrite enzyme activity is insufficient, which means that some patients with angina pectoris are ineffective with nitroglycerin as a rescue drug, which may cause a major disaster at a critical moment.
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[Package Dimension] 10cm×12cm 2pieces/box
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[Attention]
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