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From the very earliest times, disease has struck fear into people. New diseases arise and cause havoc, as the recent outbreak of H1N1swine flu shows only too clearly.
The ability to find and manufacture a medicine which has the right effect in the right place is of vital importance in the fight against disease. Think of the impact that antibiotics have had on infectious diseases – illnesses that were life threatening seventy years ago are treated easily with a course of antibiotics today.
The pharmaceutical industry has responded to the work of the Human Genome Project with great enthusiasm. Detailed knowledge of the human genome is already making possible a number of potentially exciting advances in different areas of medicine development. The application of genetics is expected to produce more powerful medicines. This is because medicines can be designed to target specific diseases, or to respond to changes in the proteins or genetic material of the cells. Knowing the human genome it will be easier to produce medicines which affect pathogens or cancer cells but which do not damage healthy body cells. In addition in the future it is hoped medicines could be tailor-made to suit each of us as individuals.
If medicines can be designed to work with our individual genetic makeup then they should work more effectively, in lower doses, with fewer side effects. The new science of pharmacogenetics has been developed to put together pharmaceutical expertise with the new knowledge of the human genome.
Research has already shown that genetic factors have a marked effect on the effectiveness of certain medicines. For example, medicines called kappa opioids appear to be much more effective pain killers in women than in men; pale skinned red haired women are more responsive to common analgesics than anyone else; and ibuprofen has little or no effect on pain relief in women during the second half of their menstrual cycle.
More detailed knowledge of our individual genetics which will come from the findings of the Human Genome Project is predicted to have enormous benefits in terms of medicine development through pharmacogenetics.
But what are the possible benefits of pharmacogenetics?
Understanding the human genome should make it much easier to prescribe the right medicine for a patient straight away. It is estimated that in the US around 100,000 people die each year, and 2 million people are hospitalised as a result of being given a medicine which doesn’t suit them. If doctors can have access to a patient’s genome they will be able to prescribe medication which will work with rather than against their patients. This approach results in personalised medicine, sometimes called stratified medicine.
Another important improvement should be in the dosages of medicines used. Taking the age or weight of a person and using it to decide what dose of a medicine they should be given is a fairly random way of doing things. Genetic information about individuals would allow doctors to work out just how rapidly each person deals with a particular medicine and excretes it from their body. Many people could have much lower doses of medicines, whilst those who need it could be given higher doses.
Advances like these would be of enormous benefit to patients, and they would also save the NHS a great deal of money in medicine wastage and treating people who react badly to the medicine they have been given.