Adhesion Molecules-28

Advances and Experimental-2

Aging-9

Agricultural Biotechnology-37

Angiogenesis-29

Antisense-4

Apoptosis-49

Atherosclerosis-12

Autoimmunity-69

Bacterial Virulence-18

Bioinformatics-13

BioMaterials-18

Biosurfactants-1

Biotechnology-99

Cancer Genetics-25

Cancer Metastasis-19

Cell Biology-16

Cell Cycle-34

Cell Metabolism-327

Channels and Transporters-79

Chaperones-11

Circadian Rhythms-13

Coagulation-14

Cytokines/Growth Factors-52

Development-223

DNA-56

DNA Surveillance and Repair-42

Drug Design-17

Endocrine-66

Evolution-33

Extracellular Matrix-30

Gastroenterology-52

Gene Expression-178

Gene Therapy-53

Heart-61

Heat Shock Proteins-19

Hematology-11

Immunology-93

Infectious Disease-71

Ischemia-Reperfusion-33

Leptin and Leptin Antagonists-1

Medical-21

MHC-17

Mitochondria-17

Molecular Biology-15

Molecular Complexes and Signaling-1

Nanomedicine-30

Neurodegenerative Disease-72

Neuropharmacology-112

Neuroscience-38

Nucleus-15

Oncogenes-8

Oncology-87

Parasitic Disease-12

Pharmacogenomics-14

Prebiotic Evolution-2

Protein-12

Reproductive Biology-59

RNA-152

Signal Transduction-186

Stem Cells-80

Surgery-37

T-Cell Activation-12

Tissue Engineering-116

Transplant-51

Vaccines-82

Viruses-85

Chapter category: Drug Design

Synopsis and Perspectives

Chapter authors:
Guilherme Suarez-Kurtz

“P harmacogenetics deals with pharmacological responses and their modification by hereditary influences”. This definition, offered by Werner Kalow in the first book dedicated to pharmacogenetics,1 highlights the three pillars of this discipline: pharmacology, genetics and human diversity. Pharmacogenetics has evolved greatly over the 50 years elapsed since Kalow´s book was published, was rechristened as pharmacogenomics in the fashion of the “omics” revolution, but its conceptual development and praxis remain contingent upon a better understanding of human genomic diversity and its impact on drug pharmacokinetics and pharmacodynamics. The evolution and structure of human genetic diversity has been reviewed in this book by Sergio Pena (Chapter 2),2 who presented three models: The first, essentially typological, is based on the partition of humanity into races, visualized as being very different from each other, but internally homogeneous; the second, proposes a division into (continental) populations rather than races; the third, labeled the variable mosaic genome-VMG-paradigm, stresses individuality rather than membership in population categories based on race, ethnicity or geographical origin.2 I would suggest that most pharmacogenetics/-genomics (PGx) studies continue to be performed, and their data analyzed, reported and fed into databases, in consonance with either the first or the second models described by Pena.2 A caveat with this approach is that either model is a poor descriptor of admixed populations—which are the focus of this book—since genetic admixture is best modeled as a continuous variable, consistent with the VGM paradigm.2,3 The individual uniqueness that is central to this paradigm implies that “each person must be treated as an individual. rather than as an exemplar of a race”4 or in the words of Howard McLeod (Chapter 4),5 “data from ethnic groups will not be as useful as analysis of individuals patients. While knowledge of ethnic differences may be relevant to much of the world´s population, its usefulness is significantly limited in situations of extensive genetic mixing”. Rashmi Shah (Chapter 12)6 predicts that “with increasing global migration and the resulting admixing of different ethnic populations, the challenge in the future will be even greater”.

Guilherme Suarez-Kurtz
Instituto Nacional de Câncer
Rio de Janeiro, Brasil

» Access chapter for $19

Additional chapters from this book: