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Daoud Lecture One
Overview/Definitions
50
Agriculture
3rd Grade
04/28/2013

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Term
talking about a SINGLE GENE that gets mutated and will affect the drug response (ex: p53 tumor suppressor gene)
Definition
Pharmacogenetics
Term
study of inter-individual variation in the whole genome and looking at candidate gene SNP maps, haplotype markers, and alteration in gene expression or inactivation that may be correlated with pharmacological function or therapeutic response
Definition
Pharmacogenomics
Term
based on the whole genome, we have drugs that are targeted to certain genes and based on that gene sequence in a specific patient you can have a certain drug response in that patient
Definition
Targeted Gene Therapy
Term
You can see which genes are affected by which drugs and this helps to identify if there are differences in your specific patient to avoid side effects, etc
Definition
Specific gene signatures
Term
Pharmacogenomics identifies biomarkers for diagnostic testing
Definition
identifies responders for early txt, excludes non-responders to avoid toxicities, lifts financial burden, enriches clinical trials of novel therapeutics
Term
defined as a variation in DNA sequence
Definition
Polymorphism
Term
if DNA variation present in less than 1% of population
Definition
mutation
Term
if DNA variation present in more than 1% of population
Definition
genetic polymorphism
Term
SNPs, > 1 nt change, entire gene insertion/deletion, or extra copies of a gene
Definition
Types of Polymorphism
Term
nomenclature: "VKORC2" from VKORC2 1173 C>T
Definition
identifies the gene
Term
nomenclature: "1173" from VKORC2 1173 C>T
Definition
indicates the nucleotide on the gene
Term
nomenclature: "C" from VKORC2 1173 C > T
Definition
represents the original (wild-type) nucleotide
Term
nomenclature: "T" from VKORC2 1173 C > T
Definition
represents the nucleotide that has changed to result in the SNP
Term
single database for all genetic variation information
Definition
dbSNP
Term
the variant (and wild type) forms of a gene at a particular location on a chromosome
Definition
Allele
Term
each individual carries 2 alleles of each gene; the 2 alleles that any individual has
Definition
genotype
Term
set of alleles at multiple loci or areas of a gene that coexist on the same chromosome
Definition
haplotype
Term
when a higher frequency of the set of alleles co-exist than would be predicted by random chance
Definition
linkage disequilibrium
Term
a single base substitution occurs within a gene; several million have been identified; may or may not alter protein synthesis
Definition
SNP
Term
substitution of one base for another in an exon of a gene coding for a protein, such that the produced amino acid sequence is not modified
Definition
Synonymous
Term
substitution of one base for another in an exon of a gene coding for a protein, such that the produced amino acid sequence is not modified
Definition
Synonymous
Term
a change in amino acid that may result in a conservative, semi-conservative or radical change to the protein wild-type
Definition
non-synonymous
Term
proteins that contain oligosaccharide chains covalently attached to polypeptide side-chains
Definition
glycoproteins
Term
the carbohydrate is attached to the protein in a co-translational or posttranslational modification (glycoproteins)
Definition
glycosylation (plays a role in cell-cell interactions)
Term
Synonymous: SNP P-Glycoprotein (P-gp) affected drugs
Definition
Efavirenz, Cyclosporine
Term
Non-synonymous: SNP TPMT affected drugs
Definition
Azathioprine, 6-mercaptopurine
Term
There is a decreased conversion of 6-MP to its inactive metabolite and results in an INCREASE of thioguanine nucleotides (6-TGN) an active metabolites which will affect efficacy and toxicity
Definition
TPMT*3A SNP
Term
SNP CYP2C19 ---> CYP2C19*3
Definition
Premature Stop Codon
Term
results in no enzyme activity
Definition
CYP2C19*3
Term
Premature Stop Codon (CYP2C19*3) Affected Drugs
Definition
Proton Pump Inhibitors (Omeprazole, Lansooprazole)
Term
wild-type enzyme activity: cure rate of H. pylori for wild-type alleles is only around 20-30% due to a high metabolism of PPI into inactive metabolites
Definition
CYP2C19*1/*1
Term
with somewhat reduced enzyme activity there is a slight buildup of drug and the cure rate of H. pylori is about 50-60%
Definition
CYP2C19 *1/*2 or *1/*3
Term
major decrease in enzyme activity, resulting in a 14 fold increase in drug concentration and decreased metabolite concentration-- results in almost 100% cure rate of H. pylori
Definition
CYP2C19 *2/*2 or *2/*3 or *3/*3
Term
Gene Deletion: CYP2D6 SNPs Affected Drugs
Definition
SSRIs, tamoxifen, codeine, beta-blockers
Term
not just a single nucleotide polymorphism, but thousands of nucleotide base pairs that comprise this gene are deleted
Definition
CYP2D6*5
Term
Function effect for CYP2D6*5
Definition
Loss of function (or null activity); results in a poor metabolizer phenotype, the drug is not metabolized as well and there is buildup of these drugs in their system
Term
Copy Number Variant -- extra copies of this gene are present
Definition
CYP2D6*2XN
Term
With extra copies of the CYP2D6 gene
Definition
more enzymes present to break down the drug
Term
Result of CYP2D6*2XN
Definition
ultra rapid metabolizer (UM) phenotype
Term
CYP2D6*2XN affected drugs
Definition
SSRIs, tamoxifen, codeine, beta-blockers
Term
higher frequency of the CYP2C19*3 allele
Definition
Asian populations
Term
CYP2C19*3
Definition
NO CYP2C19 activity
Term
Therapeutic Area Discussion Format
Definition
patient case, gene/allele of interest, functional effect, population prevalence, clinical relevance, genome test/testing recommendation, patient case summary
Term
human leukocyte antigen subclass B
Definition
HLA-B*5701
Term
Functional effect of HLA-B*5701
Definition
high risk of abacavir-induced hypersensitivity reaction
Term
highest prevalence of HLA-B*5701 (5-8%)
Definition
Caucasian population
Term
can accurately predict patients who may be at risk for abacavir HSR
Definition
PREDICT-1 study
Term
showed similar trend in whites and blacks; accurately predicted 100% of abacavir HSR cases
Definition
SHAPE study
Term
investigated HLA-B*5701 negative patients
Definition
ARIES study
Term
HLA typing: positive test for HLA-B*5701
Definition
confers an increased risk for HSR
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