January 16, 2009

Doctors to tailor dose by your smart card

You may have heard of a smart card with biometric features, but soon those visiting a physician will carry one bearing their genetic
profile, making it possible for the doctor to prescribe the medicine best suited to the patient.

So those suffering from hypertension, and whose blood pressure can't be controlled, won't have to consult a doctor time and again until a medicine and dosage works for them.

It's goodbye to the hit and trial method of trying out various drug combinations. This controlled method of medicines being tailor-made according to the genetic make-up will also mean the end of allergies associated with particular drugs.

KK Kohli, professor, department of biochemistry, PGI, has studied working of an enzyme and its effect on how a drug works on patients with diabetes, epilepsy, depression and gastritis. Explaining the process, he said the recovery from a disease depends on the level of drug absorbed. And more the absorption, better the chances of recovery. Those individuals who have a faster rate of metabolizing drugs have lower absorption of medicine as compared to people with slow rates.

Kohli found that 88% of North Indians had less absorption of drugs in blood and 12% had slow rate of drug assimilation in the blood stream. And, the enzyme responsible for drugs and rate of their absorption and efficacy of medicines is cytochrome P450 2C19. "This enzyme affects the working of antidepressants, antiepileptic and antidiabetic drugs," he added. This in turn implies that levels of this enzyme in the body determine how effectively it will work on patients.

As every patient responds in a different way to medicines, the genetic design can help doctors decide the right dosage and drug as per requirement.

"This is futuristic medicine whereby it is expected that a smart card of genetic profile carried by the patient can help the physicians prescribe medicines," added Pallab Ray, department of microbiology, PGI. Kohli has worked on this enzyme for gastritis patients in collaboration with the hepatology and gastroenterology department, PGI. Now, he is planning a similar study on hypertension and heart patients.

Enumerating the benefits of personalized medicine, especially for cancer patients, Kohli pointed out that if the metabolic status of an individual is known prior to chemotherapy, optimum dose can be prescribed for better therapeutic outcome

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