Individualized Medicine for Epilepsy -Based on Genetic Information-
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概要
- 論文の詳細を見る
Current antiepileptic drug (AED) therapy requires trial and error in determining the most effective AED and dosage for a patient, and almost one-fourth of patients are resistant to AED therapy. The introduction of individualized medicine for epilepsy based on genetic information is a new avenue to improve current AED therapy. However, several crucial issues remain to be resolved before the development of individualized medicine for epilepsy can proceed further. The epilepsy genes responsible for common phenotypes have not yet been identified, and ongoing pharmacogenetic studies continue to search for an explanation of why 25 to 30% of patients do not respond to AEDs. There is no convincing clinical evidence indicating the impact of P-glycoprotein on prediction of clinical response. This article provides a critical review of the status and perspectives for the development of individualized medicine for epilepsy based on genetic polymorphisms/mutations in relation to core elements such as pharmacodynamic pathway, pharmacokinetic pathway, prediction of idiosyncratic reaction to AED, and mechanisms of action of AEDs.
著者
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Kaneko Sunao
Department Of Neuropsychiatry Hirosaki University
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Iwasa Hiroto
Department Of Neuro-psychiatry School Of Medicine Hirosaki University
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Liu Fang
Department Of Analysis Of Traditional Chinese Medicine School Of Traditional Chinese Medicine Shenya
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Yoshida Shuichi
Department Of Neuropsychiatory Hirosaki University Graduate School Of Medicine
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CHEN Lei
Department of Aging Biology, Institute on Aging and Adaptation, Shinshu University Graduate School of Medicine
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Sugawara Takayuki
Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Japan
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Saruwatari Junji
Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Japan
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Japan The
The Epilepsy Genetic Study Group, Japan
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Liu Fang
Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Japan
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