An updated examination of the perception of barriers for pharmacogenomics implementation and the usefulness of drug/gene pairs in Latin America and the Caribbean.

Autor:	Salas-Hernández A; Department of Pharmacology, Toxicology and Pharmaco-Dependence, Faculty of Pharmacy, University of Costa Rica, San Jose, Costa Rica., Galleguillos M; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile., Carrasco M; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile., López-Cortés A; Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Américas, Quito, Ecuador., Redal MA; Molecular Diagnostic Laboratory, Genetics Division, Faculty of Medicine, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina., Fonseca-Mendoza D; Universidad del Rosario, School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Bogotá, Colombia., Esperón P; Molecular Genetic Unit, School of Chemistry, Universidad de la República, General Flores, CP 1800 2124, Montevideo, Uruguay., González-Martínez F; Toxicology and Public Health Research Laboratory, Department of Research, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia., Lares-Asseff I; Academy of Genomics and Laboratory of Pharmacogenomics and Molecular Biomedicine, Instituto Politécnico Nacional, CIIDIR-Unidad Durango, Durango, Mexico., Lazarowski A; Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires- Argentina, Buenos Aires, Argentina., Loera-Castañeda V; Academy of Genomics and Laboratory of Pharmacogenomics and Molecular Biomedicine, Instituto Politécnico Nacional, CIIDIR-Unidad Durango, Durango, Mexico., Remírez D; National Centre for Quality Control of Drugs, La Havana, Cuba., Martínez MF; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile.; Department of Pharmaceutical Sciences and Technology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile., Vargas R; Department of Molecular Biology, Galileo University, Guatemala City, Guatemala., Rios-Santos F; Department of Health. Faculty of Medicine, Federal University of Mato Grosso (UFMT), Cuibá, Brazil., Macho A; Morphology and Applied Immunology Research Center (NuPMIA), University of Brasilia (UnB), Brasília, Brazil., Cayún JP; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile., Perez GR; Department of Microbiology, Faculty of Biochemical and Pharmaceutical Sciences. National University of Rosario, Rosario, Argentina., Gutierrez C; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile., Cerpa LC; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile., Leiva T; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile., Calfunao S; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile.; Laboratory Pathological Anatomy, Hospital Luis Calvo Mackenna, Santiago, Chile., Xajil L; Department of Research in Pharmacogenomics, Faculty of Chemical Sciences and Pharmacy, University of San Carlos de Guatemala, Guatemala, Guatemala., Sandoval C; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile.; Clinical Laboratory Blood Biochemistry and Immunoassay Section, Hospital Clínico Félix Bulnes Cerda, Santiago, Chile., Suárez M; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile.; Pharmacy Service, Hospital UC-Christus, Santiago, Chile., Gonzalez A; Medical Genetics Platform, Santa Fe, Argentina., Echeverría-Garcés G; Facultad de Ciencias de La Salud, Universidad Internacional de Valencia, Valencia, España., Sullón-Dextre L; Sociedad de Farmacología Molecular del Perú, Lima, Perú., Cordero-García E; Department of Pharmacology, Toxicology and Pharmaco-Dependence, Faculty of Pharmacy, University of Costa Rica, San Jose, Costa Rica., Morales AR; Department of Toxicology and Pharmacology, Faculty of Pharmacy and Bioanalisis, University of Los Andes, Merida, Venezuela., Avendaño A; Department of Pediatrics, Medical Genetics Unity, Faculty of Medicine, University of Los Andes, Mérida, Venezuela., Sánchez E; Vivian Pellas Hospital, Managua, Nicaragua., Bastone LC; Laboratorio de Medicina Genómica, Gammalab, Grupo Gamma, Rosario, Argentina., Lara C; Betesda La Alternativa Natural, San José, Costa Rica., Zuluaga-Arias P; Colombian Association of Pharmacovigilance, Bogotá, Colombia., Soler AM; Laboratorio de Genética Molecular Humana, Departamento de Ciencias Biológicas, Universidad de La República, Montevideo, Uruguay., Da Luz J; Laboratorio de Genética Molecular Humana, Departamento de Ciencias Biológicas, Universidad de La República, Montevideo, Uruguay., Burgueño-Rodríguez G; Laboratorio de Genética Molecular Humana, Departamento de Ciencias Biológicas, Universidad de La República, Montevideo, Uruguay., Vital M; Molecular Genetic Unit, School of Chemistry, Universidad de la República, General Flores 2124, Montevideo, Uruguay., Reyes-Reyes E; Clinical Experimental Pharmacology Section, Teaching and Research Department, Institute of Oncology and Radiobiology, Havana, Cuba., Huaccha A; Pharmacy Service, Hospital II 1 Moyobamba, San Martín, Perú., Ariza YV; Pharmaceutical Chemistry Program, El Bosque University, Bogotá, Colombia., Tzul N; Drug Inspectorate Unit, Ministry of Health and Wellness, Belmopan, Belize., Rendón AL; Department of Pharmaceutical Technology, National Autonomous University of Honduras, Tegucigalpa, Honduras., Serrano R; PhV Latam, San Salvador, El Salvador., Acosta L; Faculty of Biology, Chemistry and Pharmacy, Galileo University, Guatemala, Guatemala., Motta-Pardo A; GENOBIDC, Faculty of Pharmacy and Biochemistry, Universidad Nacional Mayor de San Marcos (UNMSM), CIGBM, Faculty of Medicine, Universidad de San Martin de Porres (USMP), Lima, Peru., Beltrán-Angarita L; Faculty of Heath Sciences, Central Unit of Valle del Cauca, Tuluá, Colombia.; Chemistry School, Universidad Tecnológica de Pereira, Pereira, Colombia., Brand E; Postgraduate Department, Master's Degree in Immunology, Universidad Cayetano Heredia, Lima, Perú., Jiménez MA; Clinical Pharmaceutical Services, Health Division, Chillán, Chile., Hidalgo-Lozada GM; Department of Physiology, Health Sciences University Center, University of Guadalajara, Guadalajara, Mexico., Romero-Prado MMJ; Department of Physiology, Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico., Escobar-Castro K; Laboratory of Histocompatibility and Immunogenetics, Department of Nephrology and Transplant, Hospital General San Juan de Dios, Guatemala, Guatemala., Umaña-Rivas M; Department of Tropical Medicine, Faculty of Medicine, University of Brasília, Brasília, Brazil., Vivas JD; Department of Clinical Pharmacology, Faculty of Medicine, University of La Sabana, Chía, Colombia., Lagos P; Recombinant Biopharmaceutical Laboratory, Department of Pharmacology, Faculty of Biological Sciences, University of Concepción, Concepción, Chile., Martínez YB; Medical Specialist in Epidemiology Clinical Pharmacology Teacher; Medical Scientific and Pharmacovigilance Advisor in the Pharmaceutical Industry, Bogotá, Colombia., Quesada S; Faculty of Pharmacy, University of Costa Rica, San Jose, Costa Rica., Calfio C; International Center for Biomedicine ICC, Santiago, Chile., Arias ML; Tropical Diseases Research Center and Microbiology Faculty, University of Costa Rica, San José, Costa Rica., Lavanderos MA; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile., Cáceres DD; Environmental Health Programme, School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile., Salazar-Granara A; Universidad de San Martín de Porres, Facultad de Medicina Humana, Centro de Investigación de Medicina Tradicional y Farmacología, Lima, Perú., Varela NM; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile., Quiñones LA; Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago, Chile.; Department of Pharmaceutical Sciences and Technology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile.
Jazyk:	angličtina
Zdroj:	Frontiers in pharmacology [Front Pharmacol] 2023 May 11; Vol. 14, pp. 1175737. Date of Electronic Publication: 2023 May 11 (Print Publication: 2023).
DOI:	10.3389/fphar.2023.1175737
Abstrakt:	Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region's continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the "need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics". Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%-99%) gene/drug pairs perceived as important were CYP2D6 /tamoxifen, CYP3A5 /tacrolimus, CYP2D6 /opioids, DPYD /fluoropyrimidines, TMPT /thiopurines, CYP2D6 /tricyclic antidepressants, CYP2C19 /tricyclic antidepressants, NUDT15 /thiopurines, CYP2B6 /efavirenz, and CYP2C19 /clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Salas-Hernández, Galleguillos, Carrasco, López-Cortés, Redal, Fonseca-Mendoza, Esperón, González-Martínez, Lares-Asseff, Lazarowski, Loera-Castañeda, Remírez, Martínez, Vargas, Rios-Santos, Macho, Cayún, Perez, Gutierrez, Cerpa, Leiva, Calfunao, Xajil, Sandoval, Suárez, Gonzalez, Echeverría-Garcés, Sullón-Dextre, Cordero-García, Morales, Avendaño, Sánchez, Bastone, Lara, Zuluaga-Arias, Soler, Da Luz, Burgueño-Rodríguez, Vital, Reyes-Reyes, Huaccha, Ariza, Tzul, Rendón, Serrano, Acosta, Motta-Pardo, Beltrán-Angarita, Brand, Jiménez, Hidalgo-Lozada, Romero-Prado, Escobar-Castro, Umaña-Rivas, Vivas, Lagos, Martínez, Quesada, Calfio, Arias, Lavanderos, Cáceres, Salazar-Granara, Varela and Quiñones.)
Databáze:	MEDLINE
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