Pharmacogenomics of Preeclampsia therapies: Current evidence and future challenges for clinical implementation
Issued Date
2024-02-01
Resource Type
ISSN
15216934
eISSN
15321932
Scopus ID
2-s2.0-85180103632
Pubmed ID
38103508
Journal Title
Best Practice and Research: Clinical Obstetrics and Gynaecology
Volume
92
Rights Holder(s)
SCOPUS
Bibliographic Citation
Best Practice and Research: Clinical Obstetrics and Gynaecology Vol.92 (2024)
Suggested Citation
Chaemsaithong P., Biswas M., Lertrut W., Warintaksa P., Wataganara T., Poon L.C., Sukasem C. Pharmacogenomics of Preeclampsia therapies: Current evidence and future challenges for clinical implementation. Best Practice and Research: Clinical Obstetrics and Gynaecology Vol.92 (2024). doi:10.1016/j.bpobgyn.2023.102437 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95736
Title
Pharmacogenomics of Preeclampsia therapies: Current evidence and future challenges for clinical implementation
Corresponding Author(s)
Other Contributor(s)
Abstract
Preeclampsia is a pregnancy-specific disorder, and it is a leading cause of maternal and perinatal morbidity and mortality. The application of pharmacogenetics to antihypertensive agents and dose selection in women with preeclampsia is still in its infancy. No current prescribing guidelines from the clinical pharmacogenetics implementation consortium (CPIC) exist for preeclampsia. Although more studies on pharmacogenomics are underway, there is some evidence for the pharmacogenomics of preeclampsia therapies, considering both the pharmacokinetic (PK) and pharmacodynamic (PD) properties of drugs used in preeclampsia. It has been revealed that the CYP2D6*10 variant is significantly higher in women with preeclampsia who are non-responsive to labetalol compared to those who are in the responsive group. Various genetic variants of PD targets, i.e., NOS3, MMP9, MMP2, TIMP1, TIMP3, VEGF, and NAMPT, have been investigated to assess the responsiveness of antihypertensive therapies in preeclampsia management, and they indicated that certain genetic variants of MMP9, TIMP1, and NAMPT are more frequently observed in those who are non-responsive to anti-hypertensive therapies compared to those who are responsive. Further, gene–gene interactions have revealed that NAMPT, TIMP1, and MMP2 genotypes are associated with an increased risk of preeclampsia, and they are more frequently observed in the non-responsive subgroup of women with preeclampsia. The current evidence is not rigorous enough for clinical implementation; however, an institutional or regional-based retrospective analysis of audited data may help close the knowledge gap during the transitional period from a traditional approach (a “one-size-fits-all” strategy) to the pharmacogenomics of preeclampsia therapies.