Genetic and Environmental factors

Pharmacogenomics may help to explain much of the variation in response to medications, but it will not explain all of the difference. Drug interactions, age, nutrition, renal and liver function, and a variety of environmental factors influence the essential pharmocodynamics and pharmacokinetics of drug response (Evans and Relling, 1999; Omenn, 2001). Thus, to understand the role of genetic factors, it will also be necessary to study the effects of environmental factors, both individually and in combination. Only with greater knowledge about the role of both genetic and environmental factors will it be possible to develop drug response profiles for individual patients as well as patient-specific prevention strategies.

The National Institute of General Medical Sciences (NIGMS) of the NIH has initiated the Pharmacogenetics Research Network focusing on the study of "how genes affect the way people respond to medicines." NIGMS defines the ultimate goal of pharmacogenetics research as helping physicians tailor doses of medicines to a person's unique genetic makeup, thereby making medicines safer and more effective for everyone. Information regarding pharmacogenetic research is available at http://www.nigms.nih.gov/pharmacogenetics/index.html.

The National Institute of Environmental Health Sciences (NIEHS) within the NIH is the lead institute for the Environmental Genome Project (EGP). Relying on technology developed by the HGP, the goal of the EGP is to identify polymorphisms of environmental disease susceptibility, develop a central database of these polymorphisms, and foster population-based studies of gene-environment interaction in disease etiology (NIEHS, 2001). Although the EGP is more concerned with toxicology than pharmacology, broad scientific understanding of gene-environment interaction will have widespread applicability, including in pharmacogenomics.

Additional information regarding progress of the EGP is available at http://www.niehs.nih.gov/envgenom/home.htm.

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