Germline genetic variants with implications for disease risk and therapeutic outcomes

Physiol Genomics. 2017 Oct 1;49(10):567-581. doi: 10.1152/physiolgenomics.00035.2017. Epub 2017 Sep 8.

Abstract

Genetic testing has multiple clinical applications including disease risk assessment, diagnosis, and pharmacogenomics. Pharmacogenomics can be utilized to predict whether a pharmacologic therapy will be effective or to identify patients at risk for treatment-related toxicity. Although genetic tests are typically ordered for a distinct clinical purpose, the genetic variants that are found may have additional implications for either disease or pharmacology. This review will address multiple examples of germline genetic variants that are informative for both disease and pharmacogenomics. The discussed relationships are diverse. Some of the agents are targeted for the disease-causing genetic variant, while others, although not targeted therapies, have implications for the disease they are used to treat. It is also possible that the disease implications of a genetic variant are unrelated to the pharmacogenomic implications. Some of these examples are considered clinically actionable pharmacogenes, with evidence-based, pharmacologic treatment recommendations, while others are still investigative as areas for additional research. It is important that clinicians are aware of both the disease and pharmacogenomic associations of these germline genetic variants to ensure patients are receiving comprehensive personalized care.

Keywords: ADBR1; BRCA; CFTR; CMT genes; COMT; G6PD; INFL3; RYR1; UGT1A1; disease genetics; genetics; pharmacogenetics; pharmacogenomics.

Publication types

  • Review

MeSH terms

  • Catechol O-Methyltransferase / genetics
  • Charcot-Marie-Tooth Disease / genetics
  • Cystic Fibrosis Transmembrane Conductance Regulator / genetics
  • Drug-Related Side Effects and Adverse Reactions / genetics*
  • Genes, BRCA1
  • Genes, BRCA2
  • Genetic Predisposition to Disease
  • Genetic Variation
  • Germ-Line Mutation*
  • Glucosephosphate Dehydrogenase / genetics
  • Glucuronosyltransferase / genetics
  • Humans
  • Interferons
  • Interleukins / genetics
  • Molecular Targeted Therapy / methods
  • Pharmacogenetics / methods*
  • Receptors, Adrenergic, beta-1 / genetics
  • Ryanodine Receptor Calcium Release Channel / genetics

Substances

  • ADRB1 protein, human
  • CFTR protein, human
  • interferon-lambda, human
  • Interleukins
  • Receptors, Adrenergic, beta-1
  • Ryanodine Receptor Calcium Release Channel
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Interferons
  • Glucosephosphate Dehydrogenase
  • COMT protein, human
  • Catechol O-Methyltransferase
  • UGT1A1 enzyme
  • Glucuronosyltransferase