Pharmacogenomics Leveraging “omics” to Improve Treatment Response

Pharmacogenomics is relevant worldwide for modern therapeutics and yet needs further uptake in developing countries. There is paucity of studies with a naturalistic design in real-life clinical practice in patients with comorbidities and multiple drug treatments. To evaluate the role and impact of host underlying genetics on treatment response, different approaches are used depending on existing levels of understanding on the functional significance of genetic variants in question. This lecture showcases the work done pharmacogenomics research and how this has occurred in Africa and how “omics” is being leveraged. Our approach focuses on common disease conditions and commonly used medications including herbal medicinal plants.

We report on antiretroviral therapy and other treatments alter microRNA expression signatures and expression of drug-metabolizing enzyme genes, in vitro. These data point to several important clinical implications through changes in drug/drug interaction risks and achieving optimal therapeutics.  Thus, differential expression of microRNAs after treatment with EFV and RMP adds another layer of complexity that should be incorporated in pharmacogenomic algorithms to render drug response more predictable. The lecture will reflect also on pharmacogenomics of herbal medicines, and interaction with conventional drugs.  There is a trend of important genes and their variants coming being prominent biomarkers for responses for commonly used drugs. The use of a wholistic approach in pharmacogenomics research translation that transcends disciplinary boundaries incorporating different “omics” ultimately leading to precision medicine.