组学标志物在华法林个体化治疗中的研究进展

Advances of omics biomarkers in individualized warfarin therapy

华法林是用于防治静脉和动脉血栓栓塞性疾病最为广泛的抗凝药物,其治疗窗窄、个体药效差异大,一直以来都是个体化用药关注的焦点。同等剂量的华法林对于不同患者可能出现剂量不足达不到抗凝疗效,或剂量过大而引发出血的不同治疗反应。对于华法林剂量的预测,即使联合基因组学,也有50%的剂量差异得不到解释。近年来,随着多组学技术的发展,代谢组学和微生物组学为实现华法林个体化治疗提供了新的机会。深入了解患者的代谢物谱和肠道微生物群,可更准确预测患者的华法林剂量需求,从而改善治疗效果,减少不良反应的风险。文章主要对与华法林个体化治疗相关的代谢组学和微生物组学标志物进行综述。

Warfarin is the most widely used anticoagulant drug for the prevention and treatment of venous and arterial thromboembolic diseases.It has a narrow therapeutic window and significant individual differences in drug efficacy,making it a focus in individualized medication.The same dosage of warfarin can lead to inadequate anticoagulation or excessive bleeding in different patients due to varying therapeutic responses.For the predictionof Warfarin dosage,even with the combination of genomics,about 50%of the dosage variance remains unexplained.In recent years,with the development of multi-omics technologies,metabolomics and microbiomics have offered new opportunities for individualized warfarin therapy.Through a deeper understanding of patients′metabolomic profiles and gut microbiota,it can more accurately predict individual warfarin dosage requirements,thereby improving therapeutic effects and reducing the risk of adverse reactions.The paper mainly reviews metabolomics and microbiomics biomarkers related to individualized warfarin therapy.