Personalized Medicine: The Potential and Challenges presented by Genetic Technology

processes underlying the pathogenesis and progression of diseases and the response to treatment. For instance, differences in sensitivity to warfarin among patients that lead to differences in the dose required for effectiveness, have been attributed to polymorphism in the genes encoding cytochrome P-450 2C9 enzyme (CYP2C9) and vitamin K epoxide reductase (VKORC1) (Schwarz et al., 2008). The two enzymes play critical roles in the metabolism of warfarin and formation of essential cofactors in the clotting cascade. The variation of treatment outcomes arising from variation in genes has made genetic technology a critical tool in the development of personalized medicine. However, challenges such as incomplete knowledge of the molecular genetics of identified gene variants that are potential markers for classifying populations (Saade, 2011), have limited the extent to which gene technology can be leveraged for development of personalized medicine. This paper considers the application of modern genetic technology in development of personalized medicine, benefits of personalized medicine and the challenges in the use of gene technology to develop personalized medicine.

The concept of personalized medicine envisages the development of therapies tailored to meet the individual characteristics of a patient thus leading to better therapies (Bates, 2010). However, the aim is not to make therapies unique to every patient but to classify populations “into subpopulations that differ in their susceptibility to a particular disease or their response to a specific treatment” (Bates, 2010, p. 116). In this respect, modern genetic technology offers various potentials for development of personalized medicine. For instance, DNA technologies help in the identification of biomarkers that facilitate the classification of individuals into responders and non-responders for a particular medication. Such technologies include glass and nylon microarray systems that enable characterization of expression levels of various genes from different individuals and high throughput technologies used in the discovery of DNA polymorphism and single nucleotide polymorphism (SNP) (Meyer & Ginsburg, 2002). Biomarkers identified through such technologies are critical in guiding therapies to fit individual characteristics in a variety of ways. For instance, biomarkers that relate to drug-metabolism enzymes (e.g. CYP enzymes) and membrane transporters (e.g. MDR1) are critical in determining optimal doses and avoiding toxicity (Saade, 2011). Conversely, biomarkers that identify polymorphism in genes coding for receptors and signaling-pathway components are potent guides to the class of drug to be administered (Saade, 2011). Proceed to benefits and drawbacks of personalized medicine

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