Following the 1995 Audit Commission into the standard of hospital records within the NHS, the UK government invested heavily in information technology. This investment has helped change radically the way in which information on routine clinical care is recorded. Now, James Mackay and Ailsa Taylor of The Doctors Organisation for Clinical Studies based in London, say that, despite technical issues with the original IT technology, the system has accumulated a vast amount of potentially invaluable data.
The coupling of this medical data resource with e-Science technologies built with Medical Research Council funding presents a unique opportunity to carry out large-scale pharmacogenetic studies of drug effectiveness and safety for important diseases, such as cancer.
"Many of the ingredients required to start the process of obtaining new knowledge from routinely collected clinical data are already in place," the researchers explain, "However, the vast majority of clinicians and other health professionals are completely unaware of the potential and what progress might be made in a very short time, rather than waiting decades."
Pharmacogenetics is one of the fastest growing areas of medical research because individuals respond to different drugs in different ways. Tiny variations in a person's genetic make up, known as SNPs, single nucleotide polymorphisms, change the structure of key metabolic enzymes in subtle ways. Such changes mean that not all drugs work in the same way for everyone.
For instance, people with a SNP associated with the liver enzyme cytochrome P450 cannot process the common painkiller paracetamol into its active form in their bodies. This makes the drug totally ineffective in those people. SNPs also exist for the metabolic enzymes and protein receptors associated with chemotherapy drugs for cancer and can have subtle or devastating effects.
Doctors would like to know in advance whether particular patients with different genetic backgrounds or ethnic groups have a SNP associated with inactivity of such drugs. Moreover, the presence of certain SNPs in particular patients can make them more susceptible to a drug's side effects or potentially lead to adverse drug reactions. Knowing in advance how a patient might respond to a drug, would give doctors the opportunity to choose an alternative drug or therapy that is not doomed to failure in those patients.
Mackay and Taylor detail the various known SNPs associated with particular drugs. Variations in the cytochrome P450 that makes paracetamol ineffective for some people, also has an effect on how quickly patients respond to a wide range of antidepressants as well as the anticoagulant warfarin used to prevent clotting in heart patients. The team also explains how more than half of Caucasian HIV/AIDS patients who suffer side-effects caused by the antiviral drug abacavir carry a SNP that affects their white blood cells. Testing for the SNP in advance of prescribing the drug could improve outcomes for many AIDS patients.
There are also several examples of how IT coupled with genetics has allowed medical scientists to home in on particular SNPs associated with a positive response to a drug, such as Glivec in chronic myeloid leukaemia. The researchers suggest that, "The rapidly advancing field of genetics has opened up a number of opportunities in medical research likely to significantly impact future clinical practice, including the prescription of drugs based on a patient's genes." They add, "Opportunities to learn new knowledge from routinely collected clinical data held within NHS databases, are very valuable, and should be encouraged."
Jim Corlett | alfa
Hot cars can hit deadly temperatures in as little as one hour
24.05.2018 | Arizona State University
3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg
The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.
Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...
A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.
The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...
At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.
At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...
There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?
At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...
So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics
Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...
25.05.2018 | Event News
02.05.2018 | Event News
13.04.2018 | Event News
25.05.2018 | Event News
25.05.2018 | Machine Engineering
25.05.2018 | Life Sciences