Pharmacogenetics and Individualizing Drug Treatment During Pregnancy

Haas, David M.

doi:10.2217/pgs.13.228

Cited by 21 publications

(9 citation statements)

References 92 publications

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“…The advent of individualized therapeutics and diagnostics are forcing this conversation to accelerate. 372 In addition, the utilization of biorepositories can help stimulate this translational process by focusing on potential pooled resources and collaborations.…”

Section: Identification Of Potentially Useful or Experimental Drmentioning

confidence: 99%

Placental origins of adverse pregnancy outcomes: potential molecular targets: an Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development

Ilekis

Tsilou

Fisher

et al. 2016

American Journal of Obstetrics and Gynecology

237

167

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Although much progress is being made in understanding the molecular pathways in the placenta involved in the pathophysiology of pregnancy related disorders, a significant gap exists in utilizing this information for developing new drug therapies to improve pregnancy outcome. On March 5–6, 2015, the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health sponsored a two day workshop titled Placental Origins of Adverse Pregnancy Outcomes: Potential Molecular Targets to begin to address this gap. Particular emphasis was given in the identification of important molecular pathways that could serve as drug targets and the advantages and disadvantages of targeting these particular pathways. This article is a summary of the proceedings of this workshop. A broad number of topics were covered ranging from basic placental biology to clinical trials. This included research in the basic biology of placentation, such as trophoblast migration and spiral artery remodeling, and trophoblast sensing and response to infectious and non-infectious agents. Research findings in these areas will be critical for formulating developing future treatments and developing therapies for the prevention of a number of pregnancy disorders of placental origin including preeclampsia, fetal growth restriction, and uterine inflammation. Research was also presented summarizing ongoing clinical efforts in the U.S. and in Europe testing novel interventions for preeclampsia and fetal growth restriction, including agents such as oral arginine supplementation, sildenafil, pravastatin, gene therapy using virally-delivered vascular endothelial growth factor, and oxygen supplementation therapy. Strategies were also proposed to improve fetal growth by enhancing nutrient transport to the fetus by modulating their placental transporters, as well as targeting placental mitochondrial dysfunction and oxidative stress to improve placental health. The roles of microRNAs and placental-derived exosomes, as well as messenger RNAs, were also discussed in the context of their use for diagnostics and as drug targets. The workshop discussed the aspect of safety and pharmacokinetic profiles of potential existing and new therapeutics that will need to be determined especially in the context of the unique pharmacokinetic properties of pregnancy, as well as the hurdles and pitfalls of translating research findings into practice. The workshop also discussed novel methods of drug delivery and targeting during pregnancy using macromolecular carriers, such as nanoparticles and biopolymers, to minimize placental drug transfer and hence fetal drug exposure. In closing, a major theme that developed from the workshop was that the scientific community needs to change their thinking of the pregnant women and her fetus as a vulnerable patient population for which drug development should be avoided, but rather thought of as a deprived population in need of more effective therapeutic interventions.

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Section: Identification Of Potentially Useful or Experimental Drmentioning

confidence: 99%

Placental origins of adverse pregnancy outcomes: potential molecular targets: an Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development

Ilekis

Tsilou

Fisher

et al. 2016

American Journal of Obstetrics and Gynecology

237

167

View full text Add to dashboard Cite

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“…The goal of these new sciences is to better apply the knowledge of genome in medical practice, improving the treatment and the drug response. Nowadays, it is possible in several fields of application such as, first of all, for antineoplastic and immunomodulatory drugs [14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Personalized Medicine and Adverse Drug Reactions: The Experience of An Italian Teaching Hospital

Russa

Fineschi

Sanzo

et al. 2017

CPB

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“…In addition, the advent of pharmacogenomics and accounting for drug metabolizing enzyme and transporter changes in pregnancy may aid in developing therapeutic models for these drugs in pregnancy. 85 Many of the psychotropic drugs are metabolized by enzymes that are impacted by commonly prescribed medications in pregnancy, such as antacids, gastrointestinal medications, and cardiovascular drugs (http://medicine.iupui.edu/CLINPHARM/ ddis/main-table). Because so many pregnant women take multiple medications, it is important to take all these factors into consideration when prescribing or continuing a psychotropic medication.…”

Section: Discussionmentioning

confidence: 99%

Psychotropic Medications in Pregnancy and the Postpartum Period

Haas

McHugh

Durst

et al. 2015

Clinical Medicine Insights: Therapeutics

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Many pregnant women suffer from mental health conditions while pregnant. As providers and patients make decisions about risks of the conditions and treatments during pregnancy, information to populate those discussions is needed. Taking into account the physiologic changes in pregnancy, we may need to optimize medication therapy. This article reviews and summarizes some of the most common mental health conditions suffered in pregnancy: depression, bipolar disorder, anxiety, and psychosis. It further discusses the different medications used to treat them, as well as risks associated with these medications.

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Pharmacogenetics and Individualizing Drug Treatment During Pregnancy

Cited by 21 publications

References 92 publications

Placental origins of adverse pregnancy outcomes: potential molecular targets: an Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development

Placental origins of adverse pregnancy outcomes: potential molecular targets: an Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development

Personalized Medicine and Adverse Drug Reactions: The Experience of An Italian Teaching Hospital

Psychotropic Medications in Pregnancy and the Postpartum Period

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