Genetic susceptibility to teratogens: State of the art

There is evidence that the susceptibility to the teratogenic effect of drugs within human populations varies extremely from one individual to another, even after identical exposures. One of the factors that may explain these interindividual differences is the genetic makeup in the pharmacokinetics and pharmacodynamics of the respective drugs. In fact, both maternal and embryonic/fetal genotypes can affect placental transport, absorption, metabolism, distribution and receptor binding of an agent, influencing its teratogenicity. We have reviewed the literature and commented on the reported correlations between genetic factors and drug-induced birth defects. There is still a clear lack of knowledge regarding this issue and the available data are often conflicting. However, the identification of specific polymorphisms associated with predisposition to teratogenesis may allow in the future the development of personalized non-teratogenic therapies for pregnant women.

► Drug-induced teratogenicity is related to both maternal and fetal genetic variants.
► There is still a clear lack of knowledge regarding the genetic risk factors.
► Few epidemiological studies in humans have been reported.
► Few genetic polymorphisms have been suggested to give susceptibility.
► The identification of specific polymorphisms may allow non-teratogenic therapies.