La pharmaco-toxicogénétique et ses applications médicales

Pharmacogenetics is defined as the study of interin-dividual variability, of genetic origin, in drug response. The aim of this discipline is to better understand and, furthermore, to predict the occurrence of inadequate response (adverse effects or therapeutic failure) to standard dosages of drugs in certain individuals. In this context, the ultimate goal of pharmacogenetics is the individualization of drug treatments, both in terms of efficacy and safety. By extension, toxicogenetics can be considered as a sub-discipline of pharmacogenetics, being restricted to the field of acute or chronic toxicity of drugs, but also of all xenobiotics to which humans are exposed. Numerous polymorphisms in genes encoding drug-metabolising enzymes, trans-porters, pharmacological targets or even xenosensors have been described and their consequences on the disposition and effects of a substantial number of xenobiotics have been elucidated. After presentation of general aspects and associated methodologies, a few examples of current medical applications of pharmaco/toxicogenetics will illustrate the relevance of this discipline for patient-tailored drug therapy, as well as its development in other medical areas, such as forensic toxicology.