Vitamins behave in a wide variety of ways inside the human body. Vitamin K, for instance, is significant for the role it plays in the biology of living systems. It is basically a cofactor involved in the synthesis of γ- carboxy-glutamic acid. The amino acid is linked with the structural and functional properties of at least 14 different proteins. Many of these proteins are linked with blood clotting factors.
This shows the link that starts off with Vitamin K. Interestingly, the human body cannot synthesize Vitamin K, and its acquisition within the body must be achieved through dietary products. The Vitamin K pathways essentially include a number of enzymes that lead to the conversion of glutamic acid residues.
The discussion of pharmacogenomics becomes important because the pathway is linked with production of coagulants in our body. Anti-coagulant drugs such as Warfarin can inhibit the production of an enzyme called Vitamin K epoxide reductase (VKOR) and hinder the Vitamin K cycle. The dosage and the impact of drugs such as Warfarin can be studied in a better manner through pharmacogenomic tools.
Anti-coagulant agents and monitoring
Ever since the human genome was sequenced in 2003, a lot of interest has been shown towards the field of genomics and how it enhances our understanding of the human body from a healthcare perspective.
Each drug, depending on the family of compounds, has a specific impact on our enzyme systems as well as vitamin mediated pathways. This is where the concept of prescription drug monitoring becomes important because through evidence-based tools and information, doctors can select an appropriate drug and dosage based on a patient’s gene sequence. This allows for the creation of a balance between effective drugs and those that may have adverse effects.
The example of variable response can be understood with the example of Warfarin, which belongs to the anti-coagulant class of compound. Pharmacogenomic techniques allow the level of inhibition to be studied using the parameter of ‘prothrombin time.’
Prothrombin time refers to the time taken by the Vitamin K to allow clotting factors to work. Based on the genetics of the individual, variable reactions can be recorded. People using anti-coagulation can suffer from massive bleeding due to over re-activity or from thrombosis caused by under-activity.
Pharmacogenomics laden intervention
Pharmacogenomics helps in determining the ideal dosage, which is known as the international normalized ratio (INR). However, INR can be easily displaced by factors such as additional drugs or the intake of Vitamin K. In this case, additional Vitamin K intake may lead to inactivity of the anti-coagulant.
Pharmacogenomics has also revealed that there is a link between the reaction of the drug and our genes. There is a special complex in the liver known as cytochrome P-450. The polymorphism of gene sequences within variants can lead to two individuals having different responses after taking a similar dosage of Warfarin. Likewise, people who have a higher turnover rate of the VKOR enzyme would have a reduced drug effect.
The above info shows how people can use pharmacogenomics as a diagnostic tool for determining the appropriate amount of drug needed. The example of Warfarin is very relevant since a lot of people with cardiovascular disorders have to take anti-coagulants. This form of healthcare can be used to extract optimal benefits from therapy.
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