FARMACOGENÉTICA NA AMÉRICA LATINA

Autores

  • Mariana Meira Scudeler Universidade Federal do Triângulo Mineiro
    • Fernanda Rodrigues-Soares Universidade Federal do Triângulo Mineiro

      DOI:

      https://doi.org/10.18554/acbiobras.v3i2.8748

      Palavras-chave:

      ancestralidade, miscigenação, medicina personalizada

      Resumo

      A farmacogenética é uma especialidade que estuda a relação entre os polimorfismos genéticos e a variabilidade interindividual na resposta a fármacos. Esta área é parte da chamada ''medicina personalizada'', baseando-se no perfil genético de cada paciente para uma prescrição farmacológica individualizada e, portanto, mais precisa. Levando em conta que a frequência das variantes genéticas pode ser associada com ancestralidade, é possível que esta seja também associada com a resposta a fármacos. Na América Latina, as populações são originárias de um processo de miscigenação entre nativo-americanos, africanos e europeus; desse modo, as raízes étnicas populacionais são heterogêneas e se distribuem em diferentes proporções ao se comparar países e até mesmo diferentes regiões de um mesmo país. A partir da heterogeneidade dessas populações, a implementação clínica da farmacogenética se torna mais complexa, pois se trata de indivíduos sub-representados nos estudos farmacogenéticos. Iniciativas como a Rede Iberoamericana de Farmacogenética e Farmacogenômica e a Rede Nacional de Farmacogenética têm surgido com o propósito de mudar este cenário ao promover a inclusão de populações latinas nas pesquisas farmacogenéticas, além de atuarem no desenvolvimento de simpósios e cursos educativos. Apesar disso, existem desafios a serem ainda transpassados. Através de esforços colaborativos, seria possível que a farmacogenética cumprisse seu propósito ao impactar positivamente a saúde pública mundialmente, possibilitando tratamentos mais eficazes e seguros em um contexto individual e específico.

      Referências

      1. Borges-Osório MR, Robinson WM. 2013. Genética Humana. 3a ed. Porto Alegre; 2013. p.

      2. Stanek EJ, Sanders CL, Taber KAJ, Khalid M, Patel A, Verbrugge RR, et al. 2012. Adoption of Pharmacogenomic Testing by US Physicians: Results of a Nationwide Survey. Clin Pharmacol Ther [Internet]. 91(3):450–8. Available from: http://dx.doi.org/10.1038/clpt.2011.306/nature06264

      3. Ansolin PL, Damin DC, Alexandre COP. 2010. Polimorfismos das isoformas M1, T1 e P1 da glutationa S-transferase e associação com os aspectos clínico-patológicas no carcinoma colorretal. Rev Bras Coloproctol [Internet]. 30(3):281–8. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-98802010000300003&lng=pt&tlng=pt

      4. Nussbaum RL. 2019. Thompson & Thompson Genética Médica. 8a ed. Rio de Janeiro: GEN Guanabara Koogan; 2019.

      5. Sosa-Macías M, LLerena A. 2013. Cytochrome P450 genetic polymorphisms of Mexican indigenous populations. Drug Metabol Drug Interact [Internet]. 28(4):193–208. Available from: https://www.degruyter.com/view/j/dmdi.2013.28.issue-4/dmdi-2013-0037/dmdi-2013-0037.xml

      6. Suarez-Kurtz G. 2010. Pharmacogenetics in the Brazilian Population. Front Pharmacol [Internet]. 1(October):1–10. Available from: http://journal.frontiersin.org/article/10.3389/fphar.2010.00118/abstract

      7. Ma Q, Lu AYH. 2011. Pharmacogenetics, Pharmacogenomics, and Individualized Medicine. Sibley DR, editor. Pharmacol Rev [Internet]. 63(2):437–59. Available from: http://pharmrev.aspetjournals.org/lookup/doi/10.1124/pr.110.003533

      8. Suarez-Kurtz G. 2018. Pharmacogenetic testing in oncology: a Brazilian perspective. Clinics [Internet]. 73(Suppl 1):1–12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157069/?report=classic

      9. Nelson DR, Nebert DW. 2018. Cytochrome P450 ( CYP ) Gene Superfamily. eLS [Internet]. 450(January):1–19. Available from: http://doi.wiley.com/10.1002/9780470015902.a0005667.pub3

      10. Gaedigk A, Simon S, Pearce R, Bradford L, Kennedy M, Leeder J. 2008. The CYP2D6 Activity Score: Translating Genotype Information into a Qualitative Measure of Phenotype. Clin Pharmacol Ther [Internet]. 83(2):234–42. Available from: http://doi.wiley.com/10.1038/sj.clpt.6100406

      11. Crews KR, Gaedigk A, Dunnenberger HM, Leeder JS, Klein TE, Caudle KE, et al. 2014. Clinical Pharmacogenetics Implementation Consortium Guidelines for Cytochrome P450 2D6 Genotype and Codeine Therapy: 2014 Update. Clin Pharmacol Ther [Internet]. 95(4):376–82. Available from: http://doi.wiley.com/10.1038/clpt.2013.254

      12. Hicks J, Bishop J, Sangkuhl K, Müller D, Ji Y, Leckband S, et al. 2015. Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Selective Serotonin Reuptake Inhibitors. Clin Pharmacol Ther [Internet]. 98(2):127–34. Available from: http://doi.wiley.com/10.1002/cpt.147

      13. Scott SA, Sangkuhl K, Stein CM, Hulot J-S, Mega JL, Roden DM, et al. 2013. Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C19 Genotype and Clopidogrel Therapy: 2013 Update. Clin Pharmacol Ther [Internet]. 94(3):317–23. Available from: http://doi.wiley.com/10.1038/clpt.2013.105

      14. Theken KN, Lee CR, Gong L, Caudle KE, Formea CM, Gaedigk A, et al. 2020. Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti‐Inflammatory Drugs. Clin Pharmacol Ther [Internet]. 108(2):191–200. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/cpt.1830

      15. Céspedes-Garro C, Naranjo M-EG, Ramírez R, Serrano V, Fariñas H, Barrantes R, et al. 2015. Pharmacogenetics in Central American healthy volunteers: interethnic variability. Drug Metab Pers Ther [Internet]. 30(1):19–31. Available from: https://www.degruyter.com/view/j/dmdi.2015.30.issue-1/dmdi-2014-0025/dmdi-2014-0025.xml

      16. Ramos E, Doumatey A, Elkahloun AG, Shriner D, Huang H, Chen G, et al. 2014. Pharmacogenomics, ancestry and clinical decision making for global populations. Pharmacogenomics J [Internet]. 14(3):217–22. Available from: http://www.nature.com/articles/tpj201324

      17. Naranjo M-EG, Rodrigues-Soares F, Peñas-Lledó EM, Tarazona-Santos E, Fariñas H, Rodeiro I, et al. 2018. Interethnic Variability in CYP2D6 , CYP2C9 , and CYP2C19 Genes and Predicted Drug Metabolism Phenotypes Among 6060 Ibero- and Native Americans: RIBEF-CEIBA Consortium Report on Population Pharmacogenomics. Omi A J Integr Biol [Internet]. 22(9):575–88. Available from: https://www.liebertpub.com/doi/10.1089/omi.2018.0114

      18. Scott SA. 2011. Personalizing medicine with clinical pharmacogenetics. Genet Med [Internet]. 13(12):987–95. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00125817-201112000-00002

      19. Sosa-Macías M, Teran E, Waters W, Fors MM, Altamirano C, Jung-Cook H, et al. 2016. Pharmacogenetics and ethnicity: relevance for clinical implementation, clinical trials, pharmacovigilance and drug regulation in Latin America. Pharmacogenomics [Internet]. 17(16):1741–7. Available from: https://www.futuremedicine.com/doi/10.2217/pgs-2016-0153

      20. Urban TJ. 2010. Race, Ethnicity, Ancestry, and Pharmacogenetics. Mt Sinai J Med A J Transl Pers Med [Internet]. 77(2):133–9. Available from: http://doi.wiley.com/10.1002/msj.20168

      21. Rodrigues‐Soares F, Peñas‐Lledó EM, Tarazona‐Santos E, Sosa‐Macías M, Terán E, López‐López M, et al. 2020. Genomic Ancestry, CYP 2D6 , CYP 2C9 , and CYP 2C19 Among Latin Americans. Clin Pharmacol Ther [Internet]. 107(1):257–68. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1002/cpt.1598

      22. Suarez-Kurtz G. 2012. Pharmacogenomic Applications in the Developing World: The American Continent. In: Nelson KE, Jones-Nelson B, editors. Genomics Applications for the Developing World [Internet]. Springer-Verlag New York; 2012. p. 147–59. Available from: http://link.springer.com/10.1007/978-1-4614-2182-5_10

      23. Suarez-Kurtz G, Pena SDJ, Struchiner CJ, Hutz MH. 2012. Pharmacogenomic Diversity among Brazilians: Influence of Ancestry, Self-Reported Color, and Geographical Origin. Front Pharmacol [Internet]. 3(November):1–7. Available from: http://journal.frontiersin.org/article/10.3389/fphar.2012.00191/abstract

      24. Suarez-Kurtz G, Hutz MH. 2014. Pharmacogenomics in Brazil. In: Handbook of Pharmacogenomics and Stratified Medicine [Internet]. Elsevier; 2014. p. 1015–35. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9780123868824000451

      25. Kehdy FSG, Gouveia MH, Machado M, Magalhães WCS, Horimoto AR, Horta BL, et al. 2015. Origin and dynamics of admixture in Brazilians and its effect on the pattern of deleterious mutations. Proc Natl Acad Sci [Internet]. 112(28):1–6. Available from: http://www.pnas.org/lookup/doi/10.1073/pnas.1504447112

      26. Saloum de Neves Manta F, Pereira R, Vianna R, Rodolfo Beuttenmüller de Araújo A, Leite Góes Gitaí D, Aparecida da Silva D, et al. 2013. Revisiting the Genetic Ancestry of Brazilians Using Autosomal AIM-Indels. O’Rourke D, editor. PLoS One [Internet]. 8(9):e75145. Available from: https://dx.plos.org/10.1371/journal.pone.0075145

      27. Galanter JM, Fernandez-Lopez JC, Gignoux CR, Barnholtz-Sloan J, Fernandez-Rozadilla C, Via M, et al. 2012. Development of a Panel of Genome-Wide Ancestry Informative Markers to Study Admixture Throughout the Americas. Gibson G, editor. PLoS Genet [Internet]. 8(3):1–16. Available from: http://dx.plos.org/10.1371/journal.pgen.1002554

      28. Ventura Santos R, da Silva GO, Gibbon S. 2015. Pharmacogenomics, human genetic diversity and the incorporation and rejection of color/race in Brazil. Biosocieties [Internet]. 10(1):48–69. Available from: http://link.springer.com/10.1057/biosoc.2014.21

      29. Suarez-Kurtz G, Paula DP, Struchiner CJ. 2014. Pharmacogenomic implications of population admixture: Brazil as a model case. Pharmacogenomics [Internet]. 15(2):209–19. Available from: https://www.futuremedicine.com/doi/10.2217/pgs.13.238

      30. Ma Y, Zhao J, Wong J-S, Ma L, Li W, Fu G, et al. 2015. Accurate Inference of Local Phased Ancestry of Modern Admixed Populations. Sci Rep [Internet]. 4(1):1–4. Available from: http://www.nature.com/articles/srep05800

      31. Rodeiro I, Remírez-Figueredo D, García-Mesa M, Dorado P, LLerena A. 2012. Pharmacogenetics in Latin American populations: regulatory aspects, application to herbal medicine, cardiovascular and psychiatric disorders. Drug Metabol Drug Interact [Internet]. 27(1):57–60. Available from: https://www.degruyter.com/view/j/dmdi.2012.27.issue-1/dmdi-2012-0006/dmdi-2012-0006.xml

      32. Suarez-Kurtz G. 2004. Pharmacogenomics in admixed populations: the Brazilian pharmacogenetics/pharmacogenomics network—REFARGEN. Pharmacogenomics J [Internet]. 4(6):347–8. Available from: http://www.nature.com/articles/6500287

      33. Bonifaz-Peña V, Contreras A V., Struchiner CJ, Roela RA, Furuya-Mazzotti TK, Chammas R, et al. 2014. Exploring the Distribution of Genetic Markers of Pharmacogenomics Relevance in Brazilian and Mexican Populations. Gong Y, editor. PLoS One [Internet]. 9(11):1–22. Available from: https://dx.plos.org/10.1371/journal.pone.0112640

      34. Rodrigues‐Soares F, Suarez‐Kurtz G. 2019. Pharmacogenomics research and clinical implementation in Brazil. Basic Clin Pharmacol Toxicol [Internet]. 124(5):538–49. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/bcpt.13196

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      Publicado

      01-10-2025

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      Revisão da Literatura

      Como Citar

      1.
      Scudeler MM, Rodrigues-Soares F. FARMACOGENÉTICA NA AMÉRICA LATINA. Acta Biol. Bras. [Internet]. 1º de outubro de 2025 [citado 6º de abril de 2026];3(2):85-10. Disponível em: https://seer.uftm.edu.br/revistaeletronica/index.php/acbioabras/article/view/8748