Personalisierte Therapie in der Kardiologie. Biomarker, Pharmakogenetik und Therapie monogener Erkrankungen

TY - JOUR

T1 - Personalisierte Therapie in der Kardiologie. Biomarker, Pharmakogenetik und Therapie monogener Erkrankungen

AU - Eschenhagen, T

AU - Blankenberg, S

PY - 2013/2/1

Y1 - 2013/2/1

N2 - Improved therapy and prophylaxis of cardiovascular diseases have contributed to an increase in life expectancy like no other field of medicine. However, many cardiological diseases remain untreatable and standard therapies often work only in a minority of patients or cause more harm than benefit. Personalized approaches appear to be a promising solution. Monogenic heart diseases are paradigmatic for this approach and can in rare cases be treated mutation specifically. Overall, however, success remains limited. Next generation sequencing will facilitate the identification of mutations causing diseases. Cell culture models based on induced pluripotent stem cells open the perspective of individualized testing of disease severity and pharmacological or genetic therapy. In contrast to monogenic diseases genetic testing plays no practical role yet in the management of multifactorial cardiovascular diseases. Biomarkers can identify individuals with increased cardiovascular risk. Furthermore, biomarker-guided therapy represents an attractive option with troponin-guided therapy of acute coronary syndromes as a successful example. Individual responses to drugs vary and are partly determined by genes. Simple genetic analyses can improve response prediction and minimize side effects in cases such as warfarin and high doses of simvastatin. Taken together personalized approaches will gain importance in the cardiovascular field but this requires the development of better methods and research that quantifies the true value of the new knowledge.

AB - Improved therapy and prophylaxis of cardiovascular diseases have contributed to an increase in life expectancy like no other field of medicine. However, many cardiological diseases remain untreatable and standard therapies often work only in a minority of patients or cause more harm than benefit. Personalized approaches appear to be a promising solution. Monogenic heart diseases are paradigmatic for this approach and can in rare cases be treated mutation specifically. Overall, however, success remains limited. Next generation sequencing will facilitate the identification of mutations causing diseases. Cell culture models based on induced pluripotent stem cells open the perspective of individualized testing of disease severity and pharmacological or genetic therapy. In contrast to monogenic diseases genetic testing plays no practical role yet in the management of multifactorial cardiovascular diseases. Biomarkers can identify individuals with increased cardiovascular risk. Furthermore, biomarker-guided therapy represents an attractive option with troponin-guided therapy of acute coronary syndromes as a successful example. Individual responses to drugs vary and are partly determined by genes. Simple genetic analyses can improve response prediction and minimize side effects in cases such as warfarin and high doses of simvastatin. Taken together personalized approaches will gain importance in the cardiovascular field but this requires the development of better methods and research that quantifies the true value of the new knowledge.

KW - Biological Markers

KW - Cardiology

KW - Cardiovascular Diseases

KW - Genetic Markers

KW - Genetic Testing

KW - Genetic Therapy

KW - Humans

KW - Individualized Medicine

KW - Molecular Targeted Therapy

KW - Pharmacogenetics

U2 - 10.1007/s00108-012-3157-8

DO - 10.1007/s00108-012-3157-8

M3 - SCORING: Zeitschriftenaufsatz

C2 - 23371262

VL - 54

SP - 147-8, 150-2, 154

JO - INTERNIST

JF - INTERNIST

SN - 0020-9554

IS - 2

ER -