Pharmacogenomics in clinical allergy

Background: The emerging field of pharmacogenomics promises to provide individualized pharmacotherapy based on genotyping. It is relevant for the study of pharmacokinetics, pharmacodynamics, adverse drug reactions, and selection of patients for clinical pharmaceutical trials. There are associated economic, ethical and technological implications. Methods/Data base: Articles were selected from review of MEDLINE, Online Mendelian Inheritance in Man, and the Pharmacogenetics and Pharmacogenomics Knowledge Base. Results: In the discipline of allergy-immunology, specific genes and mutations have been identified for most of the primary immunodeficiency diseases. However, the field of clinical allergy has been less fortunate because of the multiplicity of genes involved, and the potential for multiple gene-environment interactions. In asthma, pharmacogenomics is currently most relevant for the study of beta-2 adrenergic receptor agonists and leukotriene receptor antagonists. However, some pharmaceuticals in development have a very narrow target and will be amenable to this approach. Conclusion: In the next few years, clinical pharmacogenomics will be part of the everyday practice of medicine, including clinical allergy. It will be necessary to use tools of medical informatics in order to assimilate the vast amount of information available from study of the human genome.