Pregledni rad
Clinical Implications of Associations between Genetic Mechanisms and Oral Isotretinoin Therapy: A Review of Literature
Luka Bulić
; School of Medicine University of Zagreb Zagreb, Croatia
Eva Brenner
; School of Medicine University of Zagreb Zagreb, Croatia
Nives Pustišek
; Department of Pediatric Dermatology Children’s Hospital Zagreb Zagreb, Croatia
Suzana Ožanić Bulić
; Department of Pediatric Dermatology Children’s Hospital Zagreb Zagreb, Croatia
Sažetak
Isotretinoin (13-cis-retinoic acid) is a vitamin A derivative most commonly used for the treatment of acne vulgaris. While its therapeutic effectiveness in this skin condition has been demonstrated by numerous studies, oral isotretinoin therapy impacts many other organ systems by interacting with complex genetic mechanisms. Epigenetic modifi cations make up a large portion of these interactions and they entail induction or suppression of specifi c gene expressions. While gene expression modifi cation has been shown as important for the mechanism of action of isotretinoin, it is also deemed responsible by some for certain adverse events. Studies have postulated associations between isotretinoin and infl ammatory bowel disease (IBD), autoimmune thyroiditis, and skeletal system diseases in the context of specifi c genetic predispositions. Isotretinoin has also been shown to negatively affect the glucose and lipid metabolic profi le via these interactions. Furthermore, it can alter the therapeutic effect of other drugs by modulating the activity of their metabolizing enzymes. On the other hand, isotretinoin has shown anti-tumor activity and a positive effect in anthracycline cardiotoxicity. The other relevant component of genetic factors in isotretinoin therapy is pharmacogenetics, which entails genetic products that take part in isotretinoin metabolism. Variants in these genes alter the mechanism by which the body metabolizes isotretinoin, which can cause therapeutic ineffectiveness or toxicity depending on the variant. The aim of this review was to provide a synthesis of knowledge regarding these interactions and potentially contribute to individualized isotretinoin therapy based on certain genetic fi ndings.
Ključne riječi
epigenetics; isotretinoin; metabolism; pharmacogenetics
Hrčak ID:
334382
URI
Datum izdavanja:
2.12.2024.
Posjeta: 195 *