Opportunities in pharmacogenomics for the treatment of Alzheimer’s disease

Written by Ramón Cacabelos, Clara Torrellas & Iván Carrera

In Alzheimer's disease (AD), approximately 10–20% of direct costs are associated with pharmacological treatment. Pharmacogenomics account for 30–90% variability in pharmacokinetics and pharmacodynamics. Genes potentially involved in the pharmacogenomics outcome include pathogenic, mechanistic, metabolic, transporter and pleiotropic genes. Over 75% of the Caucasian population is defective for the CYP2D6+2C9+2C19 cluster. Polymorphic variants in the APOE-TOMM40 region influence AD pharmacogenomics. APOE-4 carriers are the worst responders and APOE-3 carriers are the best responders to conventional treatments. TOMM40 poly T-S/S carriers are the best responders, VL/VL and S/VL carriers are intermediate responders and L/L carriers are the worst responders. The haplotype 4/4-L/L...

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