International Journal of Clinical Case Reports 2024, Vol.14, No.2, 87-93 http://medscipublisher.com/index.php/ijccr 89 In this regard, the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) is also associated with adverse effects on the cardiovascular system. NSAIDs may increase the risk of hypertension, heart attack, and stroke. Among antipsychotic drugs, some specific antipsychotic drugs may be associated with cardiovascular toxicity, causing arrhythmias, cardiovascular events, and other cardiovascular problems. In addition, the abuse of stimulants, especially some illegal drugs or excessive use of prescription drugs such as cocaine and methamphetamine (methamphetamine), may have direct toxic effects on the cardiovascular system, leading to hypertension, arrhythmia, and myocardial infarction. 1.3 Immune system toxicity Immune system toxicity refers to the adverse effects of drugs or other chemicals on the immune system, which may include allergic reactions, immune-mediated hepatitis, increased risk of infection caused by immunosuppressive drugs, and potential autoimmune diseases caused by certain drugs. The mechanisms of immune system toxicity are diverse and may involve direct interaction between drugs and immune cells, affecting their function. Meanwhile, there are complex interactions between the immune system and drug metabolism, and some drugs may affect drug metabolism by affecting the activity of immune cells, leading to immune system toxicity. Drugs may trigger excessive activation of the immune system, leading to abnormal immune responses. In this case, the immune system may produce allergic reactions to drugs, with the mechanism mediated by immunoglobulin E (IgE) playing a crucial role. This allergic reaction triggers the release of histamine and other inflammatory mediators, leading to a series of reactions of varying degrees, ranging from mild rash to severe allergic shock. Certain drugs may lead to immune-mediated hepatitis, a response caused by the immune system's attack on liver tissue, manifested as elevated liver enzyme levels, jaundice, and other symptoms (Zhang et al., 2020). Immunosuppressive drugs are commonly used to prevent organ transplant rejection or treat autoimmune diseases, but such drugs may weaken normal immune responses and increase the risk of infection. Therefore, doctors need to carefully balance the relationship between treatment effectiveness and infection risk when using such drugs. In addition, some drugs may induce autoimmune diseases, where the immune system mistakenly attacks the body's tissues and is associated with the occurrence of autoimmune diseases such as systemic lupus erythematosus or rheumatoid arthritis. 2 The Relationship between Genetic Variation and Drug Metabolism 2.1 The impact of CYP family gene mutations The cytochrome P450 family (CYP family) is a gene family that encodes important drug metabolism enzymes in the liver, playing a crucial role in drug metabolism. Genetic variation refers to the genetic variation of CYPgenes in the human body, which may have a significant impact on drug metabolism and individual response to drugs. This genetic variation is an important source of individual differences, which can lead to different metabolic rates of drugs in the body, thereby affecting the efficacy and adverse reactions of drugs. The variation of CYP family genes is mainly manifested in differences in genotype and allele frequencies. The differences between different genotypes may lead to differences in drug metabolism ability, which in turn affects the concentration of drugs in the body. This difference is widely studied in clinical practice because it has significant implications for the metabolism and response of individuals to certain drugs. The variation of some CYP genes has been confirmed to be associated with a decrease or increase in drug metabolism enzyme activity, thereby affecting the clearance rate of drugs in the body. The most prominent impact is on genes such as CYP2D6, CYP2C9, and CYP2C19. For example, mutations in the CYP2D6 gene are associated with various drug metabolism, including antidepressants β Receptor antagonists and antiarrhythmic drugs, etc. The variation of the CYP2C9 gene affects the metabolism of anticoagulants such as warfarin, which may increase the risk of bleeding or thrombosis (Wang, 2023).
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