International Journal of Molecular Medical Science, 2024, Vol.14, No.1, 61-68 http://medscipublisher.com/index.php/ijmms 64 thermal visceral stimulation and cold pressure test. The results showed that COMT The V108/158M genotype is associated with pain sensitivity. Other studies have found that the COMT V108/158M gene polymorphism is associated with postoperative opioid consumption. 2.2 Introduction to genome-guided drug dose adjustment strategies Drug dosage is a key factor affecting treatment efficacy and side effects. Traditional drug dose adjustment is mainly based on the patient's general physiological characteristics such as weight, age, and renal function, but this method often fails to fully consider the impact of individual differences on drug response (Figure 1). Genome-guided drug dosage adjustment strategies can more accurately optimize drug dosage based on individual genomic information. Li et al. (2018) analyzed the patient's genomic information to understand their metabolism rate, clearance rate and possible side effects sensitivity to drugs. This information can help doctors develop personalized drug dosage regimens for patients to ensure optimal drug concentration in the body, thereby improving treatment effectiveness and reducing the risk of side effects. Genome-guided drug dose adjustment strategies can also help doctors adjust drug doses in a timely manner during treatment (Wang Panfei, 2021, https://zhuanlan.zhihu.com/). When a patient develops drug resistance or side effects, doctors can adjust the drug dosage or change drugs based on the patient's genomic information to avoid unnecessary treatment failures and side effects. 2.3 Genome-guided drug combinations and optimized treatment options Genome-directed drug combinations and optimized treatment regimens are one approach that leverages genomic information to develop comprehensive treatment plans. It takes into account the impact of multiple genetic variations in a patient on drug response and aims to maximize treatment effectiveness and minimize side effects by combining multiple drugs. In November 2022, researchers from the University of California and an immuno-oncology therapy company used CRISPR-Cas9 gene editing technology to modify T cells so that they could specifically recognize cancer cells and launch concentrated attacks, and launched the first human clinical trial (Foy et al., 2023). Each of the 16 subjects was infused with genetically engineered T cells with up to three different targets. The researchers then found that these edited cells began to circulate in the subjects' blood, and the concentrations around the tumors were greater than the concentration of non-edited cells before treatment. One month after treatment, five subjects were in stable condition, indicating that their tumors were not growing. Only two people experienced adverse reactions that may have been caused by the activity of these edited T cells. In other words, researchers can use CRISPR gene editing technology to modify immune cells so that these cells can recognize individual-specific mutant proteins in tumor patients (Scott et al., 2023). When these cells are injected into a patient, the gene-edited T cells preferentially flow to the site of cancer cells to eliminate them. Figure 1 Traditional drug doses has different efficacy for different individuals (https://zhuanlan.zhihu.com/p/439470102) Note: The effect of different individuals is different, and some individuals may even have severe drug reactions
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