Publications by authors named "I Piatkov"

Pharmacogenetics is the study of therapeutic and adverse responses to drugs based on an individual's genetic background. Monoclonal antibodies (mAbs) are a rapidly evolving field in cancer therapy, however a number of newly developed and highly effective mAbs (e.g.

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Clozapine (CZ) has superior efficacy to other antipsychotic agents in the treatment of schizophrenia and has been extensively used in clinical practice. ATP-binding cassette (ABC) transporter proteins are responsible for the distribution of various molecules as well as drugs across extracellular and intracellular membranes, including the blood-brain barrier. Genetic variations in these proteins can account for differences in treatment response.

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Article Synopsis
  • Clozapine (CZ) is an effective treatment for resistant schizophrenia, but its use is limited due to side effects like weight gain and diabetes.
  • A study of 187 patients found that 39% carried the CYP2C19*17 genetic variant, which was linked to higher levels of norclozapine (NCZ) and lower blood glucose and HbA1c levels.
  • Patients with the CYP2C19*17 variant experienced lower rates of diabetes and greater clinical improvement, indicating that genetic factors may influence response to clozapine treatment and metabolic side effects.
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An optimal clozapine serum level is required for both optimization of clinical response and minimization of troublesome or some of the life-threatening side effects. Serum levels can be influenced by comedication that can cause phenoconversion. When norclozapine/clozapine serum levels and ratios are consistently and significantly lower/higher than expected and there are no concomitant drugs that could account for these findings, further investigation of the genetic variants of CYP1A2, 2D6 and 3A4 are warranted.

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Aims: We investigated a case of the unexpectedly high clozapine/norclozapine serum levels in a non-smoker, female patient.

Method: The RFLP genotype method was used for the loss-of-function CYP450 gene polymorphisms detection.

Results: The genotype revealed the presence of CYP2D6*41/*41, rs28371725, NM_000106.

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