4 ms·

Silly question, why do so many drugs have rare side effects? Why does it work on 999 people and then the 1,000th person takes it and becomes suicidal? If there

Silly question, why do so many drugs have rare side effects? Why does it work on 999 people and then the 1,000th person takes it and becomes suicidal? If there is something different biologically different about the 1,000th person, could it be tested for?

rojost 12y ago
That's part of the aim of personalised medicine. http://en.wikipedia.org/wiki/Personalized_medicine http://en.wikipedia.org/wiki/Personalized_medicine
Alex3917 12y ago
It doesn't work on any of the 999 people, that's the point of the article.
davecap1 12y ago
That's not really a silly question :) Drugs act on proteins which are little machines in the body, the instructions of which are encoded in our genome. The slight variations in our genetic code leads to some proteins having slight variations in their structure (and their function). Most of the time this is harmful, but sometimes it causes them to react differently when they interact with a drug or with each other. The manifestation of this can sometimes be harmful. Understanding "pharmacogenomic" effects will help us mitigate these side-effects going forward.
cryoshon 12y ago
A person's genome, epigenetic profile, physical environment, social environment, microbiome, parasite-ome, neural connectome, metabolism, enteric connectome, and diet are all unique. Some of these factors regulate the others; some have two-way regulation. There are far more combinations and variations of the above variables and sub-variables than can be tested for in clinical trials. This fact means that some obscure combination of these variables may result in unintended negative (or positive, less frequently) consequences upon consumption. Theoretically, you could test for differences in the 1000th person-- with today's technology, it would be a test which described the person's genome. Once scientists had that genomic data in hand, they'd certainly find a profile of alleles which could feasibly describe why a negative reaction occurred. Importantly, everyone's genome is unique, meaning that a correlation between genomes and negative drug reactions must be exceptionally rigorous in order to be believable. Currently, this correlation poses a problem, as our ability to quantify and understand genomes is far ahead of the other dimensions which I mentioned at the start of my post. As our understanding of the microbiome, enteric connectome, and epigenetics increases, it'll be more possible to predict adverse drug reactions beforehand, assuming the patients in question have been profiled.

rojost 12y ago

That's part of the aim of personalised medicine. http://en.wikipedia.org/wiki/Personalized_medicine http://en.wikipedia.org/wiki/Personalized_medicine

Alex3917 12y ago

It doesn't work on any of the 999 people, that's the point of the article.

davecap1 12y ago

That's not really a silly question :) Drugs act on proteins which are little machines in the body, the instructions of which are encoded in our genome. The slight variations in our genetic code leads to some proteins having slight variations in their structure (and their function). Most of the time this is harmful, but sometimes it causes them to react differently when they interact with a drug or with each other. The manifestation of this can sometimes be harmful. Understanding "pharmacogenomic" effects will help us mitigate these side-effects going forward.

cryoshon 12y ago

A person's genome, epigenetic profile, physical environment, social environment, microbiome, parasite-ome, neural connectome, metabolism, enteric connectome, and diet are all unique. Some of these factors regulate the others; some have two-way regulation. There are far more combinations and variations of the above variables and sub-variables than can be tested for in clinical trials. This fact means that some obscure combination of these variables may result in unintended negative (or positive, less frequently) consequences upon consumption. Theoretically, you could test for differences in the 1000th person-- with today's technology, it would be a test which described the person's genome. Once scientists had that genomic data in hand, they'd certainly find a profile of alleles which could feasibly describe why a negative reaction occurred. Importantly, everyone's genome is unique, meaning that a correlation between genomes and negative drug reactions must be exceptionally rigorous in order to be believable. Currently, this correlation poses a problem, as our ability to quantify and understand genomes is far ahead of the other dimensions which I mentioned at the start of my post. As our understanding of the microbiome, enteric connectome, and epigenetics increases, it'll be more possible to predict adverse drug reactions beforehand, assuming the patients in question have been profiled.