Pharmacogenomics (PGx) is a scientific field that aims to understand how an individual's genetic code regulates drug metabolism and response. The response to many anesthetic drugs varies widely among Show more
Pharmacogenomics (PGx) is a scientific field that aims to understand how an individual's genetic code regulates drug metabolism and response. The response to many anesthetic drugs varies widely among patients due to many factors including, but not limited to, age, gender, and comorbidities. However, PGx contributes to this variability, particularly regarding adverse drug reactions. This review explores the influence of PGx on five commonly used induction agents in anesthesia: propofol, midazolam, ketamine, etomidate, and thiopental. Propofol metabolism is significantly affected by polymorphisms in CYP2B6, CYP2C9, and UGT1A9, influencing both efficacy and toxicity. Midazolam's PGx is mainly mediated by variations in CYP3A4, CYP3A5, and UDP-glucuronosyltransferase enzymes, with implications for sedation depth and drug clearance. Ketamine response is modulated by polymorphisms in metabolic enzymes (e.g. CYP2B6), as well as neurobiological targets such as brain-derived neurotrophic factor and gamma-aminobutyric acid (GABA) receptors, particularly in psychiatric applications. Etomidate shows less studied but emerging PGx associations, including single-nucleotide polymorphisms in GABA receptor subunits and metabolic enzymes, which may affect both sedative depth and cardiovascular stability. Thiopental is a rapid-acting metabolite whose effect stems from GABA-A receptor potentiation; no studies have yet identified specific genetic polymorphisms influencing its action. Overall, PGx provides a promising avenue for tailoring anesthetic management to improve patient safety and outcomes. However, clinical integration remains limited due to practical and infrastructural barriers. This review highlights the potential and current limitations of pharmacogenomic-guided anesthesia, underscoring its relevance in the era of precision medicine. Show less
Alzheimer's disease (AD) is a neurodegenerative disorder associated with the loss of memory, accumulation of amyloid-beta (Aβ) plaques, and inflammation of the nervous system. Scopolamine, an antagoni Show more
Alzheimer's disease (AD) is a neurodegenerative disorder associated with the loss of memory, accumulation of amyloid-beta (Aβ) plaques, and inflammation of the nervous system. Scopolamine, an antagonist of muscarinic receptors, is commonly used to mimic the cognitive and behavioral deficits of AD in laboratory animals. In this study, we aimed to test the neuroprotective properties of hyperforin (HPF), a compound extracted from the St. John's wort plant (Hypericum perforatum), in a scopolamine rat model of AD. Sprague-Dawley rats were divided into four groups: control (saline), scopolamine (10 mg/kg, i.p.), scopolamine + hyperforin (10 mg/kg, p.o. for 7 days), and scopolamine + donepezil. Biochemical, and histopathological assessments were performed. Protein analysis related to inflammation, apoptosis, and the HMGB1/RAGE signaling pathway was performed using Western blotting. IL-1α, levels were measured by ELISA. Nissl staining evaluated neuronal damage in the hippocampus. Hyperforin significantly suppressed the activation of the HMGB1/RAGE signaling axis. Furthermore, hyperforin in this model also suppressed pyroptotic cell death and lowered IL-1α, IL-1β, and IL-18 levels. In addition, HPF reduced Aβ formation by downregulating BACE1 and blocking the activity of inflammasomes composed of canonical and non-canonical caspase-1/11. HPF appears to be a potential therapeutic candidate for neurodegeneration associated with AD, given that hyperforin actively demonstrated neuroprotective effects in a scopolamine-induced AD model, most likely through blocking the HMGB1/RAGE signaling pathway, mitigating neuroinflammation and pyroptosis, and inhibiting Aβ synthesis. Show less