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Steroid-induced ocular hypertension/glaucoma: Focus on pharmacogenomics and implications for precision medicine.

Publication ,  Journal Article
Fini, ME; Schwartz, SG; Gao, X; Jeong, S; Patel, N; Itakura, T; Price, MO; Price, FW; Varma, R; Stamer, WD
Published in: Prog Retin Eye Res
January 2017

Elevation of intraocular pressure (IOP) due to therapeutic use of glucocorticoids is called steroid-induced ocular hypertension (SIOH); this can lead to steroid-induced glaucoma (SIG). Glucocorticoids initiate signaling cascades ultimately affecting expression of hundreds of genes; this provides the potential for a highly personalized pharmacological response. Studies attempting to define genetic risk factors were undertaken early in the history of glucocorticoid use, however scientific tools available at that time were limited and progress stalled. In contrast, significant advances were made over the ensuing years in defining disease pathophysiology. As the genomics age emerged, it appeared the time was right to renew investigation into genetics. Pharmacogenomics is an unbiased discovery approach, not requiring an underlying hypothesis, and provides a way to pinpoint clinically significant genes and pathways that could not have been discovered any other way. Results of the first genome-wide association study to identify polymorphisms associated with SIOH, and follow-up on two novel genes linked to the disorder, GPR158 and HCG22, is discussed in the second half of the article. However, knowledge of genetic variants determining response to steroids in the eye also has value in its own right as a predictive and diagnostic tool. This article concludes with a discussion of how the Precision Medicine Initiative®, announced by U.S. President Obama in his 2015 State of the Union address, is beginning to touch the practice of ophthalmology. It is argued that SIOH/SIG may provide one of the next opportunities for effective application of precision medicine.

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Published In

Prog Retin Eye Res

DOI

EISSN

1873-1635

Publication Date

January 2017

Volume

56

Start / End Page

58 / 83

Location

England

Related Subject Headings

  • Precision Medicine
  • Pharmacogenetics
  • Ophthalmology & Optometry
  • Ocular Hypertension
  • Intraocular Pressure
  • Humans
  • Glucocorticoids
  • Glaucoma
  • Genome-Wide Association Study
  • Disease Management
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fini, M. E., Schwartz, S. G., Gao, X., Jeong, S., Patel, N., Itakura, T., … Stamer, W. D. (2017). Steroid-induced ocular hypertension/glaucoma: Focus on pharmacogenomics and implications for precision medicine. Prog Retin Eye Res, 56, 58–83. https://doi.org/10.1016/j.preteyeres.2016.09.003
Fini, M Elizabeth, Stephen G. Schwartz, Xiaoyi Gao, Shinwu Jeong, Nitin Patel, Tatsuo Itakura, Marianne O. Price, Francis W. Price, Rohit Varma, and W Daniel Stamer. “Steroid-induced ocular hypertension/glaucoma: Focus on pharmacogenomics and implications for precision medicine.Prog Retin Eye Res 56 (January 2017): 58–83. https://doi.org/10.1016/j.preteyeres.2016.09.003.
Fini ME, Schwartz SG, Gao X, Jeong S, Patel N, Itakura T, et al. Steroid-induced ocular hypertension/glaucoma: Focus on pharmacogenomics and implications for precision medicine. Prog Retin Eye Res. 2017 Jan;56:58–83.
Fini, M. Elizabeth, et al. “Steroid-induced ocular hypertension/glaucoma: Focus on pharmacogenomics and implications for precision medicine.Prog Retin Eye Res, vol. 56, Jan. 2017, pp. 58–83. Pubmed, doi:10.1016/j.preteyeres.2016.09.003.
Fini ME, Schwartz SG, Gao X, Jeong S, Patel N, Itakura T, Price MO, Price FW, Varma R, Stamer WD. Steroid-induced ocular hypertension/glaucoma: Focus on pharmacogenomics and implications for precision medicine. Prog Retin Eye Res. 2017 Jan;56:58–83.
Journal cover image

Published In

Prog Retin Eye Res

DOI

EISSN

1873-1635

Publication Date

January 2017

Volume

56

Start / End Page

58 / 83

Location

England

Related Subject Headings

  • Precision Medicine
  • Pharmacogenetics
  • Ophthalmology & Optometry
  • Ocular Hypertension
  • Intraocular Pressure
  • Humans
  • Glucocorticoids
  • Glaucoma
  • Genome-Wide Association Study
  • Disease Management