Pharmacogenomics network in ASEAN, SEAPHARM
(South East Asian Pharmacogenomics Research Network)
Pharmacogenomics is the study of population genetic variability that affects the use of drugs. In a hypothesis situation, a particular drug might be excellence for most people, but it might not effective in some others, and rare severe side effect eventually occurs in a certain minority of population. Whole human genome sequencing is an useful tool for prioritize medical treatment by giving information for selecting the most effective drug with the lowest probability of causing adverse drug effects for each patient. For example, a pharmacogenetic screening assay (DNA testing) of HLA-B * 5701 gene enabled us to avoid a serious side effect of the antiretroviral drug, abacavir, prior to treatment. This proved to be statistically significant in reducing the number of patients who stop taking their medication (abacavir) because of its side effects.
It is interesting that people in East Asia and Southeast Asia is commonly affect by rare skin adverse reactions called SJS/TENS. Two of the most common drugs causing SJS/TENS are carbamazepine and allopurinol. US FDA recommended testing HLA B*1502 before starting carbamazepine in Chinese and descendents of South East Asians where HLA-B*1502 are prevalent, these countries include Thailand, Malaysian, should have their blood (DNA) tested for the HLA-B*1502 gene before starting anti-epileptic carbamazepine drugs, in order to avoid the serious side effect of Stevens-Johnson syndrome (SJS). There is no need for such gene testing in Caucasian or Japanese populations. Recently, genome research was limited to developed countries only, due to high research costs. In the year 2011, individual genome re-sequencing could cost up to approximately five hundred thousand Baht. Therefore, most of the genomic information available came from people in developed countries, and that cannot be used as a reference for the Southeast Asian population. Our previous study, which was funded by the Thailand Center of Excellence for Life Sciences (TCELS), found that the genomic variations of populations in Africa, Europe, Japan, Korea, and Mainland China are different from those of Southeast Asian countries, such as Thailand.
However, the cost of decoding the human genome has been greatly reduced. This year, 2012, it came down to only US$ 1,000, or about 30,000 baht per person, and has continued to decline steadily. Now, most developing countries can afford this research and have the great potential to study their own genomes, due to their rich genomic variation of humans, plants, animals and microbes. According to medication, this will strengthen research in the field of medical genetics, genomic medicine, and pharmacogenomics among Southeast Asian countries, which have similar genetic diversity and a driving force to develop guidelines for the pharmacogenetic screening test. In turn, Southeast Asian countries can interpret data specifically for the Southeast Asian population of 560 million people, instead of using information from countries outside the region, which result in inaccuracies or errors due to differences among the genomes.
The TCELS, Department of Medical Sciences; Ministry of Public Health, Ramathibodi Hospital; Mahidol University, and Riken, Genome Research Institute, Japan, which have been collaborating in genomic research since 2006, joined hands to push for a pharmacogenomics network in Southeast Asia by inviting leading researchers from Japan, Korea, Taiwan, Malaysia, Indonesian and Thailand to share knowledge and experience in pharmacogenomics research. To achieve sustainable pharmacogenomics research, countries need to work together in conducting clinical trial studies in various drugs, which are effective and free of side effects for 560 million Southeast Asians.