你的基因如何，你的日子也必如何？（藥物篇） Your Genes, Your Fate? (Drug Reaction)
藥物，相信對你同我都唔會陌生，大家可能食過唔同嘅藥物，例如消炎止痛藥，但你有無發現，明明朋友食完好有效，但自己就止唔到痛呢？明明朋友食完無副作用，但自己食完就胃痛呢？基因，有可能解答到你嘅疑問。
Drugs are nothing new to us, as everyone of us may have had various medications in our lifetime, like anti-inflammatory painkillers. But have you ever found that the same drug can stop the pain of your friend but has totally no effect on yourself? And why do you have stomach pain from the same drug which causes no side effect on others? Genes may answer your doubts.
藥物進入身體後，就會開始發揮佢嘅功效。同一時間，身體內嘅代謝酶亦會開始工作，代謝剛服用嘅藥物，讓藥物排出體外。研究指出，基因突變會影響代謝酶嘅運作方式，改變代謝速度。
A drug starts exerting its effect once it enters our body. At the same time, metabolic enzymes in our body also start breaking down the drug actively, so that the drug can be eventually excreted. Studies have shown that genetic mutations can affect the way metabolic enzymes work, and hence change the rate of metabolism.
以一般消炎止痛藥為例，如果代謝速度過快，會令藥物分解速度加快。因此，喺正常劑量之下，身體唔能夠累積足夠嘅止痛藥，發揮唔到止痛功效。相反，如果代謝速度較慢，身體積聚過量嘅消炎止痛藥，就有機會引致副作用，例如胃痛。
Take anti-inflammatory painkillers as an example. If the metabolism is too fast, the drug will be broken down too quickly. Therefore, under normal dose, the drug level in our body would be inadequate to exert its anti inflammatory and pain-killing effect. On the contrary, if the metabolism is too slow, excessive drug would accumulate in the body. This increases the risk of side effects like stomach pain.
除咗消炎止痛藥之外，另一隻會受基因影響嘅藥物就係「華法林」。「華法林」係一隻俗稱「薄血藥」嘅口服抗凝血藥，用嚟防止有害血塊喺血管內形成。研究發現，「華法林」嘅吸收同代謝喺唔同病人之間，存在極大差異，令醫生喺判斷用藥劑量時比較困難。研究證實，導致差異嘅原因就係 CYP2C9 同 VKORC1 嘅基因型變異。如果基因型變異令代謝速度過快，就會發揮唔到「薄血」功效，需要增加劑量。相反，代謝速度較慢，身體積聚過量嘅「華法林」，就會增加出血風險，例如流鼻血、大便帶血、甚至創傷後流血不止等副作用。
Apart from anti-inflammatory painkillers, the effect of warfarin is also greatly affected by genes. Warfarin is an oral anti-coagulant commonly known as “blood-thinner”. It prevents the formation of harmful blood clots in blood vessels. Researchers have found that there is a great variation in drug absorption and metabolism among patients taking warfarin, making it difficult for doctors to dose accurately. It is proven that the gene variation of CYP2C9 and VKORC1 genotypes is causing such a difference. If the metabolism is too fast, warfarin cannot exert its “blood-thinning” effect and a higher dose is therefore needed. On the contrary, if the metabolism is too slow, excessive warfarin would accumulate in the body, increasing the risk of bleeding, such as nosebleed, blood in the stool, and difficulty to stop bleeding after trauma.
要了解自己嘅基因，可以透過基因測試，簡易收集唾液樣本，得出過百個檢測結果。報告將會成為你嘅用藥指南，讓醫生同藥劑師了解你嘅基因組合，以及身體對藥物嘅反應，從而調整劑量，提高藥物療效，減少副作用，為你製定個人化嘅治療方案。
To understand your own genes, a gene test can help. A small amount of saliva sample can provide hundreds of test results. The report will be your own guide of drug use, allowing doctors and pharmacists to understand your gene combination and your responses to drugs. By personalizing the choice of drugs and dosing according to your own condition, it can improve the efficacy and reduce side effects of your medications.
及早了解你嘅基因，選用最適合你嘅藥物。即使你嘅基因如何，你都有能力掌控你嘅日子！
Get to know your genes and get the most suitable medications for you. No matter how your genes are, you still can control your days!
