Not all drugs have the same effect in all patients. The effectiveness of a drug also depends on the genetic constitution of the patient. Not all patients react to a drug in the same way. For instance, in many patients even the standard dosage of a common drug leads to severe complications. The spectrum of side effects ranges from nausea and allergic reactions to cardiac insufficiency and increased risk for cancer.
The reasons for such side effects are genetic variations in the proteins of each patient, for example in the proteins which are responsible for the resorption of drugs. Some of these proteins are altered to such an extent that they do not or only very slowly eliminate drugs from the body.
In some patients a drug has no effect at all – even though, as a general rule, with the same drug good chances for a cure can be achieved. Most drugs function so that they have to dock to a damaged protein to block its dangerous activity. But sometimes right at the docking site the protein is genetically altered in such a way that the drug can no longer adsorb there, thus remaining without any effect.
Through genome research it would be possible to identify such patients already in advance. Then the doctors could reduce the dosage of a drug early enough or introduce another therapy.
However, analyzing and investigating DNA for potential risks of disease always bears the danger of the "glass human-being", too. What if in the future a DNA analysis would be required before getting medical insurance? Will people with a genetic risk of getting a disease have to pay more?
Asked about this issue, Professor Schreiber, one of the two spokespeople for the National Genome Research Network, replied: "Only in particular cases will individual genome analysis be necessary. It will have to be performed if we really want to cure illnesses like Crohn’s disease someday or help prevent such illnesses better. But the issue is how we deal with this new knowledge. It is a question concerning the whole solidarity community which will have to be addressed early on. We must be extremely careful. Genetic discrimination is the absolute last thing we want or need." (Read the entire article in the Newsletter "National Genom Research Network", June 2003, published by: Federal Ministry of Education and Research).
