Chapter 12 - Pharmacogenomics in autoimmune diseases

Abstract

Autoimmune diseases result from the inability of the immune system to xenobiotics and endogenous substances and are increasingly becoming the most prominent cause of global health burdens. In the pathogenesis of autoimmune diseases, abnormal immune responses and inflammatory reactions are involved. In the onset of autoimmune diseases, a significant role is played by individual genetic composition in addition to environmental factors, gender bias, gut microbiota, and infections. In autoimmune diseases, there is an intricate genetic heterogeneity with multiple genes associated with disease risk. It is clearly evident that multiple autoimmune disorders (e.g., diabetes, multiple sclerosis, rheumatoid arthritis, and hepatitis) are underlined by common genes. Major histocompatibility complex (MHC) has been considered a prominent risk factor for complex diseases, and its components are common elements for several autoimmune disorders. MHC encodes antigen molecules that are essential for differentiating self versus non-self. The inability of the immune system (loss of self-tolerance) against the body’s own components leads to autoimmunity. Historically, to understand autoimmune diseases, many species of animals have been modeled to study autoimmune diseases. The use of animal models has become significant to understand disease states and develop treatment procedures. The field of pharmacogenomics can improve the usage of drugs by deciphering which drugs will be most effective for treating autoimmune disorders. The emergence of personalized medicine and its associated approaches considers individual variability to suggest best therapeutic and preventive policies. Pharmacogenomics has enabled the detection of predictive biomarkers of drug pharmacokinetics and dynamics considering interindividual variability. In the coming years, the pharmacogenomic field will offer a significant promise of personalized medicine to treat immune-mediated disorders.