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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">safetyrisk</journal-id><journal-title-group><journal-title xml:lang="ru">Безопасность и риск фармакотерапии</journal-title><trans-title-group xml:lang="en"><trans-title>Safety and Risk of Pharmacotherapy</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2312-7821</issn><issn pub-type="epub">2619-1164</issn><publisher><publisher-name>Federal State Budgetary Institution ‘Scientific Centre for Expert Evaluation of Medicinal Products’ of the Ministry of Health of the Russian Federation (FSBI ‘SCEEMP’)</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30895/2312-7821-2024-12-2-132-154</article-id><article-id custom-type="elpub" pub-id-type="custom">safetyrisk-423</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ГЛАВНАЯ ТЕМА: ГЕНЕТИКА И ФАРМАКОЛОГИЯ: ИССЛЕДОВАНИЯ И ДОСТИЖЕНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>MAIN TOPIC: GENETICS AND PHARMACOLOGY: RESEARCH AND ADVANCES</subject></subj-group></article-categories><title-group><article-title>Роль фармакогенетического тестирования в оценке риска и безопасности применения вальпроатов: этнический аспект (обзор)</article-title><trans-title-group xml:lang="en"><trans-title>Role of Pharmacogenetic Testing in the Risk and Safety Assessment of Valproates: The Ethnic Aspect (Review)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2840-837X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шнайдер</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shnayder</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шнайдер Наталья Алексеевна, д-р мед. наук, профессор</p><p>ул. Бехтерева, д. 3, Санкт-Петербург, 192019;</p><p>ул. Партизана Железняка, д. 1, г. Красноярск, 660022</p></bio><bio xml:lang="en"><p>Natalia А. Shnayder, Dr. Sci. (Med.), Professor.</p><p>3 Bekhterev St., St Petersburg 192019;</p><p>1 Partizan Zheleznyak St., Krasnoyarsk 660022</p></bio><email xlink:type="simple">naschnaider@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8279-4198</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гречкина</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Grechkina</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гречкина Виолетта Владимировна</p><p>ул. Бехтерева, д. 3, Санкт-Петербург, 192019</p></bio><bio xml:lang="en"><p>Violetta V. Grechkina</p><p>3 Bekhterev St., St Petersburg 192019</p></bio><email xlink:type="simple">grechkina.vv@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1441-3418</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Архипов</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Arkhipov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Архипов Владимир Владимирович, д-р мед. наук, доцент</p><p>ул. Победы, д. 85, г. Белгород, 308015</p></bio><bio xml:lang="en"><p>Vladimir V. Arkhipov, Dr. Sci. (Med.), Associate Professor</p><p>85 Pobeda St., Belgorod 308015</p></bio><email xlink:type="simple">arkhipov@expmed.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1874-9434</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Насырова</surname><given-names>Р. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Nasyrova</surname><given-names>R. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Насырова Регина Фаритовна, д-р мед. наук</p><p>ул. Бехтерева, д. 3, Санкт-Петербург, 192019</p></bio><bio xml:lang="en"><p>Regina F. Nasyrova, Dr. Sci. (Med.).</p><p>3 Bekhterev St., St Petersburg 192019</p></bio><email xlink:type="simple">regina_nmrcpn@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Институт персонализированной психиатрии и неврологии, Центр общего пользования, Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева; &#13;
Центр коллективного пользования «Молекулярные и клеточные технологии», Красноярский государственный медицинский университет имени профессора В.Ф. Войно-Ясенецкого</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Personalized Psychiatry and Neurology, Shared Use Center, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology; &#13;
Shared Core Facilities “Molecular and Cell Technologies”, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Институт персонализированной психиатрии и неврологии, Центр общего пользования, Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Personalized Psychiatry and Neurology, Shared Use Center, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Федеральное государственное автономное учреждение высшего образования «Белгородский государственный национальный исследовательский университет»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Belgorod State National Research University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>17</day><month>04</month><year>2024</year></pub-date><volume>12</volume><issue>2</issue><fpage>132</fpage><lpage>154</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Шнайдер Н.А., Гречкина В.В., Архипов В.В., Насырова Р.Ф., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Шнайдер Н.А., Гречкина В.В., Архипов В.В., Насырова Р.Ф.</copyright-holder><copyright-holder xml:lang="en">Shnayder N.A., Grechkina V.V., Arkhipov V.V., Nasyrova R.F.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.risksafety.ru/jour/article/view/423">https://www.risksafety.ru/jour/article/view/423</self-uri><abstract><sec><title>ВВЕДЕНИЕ</title><p>ВВЕДЕНИЕ. Фармакогенетическое тестирование (ФГТ) играет важную роль в прогнозировании риска развития нежелательных реакций при применении препаратов вальпроевой кислоты (ВК), которые являются одними из наиболее часто назначаемых в неврологии и психиатрии. Однако чувствительность и специфичность скрининговых панелей ФГТ может быть недостаточной в связи с межиндивидуальными различиями метаболизма вальпроатов у пациентов различных этнических/расовых групп.</p></sec><sec><title>ЦЕЛЬ</title><p>ЦЕЛЬ. Выявить направления для реализации персонализированного подхода к разработке панелей ФГТ для оценки безопасности и риска фармакотерапии вальпроатами в различных этнических и расовых группах популяции Российской Федерации.</p></sec><sec><title>ОБСУЖДЕНИЕ</title><p>ОБСУЖДЕНИЕ. Проведен анализ результатов популяционных исследований частот нефункциональных и низкофункциональных аллелей генов, кодирующих ключевые изоферменты Р-окисления ВК в печени, опубликованных в период 2012–2022 гг. и размещенных в базах данных eLIBRARY.RU, PubMed, Scopus, Google Scholar. Критерии отбора публикаций: наличие полнотекстовой версии на русском или английском языках, тип публикации — оригинальная статья, систематический обзор, метаанализ, Кокрейновский обзор, клинический случай. Показано, что персонализированная оценка риска и безопасности ВК может зависеть от частоты аллелей риска замедления P-окисления ВК в печени в различных расовых и этнических группах в мире в целом и в России в частности. Определены новые направления для реализации персонализированного подхода к разработке панелей ФГТ для оценки безопасности и риска фармакотерапии вальпроатами с учетом скорости Р-окисления ВК в печени у представителей различных этнических и расовых групп. Однако результаты проведенного обзора популяционных ассоциативных генетических исследований в мире демонстрируют, что прямая трансляция результатов зарубежных исследований в реальную клиническую практику в Российской Федерации путем разработки панелей ФГТ пока недостаточно ясна ввиду этнической и расовой неоднородности популяции и большой территориальной протяженности страны.</p></sec><sec><title>ВЫВОДЫ</title><p>ВЫВОДЫ. Для повышения чувствительности и специфичности российских панелей ФГТ требуется проведение «мостовых» исследований, чтобы реплицировать полученные на других этнических группах ассоциации наиболее распространенных аллелей риска нарушения Р-окисления ВК для конкретной популяции регионов России.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>INTRODUCTION</title><p>INTRODUCTION. Pharmacogenetic (PGx) testing plays a significant role in predicting the risk of adverse drug reactions (ADRs) associated with valproic acid (VPA) products, which are among the most prescribed medicinal products in neurology and psychiatry. However, the sensitivity and specificity of PGx screening panels may be insufficient as individual valproate metabolism varies across ethnically/racially diverse patient populations.</p></sec><sec><title>AIM</title><p>AIM. The study aimed to identify implementation areas for a personalised approach to the development of PGx panels for assessing the safety and risk of valproate therapy in various ethnic and racial groups residing in the Russian Federation.</p></sec><sec><title>DISCUSSION</title><p>DISCUSSION. The authors reviewed the results of population studies concerning the frequency of non-functional and low-function alleles of genes encoding isoenzymes that play key roles in VPA P-oxidation in the liver. This review focused on studies published in eLIBRARY.RU, PubMed, Scopus, and Google Scholar in 2012–2022. The inclusion criteria were full-text original articles, systematic reviews, meta-analyses, Cochrane reviews, and clinical cases in Russian or English. The analysis revealed that the need for personalised assessment of the risk and safety of VPA may depend on the frequency of risk alleles for slowing down VPA P-oxidation in the liver across racial and ethnic groups worldwide, and particularly in Russia. The authors identified new areas to implement the personalised approach to the development of PGx panels for assessing the safety and risk of valproate therapy with consideration of the rates of hepatic VPA P-oxidation in patients of different ethnic and racial backgrounds. However, the review of population-based associative genetic research from around the world demonstrated the current lack of clarity in the prospects of translating international findings directly into Russian clinical practice through the development of PGx panels due to Russia’s ethnic/racial diversity and vast territory.</p></sec><sec><title>CONCLUSIONS</title><p>CONCLUSIONS. To increase the sensitivity and specificity of Russian PGx panels, bridging studies are required to extrapolate the associations established between the most common risk alleles and VPA P-oxidation disorders in other ethnic groups to a specific population of a specific Russian region.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>вальпроевая кислота</kwd><kwd>вальпроат-индуцированные нежелательные реакции</kwd><kwd>этнос</kwd><kwd>генетические полиморфизмы</kwd><kwd>аллельные варианты</kwd><kwd>цитохром Р450</kwd><kwd>фармакогенетическое тестирование</kwd><kwd>фармакогенетическая панель</kwd><kwd>персонализированная медицина</kwd></kwd-group><kwd-group xml:lang="en"><kwd>valproic acid</kwd><kwd>valproate-induced adverse reactions</kwd><kwd>ethnicity</kwd><kwd>genetic polymorphisms</kwd><kwd>allelic variants</kwd><kwd>cytochrome P450</kwd><kwd>pharmacogenetic testing</kwd><kwd>pharmacogenetic panel</kwd><kwd>personalised medicine</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена без спонсорской поддержки</funding-statement><funding-statement xml:lang="en">The study was performed without external funding</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Насырова РФ, Незнанов НГ, ред. 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