Laboratory of Personalized Health (LPH): Delivering Personalized Medicine in Real-time

The effectiveness of drugs and their potential for both benefit and side effects are not only the result of drug selection and dose but also the rate of drug metabolism and target interaction.  For many drugs, this metabolism is accomplished by the Cytochrome P450 (CYP450) enzyme system located in the liver.

Variability in the CYP450 system, accumulated in humans since prehistoric times, results in strikingly different drug levels, drug effectiveness and drug safety among individuals when the recommended dose is designed to treat the "average" person. These variances, particularly relevant to drugs used in mental health, cardio-metabolic disease, and pain control, can now be measured by DNA typing before treatment.  Drug doses can then be tailored to provide safe and effective therapy for individual patients (DNA-Guided Medicine).

The Laboratory for Personalized Health analyzes the CYP2C9, CYP2C19, and CYP2D6 genes simply from a blood sample or buccal swab from the patient.  LPH then assists in the interpretation of these results for DNA-guided medical management of serious side effects and individualized optimization of therapy.  The genotype results and guidance delivered by LPH markedly improve the safetly and efficacy of drug therapy by providing:

  • Assessment of the patient's innate functional status for the 3 key CYP450 isoenzymes relevant to the metabolism of neuro-psychiatric and cardio-metabolic drugs: CYP2D6, CYP2C9, and CYP2C19.
  • High-resolution genotyping of a total of 37 variants in the genes coding for these isoenzymes: CYP2D6 (20 alleles), CYP2C9 (7 alleles), CYP2C19 (10 alleles).
  • Well-characterized ultra-rapid promoter alleles for genes CYP2D6 and CYP2C19 (*2a and *17, respectively) conferring gain of metabolic function in carriers
  • Objective Indices for Metabolic Reserve and Alteration, Allele and Gene Alteration
  • Analysis of the VKOR gene coding for Vitamin K Epoxide Reductase, the target for the anticoagulant drug warfarin, and interpretation for gene-guided warfarin dosing

Personalized Health Portal (PHP): Medical Informatics Enabling DNA-Guided Medicine

The Personalized Health Portal integrates pharmacokinetic information available from the FDA, drug manufacturers, pharmacogenetic databases and studies by Genomas to determine the drugs that each patient would be most likely to tolerate and process given the person's innate drug metabolism capacity determined by the HILOmet PhyzioType System. PHP provides therapeutic guidance for 250 medications: 130 neuro-psychiatric drugs (antidepressants, neuroleptics, anticonvulsants, anxiolytics, stimulants, analgesics, hypnotics) and 120 cardio-metabolic drugs (to treat hypertension, diabetes, angina, thrombosis, GERD, ED, asthma). PHP is covered by U.S. Copyright Registration Number VA 1-797-692 (Personalized Health Portal).

Personalized Health Portal

MEDtuning ReportŠ: Prescription of Best Drugs

MEDtuning is a genetic assessment of the medicines currently prescribed or being considered for the patient. MEDtuning extends to 160 Neuro-Psychiatric and 140 Cardio-Metabolic drugs featured in the Personalized Health Portal. MEDtuning is used for patients on multi-drug regimens (poly-pharmacy) for the common diseases in general medicine and mental health: blood pressure, cholesterol, heart attacks, depression, diabetes, asthma, heartburn, inflammation, blood clots, pain management, acid reflux, sexual dysfunction, addiction, diabetes, sleep. You will recognize poly-pharmacy as most common in the elderly and in diabetic patients. The elderly and diabetic are fragile patients, who require the precision medication prescription afforded by MEDtuning.

The illustration in color shows a MEDtuning Report for a diabetic patient with such poly-pharmacy, revealing 4 contraindicated drugs (red), 1 monitored drug (yellow) to

be dosed lower range, and 2 appropriate drugs (green) to be dosed at high range normal. The MEDtuning of prescription drugs to the innate drug metabolism capacity is essential to determine their suitability to the patient, resulting in optimized medical treatment.

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