Ever wonder why a certain medication may work great for a friend and do nothing for you? Interestingly, it could involve specific genes that transport the medication into and out of your cells.
Let's take fexofenadine (Allegra) for example. You have watery eyes and a drippy nose during spring allergy season and take some Allegra to help with the symptoms. Once swallowed, that medication dissolves, goes through absorption, and then transports to the cells where it acts. Plus, it must stay inside of those target cells.
How the medication stays inside the cells - instead of being transported right back out of the cell - plays into genetics.
Certain medications and toxins transport back out of cells by an ATP-binding cassette transporter protein encoded by the ABCB1 gene.
In the epithelial cells lining your intestines, the ABCB1 proteins involve the pumping of substances back into the intestinal lumen. So imagine taking an Allegra, it then dissolves, gets absorbed, and then part of that gets pumped back into the intestines to be eliminated.
Genetic variants in ABCB1 affect the amount staying in the cells vs the elimination. (through intestines, bile, urine). In general, it is a good thing for the body to get rid of a substance that it thinks might be toxic.
While an allergy medication not working well for you isn't really a bid deal, the real problem comes when trying to keep chemotherapy drugs inside of cancer cells. Thus, this gene has been studied in depth for drugs that treat cancer.
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