Ever wonder why a certain medication may work great for a friend and do nothing for you? One reason could be the genes involved in transporting 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 is dissolved, absorbed, and then transported to the cells where it is going to act. Plus, it has to stay inside of those target cells.
Staying inside the cells - instead of the medicine being transported right back out of the cell - is where genetics comes in to play here.
Certain medications and toxins are transported back out of cells by an ATP-binding cassette transporter protein encoded by the ABCB1 gene.
In the epithelial cells that line your intestines, the ABCB1 proteins are involved in pumping substances back into the intestinal lumen. So imagine if you take an Allegra, it dissolves, gets absorbed, and then part of that gets pumped back into the intestines to be eliminated.
Genetic variants in ABCB1 affect how much stays in the cells vs getting eliminated (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 drug that treat cancer.
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