Introduction to Pharmacogenomics: Role of the Histocompatibility and Immunogenetics Laboratory in Personalised Medicine-Current Status and Future Prospects.

This review provides an introduction to the rapidly expanding field of pharmacogenomics and personalised medicine, with especial relevance and focus for those working in clinical Histocompatibility and Immunogenetics (H&I) laboratories supporting HLA and disease immunogenetic testing and transplantation programmes. Drug efficacy and adverse drug reactions (ADRs) are defined, and the historical background to the field is introduced, along with a current overview of established clinically actionable gene-drug interactions. HLA associations with ADRs are reviewed, including those associations already tested for in many H&I laboratories worldwide, along with a broader overview of published HLA and ADRs, to determine which-if any-associations are likely to be of clinical significance and might be added to the testing repertoire. This review is intended to inform such decision-making. In addition, pharmacogenomics as related to the transport and metabolism of immunosuppressive drugs used in clinical transplantation is considered, again with relevance to the testing repertoire of clinical H&I laboratories. Finally, the expanding role of HLA genotyping in cancer immunotherapies is discussed, along with future developments in the broader pharmacogenomics field and how H&I laboratories can contribute to this.