Whether the powerful high-blood pressure medicine rostafuroxin will be effective for a particular patient can be predicted from a set of gene variants.
Giuseppe Bianchi at the Prassis sigma-tau Research Institute in Milan, Italy, and his colleagues show how the drug works. It normalizes sodium transport in the kidneys that is disrupted by two specific mechanisms: a mutated version of a protein called adducin and a boost in levels of a hormone called ouabain. The researchers identify several gene variants heralding the faulty mechanisms and, in a second paper, show that patients with certain combinations of variants in five specific genes respond well to rostafuroxin, but not necessarily to two other blood-pressure medicines.
The key combination of variants is present in about 25% of patients.
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Medicine: Profiling for blood pressure. Nature 468, 603 (2010). https://doi.org/10.1038/468603a
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DOI: https://doi.org/10.1038/468603a