Review Article http://doi.org/10.18231/j.ijpi.2019.015 IP International Journal of Periodontology and Implantology, July-September, 2019;4(3):69-72 69 Personalised medicine – A recent revolution in periodontics Gomathi G D 1* , S. Gopalakrishnan 2 , Uma Sudhakar 3 1 Post Graduate Student, 2 Professor, 3 Professor and Head, Dept. of Periodontics, Thai Moogambigai Dental College & Hospital, Tamil Nadu, India *Corresponding Author: Gomathi G D Email: drgomathigd@gmail.com Abstract “Personalized medicine refers to applying pharmacogenomics to clinical management of an individual which utilizes new molecular tools & technology to facilitate individualized health care based on person’s unique characteristics enabling a higher level of personalization. Modifying genetic setup can prevent or cure a disease. Though the term personalized medicine Discovery of genes involved in drug metabolism & drug alternatives can prevent adverse drug interaction. This article highlights about personalized medicine & application of Pharmacogenomics in the field of Periodontology. Keywords: Genetics, Proteomic, Pharmacogenomics. Introduction Not all patients respond similarly to a drug administered. This is the reason for developing the concept of personalized medicine. Though the term “Personalized medicine” sounds unique, it is not a new concept but an extended form of traditional approaches in understanding and treating disease with greater precision. It is a medical model involving customization of healthcare with medical decisions, practices, and/or products tailored according to the each patient need based. 1 The older concept of ‘one cut fits all’ was replaced by newer personalized medicine concept because same treatment plan is not successful for all the patients. Inter-individual variability to treatment response develops as a consequence of host–environment– microbial interactions that give rise to a specific clinical phenotype. This phenotype is the reason for difference in patient’s response to the given treatment. 2 The field of personalized medicine relies on genetic, proteomic information and patient characteristics to individualize treatment. Patient’s profile with genetic variations guides the selection of drugs or treatment protocols minimizing harmful side effects & ensuring successful treatment outcomes. Periodontal diseases are complex, multifactorial inflammatory disease affecting the bone and soft tissue of the teeth. Genetics plays a major role in periodontitis. Though personalized medicine is an emerging field, the logic behind it is nothing new. Individualized care is provided based on a person’s unique genetic profile that uses molecular tests like gene mapping, DNA profile, receptor gene amplification test, fluorescence insitu hybridization (FISH), microarray test, AmpliChip CYP450 Test, etc. 3 Personalized medicine seeks to prevent and treat disease through analyzing the variables of every individual as “what is successful for one person may not work for someone possessing different genes, existing in a different environment, and a different lifestyle”. 4 History The observations of highly variable drug response, which began in the early 1950s, led to the birth of a new scientific discipline arising from the confluence of genetics, biochemistry, and pharmacology known as pharmacogenetics. 3 Sir Archibald Garrod [1902] was the first person to make connection between genetic inheritance and susceptibility to a disease called as Alkaptonuria. In 1956, the discovery of a genetic basis for selective toxicity was made for the antimalarial drug (primaquine). In 1977, discovery of role of cytochrome P450 metabolic enzymes in chemically altering levels in bloodstream led to the fact that variation in the level of these metabolic enzymes could have a definite impact on the dosage of a drug. In the late 1990s, the term ‘Personalized medicine’ was first introduced after its scientific basis had been set over the preceding decades. Pharmacogenomics combines genomics and pharmacology for developing effective, safe medications and doses based on a person’s genetic makeup. 5 Reasons for development of pharmacogenomics are: 1. The pathogenesis of most diseases are polygenic in nature 2. Most drugs exert actions in a multigenic manner 3. Complex interactions between the genes, environment, drugs, and pathogens Pharmacogenomics is the study of the identification of genes and their corresponding products which influence genes and their corresponding products that influence individual variation in the efficacy and/or toxicity of individual variation and/or therapeutic products, and the application of genomic therapeutic products, and genomic information to help inform therapeutic product development and/or clinical application. 6 This may include: 1. Choosing the most appropriate therapeutic product for a patient; 2. Selecting optimal dose; 3. Identifying those at risk for unexpected or more frequent adverse drug reactions. Using gene as a testing tool Genes are segments of DNA that are found in all cells that can influence a person’s response to medications. Genes have various forms and different chemical messengers, interactions of which affect drug activity in the body. 7 There