A pharmacogenomics laboratory, which has been set up at the Pondicherry based Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) at a cost of Rs 26 lakh, has become operational this month.

"The key objective of our research project is to collect information about the pharmacogenomic profile of South Indian population," informed Dr C Adithan, Professor of Pharmacology, JIPMER. "We are nearing completion of the DNA analysis of samples from Tamilian population. Now, samples are being collected from Karnataka population. Following this, we will take up the analysis of Kerala and Andhra populations."

JIPMER, which includes a tertiary care referral hospital, comes under the direct administrative control of Directorate General of Health Services (DGHS).

The lab is expected to provide its services (subject to the availability of funds) to JIPMER hospital patients who will be receiving drugs with a narrow therapeutic index and a high variability in response. The information collected may help the physician to individualize drug selection and dosage. It is proposed to study its cost-effectiveness in Indian conditions. The lab will also provide training to Indian scientists in molecular pharmacogeneomics techniques.

The sponsors of the lab are JIPMER, ICMR (New Delhi), and Paris-based Inserm. Inserm carries out transfer of new knowledge and 260 pharmaceutical companies collaborate with the laboratories of the Institute through 720 contracts and more than 370 patents. The main collaborator for the JIPMER venture in Paris is Dr.R.Krishnamoorthy, Inserm Unité 458, Paris, who also happens to be JIPMER alumni.

Dr Adithan, who has undergone training at the Inserm Laboratory in Paris, told Pharmabiz.com that the lab equipment cost about Rs 20 lakh. "In addition, our Institute has spent about Rs 6 lakh for renovating the laboratory. The recurrent expenditure is high. The total recurrent expenditure depends on the number of samples and the number of alleles of each gene to be analysed."

An allele is any one of a series of two or more different genes that occupy the same position (locus) on a chromosome. Since autosomal chromosomes are paired, each autosomal locus is represented twice. If both chromosomes have the same allele, occupying the same locus, the condition is referred to as homozygous for this allele. If the alleles at the two loci are different, the individual or cell is referred to as heterozygous for both alleles.

According to Dr Adithan, pharmacogenetics, the older term largely used in relation to genes determining drug metabolism, has been replaced by the term pharmacogenomics which encompasses all genes that determine drug response. Deaths due to adverse drug reactions, the fourth largest cause of death after heart disease, cancer and stroke in the US, can be avoided if the physician has prior knowledge of the patient's genetic profile drug metabolizing enzymes and receptors which determine the drug response.

Dr Adithan believes that in the near future the US will be the first country where the current prescription model of "one dose for all" will be replaced by "the right drug in the right dose for the right person".

Inserm has also trained a senior technician of JIPMER at their pharmacogenomics laboratory at Paris. Besides, they have also deputed a Paris scientist for one month for establishing the lab and providing further training in Pondicherry.

The field of pharmacogenomics is still in its infancy in India, Dr Adithan says and suggests setting up of pharmacogenomics laboratories at select departments in the country.

While there is no likelihood of commercializing the findings of the department, Dr Adithan said the service would be extended to needy hospital patients, subject to the availability of fund.

The lab has a senior resident, two senior research fellows, one senior technician (Trained in Inserm Laboratory, France), four laboratory technicians and one lab assistant.

Talking on how expensive the genotyping facility would be, he said the approximate cost of genotyping in USA as follows: • By simple PCR for one mutation: ~$ 10; For 50 mutations: ~$ 150; By Chip for ~ 20 mutations: ~ $70; By Chip for 100 mutations: ~ $250.

To provide adequate information, the lab has to study the profile of at least 10 different alleles, he noted. "At present we are collecting information about the distribution of CYP2C9 (*1, *2,*3,*4 alleles), CYP2C19 (*1,*2,*3 alleles), CYP2D6 (*3,*4,*6*10, *6*5 alleles) and GSTT1/M1genes. We are also trying to find the relationship between genotype (CYP2C19 only at present) and phenotype of these subjects, " he added.