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Personalized treatment in the epilepsies: challenges and opportunities

Balestrini, S; Sisodiya, SM; (2018) Personalized treatment in the epilepsies: challenges and opportunities. Expert Review of Precision Medicine and Drug Development , 3 (4) pp. 237-247. 10.1080/23808993.2018.1486189. Green open access

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Abstract

Introduction: ‘Personalized’ medicine is not a new construct. Indeed, the science of medicine has been historically focused around notions of subgroups and categorization. A few decades ago, the Human Genome Project provided a complete resource of detailed information about the structure, organization, and function of the full set of human genes. This has enabled implementation of the idea that treatments could be targeted to genetically defined subgroups of individuals. / Areas covered: We provide an overview of the current pitfalls and opportunities of ‘personalized’ treatment in epilepsy. Development of targeted therapeutics has been so far mainly by repurposing drugs already available on the market but not necessarily approved for the treatment of epilepsy. Most genomic findings have not yet translated into widespread utilization for therapy. / Expert commentary: Genotypic and phenotypic heterogeneity, epigenetic modulation, variable penetrance and expressivity, environmental influence, and posttranslational changes are all factors that increase the complexity of genomic networks and generate pitfalls in the application of the ‘personalized’ treatment paradigm. Unraveling the multiple layers of biological complexity through new collaborative and computational approaches, and deep and multimodal phenotyping, is becoming fundamental for a better understanding of disease biology and in turn better tailored treatment strategies.

Type: Article
Title: Personalized treatment in the epilepsies: challenges and opportunities
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/23808993.2018.1486189
Publisher version: http://dx.doi.org/10.1080/23808993.2018.1486189
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Epilepsy, genomic, personalized medicine
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/10054822
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