Pharmaco-metabonomic phenotyping and personalized drug treatment

There is a clear case for drug treatments to be selected according to the characteristics of an individual patient, in order to improve efficacy and reduce the number and severity of adverse drug reactions1,2. However, such personalization of drug treatments requires the ability to predict how different individuals will respond to a particular drug/dose combination. After initial optimism, there is increasing recognition of the limitations of the pharmacogenomic approach, which does not take account of important environmental influences on drug absorption, distribution, metabolism and excretion3–5. For instance, a major factor underlying inter-individual variation in drug effects is variation in metabolic phenotype, which is influenced not only by genotype but also by environmental factors such as nutritional status, the gut microbiota, age, disease and the co- or pre-administration of other drugs6,7. Thus, although genetic variation is clearly important, it seems unlikely that personalized drug therapy will be enabled for a wide range of major diseases using genomic knowledge alone. Here we describe an alternative and conceptually new ‘pharmaco-metabonomic’ approach to personalizing drug treatment, which uses a combination of pre-dose metabolite profiling and chemometrics to model and predict the responses of individual subjects.We provide proof-of-principle for this new approach, which is sensitive to both genetic and environmental influences, with a study of paracetamol (acetaminophen) administered to rats. We show pre-dose prediction of an aspect of the urinary drug metabolite profile and an association between predose urinary composition and the extent of liver damage sustained after paracetamol administration

Re-Thinking Anxiety: Using Inoculation Messages to Reduce and Reinterpret Public Speaking Fears

<div><p>Inoculation theory offers a framework for protecting individuals against challenges to an existing attitude, belief, or state. Despite the prevalence and damaging effects of public speaking anxiety, inoculation strategies have yet to be used to help individuals remain calm before and during public speaking. We aimed to test the effectiveness of an inoculation message for reducing the onset of public speaking anxiety, and helping presenters interpret their speech-related anxiety more positively. Participants (<i>M</i>_<i>age</i> = 20.14, <i>SD</i> = 2.72) received either an inoculation (<i>n</i> = 102) or control (<i>n</i> = 128) message prior to engaging a public speaking task and reported a range of anxiety-related perceptions. Accounting for personality characteristics and perceptions of task importance, and relative to control participants, those who received the inoculation message reported significantly lower pre-task anxiety, and following the task, reported that they had experienced lower somatic anxiety, and that the inoculation message had caused them to view their nerves in a less debilitating light. Inoculation messages may be an effective strategy for helping participants reframe and reduce their apprehension about public speaking, and investigating their efficacy in other stress-inducing contexts may be worthwhile.</p></div

Sport, Stress und Gesundheit

Das Thema Stressregulation und Sport kann aus zwei unterschiedlichen Perspektiven betrachtet werden. Aus Sicht des Gesundheitssports geht es primär um Stressregulation durch Sport. Es stellt sich die Frage, inwieweit sich durch körperliche und sportliche Aktivität die Belastungen des Alltags besser bewältigen lassen, so dass Gesundheitsbeeinträchtigungen vermieden oder reduziert werden können. Aus Sicht des Leistungssports geht es um Stressregulation im Sport. Mit anderen Worten: Wie können Athleten und Athletinnen mit hohen Trainingsbelastungen und psychischem Druck umgehen, ohne dass dabei die Leistungsfähigkeit beeinträchtigt wird oder psychische Beschwerden entstehen? Hier geht es also um Faktoren, die dazu beitragen, dass Personen im Leistungs- und Spitzensport auch unter Druck ihre besten Leistungen abrufen können. Nachdem im ersten Teil dieses Kapitels die theoretischen Grundlagen erarbeitet werden, wird im zweiten Teil auf diese beiden Perspektiven eingegangen