Genetics of drug response to immunosuppressive treatment and prospects forpersonalized therapy

The use of immunosuppressive agents in the treatment of transplant rejectio n and autoimmune disorders is gaining momentum, with significant improvemen ts of both graft and patient survival. The individual response to drugs, ho wever, is variable and unexpected toxicity, or impaired activity might be s een, as a result of molecular determinants that eventually dictate how the individual will respond to immunosuppressive agents. This review addresses a number of issues related to pharmacogenetics, and discusses how this appr oach might be used to improve the clinical efficacy and tolerability of the rapeutic options for the management of organ transplantation and autoimmune disorders in the next decade.