Polimorfismo genético en el paciente crítico. Parte II: Aplicaciones especiales de los polimorfismos genéticos. Farmacogenética y terapia génica

Our first article outlined some of the most important studies examining the effect of genetic polymorphism on inflammation and sepsis in critically-ill patients. In the present article, we discuss how genetic polymorphism will provide further information about coagulation and acute respiratory distress syndrome (ARDS). Furthermore, individual genetic variability may play a role in the outcome of trauma patients and of major surgery, such as cardiovascular surgery, by participating in pathophysiological events during and after surgery. Finally, the potential use of DNA as a therapeutic drug (pharmacogenetics and gene therapy) is discussed. Data are now available which will enable the use of possible genomic markers for risk stratification of patients and which will identify those at high risk for a poor outcome. The identification of inherited single gene disorders that participate in complex diseases has increased interest for gene-based therapeutic strategies.