Page 126 - Genomic Medicine in Emerging Economies

Introduction 115

In 2016 they had data for 6060 healthy volunteers (admixed, Caucasians,
native Americans, Jews, and Afro-descendants) (Sosa-Macias et al., 2016).
Other international initiatives that are carrying out pharmacogenetic research
and promoting pharmacogenetics in Latin America are the Pharmacogenetics
for Every Nation Initiative (PGENI) (http://www.pgeni.org) and The Golden
Helix Institute of Biomedical Research (http://goldenhelix.org).
Most of the regulatory agencies in Latin America do not enforce specific regula-
tions for conducting pharmacogenetic research. Regulations may be inferred
from general norms of clinical research and international regulations. In the
case of new drugs, sponsors that perform pharmacogenetic studies are required
to gain regulatory approval, and specific guidelines for pharmacogenetics eval-
uation is needed in most Latin American countries (Quinones et al., 2014).
Other international resources of interest are the Pharmacogenomics Research
Network (PGRN) (www.pgrn.org), the Clinical Pharmacogenetics Implemen-
tation Consortium (CPIC) (www.pharmgkb.org/page/cpic), and the Pharma-
cogenomics Knowledge Base PharmGKB www.pharmgkb.org.

Perspectives for Future Studies
Several challenges remain for a broad implementation of genomic medicine
into the care of NPDs in Latin American countries. In the last 20 years, we have
learned that NPDs are complex and multifactorial entities, with the potential
effect of hundreds of genetic and epigenetic factors interacting with multiple
environmental variables, leading to particular individual susceptibilities to
specific diseases (Burmeister et al., 2008).

In Latin America, because of historical reasons, research initiatives into NPDs
are usually not included in the top national priorities, leading to lack of
adequate funding for the organization of the necessary clinical services and
research infrastructure. There is the need for larger public and private funding
for research into NPG in Latin American countries (Sharan et al., 2009). For
this increase in funding, it will be fundamental that researchers develop more
activities aimed to create a deeper awareness of the importance of research into
NPG among the general public, regional and national governments, profes-
sional and academic societies, and other key stakeholders. Data about preva-
lence, heritability, and burden of NPDs will help to show that they should
become key priorities for research in Latin America (Forero et al., 2014). Most
of the epidemiological studies performed in Latin America have been cross-
sectional works that did not include subsequent follow ups. The development
of longitudinal cohort studies in the general population will open new ave-
nues for research, both nationally and internationally.

Collaborations between laboratories are fundamental for research projects
in NPG and are vital for a deeper understanding of the pathophysiology of