In the last three years that the blog has been running we have heard from various innovative areas in TDM and clinical toxicology, but not yet about pharmacogenomics. This month Nicolas Picard shares about his experience and how it impacts variability in our core areas. We also hear about his vision for the future of clinical implementation and the emerging role of epigenetics.

Nicolas Picard

Professor, University of Limoges

Clinical Practitioner, Limoges University Hospital

Limoges, France

One of the things I love about the Compass is that we often gain a glimpse as to how historically we have come to where we are in the fields of Therapeutic Drug Monitoring and Clinical Toxicology. This month I revisited the December Compass where awardees from the Japan Congress reported about their experiences and life work.

Christoph Hiemke, recipient of the Charles Pippinger Award, shared the story of his involvement in demonstrating the usefulness of TDM in antidepressant management, from the start of his career as a professor in the late 80s, to chairing the publication of the latest international guideline in 2017. Alain Verstraete, recipient of the Irvine Sunshine Award likewise reflected over the last forty years of Clinical Toxicology.

Christoph Hiemke (left top)
University Medical Center Mainz, Mainz, Germany

Alain Verstraete (left bottom)
Laboratorium Voor Llinische Biologie, Gent, Belgium

This month we publish a contribution to the March Compass concerning the impact of severe inflammation on drug concentrations and Therapeutic Drug Monitoring, specifically in the context of Voriconazole metabolism. Anette Veringa and Jan-Willem Alffenaar present their work, writing on behalf of the Anti-Infective Drug Committee. Their findings have implications for any drug metabolized by CYP450 iso-enzymes, and highlights the importance of knowledge of patient genotypes. Drugs with extensive protein binding exhibit a further layer of complexity in managing these patients.

Anette Veringa (far left)
University Medical Center, Groningen, Netherlands

Jan-Willem C. Alffenaar (left)
University Medical Center, Groningen, Netherlands

This month we hear from Manuela Neuman, who joins Maria Shipkova as co-editor of our E-News. Manuela shares about her extensive experience, and her special contribution to understanding and diagnosing drug reactions of various types. Among her contributions is the Lymphocyte Toxicity Assay, an innovative diagnostic test that helps predict the drugs patients will react to, allowing the safe selection of therapy.

Manuela Neuman

Associate Professor, Faculty of Medicine, University of Toronto

CEO & CSO, In Vitro Drug Safety and Biotechnology,

Banting Institute, Toronto, CA