Pharmacology, Toxicology and Environmental Health Commons^™

Health Risk Assessment Of Heavy Metal(Loid)S Intake From Beverages In The United States, Hannah T.V. Stoner, Tewodros Rango Godebo, Pornpimol Kodsup Taylor

School of Public Health Faculty Publications

Heavy metals in beverages can pose health risks in an exposure-dependent manner, however, few studies in the United States have evaluated their metal content and health risks. This study determined the concentrations of eight metal(loid)s, As, Al, Cd, Cr, Mn, Ni, Pb, and Zn, in 60 beverages via inductively coupled plasma[sbnd]mass spectrometry (ICPMS). The highest median concentrations (µg/kg) were found in mixed fruit juices for Ni (45.7), Cr (14.8), and As (4.5); tea for Mn (5,300), Al (730), and Pb (1.4); and plant-based milk for Zn (835) and Cd (1.1). Chronic daily intake (CDI) across age groups was calculated using …

The Importance Of Well-Being For College Students, Benjamin Williamson, Dr. Mary Jan Greer, Phd, Otr

Spring 2025 OTD Capstone Symposium

Provided education on well-being, enabled independence, and improved quality of life, specifically for college students in this setting.

Advocate for Sustainable Programs:

Advocated for more programs to address the needs of college students and integrated all 8 dimensions of wellness into their current lifestyle

Support Academic Advancement:

Addressed college students' needs for overcoming occupational adversities which affects the longevity and academic success of college students

Motivate College Students:

Provided accessible and occupation-based resources that supported participating college students in independently improving their occupational roles

Advance Holistic Based Strategies:

Incorporated holistic based strategies that apply to each occupational role affecting participating …

Psilocybin Impairs The Extinction Of Contextual Fear In Adult Female, But Not Male, Rats, Lillianna P. Puppel, Aleece K. Al-Olimat, Kylie M. King, Marisa J. Savini, Claire E. Miller, Colin R. Del Valle, Heather R. Sparkman, Brooke E. Bramlage, Phillip R. Zoladz

ONU Student Research Colloquium

Fear-related disorders are often treated with exposure therapy, a technique based on the concept of extinction. However, this type of therapy is ineffective for many individuals, so finding a pharmacological adjunct that augments the extinction of fear could lead to better treatment outcomes. In recent preclinical work, investigators have shown that psychedelics can accelerate the extinction of fear, potentially through their impact on neurotrophic signaling. We previously found that psilocybin exerted sex-dependent effects on the extinction of conditioned fear to an isolated cue (i.e., a tone). Specifically, psilocybin enhanced the extinction of cue fear in male rats but impaired it …

How Can The Adoption Of Biodegradable Packaging In The Beverage Industry Specifically Contribute To Reducing Single-Use Plastic Waste, And What Regulatory Or Cost-Related Challenges Hinder Its Widespread Implementation In Developing Countries?, Rebecca Aba Gaisie

2025 Awards for Excellence in Student Research and Creative Activity - Documents

This research investigates the potential of biodegradable packaging to reduce single-use plastic waste in the beverage industry and explores the regulatory and cost-related barriers to its adoption in developing countries. The beverage sector is a major contributor to global plastic pollution, and biodegradable alternatives offer a promising path toward sustainability. Using a mixed-methods approach, this study combines qualitative interviews with industry experts and case studies of businesses implementing biodegradable solutions, alongside quantitative survey data from 100 manufacturers and 200 consumers across Africa, Asia, and Latin America. Findings reveal that while biodegradable packaging significantly reduces plastic waste and appeals to environmentally …

Investigating Mercury Contamination In Urban Fish: Atomic Absorption Spectroscopy And Histological Analysis For Environmental And Human Health, Indy L. Cockrill, Ross Andrew

SPARK Symposium Presentations

Mercury contamination in aquatic ecosystems is a pressing environmental and public health concern, particularly in urban areas where industrial runoff and wastewater contribute to heavy metal accumulation. This study investigates mercury presence in fish from Richland Creek in Nashville, TN, by analyzing histological changes in liver and muscle tissues. Mercury bioaccumulates in aquatic food chains, potentially leading to physiological damage in fish and posing health risks to humans who consume contaminated seafood. While prior research has established mercury’s toxic effects, there is a need for localized studies assessing its presence in urban waterways. The hope is to find histological abnormalities …

Investigation Of The Effects Of The Peptidylarginine Deiminase Inhibitor Cl-Amidine On Apoptosis And Gene Expression In Ovarian Cancer, Victoria Walden

Longwood Senior Thesis Proposal

Peptidylarginine deiminases (PADs) are a family of enzymatic proteins responsible for the conversion of arginine and methylarginine residues to citrulline. This conversion is important for several key cellular processes including transcriptional gene regulation. Recently, a link has been established between overexpression of a particular PAD, PAD4, and the accelerated progression of both autoimmune diseases and cancers. Ovarian cancer exhibits heightened levels of PAD4 in affected cells. High levels of PAD4 are associated with the formation of neutrophil extracellular traps (NETs) that promote cancer metastasis, and downregulation of the p53 apoptotic pathway. Thus, it is important to explore inhibitors of PAD4. …

The Pharmaceutical Applications Of Poisonous Compounds Found In Datura Stramonium, Ruby M. Raffaldt

Senior Theses

Datura stramonium is a plant that is known for its toxicity. However, a facet of this plant’s noxious chemicals, namely its tropane alkaloids, can be used medicinally. The aim of this paper was to compile knowledge on the botanical, chemical, and medicinal properties of Datura stramonium L with a focus on atropine, scopolamine, and anisodamine; three tropane alkaloid compounds with the ability to be both a poison and a medicine. Information was compiled using pre-existing studies, articles, and literature reviews on D. stramonium. For each of the three alkaloids, their biosynthetic pathways, targets, administration, distribution, metabolism, and excretion were discussed. …

Antituberculosis Potential Of Borrelidin Derivatives: An In Silico Molecular Docking And Molecular Dynamic Approach, Teni Ernawati, Donny Ramadhan, Faris Hermawan, Sasmito Wulyoadi, Bambang Marwoto, Ahmad Wibisana, Bambang Srijanto

The Thai Journal of Pharmaceutical Sciences

Background: The present tuberculosis (TB) treatment requires a significant time commitment, often lasting from 6 months to 2 years, with strict daily adherence. Non-compliance leads to drug resistance and suboptimal outcomes. Present research indicates that borrelidin shows potential activity against Mycobacterium tuberculosis, including strains that are resistant to first-line medications. Borrelidin has shown remarkable activity against M. tuberculosis H37Rv, with a minimum inhibitory concentration value of 3.12 μg/mL. Therefore, investigating the inhibition activity of borrelidin derivatives was essential for finding new anti-TB candidates. Objectives: This study aims to investigate the effects of 31 borrelidin derivative compounds …

Preparation And Evaluation Of Mesoporous Celecoxib For Improved Antiarthritic Activity In Rodents, Reena I. Fernandaes, Sayani Bhattacharyya

The Thai Journal of Pharmaceutical Sciences

Background: Celecoxib, a model anti-inflammatory drug, used in the management of arthritis exhibits limited oral bioavailability and slow onset of action due to its poor solubility. Objective: The present study explores a mesoporous drug delivery of celecoxib to investigate the efficacy of its antiarthritic activity in animal models, and develops a low-oral dose therapy. Materials and Methods: The solvent evaporation method was employed for the preparation of mesoporous delivery of celecoxib, using Syloid^®, and Neusilin^®, at a molar ratio of silica/ drug 1:2.5. The formulations were characterized for drug loading, in vitro drug release, and material …

Enhancing Topical Drug Delivery Of Apremilast Through Niosomal Gel Formulation: Ex Vivo Skin Permeation And In Vivo Evaluation For Psoriasis, Megha Shyam Matlapudi, Anka Rao Areti, Yukti Jaiswal, Veeresh Bantal, Raghavender Medishetti

The Thai Journal of Pharmaceutical Sciences

Background: Psoriasis is a dynamic and chronic disease characterized by inflammatory changes and an increased rate of keratinocyte proliferation leading to the formation of erythematous scleroderma plaques with a silvery sheen. The existing therapies come with shortcomings in terms of effectiveness and leave behind a trail of side effects. Hence, there is a need of alternative therapeutic measures. Objectives: This study aimed to assess the therapeutic potential of Apremilast Niosomal Gel (APR Nio Gel) in treating psoriasis, comparing its effectiveness with conventional gel (APR Gel) and oral suspension (APR Oral) formulations. Materials and Methods: Apremilast niosomes were prepared by thin …

Bacillus Coagulans 198 And L-Glutamine In Combination Attenuated Intestinal Mucositis In A 5-Fu-Induced Balb/C Mouse Model Via Modulation Of Gut Microbial Community Structure And Diversity, Wei-Jen Chen, Siou-Ru Shen, Wei-Hsuan Hsu, Bao-Hong Lee, Yu-Shan Wei, Hui-Fang Chu, Ming-Chung Tseng, Tang-Long Shen

Journal of Food and Drug Analysis

5-Fluorouracil (5-FU) disrupts intestinal cells and causes dysbiosis in the gut microbiota. This study explores the potential of Bacillus coagulans-198 (BC198) to mitigate gut microbiota imbalance and mucositis caused by 5-fluorouracil. L-glutamine is used to alleviate mucositis, and this study found that BC198 exhibits protective effects on the gut, including maintaining a healthy microbiota and reducing intestinal inflammation, regardless of whether L-glutamine is used in combination. Therefore, it can help reduce the deterioration of the gut environment caused by 5-fluorouracil. BC198 can be provided to cancer patients to prevent severe side effects, thereby improving their treatment outcomes and nutritional …

Protective Role Of Hsian-Tsao Ethanol Extract Against Body Fat, Serum Lipid Profiles, And Hepatic Lipid Profiles In High-Fat Diet-Fed Rats, Ching-Chang Cho, Gow-Chin Yen, Hsin-Yi Lee, Chun-Tse Tsai, Wei-Tang Chang, Chin-Lin Hsu

Journal of Food and Drug Analysis

This study investigated the preventive effects of a 40% ethanol extract of Hsian-tsao (40EEHT) on obesity in high-fat diet (HFD)-induced obese rats. Male Wistar rats were administered 0, 100, 200, or 500 mg/kg of 40EEHT, resulting in reduced body weight, total body fat, and hepatic tissue weight after 8 weeks. 40EEHT also decreased adipocyte size, improved lipid profiles, alleviated oxidative stress, and enhanced hepatic antioxidant enzyme activities. Additionally, it regulated fatty acid metabolism by reducing lipogenesis and increasing lipolysis and β-oxidation, suggesting its potential as an anti-obesity dietary supplement.

Xanthohumol As A Potential Therapeutic Strategy For Acute Myeloid Leukemia: Targeting The Flt3/Srpk1 Signaling Axis, Duan-Na Zhang, Wen-Ya Yang, Xiao-Xue Hu, Xiao-Min-Ting Song, Chuan-Jie Guo, Fu Peng, Yu-Zhi Li, Zhi-Xing Cao

Journal of Food and Drug Analysis

Xanthohumol (XN) is an isoprene chalcone found in hops (Humulus lupulus L.), a food ingredient with a wide range of pharmacological activities. The aim of this study was to reveal the therapeutic effect of XN on acute myeloid leukemia (AML) and the potential underlying molecular mechanism. Through network pharmacology analysis, molecular docking, and HTRF determination, XN was shown to inhibit the kinase activities of FLT3 and SRPK1 by targeting their ATP-binding domains, with IC₅₀ values of 1.51 ± 0.44 μM and 0.37 ± 0.15 μM, respectively. By inhibiting AML cell proliferation, promoting apoptosis, regulating autophagy, and inhibiting …

Within-Trial Cost-Effectiveness Of Novel Macrophage-Regulating Treatment On Wound Healing In Patients With Diabetic Foot Ulcers, Hsuan-Yu Su, Chen-Yi Yang, Yi-Hsin Chang, Shyi-Gen Chen, Jui-Ching Chen, Hui-Ju Ho, Huang-Tz Ou, Shihchen Kuo

Journal of Food and Drug Analysis

An M1/M2 macrophage-regulating treatment, ON101 cream, has shown its superior healing efficacy for diabetic foot ulcers (DFUs) versus standard absorbent dressing, according to a phase Ⅲ trial. Given its high cost, corroborating the economic value of ON101 treatment can facilitate clinical and policy decision-makings. This study sought to evaluate the cost-effectiveness of ON101 versus an absorbent dressing for patients with DFUs from Taiwan's healthcare sector perspective. This economic evaluation utilized effectiveness and cost data (in 2022 USD) from a randomized controlled trial of ON101, published literature, and Taiwan’s National Health Insurance program. Incremental cost-effectiveness ratio (ICER) against willingness-to-pay (WTP) threshold …

Method Development For The Determination Of Phosphine Residues In Foods, Shu-Wei Lin, Yu-Ting Liu, Ya-Chun Chou, Yu-Ching Hung, Shu-Han Chang, Ya-Min Kao, Su-Hsiang Tseng, Der-Yuan Wang

Journal of Food and Drug Analysis

Phosphine (PH₃) is a fumigant used for pest control of stored products and foods. In Taiwan, PH₃ has the maximum residue level (MRL) in 14 foods, including dried fruits, vegetables, spices, nuts, crops, roots, and tuber vegetables. In this study, gas chromatography/mass spectrometry coupled with a headspace sampler (HS-GC/MS) was used to determine the PH₃ content in foods. The stability of the PH₃ standard was evaluated either directly using the gas standard or indirectly using zinc phosphide (Zn₃P₂) with an acid. The optimal conditions for the headspace agitator were determined to …

A Deep Dive Into The Orchard Of Health: Exploring The Anti-Cancer And Anti-Aging Potential Of Apple Polyphenols, Li-Ching Chen, Han-Sheng Chang, Yuan-Soon Ho

Journal of Food and Drug Analysis

Apples, a ubiquitous and beloved fruit, harbor a treasure trove of bioactive compounds, with apple polyphenols (APs) taking center stage. This review delves into the latest scientific advancements illuminating the anti-cancer and anti-aging properties of APs. We dissect the intricate mechanisms by which APs combat cancer initiation, progression, and metastasis, highlighting their prowess in inducing apoptosis, inhibiting angiogenesis, and modulating cell signaling pathways. Furthermore, we explore the multifaceted ways APs combat aging, including their potent antioxidant and anti-inflammatory actions, DNA protective effects, and ability to modulate cellular processes like autophagy and metabolism. This comprehensive review underscores the therapeutic promise of …

Two Unique Cases Of Ponderosa Pine Needle-Induced Abortions, Kevin D. Welch, Megan A. Dietz, Steven E. Edmonds, Dale R. Gardener, Daniel Cook

Poisonous Plant Research (PPR)

Ponderosa pine (Pinus ponderosa) needles can induce abortions in cows when consumed during the last trimester of pregnancy. Traditionally pine needle-induced abortions occur in areas where cattle are forced into a stand of ponderosa pine trees to seek shelter and feed during a winter storm that is either very cold, has heavy snow or high winds. However, here we report two incidences of pine needle-induced abortions in cattle that were unique. In one case, there was no weather-related event that forced the cattle into the stand of pine trees, rather the cattle went into the pine trees seeking …

Editorial: Old Drugs: Confronting Recent Advancements And Challenges, Anna Wiktorowska-Owczarek, Diego Iacono, Magdalena Jasińska-Stroschein

Department of Neurology Faculty Papers

No abstract provided.

Adiporon, Adiponectin Receptor Agonist, Exhibits Antiproliferative And Apoptotic Effects In Ht29 And Hct116 Colon Cancer Cells, Arwa Fairaq, Ashraf N. Abdalla, Alanood S. Algarni, Yosra Alhindi

Saudi Toxicology Journal

AdipoRon is the first synthetic analog of endogenous adiponectin, which is an adipose tissue derived hormone. As it is characterized with pharmacological properties like adiponectin through binding and activating AdipoR1 and AdipoR2 receptors this makes it a target for therapeutic treatments for a multitude of disorders. In this study AdipoRon effect on HT29 and HCT116 colon cancer cells were investigated. Cytotoxic activity of AdipoRon was observed, with a significant inhibition rate in HT29 and HCT116 cells. Moreover, there was a significant decrease in the number of HCT116 colonies by clonogenicity test. In addition, cell migration assay showed significant decrease in …

Exploring The Therapeutic Potential Of Trigonella Foenum-Graecum Extract-Loaded Transferosomal Gel In Freund's Complete Adjuvant-Induced Rat Models., Vandana Singh Ms., Hema Arya Ms., Bhavana Singh Dr., Koushal Dhamija Mr., Preeti Singh Dr., Gautam Kumar Dr.

Chulalongkorn Medical Journal

Abstract:

Background: Rheumatoid arthritis (RA) is a debilitating autoimmune disorder characterized by inflammation and joint damage.

Objective: This study aimed to evaluate the antiarthritic activity of Trigonella foenum-graecum (TFG) Transferosomal gel in a Freund’s adjuvant-induced arthritic rat model and compare it with Diclofenac gel, a standard anti-inflammatory drug.

Methods: Arthritis was induced in rats by injecting a 0.1 mL (1mg/ml) CFA suspension into the left hind foot in the subplantar region, allowing them to develop arthritis for 21 days.

Results: Arthritis induction led to a significant increase in paw volume, indicative of inflammation. Treatment with both TFG-transferosomal gel and Diclofenac …

Awareness Of Aspirin’S Dual Role As An Anti-Cancer Agent And Anti- Thrombotic Agent And Its Association With Medication Adherence To Low-Dose Aspirin: A Cross-Sectional Study, Hadhyah N. Alabdali, Sarah S. Al- Harbi, Layan Z. Sharalahi, Yosra Z. Alhindi

Saudi Toxicology Journal

Background: Aspirin is known to be an effective antithrombotic agent. Multiple studies have been studying its effect on cancer as colorectal cancer. Aim: This study aimed to measure the Awareness of Aspirin's Dual Function as an Anti-Cancer Agent and Anti-Thrombotic among Residents of the Makkah region in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted involving 490 participants from the Makkah region. Data collection was achieved through a self-reported online questionnaire and distributed via social media platforms from period of November 2024 until January 2025. Results: Over 340 of the participants in this research have bachelor's degrees. …

Continuous Exposure To An Aversive Mixture: A Means Of Maintaining Aversion In Sheep Averted To Geigeria Ornativa O. Hoffm. (Vermeerbos) - An Assessment, Leendert D. Snyman

Poisonous Plant Research (PPR)

Establishing aversion to Geigeria ornativa only lasts for some time, after which the induced aversion disappears and sheep start eating G. ornativa again. This behavior is aggravated by the social influence of non-averted sheep in mixed grazing situations. Exposing sheep continuously to a so-called “aversive mixture”, containing an aversive substance (lithium chloride) and the sensory characteristics of the plant (hexane extract of G. ornativa) mixed with a tasty meal (maize meal), following an initial aversion treatment, resulted in sustained aversion to G. ornativa in the field. This method proved to be applicable to mixed grazing situations with averted and …

Could Psilocin Rescue Chronic, Stress-Accelerated, Transcriptional Aging In Brain?, Danny R. Craig, Eric M. Blalock

Journal of Pharmacology & Nutritional Sciences

Brain aging (BA) processes are complex, often affect multiple systems, and frequently lead to cognitive decline and increased susceptibility to insults. BA appears to be a primary risk for the development of many prominent neurodegenerative pathologies. The US Census Bureau predicts that the aging population (65+) will represent a greater proportion of the US population than children (under 18) by 2034, dramatically increasing the burden on health-care infrastructure.¹⁷ Several mechanisms of stress driven, aging-related neurologic dysfunction have been advanced in the past 50 years and include: Stress hormone exposure and glucocorticoid cascade;^{7, 16} calcium ion dyshomeostasis;⁸ allostatic …

Pharmacodynamics Of Aspirin Through Gestation: Predictors Of Aspirin Response And Association With Pregnancy Outcome, A Prospective Cohort Study, Rupsa C. Boelig, Emily Foecke Munden, Tingting Zhan, Steven E. Mckenzie, Walter K. Kraft

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Low-dose aspirin is recommended for prevention of hypertensive disorders of pregnancy (HDP) and preterm birth (PTB) in high-risk pregnancies. There is limited data on factors impacting aspirin response in pregnancy. We aimed to evaluate predictors of aspirin response and association with pregnancy outcome with a prospective study of high-risk pregnancies taking 81 mg aspirin daily. Aspirin response was evaluated with Platelet Function Assay-100 (PFA-100) epinephrine closure time at baseline (< 16 weeks' gestation), follow-up 1 (2-4 weeks after aspirin initiation), and follow-up 2 (28-32 weeks gestation). Multivariable regression was used to identify factors associated with PFA-100 at each visit, and results presented with beta coefficient (B) and confidence interval. The median difference (MD) in PFA-100 in those with and without HDP or PTB was compared. Results included 108 who completed follow-up 1 and 96 who completed both visits with > 75% adherence. PFA-100 was increased from baseline at follow-ups 1 and 2 (MD 37 (27-49); MD 26 (15.5-38.5) respectively). At follow-up 1, obesity (B = -30 (-53 to -7) seconds), …

Putting The Substance In Substantial Evidence: An Evidence-Based Approach To Flexible Drug Regulation, Emanuel Krebs, Tania M. Bubela, Melanie Mcphail, Christopher Mccabe, Dean A. Regier

Office of the Provost

For new drugs or indications, substantial evidence of clinical effectiveness is required for market authorization. In most jurisdictions, substantial evidence is not explicitly defined. Health regulators exercise discretion and are increasingly tolerant of earlier or less mature evidence. To align with flexible evidentiary standards, we argue for the adoption of a principle and, context-based approach to the evidence threshold. Our approach aims to balance the potential benefits and harms of accelerated authorization, low therapeutic value, and safety, based on a value of information (VoI) framework. In our VoI framework, substantial evidence exists when the expected net health value of further …

Antiseizure Medications And Their Differing Effects On Cardiovascular Risk, Aleena Abbasi, Bassil Abbasi, Scott Mintzer, Carla Lopinto-Khoury

Department of Neurology Faculty Papers

This review discusses the differing effects of enzyme-inducing and non-inducing antiseizure medications on cardiovascular risk and their implications for the management strategies of epilepsy patients. Traditional risk markers, including low density lipoprotein, high density lipoprotein and triglycerides, can be altered by both enzyme induction and inhibition. Other markers of vascular risk, including c-reactive protein, non-high-density lipoprotein and homocysteine, are affected by antiseizure medications, although adults and children may have different responses. The overall atherosclerotic risk picture is more complex due to indirect effects such as neuroendocrine function and the metabolic syndrome. Large scale data shows an evolving understanding of cardiovascular …

Overexpression And Biophysical And Functional Characterization Of A Recombinant Fgf21, Phuc Phan, Jason Hoang, Thallapuranam Krishnaswamy Suresh Kumar

Chemistry & Biochemistry Faculty Publications and Presentations

Fibroblast growth factor 21 (FGF21) is an endocrine FGF that plays a vital role in regulating essential metabolic pathways. FGF21 increases glucose uptake by cells, promotes fatty acid oxidation, reduces blood glucose levels, and alleviates metabolic diseases. However, detailed studies on its stability and biophysical characteristics have not been reported. Herein, we present the overexpression, biophysical characterization, and metabolic activity of a soluble recombinant FGF21 (rFGF21). The far-UV circular dichroism spectra of rFGF21 show a negative trough at 215 nm, indicating that the protein’s backbone predominantly adopts a β sheet conformation. rFGF21 shows intrinsic tyrosine fluorescence at 305 nm. Thermal …

Pulmonopoly: A Game-Based Approach To Teach And Reinforce Basic Concepts Of Pulmonary Medicine To Medical Students, Michael Dong, James Uricheck, Urvashi Vaid

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

INTRODUCTION: Pulmonopoly is an innovative active-learning medical board game addressses core pulmonary concepts in an engaging, competitive style. The strength of Pulmonopoly lies in its ability to combine ease of setup and play with comprehensive content coverage that comprises a significant proportion of national board examinations, offering a gamification experience that can be readily applied in different settings and modified for learner levels.

METHODS: We created an instructional game, Pulmonopoly, based on pulmonary content delivered to preclinical medical students and required for national board examinations. We invited first-year medical students to participate in 60-minute small-group sessions. Content addressed pulmonary subject …

Retrospective Analysis Of Angiotensin Receptor Blockers And Knee Cartilage Volume In Osteoarthritis: Evidence From The Osteoarthritis Initiative, Parv Kale, Vijay Kale

Annual Research Symposium

No abstract provided.

Pharmacogenomics Implications Of Tamoxifen In Breast Cancer Treatment: Clinical Relevance And Future Directions, Khalda E. M. Elhaj, Mahmoud M. E. Mudawi, Hamad A. Albagir A. Ali, Kamal A.A. Mohammed

Saudi Toxicology Journal

Tamoxifen is a cornerstone therapy for estrogen receptor-positive (ER+) breast cancer, improving survival and reducing recurrence. Its efficacy and toxicity, however, vary due to genetic polymorphisms influencing metabolism and transport. Key genes, such as CYP2D6, CYP3A4, and ATP-binding cassette transporters (ABCB1, ABCC2), are crucial in forming and distributing active metabolites like endoxifen. This review explores tamoxifen pharmacogenetics through an analysis of literature from PubMed, Scopus, Google Scholar, and PharmaGKB. Genetic variations like CYP2D6*10 in Asians and CYP2D6*17/29 in Africans impact therapeutic outcomes. Barriers to personalized tamoxifen therapy include inconsistent guidelines, limited access to genetic testing, and underrepresentation of ethnic groups …