Recent pharmacoproteomics studies of warfarin in the Asia-Pacific: A new strategy for personalized medicine?

Warfarin is an oral anticoagulant used worldwide for prevention and treatment of thromboembolic disorders. Marked inter-individual responses to warfarin have been a mainstay challenge to optimal prescription of warfarin. More recently, clinical pharmacogenomics studies of warfarin have categorized patients into low- and high-dose groups, in part by associating warfarin dosing with patients' genomic variation. It is expected that post-genomics methodologies such as pharmacoproteomics, by analyzing differentially expressed proteins, will provide additional insights on mechanisms of warfarin dosage variations. As thromboembolic disorders are vastly prevalent in both the developed and the resourcelimited countries, warfarin studies in western countries should be complemented by those in the Asia-Pacific region so as to account for global variations in the human genome and proteome, not to mention the diverse regional differences in environmental exposures. This paper offers an introduction to personalized warfarin dosing, followed by current advances in warfarin pharmacoproteomics. Furthermore, the biotechnology associated with pharmacoproteomics is discussed, as well as a brief summary of approaches to warfarin therapy in the Asia-pacific region. Finally, trends on recent miniaturization of pharmacoproteomics and other "-omics" applications in pharmacology are offered as a future outlook in this nascent field of post-genomics medicine and personalized therapeutics.