{"id":1384299,"date":"2026-09-21T10:05:46","date_gmt":"2026-09-21T08:05:46","guid":{"rendered":"https:\/\/dnaera.com\/cs\/?p=1384299"},"modified":"2026-09-21T10:05:47","modified_gmt":"2026-09-21T08:05:47","slug":"sertralin-a-geny","status":"publish","type":"post","link":"https:\/\/dnaera.com\/cs\/blog\/sertralin-a-geny\/","title":{"rendered":"Sertralin a geny: pro\u010d p\u016fsob\u00ed tento l\u00e9k na ka\u017ed\u00e9ho jinak?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><em><em>Deprese a \u00fazkostn\u00e9 poruchy pat\u0159\u00ed mezi nej\u010dast\u011bj\u0161\u00ed du\u0161evn\u00ed onemocn\u011bn\u00ed a dnes je um\u00edme \u00fa\u010dinn\u011b l\u00e9\u010dit. Jedn\u00edm z \u010dasto pou\u017e\u00edvan\u00fdch l\u00e9k\u016f je sertralin, jeho \u00fa\u010dinek v\u0161ak nemus\u00ed b\u00fdt u ka\u017ed\u00e9ho stejn\u00fd. Zat\u00edmco jednomu pacientovi m\u016f\u017ee pomoci bez v\u011bt\u0161\u00edch pot\u00ed\u017e\u00ed, u jin\u00e9ho se mohou objevit nep\u0159\u00edjemn\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky a dal\u0161\u00ed nemus\u00ed na l\u00e9\u010dbu reagovat podle o\u010dek\u00e1v\u00e1n\u00ed. Za t\u011bmito rozd\u00edly stoj\u00ed \u0159ada faktor\u016f, p\u0159i\u010dem\u017e jedn\u00edm z nich je i na\u0161e genetick\u00e1 v\u00fdbava.<\/em><\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Sertralin a jeho pou\u017eit\u00ed<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Sertralin se pou\u017e\u00edv\u00e1 k l\u00e9\u010db\u011b deprese, panick\u00e9 poruchy, obsedantn\u011b-kompulzivn\u00ed poruchy (OCD), posttraumatick\u00e9 stresov\u00e9 poruchy nebo soci\u00e1ln\u00ed \u00fazkostn\u00e9 poruchy. Pat\u0159\u00ed mezi takzvan\u00e9 <strong>SSRI<\/strong>, tedy <strong>selektivn\u00ed inhibitory zp\u011btn\u00e9ho vychyt\u00e1v\u00e1n\u00ed serotoninu<\/strong>. Serotonin je l\u00e1tka, kter\u00e1 se v mozku pod\u00edl\u00ed mimo jin\u00e9 na regulaci n\u00e1lady, sp\u00e1nku \u010di reakci na stres, a sertralin ovliv\u0148uje jeho dostupnost mezi nervov\u00fdmi bu\u0148kami. T\u00edm m\u016f\u017ee postupn\u011b p\u0159isp\u00edvat ke zm\u00edrn\u011bn\u00ed p\u0159\u00edznak\u016f deprese a \u00fazkosti.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Rychlost odbour\u00e1v\u00e1n\u00ed sertralinu<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Po u\u017eit\u00ed se sertralin v t\u011ble postupn\u011b zpracov\u00e1v\u00e1 a odbour\u00e1v\u00e1, p\u0159i\u010dem\u017e tento proces prob\u00edh\u00e1 zejm\u00e9na v j\u00e1trech za \u00fa\u010dasti n\u011bkolika enzym\u016f. Jedn\u00edm z d\u016fle\u017eit\u00fdch <strong>enzym\u016f<\/strong> je <strong>CYP2C19<\/strong>, jeho\u017e aktivita se u jednotliv\u00fdch lid\u00ed p\u0159irozen\u011b li\u0161\u00ed. Do zna\u010dn\u00e9 m\u00edry ji ovliv\u0148uje <strong>gen CYP2C19<\/strong>, kter\u00fd se v populaci vyskytuje v n\u011bkolika variant\u00e1ch.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pokud tento enzym pracuje m\u00e9n\u011b efektivn\u011b, m\u016f\u017ee se sertralin z t\u011bla vylu\u010dovat pomaleji, a proto m\u016f\u017ee b\u00fdt jeho hladina v organismu vy\u0161\u0161\u00ed. To m\u016f\u017ee souviset s vy\u0161\u0161\u00edm rizikem ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f i s v\u011bt\u0161\u00ed pravd\u011bpodobnost\u00ed, \u017ee pacient l\u00e9\u010dbu p\u0159ed\u010dasn\u011b ukon\u010d\u00ed. P\u0159i vy\u0161\u0161\u00ed aktivit\u011b enzymu se naopak l\u00e9k odbour\u00e1v\u00e1 rychleji, av\u0161ak u sertralinu tento rozd\u00edl obvykle nen\u00ed natolik v\u00fdznamn\u00fd, aby vy\u017eadoval \u00fapravu d\u00e1vkov\u00e1n\u00ed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Geny a metabolismus sertralinu<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Na z\u00e1klad\u011b variant <strong>genu CYP2C19 <\/strong>lze odhadnout, jak rychle bude organismus sertralin metabolizovat, a podle p\u0159edpokl\u00e1dan\u00e9 aktivity enzymu za\u0159adit danou osobu do jedn\u00e9 z n\u011bkolika skupin:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>slab\u00fd metaboliz\u00e9r<\/li>\n\n\n\n<li>slab\u0161\u00ed metaboliz\u00e9r<\/li>\n\n\n\n<li>standardn\u00ed metaboliz\u00e9r<\/li>\n\n\n\n<li>rychl\u00fd metaboliz\u00e9r<\/li>\n\n\n\n<li>ultrarychl\u00fd metaboliz\u00e9r<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">V p\u0159\u00edpad\u011b genetick\u00e9 predispozice ke <strong>slab\u00e9mu metabolismu<\/strong> m\u016f\u017ee l\u00e9ka\u0159 zv\u00e1\u017eit ni\u017e\u0161\u00ed po\u010d\u00e1te\u010dn\u00ed d\u00e1vku a p\u0159ibli\u017en\u011b o polovinu ni\u017e\u0161\u00ed udr\u017eovac\u00ed d\u00e1vku, p\u0159\u00edpadn\u011b zvolit jin\u00e9 vhodn\u00e9 antidepresivum. U <strong>rychl\u00fdch a ultrarychl\u00fdch metaboliz\u00e1tor\u016f<\/strong> obvykle nen\u00ed nutn\u00e9 d\u00e1vkov\u00e1n\u00ed sertralinu upravovat.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CYP2C19 v\u0161ak nen\u00ed jedin\u00fdm enzymem, kter\u00fd se pod\u00edl\u00ed na metabolismu sertralinu, proto v\u00fdsledek genetick\u00e9 anal\u00fdzy popisuje pouze jednu \u010d\u00e1st komplexn\u00edho procesu ovliv\u0148uj\u00edc\u00edho hladinu l\u00e9\u010diva v organismu a jeho \u00fa\u010dinek. Krom\u011b genetick\u00fdch predispozic hraj\u00ed roli i dal\u0161\u00ed faktory, nap\u0159\u00edklad jin\u00e9 u\u017e\u00edvan\u00e9 l\u00e9ky nebo celkov\u00fd zdravotn\u00ed stav \u010dlov\u011bka.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><strong><strong><strong><strong><strong><strong><strong><strong>V\u00fdhody znalosti t\u00e9to genetick\u00e9 predispozice<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Informace o tom, jak rychle va\u0161e t\u011blo pravd\u011bpodobn\u011b metabolizuje sertralin, m\u016f\u017ee b\u00fdt u\u017eite\u010dn\u00e1 pro l\u00e9ka\u0159e \u010di l\u00e9k\u00e1rn\u00edka, kte\u0159\u00ed ji mohou zohlednit spolu s dal\u0161\u00edmi faktory p\u0159i v\u00fdb\u011bru a nastaven\u00ed l\u00e9\u010dby. V n\u011bkter\u00fdch p\u0159\u00edpadech tak mohou genetick\u00e9 informace pomoci l\u00e9pe p\u0159izp\u016fsobit l\u00e9\u010dbu konkr\u00e9tn\u00edmu pacientovi a sn\u00ed\u017eit riziko ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">O v\u00fdb\u011bru l\u00e9ku a jeho konkr\u00e9tn\u00edm d\u00e1vkov\u00e1n\u00ed v\u0161ak v\u017edy rozhoduje l\u00e9ka\u0159. Genetika p\u0159edstavuje pouze jeden z faktor\u016f, m\u016f\u017ee v\u0161ak poskytnout u\u017eite\u010dnou informaci o tom, pro\u010d stejn\u00fd l\u00e9k nemus\u00ed na ka\u017ed\u00e9ho p\u016fsobit stejn\u011b.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong><strong><strong><strong><strong>Nov\u00fd v\u00fdsledek <strong>ve va\u0161\u00ed DNA anal\u00fdze<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/app.dnaera.com\/sign-in?&amp;lng=cz\">P\u0159ihlaste se<\/a> ke sv\u00fdm v\u00fdsledk\u016fm a&nbsp;pod\u00edvejte se na svou genetickou predispozici k metabolismu sertralinu. ov\u00fd v\u00fdsledek je od nyn\u011bj\u0161ka bezplatn\u011b k dispozici v\u0161em na\u0161im st\u00e1vaj\u00edc\u00edm z\u00e1kazn\u00edk\u016fm a bude sou\u010d\u00e1st\u00ed anal\u00fdzy i pro ka\u017ed\u00e9ho nov\u00e9ho z\u00e1kazn\u00edka, kter\u00fd vstoup\u00ed do sv\u011bta DNA s <a href=\"https:\/\/dnaera.com\/cs\/produkt\/dna-complex-test\/\" target=\"_blank\" rel=\"noreferrer noopener\">DNA Complex testem<\/a>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u010c\u00edm l\u00e9pe zn\u00e1te sv\u00e9 genetick\u00e9 vybaven\u00ed, t\u00edm v\u00edce informac\u00ed m\u00e1te k dispozici p\u0159i rozhodov\u00e1n\u00ed o sv\u00e9m zdrav\u00ed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-medium-font-size\"><strong><strong>Zdroje<\/strong><\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list has-small-font-size\">\n<li class=\"has-small-font-size\">Bousman, C. A., Stevenson, J. M., Ramsey, L. B., et al. (2023). Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A genotypes and serotonin reuptake inhibitor antidepressants. <em>Clinical Pharmacology &amp; Therapeutics, 114<\/em>(1), 51\u201368.<\/li>\n\n\n\n<li class=\"has-small-font-size\">Rudberg, I., Hermann, M., Refsum, H., &amp; Molden, E. (2008). Serum concentrations of sertraline and N-desmethyl sertraline in relation to CYP2C19 genotype in psychiatric patients. <em>European Journal of Clinical Pharmacology, 64<\/em>(12), 1181\u20131188.<\/li>\n\n\n\n<li class=\"has-small-font-size\">Br\u00e5ten, L. S., Ingelman-Sundberg, M., Jukic, M. M., Molden, E., &amp; Kringen, M. K. (2022). Impact of the novel CYP2C haplotype and CYP2B6 variants on sertraline exposure in a large patient population. <em>Clinical and Translational Science, 15<\/em>(9), 2135\u20132145.<\/li>\n\n\n\n<li class=\"has-small-font-size\"><a href=\"https:\/\/www.clinpgx.org\/chemical\/PA451333\">https:\/\/www.clinpgx.org\/chemical\/PA451333<\/a><\/li>\n\n\n\n<li class=\"has-small-font-size\"><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a697048.html\">https:\/\/medlineplus.gov\/druginfo\/meds\/a697048.html<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Deprese a \u00fazkostn\u00e9 poruchy pat\u0159\u00ed mezi nej\u010dast\u011bj\u0161\u00ed du\u0161evn\u00ed onemocn\u011bn\u00ed a dnes je um\u00edme \u00fa\u010dinn\u011b l\u00e9\u010dit. Jedn\u00edm z \u010dasto pou\u017e\u00edvan\u00fdch l\u00e9k\u016f je sertralin, jeho \u00fa\u010dinek v\u0161ak nemus\u00ed b\u00fdt u ka\u017ed\u00e9ho stejn\u00fd. Zat\u00edmco jednomu pacientovi m\u016f\u017ee pomoci bez v\u011bt\u0161\u00edch pot\u00ed\u017e\u00ed, u jin\u00e9ho se mohou objevit nep\u0159\u00edjemn\u00e9 vedlej\u0161\u00ed \u00fa\u010dinky a dal\u0161\u00ed nemus\u00ed na l\u00e9\u010dbu reagovat podle o\u010dek\u00e1v\u00e1n\u00ed. Za [&hellip;]<\/p>\n","protected":false},"author":876,"featured_media":1384300,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","inline_featured_image":false,"footnotes":"[]"},"categories":[33],"tags":[58,59,100],"place-taxonomy":[84],"class_list":["post-1384299","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-cs","tag-dna-analyza","tag-dna-test","tag-predispozice"],"acf":[],"views":2749,"_links":{"self":[{"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/posts\/1384299","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/users\/876"}],"replies":[{"embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/comments?post=1384299"}],"version-history":[{"count":2,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/posts\/1384299\/revisions"}],"predecessor-version":[{"id":1384302,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/posts\/1384299\/revisions\/1384302"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/media\/1384300"}],"wp:attachment":[{"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/media?parent=1384299"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/categories?post=1384299"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/tags?post=1384299"},{"taxonomy":"place-taxonomy","embeddable":true,"href":"https:\/\/dnaera.com\/cs\/wp-json\/wp\/v2\/place-taxonomy?post=1384299"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}