Genetics and Pharmacogenomics for Athletic Performance: Current Trends and Future Pathways in ASEAN
Article Sidebar
Main Article Content
Page: 541-566
Abstract
The integration of sport genomics and pharmacogenomics has become a central pillar of precision sports medicine, enabling individualized training, nutrition, and medication/supplement strategies for athletes. This structured narrative review synthesizes literature published between 2015 and 2025 from PubMed, ScienceDirect, and Google Scholar, with particular emphasis on implementation relevance in ASEAN, especially Indonesia. Findings are organized into three major themes: (1) genetic contributions to strength and endurance phenotypes, body composition, recovery, and injury susceptibility; (2) pharmacogenomic implications for drug selection, dose optimization, therapeutic safety, and potential exercise with drug interactions (e.g., NSAIDs, inhaled bronchodilators, caffeine, and creatine); and (3) ethical, privacy, equity, and gene-doping considerations. Athletic performance is inherently polygenic; variants in genes such as ACTN3, ACE, PPARGC1A, PPARA, and VEGF-A contribute to the power–endurance spectrum and vascular–metabolic adaptation, while pharmacogenes including CYP2C9, CYP1A2, ADORA2A, and ADRB2 may modulate therapeutic efficacy and adverse-effect risk. Moreover, physical activity itself may influence drug metabolism and pharmacodynamic responses, underscoring the limitations of one-size-fits-all protocols. Overall, genetic information should be positioned as a complementary decision-support layer rather than a deterministic predictor in sports medicine practice. Strengthening implementation in ASEAN requires larger, well-characterized athlete cohorts, standardized marker panels, longitudinal data integration, and robust ethical–regulatory frameworks to ensure safe and evidence-based genomic application.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
García-Rubio J, Lozano-Tejada N, López-Sierra P, Martínez-Sánchez A, Campos-Redondo A. Highway to Hell: Participation in youth national basketball teams and senior performance. Int J Sports Sci Coach 2025;20:698–706. https://doi.org/10.1177/17479541241305124. DOI: https://doi.org/10.1177/17479541241305124
Jackson DT, Blagrove RC, Thain PK, Weldon A, Kelly AL. Key Stakeholders’ Perspectives on the Sports Science and Medicine Resources and Practices in English Non-League Male Football. Applied Sciences 2025;15:1050. https://doi.org/10.3390/app15031050. DOI: https://doi.org/10.3390/app15031050
Wang W. A biomechanical perspective on the relationship between basketball performance and college students’ physical and mental health: An integrated analysis of athletic performance and psychological regulation. Molecular & Cellular Biomechanics 2025;22:1231. https://doi.org/10.62617/mcb1231. DOI: https://doi.org/10.62617/mcb1231
Bondareva EA, Negasheva MA. Genetic aspects of athletic performance and sports selection. Biology Bulletin Reviews 2017;7:344–53. https://doi.org/10.1134/S2079086417040028. DOI: https://doi.org/10.1134/S2079086417040028
Dong Y, Wang S, Yin T. Relationship between sports gene polymorphism expression and physiological function of long-distance runners: A biomechanical analysis. Molecular & Cellular Biomechanics 2025;22:1193. https://doi.org/10.62617/mcb1193. DOI: https://doi.org/10.62617/mcb1193
Brown AD, Marko AD, Marko DM, Baranowski BJ, Silvera S, Finch MS, et al. Brain‐derived neurotrophic factor drives muscle adaptation similar to aerobic training in mice. The FASEB Journal 2025;39. https://doi.org/10.1096/fj.202402421R. DOI: https://doi.org/10.1096/fj.202402421R
Relling M V., Evans WE. Pharmacogenomics in the clinic. Nature 2015;526:343–50. https://doi.org/10.1038/nature15817. DOI: https://doi.org/10.1038/nature15817
Weinshilboum RM, Wang L. Pharmacogenomics: Precision Medicine and Drug Response. Mayo Clin Proc 2017;92:1711–22. https://doi.org/10.1016/j.mayocp.2017.09.001. DOI: https://doi.org/10.1016/j.mayocp.2017.09.001
Ginevičienė V, Utkus A, Pranckevičienė E, Semenova EA, Hall ECR, Ahmetov II. Perspectives in Sports Genomics. Biomedicines 2022;10:298. https://doi.org/10.3390/biomedicines10020298.
Tanaka M, Wang G, Pitsiladis YP. Advancing sports and exercise genomics: moving from hypothesis-driven single study approaches to large multi-omics collaborative science. Physiol Genomics 2016;48:173–4. https://doi.org/10.1152/physiolgenomics.00009.2016. DOI: https://doi.org/10.1152/physiolgenomics.00009.2016
Appel M, Zentgraf K, Krüger K, Alack K. Effects of Genetic Variation on Endurance Performance, Muscle Strength, and Injury Susceptibility in Sports: A Systematic Review. Front Physiol 2021;12. https://doi.org/10.3389/fphys.2021.694411. DOI: https://doi.org/10.3389/fphys.2021.694411
Kikuchi N, Moreland E, Homma H, Semenova EA, Saito M, Larin AK, et al. Genes and Weightlifting Performance. Genes (Basel) 2021;13:25. https://doi.org/10.3390/genes13010025. DOI: https://doi.org/10.3390/genes13010025
Ferreira CP, Silvino VO, Trevisano RG, de Moura RC, Almeida SS, Pereira dos Santos MA. Influence of genetic polymorphism on sports talent performance versus non-athletes: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2024;16:223. https://doi.org/10.1186/s13102-024-01001-5. DOI: https://doi.org/10.1186/s13102-024-01001-5
Konopka MJ, Sperlich B, Rietjens G, Zeegers MP. Genetics and athletic performance: a systematic SWOT analysis of non-systematic reviews. Front Genet 2023;14. https://doi.org/10.3389/fgene.2023.1232987. DOI: https://doi.org/10.3389/fgene.2023.1232987
Li Y, Wang L, Yi L, Liu J, Hu Y, Lu Y, et al. ACTN3 R577X genotype and performance of elite middle-long distance swimmers in China. Biol Sport 2017;1:39–43. https://doi.org/10.5114/biolsport.2017.63731. DOI: https://doi.org/10.5114/biolsport.2017.63731
Semenova EA, Hall ECR, Ahmetov II. Genes and Athletic Performance: The 2023 Update. Genes (Basel) 2023;14:1235. https://doi.org/10.3390/genes14061235. DOI: https://doi.org/10.3390/genes14061235
Pickering C, Kiely J. ACTN3: More than Just a Gene for Speed. Front Physiol 2017;8. https://doi.org/10.3389/fphys.2017.01080. DOI: https://doi.org/10.3389/fphys.2017.01080
Voisin S, Guilherme JPFL, Yan X, Pushkarev VP, Cieszczyk P, Massidda M, et al. ACVR1B rs2854464 Is Associated with Sprint/Power Athletic Status in a Large Cohort of Europeans but Not Brazilians. PLoS One 2016;11:e0156316. https://doi.org/10.1371/journal.pone.0156316. DOI: https://doi.org/10.1371/journal.pone.0156316
Khanal P, He L, Herbert AJ, Stebbings GK, Onambele-Pearson GL, Degens H, et al. The Association of Multiple Gene Variants with Ageing Skeletal Muscle Phenotypes in Elderly Women. Genes (Basel) 2020;11:1459. https://doi.org/10.3390/genes11121459. DOI: https://doi.org/10.3390/genes11121459
Hillege MM, Shi A, Galli RA, Wu G, Bertolino P, Hoogaars WM, et al. Lack of Tgfbr1 and Acvr1b synergistically stimulates myofibre hypertrophy and accelerates muscle regeneration. Elife 2022;11. https://doi.org/10.7554/eLife.77610. DOI: https://doi.org/10.7554/eLife.77610
Venckunas T, Degens H. Genetic polymorphisms of muscular fitness in young healthy men. PLoS One 2022;17:e0275179. https://doi.org/10.1371/journal.pone.0275179. DOI: https://doi.org/10.1371/journal.pone.0275179
Valdivieso P, Vaughan D, Laczko E, Brogioli M, Waldron S, Rittweger J, et al. The Metabolic Response of Skeletal Muscle to Endurance Exercise Is Modified by the ACE-I/D Gene Polymorphism and Training State. Front Physiol 2017;8. https://doi.org/10.3389/fphys.2017.00993. DOI: https://doi.org/10.3389/fphys.2017.00993
Wei Q. ACE and ACTN3 Gene Polymorphisms and Genetic Traits of Rowing Athletes in the Northern Han Chinese Population. Front Genet 2021;12. https://doi.org/10.3389/fgene.2021.736876. DOI: https://doi.org/10.3389/fgene.2021.736876
Lu H, Cassis LA, Kooi CW Vander, Daugherty A. Structure and functions of angiotensinogen. Hypertension Research 2016;39:492–500. https://doi.org/10.1038/hr.2016.17. DOI: https://doi.org/10.1038/hr.2016.17
Wu C-H, Mohammadmoradi S, Chen JZ, Sawada H, Daugherty A, Lu HS. Renin-Angiotensin System and Cardiovascular Functions. Arterioscler Thromb Vasc Biol 2018;38. https://doi.org/10.1161/ATVBAHA.118.311282. DOI: https://doi.org/10.1161/ATVBAHA.118.311282
İpekoğlu G, Ari E, Aydoğdu A, Korkmaz F, Çelik H, Öztürk F, et al. Genetic insights into endurance athlete status: A meta-analysis of ACVR1B, AGT, FTO, IL-6, and NRF2 gene polymorphisms. J Biol Methods 2024;11:e99010021. https://doi.org/10.14440/jbm.2024.0013. DOI: https://doi.org/10.14440/jbm.2024.0013
Tran N, Garcia T, Aniqa M, Ali S, Ally A, Nauli SM. Endothelial Nitric Oxide Synthase (eNOS) and the Cardiovascular System: in Physiology and in Disease States. Am J Biomed Sci Res 2022;15:153–77. DOI: https://doi.org/10.34297/AJBSR.2022.15.002087
Varillas-Delgado D, Del Coso J, Gutiérrez-Hellín J, Aguilar-Navarro M, Muñoz A, Maestro A, et al. Genetics and sports performance: the present and future in the identification of talent for sports based on DNA testing. Eur J Appl Physiol 2022;122:1811–30. https://doi.org/10.1007/s00421-022-04945-z. DOI: https://doi.org/10.1007/s00421-022-04945-z
Zmijewski P, Cięszczyk P, Ahmetov II, Gronek P, Lulińska-Kuklik E, Dornowski M, et al. The NOS3 G894T (rs1799983) and -786T/C (rs2070744) polymorphisms are associated with elite swimmer status. Biol Sport 2018;35:313–9. https://doi.org/10.5114/biolsport.2018.76528. DOI: https://doi.org/10.5114/biolsport.2018.76528
Abu Shelbayeh O, Arroum T, Morris S, Busch KB. PGC-1α Is a Master Regulator of Mitochondrial Lifecycle and ROS Stress Response. Antioxidants 2023;12:1075. https://doi.org/10.3390/antiox12051075. DOI: https://doi.org/10.3390/antiox12051075
Wei Q. Association between the PPARGC1A Gly482Ser polymorphism and muscle fitness in Chinese schoolchildren. PLoS One 2023;18:e0284827. https://doi.org/10.1371/journal.pone.0284827. DOI: https://doi.org/10.1371/journal.pone.0284827
Lopez-Leon S, Tuvblad C, Forero DA. Sports genetics: the PPARA gene and athletes’ high ability in endurance sports. A systematic review and meta-analysis. Biol Sport 2016;33:3–6. https://doi.org/10.5604/20831862.1180170.
Bulgay C, Cepicka L, Dalip M, Yıldırım S, Ceylan Hİ, Yılmaz ÖÖ, et al. The relationships between ACTN3 rs1815739 and PPARA-α rs4253778 gene polymorphisms and athletic performance characteristics in professional soccer players. BMC Sports Sci Med Rehabil 2023;15:121. https://doi.org/10.1186/s13102-023-00733-0. DOI: https://doi.org/10.1186/s13102-023-00733-0
Benak D, Sevcikova A, Holzerova K, Hlavackova M. FTO in health and disease. Front Cell Dev Biol 2024;12. https://doi.org/10.3389/fcell.2024.1500394. DOI: https://doi.org/10.3389/fcell.2024.1500394
Claussnitzer M, Dankel SN, Kim K-H, Quon G, Meuleman W, Haugen C, et al. FTO Obesity Variant Circuitry and Adipocyte Browning in Humans. New England Journal of Medicine 2015;373:895–907. https://doi.org/10.1056/NEJMoa1502214. DOI: https://doi.org/10.1056/NEJMoa1502214
Yang Z, Yu G, Zhu X, Peng T, Lv Y. Critical roles of FTO-mediated mRNA m6A demethylation in regulating adipogenesis and lipid metabolism: Implications in lipid metabolic disorders. Genes Dis 2022;9:51–61. https://doi.org/10.1016/j.gendis.2021.01.005. DOI: https://doi.org/10.1016/j.gendis.2021.01.005
Rahimi MR, Symonds ME. Effect of FTO genotype on exercise training and diet-indued weight loss in overweight and obese adults: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2025;65:4080–96. https://doi.org/10.1080/10408398.2024.2382346. DOI: https://doi.org/10.1080/10408398.2024.2382346
Krashes MJ, Lowell BB, Garfield AS. Melanocortin-4 receptor–regulated energy homeostasis. Nat Neurosci 2016;19:206–19. https://doi.org/10.1038/nn.4202. DOI: https://doi.org/10.1038/nn.4202
Fatima MT, Ahmed I, Fakhro KA, Akil ASAS. Melanocortin-4 receptor complexity in energy homeostasis,obesity and drug development strategies. Diabetes Obes Metab 2022;24:583–98. https://doi.org/10.1111/dom.14618. DOI: https://doi.org/10.1111/dom.14618
Song J-Y, Song Q-Y, Wang S, Ma J, Wang H-J. Physical Activity and Sedentary Behaviors Modify the Association between Melanocortin 4 Receptor Gene Variant and Obesity in Chinese Children and Adolescents. PLoS One 2017;12:e0170062. https://doi.org/10.1371/journal.pone.0170062. DOI: https://doi.org/10.1371/journal.pone.0170062
Zhang Y, Li S, Nie H, Wang X, Li X, Wen J, et al. The rs17782313 polymorphism near MC4R gene confers a high risk of obesity and hyperglycemia, while PGC1α rs8192678 polymorphism is weakly correlated with glucometabolic disorder: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023;14. https://doi.org/10.3389/fendo.2023.1210455. DOI: https://doi.org/10.3389/fendo.2023.1210455
Kwak MK, Ha ES, Lee J, Choi YM, Kim B-J, Hong E-G. C-C motif chemokine ligand 2 promotes myogenesis of myoblasts via the AKT-mTOR pathway. Aging 2022;14:9860–76. https://doi.org/10.18632/aging.204451. DOI: https://doi.org/10.18632/aging.204451
Ziemkiewicz N, Hilliard G, Pullen NA, Garg K. The Role of Innate and Adaptive Immune Cells in Skeletal Muscle Regeneration. Int J Mol Sci 2021;22:3265. https://doi.org/10.3390/ijms22063265. DOI: https://doi.org/10.3390/ijms22063265
Baumert P, Lake MJ, Stewart CE, Drust B, Erskine RM. Genetic variation and exercise-induced muscle damage: implications for athletic performance, injury and ageing. Eur J Appl Physiol 2016;116:1595–625. https://doi.org/10.1007/s00421-016-3411-1. DOI: https://doi.org/10.1007/s00421-016-3411-1
Flore L, Robledo R, Dettori L, Scorcu M, Francalacci P, Tocco F, et al. Association of VDR Polymorphisms with Muscle Mass Development in Elite Young Soccer Players: A Pilot Study. Sports 2024;12:253. https://doi.org/10.3390/sports12090253. DOI: https://doi.org/10.3390/sports12090253
Bollen SE, Bass JJ, Wilkinson DJ, Hewison M, Atherton PJ. The impact of genetic variation within the vitamin D pathway upon skeletal muscle function: A systematic review. J Steroid Biochem Mol Biol 2023;229:106266. https://doi.org/10.1016/j.jsbmb.2023.106266. DOI: https://doi.org/10.1016/j.jsbmb.2023.106266
Latham CM, Brightwell CR, Keeble AR, Munson BD, Thomas NT, Zagzoog AM, et al. Vitamin D Promotes Skeletal Muscle Regeneration and Mitochondrial Health. Front Physiol 2021;12. https://doi.org/10.3389/fphys.2021.660498. DOI: https://doi.org/10.3389/fphys.2021.660498
Massidda M, Corrias l, Bachis V, Cugia P, Piras F, Scorcu M, et al. Vitamin D receptor gene polymorphisms and musculoskeletal injuries in professional football players. Exp Ther Med 2015;9:1974–8. https://doi.org/10.3892/etm.2015.2364. DOI: https://doi.org/10.3892/etm.2015.2364
Verma M, Asakura Y, Murakonda BSR, Pengo T, Latroche C, Chazaud B, et al. Muscle Satellite Cell Cross-Talk with a Vascular Niche Maintains Quiescence via VEGF and Notch Signaling. Cell Stem Cell 2018;23:530-543.e9. https://doi.org/10.1016/j.stem.2018.09.007. DOI: https://doi.org/10.1016/j.stem.2018.09.007
Verma M, Asakura Y, Wang X, Zhou K, Ünverdi M, Kann AP, et al. Endothelial cell signature in muscle stem cells validated by VEGFA-FLT1-AKT1 axis promoting survival of muscle stem cell. Elife 2024;13. https://doi.org/10.7554/eLife.73592. DOI: https://doi.org/10.7554/eLife.73592
Lu C-Y, Santosa KB, Jablonka-Shariff A, Vannucci B, Fuchs A, Turnbull I, et al. Macrophage-Derived Vascular Endothelial Growth Factor-A Is Integral to Neuromuscular Junction Reinnervation after Nerve Injury. The Journal of Neuroscience 2020;40:9602–16. https://doi.org/10.1523/JNEUROSCI.1736-20.2020. DOI: https://doi.org/10.1523/JNEUROSCI.1736-20.2020
Jürimäe J, Vaiksaar S, Purge P. Circulating Inflammatory Cytokine Responses to Endurance Exercise in Female Rowers. Int J Sports Med 2018;39:1041–8. https://doi.org/10.1055/a-0723-4421. DOI: https://doi.org/10.1055/a-0723-4421
de Albuquerque-Neto SL, Santos MAP dos, Silvino VO, Herrera JJB, Rosa TS, Silva GCB, et al. Association between ACTN3 (R577X), ACE (I/D), BDKRB2 (-9/+9), and AGT (M268T) polymorphisms and performance phenotypes in Brazilian swimmers. BMC Sports Sci Med Rehabil 2024;16:50. https://doi.org/10.1186/s13102-024-00828-2. DOI: https://doi.org/10.1186/s13102-024-00828-2
Chiu Y-H, Lai J-I, Tseng C-Y, Wang S-H, Li L-H, Kao W-F, et al. Impact of angiotension I converting enzyme gene I/D polymorphism on running performance, lipid, and biochemical parameters in ultra-marathoners. Medicine 2019;98:e16476. https://doi.org/10.1097/MD.0000000000016476. DOI: https://doi.org/10.1097/MD.0000000000016476
Ben-Zaken S, Eliakim A, Nemet D, Meckel Y. Genetic Variability Among Power Athletes: The Stronger vs. the Faster. J Strength Cond Res 2019;33:1505–11. https://doi.org/10.1519/JSC.0000000000001356. DOI: https://doi.org/10.1519/JSC.0000000000001356
González-Estrada G, Berrio G, Gomez-Rios D. Association between ACE, ACTN3, AGT, BDKRB2, and IL-6 gene polymorphisms and elite status in Colombian athletes. Journal of Physical Education and Sport n.d.;23.
Chen EY, Olino TM, Conklin CJ, Mohamed FB, Hoge WS, Foster GD, et al. Genetic and neural predictors of behavioral weight loss treatment: A preliminary study. Obesity 2017;25:66–75. https://doi.org/10.1002/oby.21691. DOI: https://doi.org/10.1002/oby.21691
Jacob Y, Anderton RS, Cochrane Wilkie JL, Rogalski B, Laws SM, Jones A, et al. Genetic Variants within NOGGIN, COL1A1, COL5A1, and IGF2 are Associated with Musculoskeletal Injuries in Elite Male Australian Football League Players: A Preliminary Study. Sports Med Open 2022;8:126. https://doi.org/10.1186/s40798-022-00522-y. DOI: https://doi.org/10.1186/s40798-022-00522-y
Hall ECR, Baumert P, Larruskain J, Gil SM, Lekue JA, Rienzi E, et al. The genetic association with injury risk in male academy soccer players depends on maturity status. Scand J Med Sci Sports 2022;32:338–50. https://doi.org/10.1111/sms.14077. DOI: https://doi.org/10.1111/sms.14077
Niemiec P, Jarosz A, Balcerzyk-Matić A, Iwanicka J, Nowak T, Iwanicki T, et al. Genetic Variability in VEGFA Gene Influences the Effectiveness of Tennis Elbow Therapy with PRP: A Two-Year Prospective Cohort Study. Int J Mol Sci 2023;24:17292. https://doi.org/10.3390/ijms242417292. DOI: https://doi.org/10.3390/ijms242417292
Bıçakçı B, Cięszczyk P, Humińska-Lisowska K. Genetic Determinants of Endurance: A Narrative Review on Elite Athlete Status and Performance. Int J Mol Sci 2024;25:13041. https://doi.org/10.3390/ijms252313041. DOI: https://doi.org/10.3390/ijms252313041
Williams CJ, Williams MG, Eynon N, Ashton KJ, Little JP, Wisloff U, et al. Genes to predict VO2max trainability: a systematic review. BMC Genomics 2017;18:831. https://doi.org/10.1186/s12864-017-4192-6. DOI: https://doi.org/10.1186/s12864-017-4192-6
Moreland E, Borisov O V, Semenova EA, Larin AK, Andryushchenko ON, Andryushchenko LB, et al. Polygenic Profile of Elite Strength Athletes. 2020. DOI: https://doi.org/10.1519/JSC.0000000000003901
Gineviciene V, Utkus A, Pranckeviciene E, Semenova EA, Hall ECR, Ahmetov II. Perspectives in Sports Genomics. Biomedicines 2022;10. https://doi.org/10.3390/biomedicines10020298. DOI: https://doi.org/10.3390/biomedicines10020298
Jones N, Kiely J, Suraci B, Collins DJ, Lorenzo DD, Pickering C, et al. A genetic-based algorithm for personalized resistance training. Biol Sport 2016;33:117–26. https://doi.org/10.5604/20831862.1198210. DOI: https://doi.org/10.5604/20831862.1198210
Montalvo AM, Tse-Dinh Y-C, Liu Y, Swartzon M, Hechtman KS, Myer GD. Precision Sports Medicine: The Future of Advancing Health and Performance in Youth and Beyond. Strength Cond J 2017;39:48–58. https://doi.org/10.1519/SSC.0000000000000292. DOI: https://doi.org/10.1519/SSC.0000000000000292
Cecchin E, Stocco G. Pharmacogenomics and Personalized Medicine. Genes (Basel) 2020;11:679. https://doi.org/10.3390/genes11060679. DOI: https://doi.org/10.3390/genes11060679
Juginović A, Kekić A, Aranza I, Biloš V, Armanda M. Next-Generation Approaches in Sports Medicine: The Role of Genetics, Omics, and Digital Health in Optimizing Athlete Performance and Longevity—A Narrative Review 2025;15. https://doi.org/10.3390/life15071023. DOI: https://doi.org/10.3390/life15071023
Pham H, Spaniol F. The Efficacy of Non-Steroidal Anti-Inflammatory Drugs in Athletes for Injury Management, Training Response, and Athletic Performance: A Systematic Review. Sports 2024;12:302. https://doi.org/10.3390/sports12110302. DOI: https://doi.org/10.3390/sports12110302
Urbański W, Dolata N, Balcer B, Kruczkowska A, Bulzacki E, Cebula A, et al. NSAIDs in Sports Medicine: Balancing Quick Relief with Long-Term Health Impacts. Quality in Sport 2024;36:56892. https://doi.org/10.12775/QS.2024.36.56892. DOI: https://doi.org/10.12775/QS.2024.36.56892
Guest NS, VanDusseldorp TA, Nelson MT, Grgic J, Schoenfeld BJ, Jenkins NDM, et al. International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr 2021;18. https://doi.org/10.1186/s12970-020-00383-4. DOI: https://doi.org/10.1186/s12970-020-00383-4
Greiwe J, Cooke A, Nanda A, Epstein SZ, Wasan AN, Shepard K V., et al. Work Group Report: Perspectives in Diagnosis and Management of Exercise-Induced Bronchoconstriction in Athletes. Journal of Allergy and Clinical Immunology: In Practice 2020;8:2542–55. https://doi.org/10.1016/j.jaip.2020.05.020. DOI: https://doi.org/10.1016/j.jaip.2020.05.020
Pedrinelli A, Ejnisman L, Fagotti L, Dvorak J, Tscholl PM. Medications and Nutritional Supplements in Athletes during the 2000, 2004, 2008, and 2012 FIFA Futsal World Cups. Biomed Res Int 2015;2015:1–6. https://doi.org/10.1155/2015/870308. DOI: https://doi.org/10.1155/2015/870308
Ferry B, DeCastro A, Bragg S. Common Prescription Medications Used in Athletes. Primary Care: Clinics in Office Practice 2020;47:49–64. https://doi.org/10.1016/j.pop.2019.10.003. DOI: https://doi.org/10.1016/j.pop.2019.10.003
Theken KN, Lee CR, Gong L, Caudle KE, Formea CM, Gaedigk A, et al. Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti‐Inflammatory Drugs. Clin Pharmacol Ther 2020;108:191–200. https://doi.org/10.1002/cpt.1830. DOI: https://doi.org/10.1002/cpt.1830
Agúndez JAG, Formea C, Gaedigk A, García-Martín E, Gong L, Grosser T, et al. Editorial: NSAIDs Pharmacogenomics. Front Pharmacol 2021;12. https://doi.org/10.3389/fphar.2021.798447. DOI: https://doi.org/10.3389/fphar.2021.798447
Niederberger E, Parnham MJ. The impact of diet and exercise on drug responses. Int J Mol Sci 2021;22. https://doi.org/10.3390/ijms22147692. DOI: https://doi.org/10.3390/ijms22147692
Buciuman CA, Dobrea CM, Butuca A, Frum A, Gligor FG, Botea MO, et al. Pharmacovigilance Insights into Ibuprofen’s Neuropsychiatric Safety: A Retrospective Analysis of EudraVigilance Reports. Pharmaceuticals 2025;18:1301. https://doi.org/10.3390/ph18091301. DOI: https://doi.org/10.3390/ph18091301
de Souza RF, de Matos DG, Ferreira ARP, Chilibeck P, Barros N de A, Oliveira AS, et al. Effect of Ibuprofen on Muscle, Hematological and Renal Function, Hydric Balance, Pain, and Performance During Intense Long-Distance Running. J Strength Cond Res 2020;34:2076–83. https://doi.org/10.1519/JSC.0000000000002502. DOI: https://doi.org/10.1519/JSC.0000000000002502
Aggarwal B, Mulgirigama A, Berend N. Exercise-induced bronchoconstriction: prevalence, pathophysiology, patient impact, diagnosis and management. NPJ Prim Care Respir Med 2018;28. https://doi.org/10.1038/s41533-018-0098-2. DOI: https://doi.org/10.1038/s41533-018-0098-2
Koya T, Ueno H, Hasegawa T, Arakawa M, Kikuchi T. Management of Exercise-Induced Bronchoconstriction in Athletes. J Allergy Clin Immunol Pract 2020;8:2183–92. https://doi.org/10.1016/j.jaip.2020.03.011. DOI: https://doi.org/10.1016/j.jaip.2020.03.011
Ora J, De Marco P, Gabriele M, Cazzola M, Rogliani P. Exercise-Induced Asthma: Managing Respiratory Issues in Athletes. J Funct Morphol Kinesiol 2024;9:15. https://doi.org/10.3390/jfmk9010015. DOI: https://doi.org/10.3390/jfmk9010015
Vertadier N, Trzepizur W, Faure S. Overuse of Short-Acting Beta-2 Agonists (SABAs) in Elite Athletes: Hypotheses to Explain It. Sports 2022;10:36. https://doi.org/10.3390/sports10030036. DOI: https://doi.org/10.3390/sports10030036
Pillard F, Lavit M, Cances VL, Rami J, Houin G, Didier A, et al. Medical and pharmacological approach to adjust the salbutamol anti-doping policy in athletes. Respir Res 2015;16:155. https://doi.org/10.1186/s12931-015-0315-2. DOI: https://doi.org/10.1186/s12931-015-0315-2
Merlini M, Beato M, Marcora S, Dickinson J. The Effect of 1600 μg Inhaled Salbutamol Administration on 30 m Sprint Performance Pre and Post a Yo-Yo Intermittent Running Test in Football Players. J Sports Sci Med 2019;18:716–21.
Marques L, Vale N. Salbutamol in the Management of Asthma: A Review. Int J Mol Sci 2022;23:14207. https://doi.org/10.3390/ijms232214207. DOI: https://doi.org/10.3390/ijms232214207
Puccini V. Antibiotic Therapy and Athletes: Is the Mitochondrial Dysfunction the Real Achilles’ Heel? Sports 2022;10:131. https://doi.org/10.3390/sports10090131. DOI: https://doi.org/10.3390/sports10090131
Ožegić O, Bedenić B, Sternak SL, Sviben M, Talapko J, Pažur I, et al. Antimicrobial Resistance and Sports: The Scope of the Problem, Implications for Athletes’ Health and Avenues for Collaborative Public Health Action. Antibiotics 2024;13:232. https://doi.org/10.3390/antibiotics13030232. DOI: https://doi.org/10.3390/antibiotics13030232
Islam RK, Islam KN. Microbial Skin Infections in Contact Sports: Epidemiology and Prevention. Premier Journal of Infectious Diseases 2025. https://doi.org/10.70389/PJID.100005. DOI: https://doi.org/10.70389/PJID.100005
Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019;200:e45–67. https://doi.org/10.1164/rccm.201908-1581ST. DOI: https://doi.org/10.1164/rccm.201908-1581ST
Duman E, Müller-Deubert S, Pattappa G, Stratos I, Sieber SA, Clausen-Schaumann H, et al. Fluoroquinolone-Mediated Tendinopathy and Tendon Rupture. Pharmaceuticals 2025;18:184. https://doi.org/10.3390/ph18020184. DOI: https://doi.org/10.3390/ph18020184
Guest N, Corey P, Vescovi J, EL-Sohemy A. Caffeine, CYP1A2 Genotype, and Endurance Performance in Athletes. Med Sci Sports Exerc 2018;50:1570–8. https://doi.org/10.1249/MSS.0000000000001596. DOI: https://doi.org/10.1249/MSS.0000000000001596
Grgic J, Pickering C, Del Coso J, Schoenfeld BJ, Mikulic P. CYP1A2 genotype and acute ergogenic effects of caffeine intake on exercise performance: a systematic review. Eur J Nutr 2021;60:1181–95. https://doi.org/10.1007/s00394-020-02427-6. DOI: https://doi.org/10.1007/s00394-020-02427-6
Nunes RA, Mazzotti DR, Hirotsu C, Andersen ML, Tufik S, Bittencourt L. The association between caffeine consumption and objective sleep variables is dependent on ADORA2A c.1083T>C genotypes. Sleep Med 2017;30:210–5. https://doi.org/10.1016/j.sleep.2016.06.038. DOI: https://doi.org/10.1016/j.sleep.2016.06.038
Silva V da C, Teixeira RL de F, do Livramento REENO, Lopes MQP, Leal-Calvo T, Filho JE, et al. ADRB2 and ADCY9 Sequence Variations in Brazilian Asthmatic Patients. Curr Issues Mol Biol 2024;46:6951–9. https://doi.org/10.3390/cimb46070414. DOI: https://doi.org/10.3390/cimb46070414
Ostojic SM, Rátgéber L. Creatine as a mitochondrial theranostic in predictive, preventive, and personalized medicine. EPMA Journal 2025;16:541–53. https://doi.org/10.1007/s13167-025-00420-9. DOI: https://doi.org/10.1007/s13167-025-00420-9
Medeiros MA, Abreu BJ, Lima JPMS. Assessing Creatine-Related Gene Expression in Kidney Disease: Can Available Data Give Insights into an Old Discussion? Nutrients 2025;17:651. https://doi.org/10.3390/nu17040651. DOI: https://doi.org/10.3390/nu17040651
Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 2017;14. https://doi.org/10.1186/s12970-017-0173-z. DOI: https://doi.org/10.1186/s12970-017-0173-z
Pickering C, Kiely J, Grgic J, Lucia A, Del Coso J. Can Genetic Testing Identify Talent for Sport? Genes (Basel) 2019;10:972. https://doi.org/10.3390/genes10120972. DOI: https://doi.org/10.3390/genes10120972
Sellami M, Elrayess MA, Puce L, Bragazzi NL. Molecular Big Data in Sports Sciences: State-of-Art and Future Prospects of OMICS-Based Sports Sciences. Front Mol Biosci 2022;8. https://doi.org/10.3389/fmolb.2021.815410. DOI: https://doi.org/10.3389/fmolb.2021.815410
Mijaica R, Tohănean DI, Alexe DI, Balint L. Physical Performance and Sports Genetics: A Systematic Review of Candidate Gene Polymorphisms Involved in Team Sports. Genes (Basel) 2025;16:1079. https://doi.org/10.3390/genes16091079. DOI: https://doi.org/10.3390/genes16091079
Qahwaji R, Ashankyty I, Sannan NS, Hazzazi MS, Basabrain AA, Mobashir M. Pharmacogenomics: A Genetic Approach to Drug Development and Therapy. Pharmaceuticals 2024;17:940. https://doi.org/10.3390/ph17070940. DOI: https://doi.org/10.3390/ph17070940
Sadee W, Wang D, Hartmann K, Toland AE. Pharmacogenomics: Driving Personalized Medicine. Pharmacol Rev 2023;75:789–814. https://doi.org/10.1124/pharmrev.122.000810. DOI: https://doi.org/10.1124/pharmrev.122.000810
Dorji PW, Tshering G, Na‐Bangchang K. CYP2C9, CYP2C19, CYP2D6 and CYP3A5 polymorphisms in South‐East and East Asian populations: A systematic review. J Clin Pharm Ther 2019:jcpt.12835. https://doi.org/10.1111/jcpt.12835. DOI: https://doi.org/10.1111/jcpt.12835
Runcharoen C, Fukunaga K, Sensorn I, Iemwimangsa N, Klumsathian S, Tong H, et al. Prevalence of pharmacogenomic variants in 100 pharmacogenes among Southeast Asian populations under the collaboration of the Southeast Asian Pharmacogenomics Research Network (SEAPharm). Hum Genome Var 2021;8. https://doi.org/10.1038/s41439-021-00135-z. DOI: https://doi.org/10.1038/s41439-021-00135-z
Htet S, Zannah M, Moe TH, Wongveerakul P, Charoenpanich N, Saengsirisuwan V, et al. The speed-gene study: methods, study design and preliminary results. BMC Res Notes 2023;16. https://doi.org/10.1186/s13104-023-06617-3. DOI: https://doi.org/10.1186/s13104-023-06617-3
Sukasem C, Jantararoungtong T, Koomdee N. Pharmacogenomics research and its clinical implementation in Thailand: Lessons learned from the resource-limited settings. Drug Metab Pharmacokinet 2021;39:100399. https://doi.org/10.1016/j.dmpk.2021.100399. DOI: https://doi.org/10.1016/j.dmpk.2021.100399
Piriyapongsa J, Chumnumwat S, Kaewprommal P, Triparn K, Suvichapanich S, Udomsinprasert W, et al. Pharmacogenomic landscape of the Thai population from genome sequencing of 949 individuals. Sci Rep 2024;14. https://doi.org/10.1038/s41598-024-79018-6. DOI: https://doi.org/10.1038/s41598-024-79018-6
Wong E, Bertin N, Hebrard M, Tirado-Magallanes R, Bellis C, Lim WK, et al. The Singapore National Precision Medicine Strategy. Nat Genet 2023;55:178–86. https://doi.org/10.1038/s41588-022-01274-x. DOI: https://doi.org/10.1038/s41588-022-01274-x
Kamath A, Shenoy PJ, Ullal SD, Shenoy AK, Acharya SD, Shastry R, et al. Clinical pharmacology and pharmacogenomics for implementation of personalized medicine. Pharmacogenomics 2023;24:873–9. https://doi.org/10.2217/pgs-2023-0188. DOI: https://doi.org/10.2217/pgs-2023-0188
Ng FFJ, Verma R, Sani L, Irwanto A, Lee M, Wee A, et al. A feasibility study on implementing pre-emptive pharmacogenomics testing in outpatient clinics in Singapore (IMPT study). Pharmacogenomics Journal 2025;25. https://doi.org/10.1038/s41397-025-00366-1. DOI: https://doi.org/10.1038/s41397-025-00366-1
Tong H, Phan VTN, Nguyen T, Le L. Genetic Landscape of VIP Pharmacogenomic Variants in the Kinh Vietnamese Population. Pharmacogenomics and Personalized Medicine 2025;18:251–61. https://doi.org/10.2147/PGPM.S520685. DOI: https://doi.org/10.2147/PGPM.S520685
Nguyen TVA, Le BH, Nguyen MT, Le VT, Tran VT, Le DT, et al. Pharmacogenomic Analysis of CYP3A5*3 and Tacrolimus Trough Concentrations in Vietnamese Renal Transplant Outcomes. Pharmgenomics Pers Med 2024;17:53–64. https://doi.org/10.2147/PGPM.S439400. DOI: https://doi.org/10.2147/PGPM.S439400
Mustapa MAC, Amin L, Mahadi Z. Determinants of stakeholders’ intention to adopt pharmacogenomic. Pharmacogenomics Journal 2020;20:801–12. https://doi.org/10.1038/s41397-020-0167-0. DOI: https://doi.org/10.1038/s41397-020-0167-0
Omran S, Leong SL, Blebil A, Mohan D, Ang WC, Teoh SL. The needs and gaps in pharmacogenomics knowledge and education among healthcare professionals in Malaysia: A multisite Delphi study. Clin Transl Sci 2024;17. https://doi.org/10.1111/cts.70057. DOI: https://doi.org/10.1111/cts.70057
Adesta F, Mahendra C, Junusmin KI, Rajah AMS, Goh S, Sani L, et al. Pharmacogenomics Implementation Training Improves Self-Efficacy and Competency to Drive Adoption in Clinical Practice. Front Pharmacol 2021;12. https://doi.org/10.3389/fphar.2021.684907. DOI: https://doi.org/10.3389/fphar.2021.684907
Marga Putri ER, Istifarwati, Isvina Unai Zahroya. Current Update of Pharmacogenomic in Drug Discovery and Development : A narrative review. Indonesian Journal of Pharmacology and Therapy 2022;3. https://doi.org/10.22146/ijpther.4695. DOI: https://doi.org/10.22146/ijpther.4695
Rosmerry Simanjuntak, Henny Sutrisman, Adrianus Prihartanto, Rossa Ramadhona. Pharmacogenomic Analysis in Determining Optimal Drug Dosage in Chronic Disease Patients in Indonesia. Int J Public Health 2024;1:106–14. https://doi.org/10.62951/ijph.v1i3.74. DOI: https://doi.org/10.62951/ijph.v1i3.74
Candrawati S, Gumilas NSA, Kusuma MNH, Adiningtyas PE, Sucipto MCR, Rahmah SSA. Hubungan Polimorfisme Gen ACTN3 dengan Kelincahan, Daya Ledak, dan Kecepatan. Jurnal Kedokteran Brawijaya 2017:329–34. https://doi.org/10.21776/ub.jkb.2017.029.04.8. DOI: https://doi.org/10.21776/ub.jkb.2017.029.04.8
Hutahaean MER, Tarigan APS, Ardinata D-. Hubungan Polimorfisme Gen ACTN-3 (R577X) dengan Daya Ledak Otot pada Siswa Sekolah Sepakbola di Medan. Jurnal Kedokteran Brawijaya 2018;30:121–6. https://doi.org/10.21776/ub.jkb.2018.030.02.8. DOI: https://doi.org/10.21776/ub.jkb.2018.030.02.8
Pimjan L, Ongvarrasopone C, Chantratita W, Polpramool C, Cherdrungsi P, Bangrak P, et al. A Study on ACE, ACTN3, and VDR Genes Polymorphism in Thai Weightlifters. Walailak Journal of Science and Technology (WJST) 2017;15:609–26. https://doi.org/10.48048/wjst.2018.3525. DOI: https://doi.org/10.48048/wjst.2018.3525
Saidi NF, Chee Hian T, Raja Azidin RMF, Aiman S, Yee Yu C, Geik Yong A. Association and Predictive Ability of ACTN3 C/T, ACE I/D and PPARGC1A A/G Polymorphisms on Jump Height of Elite Malaysian Footballers. Malaysian Journal of Sport Science and Recreation 2024;20:1–8. https://doi.org/10.24191/mjssr.v20i2.3229. DOI: https://doi.org/10.24191/mjssr.v20i2.3229
Sihaloho RW, Siregar Y, Savira M. Association Of Pparα Intron 7 G/C (Rs4253778) Polymorphisms With Muscular Endurance Among Soccer School Students in Medan. Buletin Farmatera 2019;4:132. https://doi.org/10.30596/bf.v4i3.3083. DOI: https://doi.org/10.30596/bf.v4i3.3083
Cheung R, Jolly S, Vimal M, Kim HL, McGonigle I. Who’s afraid of genetic tests?: An assessment of Singapore’s public attitudes and changes in attitudes after taking a genetic test. BMC Med Ethics 2022;23. https://doi.org/10.1186/s12910-022-00744-5. DOI: https://doi.org/10.1186/s12910-022-00744-5
Olesen AP, Mohd Nor SN, Amin L, Che Ngah A. Public Perceptions of Ethical, Legal and Social Implications of Pre-implantation Genetic Diagnosis (PGD) in Malaysia. Sci Eng Ethics 2017;23:1563–80. https://doi.org/10.1007/s11948-016-9857-z. DOI: https://doi.org/10.1007/s11948-016-9857-z
Marici AA, Situmeang A, Disemadi HS. Towards a Human Rights-Based Legal Framework for Genetic Technology in Indonesia. Jurnal Mediasas 2025;8:2025. https://doi.org/10.58824/mediasas.v8i4.466.
Schaibley VM, Ramos IN, Woosley RL, Curry S, Hays S, Ramos KS. Limited Genomics Training Among Physicians Remains a Barrier to Genomics-Based Implementation of Precision Medicine. Front Med (Lausanne) 2022;9. https://doi.org/10.3389/fmed.2022.757212. DOI: https://doi.org/10.3389/fmed.2022.757212
Bylstra Y, Davila S, Lim WK, Wu R, Teo JX, Kam S, et al. Implementation of genomics in medical practice to deliver precision medicine for an Asian population. NPJ Genom Med 2019;4. https://doi.org/10.1038/s41525-019-0085-8. DOI: https://doi.org/10.1038/s41525-019-0085-8
Alarcón Garavito GA, Moniz T, Déom N, Redin F, Pichini A, Vindrola-Padros C. The implementation of large-scale genomic screening or diagnostic programmes: A rapid evidence review. European Journal of Human Genetics 2023;31:282–95. https://doi.org/10.1038/s41431-022-01259-8. DOI: https://doi.org/10.1038/s41431-022-01259-8
Khoury MJ, Bowen S, Dotson WD, Drzymalla E, Green RF, Goldstein R, et al. Health equity in the implementation of genomics and precision medicine: A public health imperative. Genetics in Medicine 2022;24:1630–9. https://doi.org/10.1016/j.gim.2022.04.009. DOI: https://doi.org/10.1016/j.gim.2022.04.009
Vlahovich N, Fricker PA, Brown MA, Hughes D. Ethics of genetic testing and research in sport: a position statement from the Australian Institute of Sport. Br J Sports Med 2017;51:5–11. https://doi.org/10.1136/bjsports-2016-096661. DOI: https://doi.org/10.1136/bjsports-2016-096661
Patel S, Varley I. Exploring the Regulation of Genetic Testing in Sport. Entertainment and Sports Law Journal 2019;17. https://doi.org/10.16997/eslj.223. DOI: https://doi.org/10.16997/eslj.223
Ma A, O’Shea R, Wedd L, Wong C, Jamieson R V., Rankin N. What is the power of a genomic multidisciplinary team approach? A systematic review of implementation and sustainability. European Journal of Human Genetics 2024;32:381–91. https://doi.org/10.1038/s41431-024-01555-5. DOI: https://doi.org/10.1038/s41431-024-01555-5
Ma A, Newing TP, O’Shea R, Gokoolparsadh A, Murdoch E, Hayward J, et al. Genomic multidisciplinary teams: A model for navigating genetic mainstreaming and precision medicine. J Paediatr Child Health 2024;60:118–24. https://doi.org/10.1111/jpc.16547. DOI: https://doi.org/10.1111/jpc.16547