Ahmedzai Sam H
Department of Oncology, School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK.
J Pain Palliat Care Pharmacother. 2013 Mar;27(1):83-5. doi: 10.3109/15360288.2012.760706.
Personalized medicine can be defined as the tailoring of therapies to defined subsets of patients based on their likelihood to respond to therapy or their risk of adverse events. This medical model is more established in oncology but personalized pain therapy is showing potential promise. Pharmacogenomics is of growing relevance to the pain field, for example cytochrome P450 2D6 (CYP2D6) polymorphisms with resulting variation in degree of CYP2D6 expression may affect codeine analgesia. Research using quantitative sensory testing is seeking to identify phenotypic subgroups of neuropathic pain patients with different underlying pain mechanisms. Imaging studies have suggested that genetic, environmental, mood, and injury-specific factors combine to produce a unique cerebral pain "signature." The search for central nervous system (CNS) biomarkers for chronic pain is ongoing.
个性化医疗可定义为根据患者对治疗的反应可能性或不良事件风险，为特定患者亚组量身定制治疗方案。这种医学模式在肿瘤学领域更为成熟，但个性化疼痛治疗也显示出潜在的前景。药物基因组学与疼痛领域的相关性日益增加，例如细胞色素P450 2D6（CYP2D6）多态性导致CYP2D6表达程度的差异，可能会影响可待因的镇痛效果。使用定量感觉测试的研究正在寻求识别具有不同潜在疼痛机制的神经性疼痛患者的表型亚组。影像学研究表明，遗传、环境、情绪和损伤特异性因素共同作用，产生独特的脑部疼痛“特征”。针对慢性疼痛的中枢神经系统（CNS）生物标志物的研究正在进行中。
