Dragic Lisa Lynn, Wegrzyn Erica L, Schatman Michael E, Fudin Jeffrey
Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.
Department of Pharmacy, Albany Stratton VA Medical Center, Albany, NY, USA.
J Pain Res. 2017 Dec 22;11:37-40. doi: 10.2147/JPR.S144560. eCollection 2018.
The use of pharmacogenomics has become more prevalent over the past several years in treating many disease states. Several cytochrome P450 enzymes play a role in the metabolism of many pain medications including opioids and antidepressants. Noncytochrome P450 enzymes such as methylenetetrahydrofolate reductase (MTHFR) and catechol--methyl transferase (COMT) also play a role in the explanation of opioid dosage requirements as well as in response to certain antidepressants. We present the case of a patient with reduced and expression treated with leucovorin 10 mg daily for the management of chronic pain. The use of leucovorin in this patient decreased pain scores, which were clinically significant and increased functionality. This case demonstrates the importance of pharmacogenetics testing in patients, as this can help direct providers to better therapeutic options for their patients.
在过去几年中，药物基因组学在治疗多种疾病状态方面的应用变得更加普遍。几种细胞色素P450酶在许多止痛药物（包括阿片类药物和抗抑郁药）的代谢中发挥作用。非细胞色素P450酶，如亚甲基四氢叶酸还原酶（MTHFR）和儿茶酚 - 甲基转移酶（COMT），在解释阿片类药物剂量需求以及对某些抗抑郁药的反应方面也发挥作用。我们报告一例患者，其[此处原文可能缺失具体基因名称]表达降低，每天使用10 mg亚叶酸钙治疗慢性疼痛。该患者使用亚叶酸钙后疼痛评分降低，具有临床意义且功能得到改善。该病例证明了对患者进行药物遗传学检测的重要性，因为这有助于指导医疗服务提供者为患者选择更好的治疗方案。
