Bach-Rojecky Lidija, Vađunec Dalia, Žunić Katarina, Kurija Jelena, Šipicki Sara, Gregg Ryan, Mikula Ivan, Primorac Dragan
Department of Pharmacology, University of Zagreb Faculty of Pharmacy & Biochemistry, A Kovačića 1, 10000 Zagreb, Croatia.
OneOme LLC, 807 Broadway St NE #100, Minneapolis, MN 55413, USA.
Per Med. 2019 Mar;16(2):171-184. doi: 10.2217/pme-2018-0116. Epub 2018 Nov 28.
Successful pain management requires the delivery of analgesia with minimal risk of adverse drug reactions. Nonsteroidal anti-inflammatory drugs and opioids remain the mainstay of treatment for the majority of patients. Unfortunately, almost 50% of all patients experience inadequate pain relief and serious side effects. Allelic variants in genes coding for target proteins, transporters and enzymes, which govern analgesic drugs action and their fate in the organism, might explain inter-individual variability in pain severity and in drug-induced pain relief and toxicities. Additionally, it seems that epigenetic changes contribute to the highly variable response to pain treatment. Therefore, pharmacogenomic testing might be a valuable tool for personalization of pain treatment, with a multidisciplinary team approach involved.
成功的疼痛管理需要在药物不良反应风险最小的情况下提供镇痛效果。非甾体抗炎药和阿片类药物仍然是大多数患者治疗的主要手段。不幸的是，几乎50%的患者疼痛缓解不足且出现严重副作用。编码靶蛋白、转运体和酶的基因中的等位基因变异决定了镇痛药的作用及其在机体中的命运，这可能解释了个体间疼痛严重程度、药物诱导的疼痛缓解及毒性方面的差异。此外，表观遗传变化似乎也导致了对疼痛治疗的高度可变反应。因此，药物基因组学检测可能是实现疼痛治疗个体化的一个有价值的工具，需要多学科团队参与。
