Department of Pediatrics, Boston Medical Center, Boston, MA, USA; Grayken Center for Addiction Medicine, Boston Medical Center, Boston, MA, USA.
Departments of Medicine (Biomedical Genetics), Neurology, Ophthalmology, Epidemiology, and Biostatistics, Boston University Schools of Medicine and Public Health, Boston, MA, USA.
Semin Fetal Neonatal Med. 2019 Apr;24(2):105-110. doi: 10.1016/j.siny.2019.01.002. Epub 2019 Jan 25.
Neonatal abstinence syndrome (NAS) due to in-utero opioid exposure is a growing epidemic with significant variability in clinical presentation and severity. Currently, NAS severity cannot be predicted based on clinical factors alone. To date, small studies have identified genetic variants in opioid receptor and stress response genes that are associated with differences in NAS pharmacologic treatment rates and length of hospitalization. In addition, epigenetic variation in the mu opioid receptor (OPRM1) gene has been associated with differences in NAS hospitalization outcomes. Examination of maternal genetic and epigenetic profiles may assist in prediction of NAS severity. Large-scale genomic studies are needed to elucidate the genetic architecture of and epigenetic modification related to NAS in order to develop more tailored personalized treatments for NAS.
由于胎儿期阿片类药物暴露而导致的新生儿戒断综合征（NAS）是一种日益严重的流行疾病，其临床表现和严重程度存在显著差异。目前，NAS 的严重程度不能仅基于临床因素来预测。迄今为止，一些小型研究已经确定了阿片受体和应激反应基因中的遗传变异，这些变异与 NAS 药物治疗率和住院时间的差异有关。此外，μ阿片受体（OPRM1）基因的表观遗传变异与 NAS 住院结局的差异有关。对母体遗传和表观遗传特征的检查可能有助于预测 NAS 的严重程度。需要开展大规模的基因组研究，以阐明与 NAS 相关的遗传结构和表观遗传修饰，从而为 NAS 开发更具针对性的个体化治疗方法。
