Ning M, Tao Y, Hu X, Guo L, Ni J, Hu J, Shen H, Chen Y
Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
Niger J Clin Pract. 2019 Oct;22(10):1319-1323. doi: 10.4103/1119-3077.269019.
Morphine is a common analgesic often used to manage chronic pain, especially for patients with pain due to malignancies. Since UGT2B7 plays an important role in the metabolism of morphine, UGT2B7 gene mutation may influence the efficacy of morphine in patients with cancer being treated by this medication.
The aim of this study is to investigate the relationship between the polymorphisms of UGT2B7 and the efficacy of morphine treatment on cancer pain among the Chinese Han population.
A total of 120 patients with cancer pain were enrolled in this study. Morphine was administrated through patient-controlled analgesia infusion pump, and the visual analog score (VAS) was used for pain assessment at 0.5, 4, 6, 12, 24, 48, and 72-h post morphine treatment, respectively. The plasma concentration of morphine and genetic polymorphism of UGT2B7 C802T and G221T was analyzed, respectively.
The frequencies of UGT2B7 C802T were CC: 13.33%, CT: 45% and TT: 41.67%, and the frequencies of UGT2B7 G221T were GG: 76.67%, GT: 22.5% and TT: 0.83%. Moreover, the VAS score of patients with either C802T CT or TT was significantly higher than that in patients with C802T CC. However, no difference of VAS scores was observed between patients carrying G221T GG and patients carrying G221T GT. The plasma concentration of morphine for patients with the C802T CC was significantly lower than that in patients carrying C802T CT or TT, while there was no significant difference in the level of morphine between patients with G221T GG and G221T GT.
The polymorphism of UGT2B7 C802T, but not UGT2B7 G221T, has been associated with the efficacy of morphine treatment on cancer pain among Chinese Han population.
吗啡是一种常用的镇痛药,常用于治疗慢性疼痛,尤其是对患有恶性肿瘤疼痛的患者。由于尿苷二磷酸葡萄糖醛酸基转移酶2B7(UGT2B7)在吗啡代谢中起重要作用,UGT2B7基因突变可能会影响吗啡对接受该药物治疗的癌症患者的疗效。
本研究旨在探讨中国汉族人群中UGT2B7基因多态性与吗啡治疗癌症疼痛疗效之间的关系。
本研究共纳入120例癌症疼痛患者。通过患者自控镇痛输注泵给予吗啡,并分别在吗啡治疗后0.5、4、6、12、24、48和72小时使用视觉模拟评分法(VAS)进行疼痛评估。分别分析吗啡的血浆浓度以及UGT2B7 C802T和G221T的基因多态性。
UGT2B7 C802T的基因型频率为CC:13.33%,CT:45%,TT:41.67%;UGT2B7 G221T的基因型频率为GG:76.67%,GT:22.5%,TT:0.83%。此外,C802T为CT或TT基因型的患者的VAS评分显著高于C802T为CC基因型的患者。然而,携带G221T为GG基因型的患者与携带G221T为GT基因型的患者之间的VAS评分没有差异。C802T为CC基因型的患者的吗啡血浆浓度显著低于携带C802T为CT或TT基因型的患者,而携带G221T为GG基因型的患者与携带G221T为GT基因型的患者之间的吗啡水平没有显著差异。
在中国汉族人群中,UGT2B7 C802T的基因多态性与吗啡治疗癌症疼痛的疗效相关,而UGT2B7 G221T的基因多态性与吗啡治疗癌症疼痛的疗效无关。