在预防术后恶心呕吐（PONV）的管理中，遗传学是否有一席之地？

Is there a place for genetics in the management of PONV?

机构信息

Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miller School of Medicine, Miami, FL, 1611 NW 12th Ave, Suite C300, Miami, FL, 33136, USA.

Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miller School of Medicine, Miami, FL, 1500 NW 12th Ave, #815, Miami, FL, 33136, USA.

出版信息

Best Pract Res Clin Anaesthesiol. 2020 Dec;34(4):713-720. doi: 10.1016/j.bpa.2020.05.002. Epub 2020 May 13.

DOI:10.1016/j.bpa.2020.05.002

PMID:33288121

Abstract

Antiemetic prophylaxis for postoperative nausea and vomiting (PONV) - a frequent complication in the postoperative period - is routinely given to high-risk patients. However, standard PONV risk models do not account for genetic factors, which have been shown to have a significant influence on PONV incidence and drug response. In this review, we describe the polymorphisms of various genes (serotonin, dopamine, cholinergic, etc.) and how pharmacogenomics is involved in the pathophysiology of PONV. This review also addresses how genetics is involved in today's clinical practice related to PONV and how it will change in the upcoming years as personalized medicine advances.

摘要

术后恶心和呕吐（PONV）预防 - 这是术后时期的常见并发症 - 通常给予高风险患者。然而，标准的 PONV 风险模型并未考虑遗传因素，这些因素已被证明对 PONV 的发生率和药物反应有重大影响。在这篇综述中，我们描述了各种基因（5-羟色胺、多巴胺、胆碱能等）的多态性，以及遗传药理学如何参与 PONV 的病理生理学。这篇综述还讨论了遗传学如何参与与 PONV 相关的当今临床实践，以及随着个性化医疗的发展，它将在未来几年发生怎样的变化。