Gloor Yvonne, Czarnetzki Christoph, Curtin François, Gil-Wey Béatrice, Tramèr Martin R, Desmeules Jules A
Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals (HUG), Geneva, Switzerland.
Division of Anesthesiology, Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals (HUG), Geneva, Switzerland.
Front Genet. 2022 Jan 31;12:816908. doi: 10.3389/fgene.2021.816908. eCollection 2021.
Postoperative nausea and vomiting (PONV) are frequently occurring adverse effects following surgical procedures. Despite predictive risk scores and a pallet of prophylactic antiemetic treatments, it is still estimated to affect around 30% of the patients, reducing their well-being and increasing the burden of post-operative care. The aim of the current study was to characterize selected genetic risk factors of PONV to improve the identification of at risk patients. We genotyped 601 patients followed during the first 24 h after surgery for PONV symptoms in the absence of any antiemetic prophylaxis. These patients were recruited in the frame of a randomized, placebo controlled clinical study aiming to test the efficacy of dexamethasone as a treatment of established PONV. We examined the impact of selected single nucleotide polymorphisms (SNPs) located around 13 different genes and the predicted activity of 6 liver drug metabolizing enzymes from the cytochromes P450 family (CYP) on the occurrence and recurrence of PONV. Our genetic study confirms the importance of genetic variations in the type 3B serotonin receptor in the occurrence of PONV. Our modelling shows that integration of genotype in preoperative risk assessments may help improve the targeting of antiemetic prophylaxis towards patients at risk of PONV.
术后恶心呕吐（PONV）是外科手术后经常出现的不良反应。尽管有预测风险评分和一系列预防性止吐治疗方法，但据估计仍有大约30%的患者会受到影响，这降低了他们的舒适度并增加了术后护理负担。本研究的目的是确定PONV的特定遗传风险因素，以改善对高危患者的识别。我们对601名患者进行了基因分型，这些患者在术后24小时内未接受任何止吐预防措施的情况下，观察其PONV症状。这些患者是在一项随机、安慰剂对照的临床研究框架内招募的，该研究旨在测试地塞米松作为已确诊PONV治疗药物的疗效。我们研究了位于13个不同基因附近的选定单核苷酸多态性（SNP）以及细胞色素P450家族（CYP）中6种肝脏药物代谢酶的预测活性对PONV发生和复发的影响。我们的基因研究证实了3B型血清素受体基因变异在PONV发生中的重要性。我们的模型表明，将基因型纳入术前风险评估可能有助于改善针对PONV高危患者的止吐预防措施。
