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基因变异对重大乳腺手术患者芬太尼代谢的影响:一项候选基因关联研究。

Impact of genetic variants on fentanyl metabolism in major breast surgery patients: a candidate gene association study.

作者信息

Kumar Shathish, Ramasamy Kesavan, Natarajan Harivenkatesh, Venkatraman Shravan, Eriyat Vishnu, Kundra Pankaj

机构信息

Department of Anaesthesiology, Manipal Hospital Whitefield, Bangalore, India.

Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

出版信息

Pharmacogenomics. 2024;25(14-15):595-603. doi: 10.1080/14622416.2024.2429365. Epub 2024 Nov 20.

DOI:10.1080/14622416.2024.2429365
PMID:39563600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11703455/
Abstract

AIM

The study aimed to examine the association of two selected candidate SNPs rs2242480 (CYP3A4) and rs1045642 (ABCB1) with metabolic ratio of plasma norfentanyl to fentanyl concentrations in patients undergoing major breast surgeries.

METHODS

The retrospective cross-sectional study was done in 257 female patients. DNA extraction, genotyping of selected SNPs, and drug levels measurement were employed.

RESULTS

A total of 257 female patients were recruited with no loss to follow up. There was no significant association between the two mentioned SNPs and the metabolic ratio ( value > 0.05). As an exploratory analysis, there was a moderately significant negative correlation between metabolic ratio and pupillary constriction to fentanyl ( = -0.27;  < 0.001). There was also a weak but significant positive correlation between metabolic ratio and time for first analgesia in the postoperative period ( = 0.17;  = 0.01).

CONCLUSION

There was no significant association with the selected candidate SNPs in and and metabolic ratio of norfentanyl to fentanyl in South Indian patients undergoing major breast surgery.

摘要

目的

本研究旨在探讨两个选定的候选单核苷酸多态性(SNP),即rs2242480(CYP3A4)和rs1045642(ABCB1)与接受大型乳房手术患者血浆中去甲芬太尼与芬太尼浓度代谢比之间的关联。

方法

对257名女性患者进行了回顾性横断面研究。采用了DNA提取、选定SNP的基因分型以及药物水平测量。

结果

共招募了257名女性患者,无失访情况。上述两个SNP与代谢比之间无显著关联(P值>0.05)。作为探索性分析,代谢比与对芬太尼的瞳孔收缩之间存在中度显著的负相关(r = -0.27;P < 0.001)。代谢比与术后首次镇痛时间之间也存在微弱但显著的正相关(r = 0.17;P = 0.01)。

结论

在接受大型乳房手术的南印度患者中,CYP3A4和ABCB1中选定的候选SNP与去甲芬太尼与芬太尼的代谢比无显著关联。

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本文引用的文献

1
Predictive models for fentanyl dose requirement and postoperative pain using clinical and genetic factors in patients undergoing major breast surgery.预测接受大型乳房手术的患者使用临床和遗传因素所需芬太尼剂量和术后疼痛的模型。
Pain. 2023 Jun 1;164(6):1332-1339. doi: 10.1097/j.pain.0000000000002821. Epub 2022 Nov 9.
2
Impact of Genetic Variants on Postoperative Pain and Fentanyl Dose Requirement in Patients Undergoing Major Breast Surgery: A Candidate Gene Association Study.遗传变异对行大乳房手术患者术后疼痛和芬太尼剂量需求的影响:候选基因关联研究。
Anesth Analg. 2023 Aug 1;137(2):409-417. doi: 10.1213/ANE.0000000000006330. Epub 2022 Dec 20.
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Foreseeing postoperative pain in neurosurgical patients: pupillometry predicts postoperative pain ratings-an observational study.预见神经外科患者术后疼痛:瞳孔测量预测术后疼痛评分——一项观察性研究。
J Clin Monit Comput. 2021 Oct;35(5):1111-1118. doi: 10.1007/s10877-020-00570-3. Epub 2020 Jul 29.
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Lack of Efficacy: When Opioids Do Not Achieve Analgesia from the Beginning of Treatment in Cancer Patients.疗效欠佳:癌症患者从治疗开始使用阿片类药物时未实现镇痛效果的情况。
Cancer Manag Res. 2019 Dec 10;11:10337-10344. doi: 10.2147/CMAR.S211818. eCollection 2019.
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Predicting inadequate postoperative pain management in depressed patients: A machine learning approach.预测抑郁患者术后疼痛管理不足:一种机器学习方法。
PLoS One. 2019 Feb 6;14(2):e0210575. doi: 10.1371/journal.pone.0210575. eCollection 2019.
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Impact of CYP3A4*1G Polymorphism on Fentanyl Analgesia Assessed by Analgesia Nociception Index in Chinese Patients Undergoing Hysteroscopy.CYP3A4*1G 多态性对行宫腔镜检查的中国患者镇痛感觉指数评估的芬太尼镇痛的影响。
Chin Med J (Engl). 2018 Nov 20;131(22):2693-2698. doi: 10.4103/0366-6999.243934.
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A systematic review of the risk factors for clinical response to opioids for all-age patients with cancer-related pain and presentation of the paediatric STOP pain study.癌症相关疼痛的所有年龄段患者对阿片类药物临床反应的风险因素的系统评价及儿科 STOP 疼痛研究介绍。
BMC Cancer. 2018 May 18;18(1):568. doi: 10.1186/s12885-018-4478-3.
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New Advances in Acute Postoperative Pain Management.急性术后疼痛管理的新进展。
Curr Pain Headache Rep. 2018 Apr 4;22(5):35. doi: 10.1007/s11916-018-0690-8.
9
Predicting drug efficacy in chronic low back pain by quantitative sensory tests.通过定量感觉测试预测慢性下腰痛的药物疗效。
Eur J Pain. 2018 May;22(5):973-988. doi: 10.1002/ejp.1183. Epub 2018 Jan 23.
10
B-mode ultrasound assessment of pupillary function: Feasibility, reliability and normal values.B 型超声瞳孔功能评估:可行性、可靠性和正常值。
PLoS One. 2017 Dec 6;12(12):e0189016. doi: 10.1371/journal.pone.0189016. eCollection 2017.