Single-Nucleotide Polymorphism C3435T in the ABCB1 Gene is Associated with Opioid Consumption in Postoperative Pain
Single-Nucleotide Polymorphism C3435T in the ABCB1 Gene is Associated with Opioid Consumption in Postoperative Pain
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DOI：
10.1111/pme.12226
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发表时间：
2013-12-01
期刊：
影响因子：
3.1
通讯作者：
Gitlin, Melvin
中科院分区：
文献类型：
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作者：
Candiotti, Keith;Yang, Zhe;Gitlin, Melvin
背景ABCB1 是阿片类药物生物利用度的主要决定因素；然而，之前的研究尚未提供 ABCB1 的单核苷酸多态性 (SNP) 与急性疼痛治疗中阿片类药物使用之间存在关联的积极证据。本研究的目的是测试 ABCB1 中的功能性 SNP C3435T 与接受肾切除术的患者术后疼痛中阿片类药物消耗之间的关联。此外，我们还探讨了 C3435T 与阿片类药物副作用之间的关联。方法对 152 名接受肾切除术的患者进行了 C3435T 基因分型。还评估了阿片类药物的消耗和疼痛评分。使用一般线性混合模型对基因型对阿片类药物消耗的影响进行建模。结果基于混合线性模型，ABCB1 三种基因型对阿片类药物消耗的影响具有统计学意义（F=4.20，P=0.017）。 ABCB1 三种基因型的阿片类药物消耗量在 0-6 小时（P=0.031，95% 置信区间 [CI] CC 14.7-24.8mg 和 TT 5.2-14.6mg）和 6-12 小时（P=0.009，95% CI CC 5.6-13.8mg 和 TT）存在统计学显着性差异。 1.2mg-5.1mg）术后期间。 ABCB1三种基因型术后12-24小时（P=0.302）和24-48小时（P=0.763）阿片类药物使用量差异无统计学意义。术后24小时内，TT基因型的阿片类药物累积消耗量显着低于CC基因型（P=0.029）。三个基因型组在术后疼痛评分或术后 24 小时内的呕吐药物使用方面没有显着差异。结论我们的结果表明 ABCB1 多态性 (C3435T) 与肾切除术后急性期阿片类药物消耗的个体差异之间存在关联。 ABCB1多态性可能作为指导术后患者急性疼痛治疗的重要因素。
BackgroundABCB1 is a major determinant of opioid bioavailability; however, no previous studies have provided positive evidence of an association between single-nucleotide polymorphisms (SNPs) of ABCB1 and opioid usage in acute pain management. The aim of this study was to test the association between the functional SNP C3435T in ABCB1 and opioid consumption in postoperative pain in patients undergoing a nephrectomy. Additionally, we explored the association between C3435T and opioid side effect.MethodsC3435T was genotyped in 152 patients undergoing a nephrectomy. Opioid consumption and pain scores were evaluated as well. The effect of genotype on opioid consumption was modeled using a general linear mixed model.ResultBased on a mixed linear model, the ABCB1 three genotypes showed a statistically significant effect on opioid consumption (F=4.20, P=0.017). There was a statistically significant difference in opioid consumption among the ABCB1 three genotypes in the 0-6 hours (P=0.031, 95% confidence interval [CI] CC 14.7-24.8mg and TT 5.2-14.6mg) and 6-12 hours (P=0.009, 95% CI CC 5.6-13.8mg and TT 1.2mg-5.1mg) postoperative period. There were no significant statistical differences in opioid consumption among the ABCB1 three genotypes in the 12-24 hours (P=0.302) and 24-48 hours (P=0.763) postoperative period. The TT genotype had significantly lower levels of cumulative opioid consumption compared with the CC genotype in first 24 hours after surgery (P=0.029). No statistically significant differences among the three genotype groups were noted for postoperative pain scores or emesis medication use in the first 24 hours after surgery.ConclusionOur results demonstrate an association between the ABCB1 polymorphism (C3435T) and interindividual variations in opioid consumption in the acute postoperative period after nephrectomy. The ABCB1 polymorphism may serve as an important factor to guide acute pain therapy in postoperative patients.