OPRM1 c.118A>G Polymorphism and Duration of Morphine Treatment Associated with Morphine Doses and Quality-of-Life in Palliative Cancer Pain Settings.
OPRM1 c.118A>G Polymorphism and Duration of Morphine Treatment Associated with Morphine Doses and Quality-of-Life in Palliative Cancer Pain Settings.
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DOI：
10.3390/ijms18040669
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发表时间：
2017-03-27
影响因子：
5.6
通讯作者：
Rabbaa Khabbaz L
中科院分区：
文献类型：
--
作者：
Hajj A;Halepian L;Osta NE;Chahine G;Kattan J;Rabbaa Khabbaz L
尽管人们越来越关注评估和管理，但疼痛仍然是癌症患者最持久的症状，特别是在生命结束时，对他们的生活质量（QOL）产生不利影响。我们进行了这项研究，以评估确定一些遗传和非遗传因素的附加值，以优化癌症疼痛治疗。89例患者被纳入研究，以评估姑息性癌症疼痛管理。回归分析显示，年龄、OPRM 1单核苷酸多态性（SNP）以及吗啡治疗的持续时间与24 h时的吗啡剂量显著相关（通过输液泵给药;分别为p = 0.043、0.029和<0.001）。吗啡的平均剂量随着年龄的增长而下降，但随着吗啡治疗的持续时间而增加。此外，具有AG基因型c.118A>G OPRM 1的患者比AA患者需要更高剂量的吗啡。此外，转移、OPRM 1 SNP、年龄和性别与我们人群的QOL显著相关。特别是，AA患者的OPRM 1 SNP的认知功能显着低于AG患者，这一结果以前没有在文献中报道。这些发现可能有助于提高吗啡治疗的有效性，并在个性化医疗方面提高患者的生活质量。
Despite increased attention on assessment and management, pain remains the most persistent symptom in patients with cancer, in particular in end-of-life settings, with detrimental impact on their quality-of-life (QOL). We conducted this study to evaluate the added value of determining some genetic and non-genetic factors to optimize cancer pain treatment. Eighty-nine patients were included in the study for the evaluation of palliative cancer pain management. The regression analysis showed that age, OPRM1 single nucleotide polymorphism (SNP), as well as the duration of morphine treatment were significantly associated with morphine doses at 24 h (given by infusion pump; p = 0.043, 0.029, and <0.001, respectively). The mean doses of morphine decreased with age but increased with the duration of morphine treatment. In addition, patients with AG genotype c.118A>G OPRM1 needed a higher dose of morphine than AA patients. Moreover, metastases, OPRM1 SNP, age, and gender were significantly associated with the QOL in our population. In particular, AA patients for OPRM1 SNP had significantly lower cognitive function than AG patients, a result not previously reported in the literature. These findings could help increase the effectiveness of morphine treatment and enhance the QOL of patients in regards to personalized medicine.