A genetic association study of the functional A118G polymorphism of the human μ-opioid receptor gene in patients with acute and chronic pain
A genetic association study of the functional A118G polymorphism of the human μ-opioid receptor gene in patients with acute and chronic pain
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DOI：
10.1213/01.ane.0000231634.20341.88
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发表时间：
2006-10-01
影响因子：
5.7
通讯作者：
Mets, Berend
中科院分区：
文献类型：
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作者：
Janicki, Piotr K.;Schuler, Gregg;Mets, Berend
在这项前瞻性、观察性研究中，我们探讨了人类μ阿片受体（莫尔）基因A118 G单核苷酸多态性是否可以解释急性术后疼痛和慢性疼痛患者阿片类镇痛需求的个体间差异。在慢性非癌性疼痛受试者（n = 121）和未接受过阿片类药物治疗的急性术后疼痛受试者（n = 101）（作为对照组）中，检测野生型A118莫尔（主要）和变异型G118莫尔（次要）等位基因的频率。在两组中分析A118 G莫尔基因型、阿片类药物需求和疼痛数值评分之间的关系。与术后急性疼痛组相比，慢性疼痛受试者中次要等位基因的频率显著较低（0.079 vs 0.158; X-2检验P = 0.009）。A118 G莫尔多态性的存在与平均术后疼痛评分或术后即刻使用的吗啡剂量之间没有统计学显著相关性。在高四分位数、阿片类药物使用、慢性疼痛患者中，主要等位基因的纯合子携带者需要的阿片类药物剂量显著高于次要等位基因携带者。结果表明，虽然次要等位基因的存在似乎不会影响阿片类镇痛药在急性术后疼痛中的使用，但次要等位基因在慢性疼痛患者中不太常见，特别是在那些需要更高剂量阿片类镇痛药的患者中。
In this prospective, observational study we explored whether A118G single nucleotide polymorphism in the human mu-opioid receptor (MOR) gene could explain the inter-individual differences in opioid analgesic requirements in patients with acute postoperative pain and chronic pain. The frequency of the wild-type A118 MOR (major) and variant G118 MOR (minor) alleles in the subjects with chronic, noncancer pain (n = 121) and opioid-naive subjects with acute postoperative pain (n = 101), serving as the control group, were examined. The relationships among the A118G MOR genotype, opioid requirements, and the numerical pain score were analyzed in both groups. The frequency of the minor allele was significantly lower in the subjects with chronic pain when compared with the group with acute postoperative pain (0.079 versus 0.158; P = 0.009 by X-2 test). No statistically significant association was observed between the presence of A118G MOR polymorphism and the average postoperative pain score or the doses of morphine used in the immediate postoperative period. In the high-quartile, opioid utilization, chronic pain patients, the homozygotic carriers of the major allele required significantly higher opioid dose than did the carriers of the minor allele. The results indicate that although the presence of the minor allele does not appear to affect opioid analgesic use in acute postoperative pain, the minor allele is less common in chronic pain patients, especially in those requiring higher doses of opioid analgesics.