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Human Genetic Variability Contributes to Postoperative Morphine Consumption.

Manuela De Gregori1, Luda Diatchenko2, Pablo M Ingelmo3

  • 1Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; SIMPAR (Study In Multidisciplinary Pain Research) Group, UO 2(a) Anestesia, Rianimazione e Terapia Antalgica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy; YAP (Young Against Pain) Group, UO 2(a) Anestesia, Rianimazione e Terapia Antalgica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.

The Journal of Pain
|February 24, 2016
PubMed
Summary
This summary is machine-generated.

Genetic variations in OPRM1, COMT, and ESR1 genes influence how patients consume morphine for pain relief after surgery. Combinations of these genetic markers can better predict morphine use than single markers alone.

Keywords:
Acute postoperative painOPRM1 haplotypegenetic variabilitygenetic variants combinationpostoperative opioid consumption

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Area of Science:

  • Pharmacogenomics
  • Pain Management
  • Genetics

Background:

  • Postoperative opioid consumption shows significant interindividual variability.
  • Genetic and environmental factors contribute to this variability.
  • Understanding genetic predictors can optimize pain management strategies.

Purpose of the Study:

  • To investigate the association between single nucleotide polymorphisms (SNPs) in OPRM1, COMT, and ESR1 genes and morphine consumption.
  • To identify genetic markers for predicting postoperative opioid use and pain intensity.
  • To develop statistical models for personalized pain management.

Main Methods:

  • Analysis of 20 SNPs in 201 Caucasian patients undergoing abdominal surgery.
  • Patients received patient-controlled analgesia-administered morphine postoperatively.
  • Morphine consumption and pain intensity were measured as dependent variables, with age and sex as covariates.

Main Results:

  • A haplotype of 7 OPRM1 SNPs demonstrated significant additive effects on opioid consumption (P=.007).
  • A comprehensive linear regression model incorporating age and 9 SNPs from ESR1, OPRM1, and COMT explained 10.7% of morphine consumption variance (P=.001).
  • A minimal model with 3 SNPs from ESR1, OPRM1, and COMT explained 5% of variance (P=.007), and a significant interaction between COMT and ESR1 SNPs was observed (P=.007).

Conclusions:

  • Combinations of genetic variants within OPRM1, COMT, and ESR1 genes are more effective in explaining morphine consumption variability than single variants.
  • These findings support the development of genetic markers and statistical models for predicting opioid consumption and efficacy.
  • This research contributes to personalized medicine approaches in postoperative pain management.