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Farmacogenómica y eficacia de los opioides en la enfermedad de células falciformes
Rabab H Elshaikh1, Asaad M Babker2, Sanaa Elfatih Hussein3
1Medical Laboratory Sciences Department, College of Health and Applied Sciences, A' Sharqiyah University, Ibra 400, Oman.
Medicina (Kaunas, Lithuania)
|January 28, 2026
Resumen
Las variaciones genéticas impactan significativamente la respuesta de los pacientes con células falciformes a la terapia con opioides y el manejo del dolor. Las prescripciones personalizadas de opioides que consideran la diversidad genética son cruciales para un manejo del dolor eficaz y seguro en estos pacientes.
Área de la Ciencia:
- Farmacogenómica
- Manejo del dolor
- Enfermedad de células falciformes
Sus antecedentes:
- Las variaciones genéticas influyen en las respuestas individuales a la terapia con opioides.
- Los pacientes con enfermedad de células falciformes experimentan desafíos complejos en el manejo del dolor.
- La eficacia y seguridad de la terapia con opioides se ven afectadas por factores genéticos.
Objetivo del estudio:
- Revisar el impacto de la variabilidad genética en el manejo del dolor en la enfermedad de células falciformes.
- Explorar las variaciones en la respuesta y seguridad de la terapia con opioides.
- Destacar la necesidad de prescripciones personalizadas de opioides.
Principales métodos:
- Revisión de literatura sobre polimorfismos genéticos que afectan la farmacocinética y farmacodinamia de los opioides.
- Análisis de genes clave, incluyendo CYP2D6, UGT2B7, COMT y OPRM1.
- Examen del impacto de las variaciones genéticas en el metabolismo de los opioides y la unión a receptores.
Principales resultados:
- Los polimorfismos en CYP2D6, UGT2B7, COMT y OPRM1 modifican significativamente los efectos de los opioides.
- Las variaciones en CYP2D6 alteran el metabolismo de la codeína y el tramadol, afectando la respuesta analgésica y el riesgo de toxicidad.
- La diversidad genética requiere prescripciones de opioides personalizadas, pero la implementación clínica es escasa.
Conclusiones:
- La integración de pruebas genéticas en la práctica clínica es esencial para optimizar la selección de opioides.
- Los enfoques de medicina personalizada pueden minimizar los efectos adversos y mejorar la eficacia del tratamiento.
- La terapia con opioides personalizada puede mejorar la calidad de vida de los pacientes con enfermedad de células falciformes.
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