遗传变异与术后疼痛的关联:系统性审查和元分析
Stephan G Frangakis1, Mark MacEachern2, T Adam Akbar3
1Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan.
Anesthesiology
|September 29, 2023
概括
在OPRM1和COMT中的遗传变异显示了与术后疼痛和阿片类药物使用的小关联. 需要对更大的队列和一致的措施进行进一步的研究,以澄清对疼痛的遗传影响.
科学领域:
- 药物基因组学 药物基因组学
- 疼痛医学 医学 疼痛医学
- 遗传学 是一个遗传学.
背景情况:
- 术后疼痛显著影响康复,但其遗传基础尚未完全理解.
- 识别与术后疼痛相关的遗传变异对于个性化疼痛管理策略至关重要.
研究的目的:
- 在成年人中系统地审查和元分析与术后疼痛和阿片类药物使用相关的遗传变异.
- 评估遗传变异与急性 (0-48小时) 和慢性 (≥3个月) 术后疼痛的关联.
主要方法:
- 从PubMed,Embase和Cochrane中央注册表中,对2000-2022年间发表的研究进行系统审查.
- 包括成人患者的英语研究,检查遗传变异和术后疼痛.
- 对具有足够数据的七种变体进行了元分析 (OPRM1,COMT,ABCB1).
主要成果:
- 163项研究评估了129个基因和594个变异;许多关联缺乏复制.
- OPRM1 rs1799971显示了与急性术后阿片类药物使用和疼痛评分的小关联.
- COMT rs4680显示了与慢性术后疼痛得分的小关联.
结论:
- 只有两种基因变异,OPRM1 rs1799971和COMT rs4680,显示出与术后疼痛有很小的关联.
- 不一致的发现和小样本大小凸显了严格的大规模研究的必要性.
- 未来的研究应该集中在标准化结果措施和更大的队列上,以阐明术后疼痛的遗传贡献.
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