Do Variations in the 5-HT3A and 5-HT3B Serotonin Receptor Genes (HTR3A and HTR3B) Influence the Occurrence of Postoperative Vomiting?

Rueffert, Henrik; Thieme, V.; Wallenborn, Jan; Lemnitz, Nicole; Bergmann, Astrid; Rudlof, Kristina; Wehner, Markus; Olthoff, D; Kaisers, Udo X.

doi:10.1213/ane.0b013e3181b2359b

Cited by 59 publications

(45 citation statements)

References 26 publications

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“…Our results found the SNP rs1176713 for the serotonin receptor gene type A was also protective for PONV. This finding is consistent with work reported by Reuffort and colleagues (Reuffert et al, 2009). …”

Section: Discussionsupporting

confidence: 94%

“…We also used known proportions of allele frequency of a common 5-HT3A (rs71176713) variant and PONV from a previous study (Reuffert et al, 2009) which reported an odds ratio of 2.97. Based on that odds ratio, a sample size of 100, would produce a 2-sided 95% confidence interval for the odds ratio with a width equal to 6.140 when the estimated sample proportion 1 is 0.61, the estimated sample proportion 2 is 0.35, and the sample OR is 2.86.…”

Section: Methodsmentioning

confidence: 99%

“…We also found that variability in the promoter region of the serotonin transport gene was associated with increased nausea and vomiting in women with breast cancer after surgery yet prior to initiation of adjuvant chemotherapy (Wesmiller et al, 2014). Other single nucleotide polymorphisms (SNPs) in the serotonin receptor genes HTR3A and HTR3B gene have been identified which independently influenced the incidence of PONV (Laugsand et al, 2011; Ma et al, 2013; Reuffert et al, 2009). Because droperidol and metoclopramide are dopamine antagonists that have a history of successfully preventing PONV, variability in dopamine receptors is also a logical target to study.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the multifactorial nature of postoperative nausea and vomiting in women following surgery for breast cancer

Wesmiller

Sereika

Bender

et al. 2017

Autonomic Neuroscience

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Background Postoperative nausea and vomiting (PONV) are two of the most frequent and distressing complications following surgical procedures, with as many as 80% of patients considered to be at risk. Despite recognition of well-established risk factors and the subsequent use of clinical guidelines, 20–30% of women do not respond to antiemetic protocols, indicating that there may be a genetic risk. Objective The purpose of this pilot study was to describe the incidence and explore the risk factors associated with PONV after surgery in women diagnosed with early stage breast cancer. Methods A prospective cohort design was employed to measure PONV in women recruited prior to surgery. DNA was extracted from saliva samples collected prior to discharge. Polymorphisms for seven candidate genes with a known role in one of the neural pathways associated with PONV were included in this study; serotonin receptor (HTR3A), serotonin transport (SLC6A4), tryptophan (TPH), dopamine receptors (DRD2/ANKK and DRD3), catechol-O-methyltransferase (COMT) and histamine (H1). Results Twenty-nine (29.8%) women experienced nausea and 10 (11%) experienced nausea and vomiting while in the PACU despite administration of multiple antiemetic medications. Women who experienced PONV had higher levels of pain and received more opioids than those women who did not experienced PONV. Odds ratios demonstrated that alleles for the COMT, DRD3, and TPH genes were associated with decreased PONV. Conclusion The understanding of the multifactorial nature of PONV and the recognition of genetic risk will ultimately lead to the development of personalized interventions to manage these frequent and often debilitating symptoms.

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Section: Discussionsupporting

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the multifactorial nature of postoperative nausea and vomiting in women following surgery for breast cancer

Wesmiller

Sereika

Bender

et al. 2017

Autonomic Neuroscience

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“…This author identified genetic studies that have been undertaken by seven additional researchers specific to a particular medication's effect and the genetic variations of a receptor. [46][47][48][49][50][51][52] However, until genetics can assist the clinician with optimal interventions to match with the patient's PONV clinical presentation, the research lacks clinical efficacy.…”

Section: Geneticsmentioning

confidence: 99%

Clinical utility of antiemetics and complementary therapies in the prevention of postoperative nausea and vomiting

Collins¹

2013

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Postoperative nausea and vomiting (PONV) is a persistent problem in perianesthesia practice. Approximately 30% of patients receiving anesthesia will experience this complication, which can increase patient dissatisfaction, increase costs, and in some patients precipitate other postoperative complications. During the last three decades, there has been increasing interest and research on best practices to diminish the incidence of this clinical problem, as patient satisfaction is linked to PONV guideline use. Some institutions have low incident rates because of consistent protocol use, and new medication classifications and multiple complementary therapies have been incorporated into daily use. There are several clinically useful guidelines and algorithms used to guide primary prevention strategies, as discussed in this review. However, severe PONV continues to be refractory to available interventions, and the best hope for elimination of this complication may arise from pharmacogenomics.

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“…The most common types of genetic study associated with PONV are those of the single nucleotide polymorphisms associated with neural signaling and transmitter receptors in the PONV system. Genes regarded as related to PONV or OINV include 5-HT 3 (subunit A and B) receptor [7], muscarinic type 3 receptor, dopamine type 2 receptors [8], catechol-o-methyl-transferase [9], alpha 2 adrenoceptors [10], adenosine triphosphate-binding cassette subfamily B member 1 [11], cytochrome P450 superfamily enzyme [12], and UDP-glucuronosyltransferase.…”

Section: Pharmacogenetics Associated With Ponvmentioning

confidence: 99%

Postoperative nausea and vomiting

Allman¹,

Wilson²

2011

Oxford Handbook of Anaesthesia

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Postoperative nausea and vomiting (PONV) is a long-standing issue, not a new concept in anesthesiology. Despite many studies over the last several decades, PONV remains a significant problem due to its complex mechanism. This review presents a summary of the mechanism underlying the pathogenesis of PONV, focusing on preventive treatment, particularly the use of new drugs. In addition, we discuss the latest meta-analysis results regarding correct clinical use of classic drugs. I also summarize the latest trends of postdischarge nausea and vomiting and the pharmacogenetics, which is attracting a great deal of attention from other medical fields in PONV-related studies. Finally, we discuss the drawbacks of existing studies on PONV and suggest a focus for future investigations. (Korean J Anesthesiol 2014; 67: 164-170)

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Do Variations in the 5-HT3A and 5-HT3B Serotonin Receptor Genes (HTR3A and HTR3B) Influence the Occurrence of Postoperative Vomiting?

Abstract: Genetic variations in the HTR3A and HTR3B gene seem to be associated with the individual risk of developing POV. How strong their influence is within the multifactorial genesis of POV needs to be investigated in additional studies with an appropriate sample size.

Cited by 59 publications

References 26 publications

Exploring the multifactorial nature of postoperative nausea and vomiting in women following surgery for breast cancer

Exploring the multifactorial nature of postoperative nausea and vomiting in women following surgery for breast cancer

Clinical utility of antiemetics and complementary therapies in the prevention of postoperative nausea and vomiting

Postoperative nausea and vomiting

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