Genetic polymorphisms of
            <i>OPRM1</i>
            on the Efficacy and Safety of Anesthetic and Analgesic Agents: A Systematic Review

Liew, Yee; Capule, Francis; Makmor‐Bakry, Mohd

doi:10.2217/pgs-2022-0042

Cited by 2 publications

References 42 publications

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The Catechol‐O‐Methyltransferase (COMT) Val158Met Polymorphism Is Associated with Oxycodone Requirements, Adverse Effects, and Pain Sensitivity in Cancer Patients

Xu,

Wu,

Liu

et al. 2024

Journal of Clinical Pharmacy and Therapeutics

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Purpose. Catechol‐O‐methyltransferase (COMT) participates in the regulation of dopaminergic and adrenergic neurotransmission. COMT Val158Met polymorphism influences the efficacy and safety of opioids, but its association with oxycodone treatment in patients with cancer pain is yet to be elucidated. Hence, this study aimed to investigate the influence of COMT Val158Met polymorphism on oxycodone requirements, drug adverse effects, and pain sensitivity in patients with cancer. Methods. Patients with moderate to severe cancer pain treated with oxycodone were enrolled, of which 101 patients completed the study. All patients were genotyped for COMT Val158Met polymorphism using DNA from blood samples and were categorized into the wild‐type group (n = 50) comprising individuals with the Val/Val genotype and the mutant group (n = 51) encompassing those with the Val/Met or Met/Met genotype. Numerical rating scale (NRS) scores, oxycodone requirements, and the incidence of oxycodone‐related adverse drug reactions were compared between the two groups. Results. Patients in the mutant group exhibited higher NRS scores (6.18 ± 1.40) before the oxycodone treatment than those in the wild‐type (5.48 ± 1.54) group (P = 0.017). Patients in the wild‐type group required more oxycodone (96.00 ± 146.19 mg/24 h) than those in the mutant (77.25 ± 83.91 mg/24 h) group (P = 0.0365). The incidence rates of dysuria (2.0% vs. 16.0%, P = 0.016) and fatigue (0.0% vs. 12.0%, P = 0.013) were significantly lower in the mutant group than those in the wild‐type group. Moreover, patients with at least one Met allele showed a lower risk of suffering from oxycodone‐related side effects than those with the wild homozygote (41.2% vs. 68.0%, P = 0.007). Conclusion. Genetic variations in the COMT Val158Met gene may contribute to variability in the efficacy and safety of oxycodone in cancer pain treatment. The findings from this study emphasize the potential of pharmacogenetics in personalizing pain management. Furthermore, oxycodone therapeutic strategies can be designed based on genetic polymorphisms.

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The Catechol‐O‐Methyltransferase (COMT) Val158Met Polymorphism Is Associated with Oxycodone Requirements, Adverse Effects, and Pain Sensitivity in Cancer Patients

Xu,

Wu,

Liu

et al. 2024

Journal of Clinical Pharmacy and Therapeutics

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Effects of different methods of anesthesia on acute gastrointestinal dysfunction, postoperative cognitive impairment, and the immune status after laparoscopic radical rectal cancer surgery

zhu

Wang

2022

Preprint

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Background With an increase in the aged population in China, the annual incidence of rectal cancer is gradually increasing. This study compares the effects of two anesthesia methods on patients undergoing laparoscopic radical rectal cancer surgery. Method A total of 230 patients who underwent laparoscopic radical resection for rectal cancer in the Department of Anesthesiology, Huai'an First People's Hospital Affiliated to Nanjing Medical University from 2016 to 2021 were retrospectively analyzed. The general data, clinical symptoms, immune cell count, and cytokine count were collected on the first, third, and fifth postoperative days. In addition, the patients' Mini-Mental State Examination (MMSE) score was recorded, and dynamic analysis was performed to record gastrointestinal dysfunction after the operation. Results The postoperative awakening time (18.41 ± 2.88 vs. 23.23 ± 4.34), extubation time (27.84 ± 3.67 vs. 34.32 ± 5.73), and length of hospital stay (9.73 ± 1.32 vs. 12.32 ± 2.34) were shorter, while the postoperative MMSE score (25.43 ± 1.43 vs. 21.32 ± 2.32) was higher in patients administered general anesthesia plus epidural anesthesia than in those administered only general anesthesia. The proportion of CD4 + T lymphocytes was higher (39.45 ± 4.12 vs. 35.45 ± 4.56), and the proportion of CD8 + T lymphocytes was lower (25.34 ± 3.09 vs. 28.43 ± 3.43) in patients undergoing general anesthesia plus epidural anesthesia than in those undergoing only general anesthesia. Moreover, the count of natural killer (NK) cells was lower (0.104 ± 0.021 vs. 0.167 ± 0.024) and the level of human leukocyte antigen–DR isotype (HLA-DR) (66.43 ± 7.43 vs. 56.45 ± 6.43) was higher in patients administered general anesthesia plus epidural anesthesia. In addition, the levels of interleukin (IL)-6, IL-8, and IL-10 decreased with statistical differences (P < 0.05), and the probability of increased intra-abdominal pressure and acute gastrointestinal injury was lower (P < 0.05) in patients undergoing general anesthesia plus epidural anesthesia. Conclusion Addition of epidural anesthesia to general anesthesia can reduce the incidence of postoperative cognitive dysfunction, gastrointestinal injury, immunosuppression, postoperative awakening time, extubation time, and length of postoperative hospital stay.

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Genetic polymorphisms of OPRM1 on the Efficacy and Safety of Anesthetic and Analgesic Agents: A Systematic Review

Cited by 2 publications

References 42 publications

The Catechol‐O‐Methyltransferase (COMT) Val158Met Polymorphism Is Associated with Oxycodone Requirements, Adverse Effects, and Pain Sensitivity in Cancer Patients

The Catechol‐O‐Methyltransferase (COMT) Val158Met Polymorphism Is Associated with Oxycodone Requirements, Adverse Effects, and Pain Sensitivity in Cancer Patients

Effects of different methods of anesthesia on acute gastrointestinal dysfunction, postoperative cognitive impairment, and the immune status after laparoscopic radical rectal cancer surgery

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