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首页> 外文期刊>Pharmacogenomics >Personalized therapy in pain management: where do we stand?
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Personalized therapy in pain management: where do we stand?

机译：疼痛管理中的个性化治疗：我们站在哪里？

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摘要

Genomic variations influencing response to pharmacotherapy of pain are currently under investigation. Drug-metabolizing enzymes represent a major target of ongoing research in order to identify associations between an individual's drug response and genetic profile. Polymorphisms of the cytochrome P450 enzymes (CYP2D6) influence metabolism of codeine, tramadol, hydrocodone, oxycodone and tricyclic antidepressants. Blood concentrations of some NSAIDs depend on CYP2C9 and/or CYP2C8 activity. Genomic variants of these genes associate well with NSAIDs' side effect profile. Other candidate genes, such as those encoding (opioid) receptors, transporters and other molecules important for pharmacotherapy in pain management, are discussed; however, study results are often equivocal. Besides genetic variants, further variables, for example, age, disease, comorbidity, concomitant medication, organ function as well as patients' compliance, may have an impact on pharmacotherapy and need to be addressed when pain therapists prescribe medication. Although pharmacogenetics as a diagnostic tool has the potential to improve patient therapy, well-designed studies are needed to demonstrate superiority to conventional dosing regimes.
机译：目前正在研究影响对疼痛药物疗法反应的基因组变异。药物代谢酶是正在进行的研究的主要目标，目的是鉴定个体药物反应与遗传特征之间的关联。细胞色素P450酶（CYP2D6）的多态性影响可待因，曲马多，氢可酮，羟考酮和三环类抗抑郁药的代谢。某些NSAID的血药浓度取决于CYP2C9和/或CYP2C8活性。这些基因的基因组变体与NSAID的副作用密切相关。还讨论了其他候选基因，例如编码（阿片类）受体，转运蛋白和对疼痛治疗中药物治疗重要的其他分子的基因。然而，研究结果往往是模棱两可的。除遗传变异外，其他变量，例如年龄，疾病，合并症，合并用药，器官功能以及患者的依从性，可能会对药物治疗产生影响，并且在疼痛治疗师开药时需要解决。尽管药物遗传学作为诊断工具具有改善患者治疗的潜力，但仍需要精心设计的研究来证明其优于常规给药方案。

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