Role of pharmacogenetics in variable response to drugs: focus on opioids.
Pharmacogenetics is the study of the role of genetics in inter-individual variability to drug response and therapy. This review provides a comprehensive report of the present status of pharmacogenetic studies for opioid drugs. Opioid analgesics are widely used clinically for pain management, and inter-patient variability with opioid therapy is often reported. Information on genetic polymorphisms in enzymes, receptors and transporters related to opioid disposition (pharmacokinetics) and pharmacology (pharmacodynamics) is discussed. Pharmacogenetics of enzymes, including the cytochrome P450s and uridine diphosphoglucuronosyltransferases, opioid receptors and the ABC family of transporters, is reviewed. The role of genetic variability in clinical opioid therapy is examined, and relevant clinical trials cited. The present status of opioid pharmacogenetics, promises and challenges and future directions are discussed.
Kadiev
Esin
E
Temple University School of Pharmacy, 3307 N Broad Street, Philadelphia PA 19140, USA.
Patel
Vipul
V
Rad
Pouya
P
Thankachan
Lovely
L
Tram
Abby
A
Weinlein
Meg
M
Woodfin
Kristin
K
Raffa
Robert B
RB
Nagar
Swati
S
D000701:Analgesics, Opioid / Q000378:metabolism / Q000494:pharmacology*; D000818:Animals; D002352:Carrier Proteins / Q000378:metabolism; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D004798:Enzymes / Q000378:metabolism; D014453:Glucuronosyltransferase / Q000378:metabolism; D006801:Humans; D010597:Pharmacogenetics; D011957:Receptors, Opioid / Q000378:metabolism
D000701:Analgesics, Opioid; D002352:Carrier Proteins; D004798:Enzymes; D011957:Receptors, Opioid; D003577:Cytochrome P-450 Enzyme System; D014453:Glucuronosyltransferase