title: Cytochrome P450 polymorphism and postoperative cognitive dysfunction.
abstract: BACKGROUND
  The etiology of postoperative cognitive dysfunction (POCD) remains unclear but toxicity of anesthetic drugs and their metabolites could be important. We aimed to assess the possible association between POCD after propofol anesthesia and various phenotypes owing to polymorphisms in cytochrome P450 encoding genes.
  
  
  METHODS
  We included patients who underwent non-cardiac surgery under total intravenous anesthesia with propofol. POCD was identified using a neuropsychological test-battery administered preoperatively, one week, and three months after surgery. Genotyping of CYP2C19*2, *3, CYP2D6*3, *4, *5 and *6 was performed using pyrosequencing, and patients were characterized according to their phenotype as ultra, extensive, intermediate, or poor metabolizers.
  
  
  RESULTS
  In total, 337 patients with a median age of 67 years were included. 30 (9.4%) out of the 319 patients who underwent neuropsychological testing at one week had POCD, and 24 out of 307 (7.8%) had POCD at three months. None of the examined CYP2C19, 2D6 alleles, or various phenotypes were significantly associated with POCD.
  
  
  CONCLUSIONS
  Polymorphisms in CYP2C19, or 2D6 genes do not seem to be related to the occurrence of cognitive dysfunction after non-cardiac surgery in patients anesthetised with propofol.
authors.affiliation: Department of Anesthesia, Centre of Head and Orthopedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. jacobsteinmetz@dadlnet.dk
authors.forename: J
authors.initials: J
authors.lastname: Steinmetz
authors.forename: C
authors.initials: C
authors.lastname: Jespersgaard
authors.forename: K
authors.initials: K
authors.lastname: Dalhoff
authors.forename: P
authors.initials: P
authors.lastname: Hedley
authors.forename: H
authors.initials: H
authors.lastname: Abildstrøm
authors.forename: M
authors.initials: M
authors.lastname: Christiansen
authors.forename: L S
authors.initials: LS
authors.lastname: Rasmussen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000493:pharmacokinetics*; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics* / Q000378:metabolism; D001711:Biotransformation; D003072:Cognition Disorders / Q000201:enzymology / Q000209:etiology / Q000235:genetics*; D065731:Cytochrome P-450 CYP2C19; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics* / Q000378:metabolism; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010641:Phenotype; D011110:Polymorphism, Genetic; D011183:Postoperative Complications / Q000201:enzymology / Q000209:etiology / Q000235:genetics*; D015742:Propofol / Q000009:adverse effects / Q000493:pharmacokinetics*
chemical_list: D018686:Anesthetics, Intravenous; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D019389:Cytochrome P-450 CYP2D6; D015742:Propofol