Pain and genetics.
OBJECTIVE
Pain management is one of the most important fields in the practice of anesthesiology. The concept that genes involved in the absorption, metabolism, and receptor affinity of analgesics are critical to a drug's efficacy is becoming widely accepted. A review of pharmacogenomics and how it affects the response to analgesics, mainly opioids, is presented in this article.


RESULTS
As the field of pharmacogenomics expands, more and more candidate genes are being evaluated. Genes related to the μ-opioid receptor, ATP-binding cassette subfamily B, catechol-O-methyltransferase, and cytochrome 2D6 currently show promise in helping predict the gene phenotype. Recent studies have also focused on the interleukin-1 receptor antagonist and the melanocortin-1 receptor, further adding to the picture.


CONCLUSIONS
Through increased knowledge in the area of pharmacogenomics, it is hoped that that treatment of pain will move into the realm of personalized medicine. This should result in greater treatment success and a reduction of significant side-effects.
Department of Anesthesiology, Perioperative Medicine and Pain Management, Jackson Memorial Hospital, Miami, Florida, USA.
Claudia R
CR
Fernandez Robles
Meredith
M
Degnan
Keith A
KA
Candiotti
D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics; D000818:Animals; D002394:Catechol O-Methyltransferase / Q000235:genetics; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000235:genetics; D010146:Pain / Q000188:drug therapy* / Q000235:genetics; D020641:Polymorphism, Single Nucleotide; D057285:Precision Medicine; D044102:Receptor, Melanocortin, Type 1 / Q000235:genetics; D017450:Receptors, Opioid, mu / Q000235:genetics
C513055:ABCB1 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D053590:Interleukin 1 Receptor Antagonist Protein; C485764:OPRM1 protein, human; D044102:Receptor, Melanocortin, Type 1; D017450:Receptors, Opioid, mu; D019389:Cytochrome P-450 CYP2D6; D002394:Catechol O-Methyltransferase