title: Association of 5-HT3B Receptor Gene Polymorphisms with the Efficacy of Ondansetron for Postoperative Nausea and Vomiting.
abstract: OBJECTIVE
  Postoperative nausea and vomiting (PONV) is a common problem after general anesthesia. Although 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists have significantly reduced PONV, over 35% of patients treated with ondansetron can experience PONV. In this study, we investigated whether the Y129S and -100_-102AAG deletion polymorphisms of the 5-HT3B receptor gene affect the efficacy of ondansetron in preventing PONV.
  
  
  METHODS
  Two hundred and forty-five adult patients who underwent laparoscopic cholecystectomy were enrolled. Ondansetron 0.1 mg/kg was intravenously administered 30 minutes before the end of surgery. Genomic DNA was prepared from blood samples using a nucleic acid isolation device. Both the Y129S variant and the -100_-102AAG deletion variant were screened for using a single base primer extension assay and a DNA direct sequencing method, respectively. The relationship between genetic polymorphisms and clinical outcomes of ondansetron treatment was investigated.
  
  
  RESULTS
  Among the 5-HT3B AAG deletion genotypes, the incidence of PONV was higher in patients with the homomutant than with other genotypes during the first 2 hours after surgery (p=0.02). There were no significant differences in the incidence of PONV among genotypes at 2-24 hours after surgery. In the Y129S variants of the 5-HT3B receptor gene, there were no significant differences in the incidence of PONV among genotypes during the first 2 hours and at 2-24 hours after surgery.
  
  
  CONCLUSIONS
  The response to ondansetron for PONV was significantly influenced by the -100_-102AAG deletion polymorphisms of the 5-HT3B gene. Thus, the -100_-102AAG deletion variants may be a pharmacogenetic predictor for responsiveness to ondansetron for PONV.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Min-Soo
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jeong-Rim
authors.initials: JR
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Eun-Mi
authors.initials: EM
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun Ho
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. csho99@yuhs.ac.
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000932:Antiemetics / Q000008:administration & dosage / Q000494:pharmacology*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D015894:Genome, Human; D005838:Genotype; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000008:administration & dosage / Q000494:pharmacology*; D011110:Polymorphism, Genetic; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000188:drug therapy* / Q000453:epidemiology; D044406:Receptors, Serotonin, 5-HT3 / Q000187:drug effects* / Q000235:genetics*; D013997:Time Factors
chemical_list: D000932:Antiemetics; D044406:Receptors, Serotonin, 5-HT3; D017294:Ondansetron
keywords: 5-HT3 receptor; Postoperative nausea and vomiting; genetic polymorphism; ondansetron