title: Effect of Pregnane X Receptor*1B genetic polymorphisms on postoperative analgesia with fentanyl in Chinese patients undergoing gynecological surgery.
abstract: BACKGROUND
  The purpose of the study was to investigate the effects of the pregnane X receptor (PXR)*1B polymorphisms on CYP3A4 enzyme activity and postoperative fentanyl consumption in Chinese patients undergoing gynecological surgery.
  
  
  METHODS
  A total of 287 females of Han ethnicity, aged 20 to 50 years old, ASA I or II, scheduled to abdominal total hysterectomy or myomectomy under general anesthesia were enrolled. The analgesic model used was fentanyl consumption via patient-controlled intravenous analgesia (PCIA) in the post-operative period. Additionally, pain was assessed using a visual analog score (VAS). Pain scores, occurrence of adverse reactions and consumption of fentanyl were recorded during the 24 h postoperative period. The enzyme activity of CYP3A4 was evaluated by measuring the plasma ratio of 1'-hydroxymidazolam to midazolam 1 h after intravenous administration of 0.1 mg/kg midazolam. PXR genotyping was performed by direct DNA sequencing and the PXR*1B haplotype was analyzed via PHASE V.2.1 software.
  
  
  RESULTS
  The polymorphism frequency of PXR11156A > C/11193 T > C and 8055C > T were 49.6 and 49.3%, and the rate of PXR*1B haplotype was 48.8% in our study. None of the pain scores, consumption of fentanyl 24 h post-operatively or enzyme activity of CYP3A4, showed differences among different genotypes.
  
  
  CONCLUSIONS
  PXR11156A > C, PXR11193T > C, PXR8055C > T or the PXR*1B haplotype do not appear to be important factors contributing to CYP3A4 activity and interindividual variations in postoperative fentanyl consumption in Han female patients undergoing gynecological surgery.
  
  
  BACKGROUND
  The DNA samples were obtained since 2007 to 2010 year in our hospital, there was no registration at that time. So this section is not applicable to our research.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, No.1 East-JianShe Road, Zhengzhou, 450052, China.
authors.forename: Jing-Jing
authors.initials: JJ
authors.lastname: Yuan
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, No.1 East-JianShe Road, Zhengzhou, 450052, China.
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Ma
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, No.1 East-JianShe Road, Zhengzhou, 450052, China.
authors.forename: Zhi-Song
authors.initials: ZS
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, No.1 East-JianShe Road, Zhengzhou, 450052, China.
authors.forename: Yan-Zi
authors.initials: YZ
authors.lastname: Chang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, No.1 East-JianShe Road, Zhengzhou, 450052, China. zhangw571012@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Pharmacogenomics, No.1 East-JianShe Road, Zhengzhou, Henan Province, 450052, China.|First Affiliated Hospital of Zhengzhou University, No.1 East-JianShe Road, Zhengzhou, 450052, China.
authors.forename: Quan-Cheng
authors.initials: QC
authors.lastname: Kan
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Zhengzhou University, No.1 East-JianShe Road, Zhengzhou, 450052, China.
authors.forename: Jun-Kai
authors.initials: JK
authors.lastname: Hou
authors.affiliation: Department of Pharmacology, School of Medicine, Zhengzhou University, Zhengzhou, 450000, China.
authors.forename: Li-Rong
authors.initials: LR
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000483:Alleles; D016058:Analgesia, Patient-Controlled; D044466:Asian People / Q000235:genetics*; D002681:China; D051544:Cytochrome P-450 CYP3A / Q000378:metabolism; D004247:DNA / Q000737:chemistry / Q000302:isolation & purification / Q000378:metabolism; D004252:DNA Mutational Analysis; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D005787:Gene Frequency; D005838:Genotype; D013509:Gynecologic Surgical Procedures; D006239:Haplotypes; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D020641:Polymorphism, Single Nucleotide; D000077297:Pregnane X Receptor; D011987:Receptors, Steroid / Q000235:genetics*
chemical_list: D000077297:Pregnane X Receptor; D011987:Receptors, Steroid; D004247:DNA; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human; D005283:Fentanyl
keywords: Analgesia; CYP3A4; Fentanyl; Polymorphism; Pregnane X receptor