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Farmacogenetica del Dolore

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Abstract

Pharmacogenetics of pain is aimed to elucidate the inherited basis of interindividual differences or variations in drug disposition and effects, with the ultimate goal of providing a stronger scientific basis for a tailored drug therapy. We studied the pharmacogenetics of oppiates throuhg the analysis of SNPs in several key genes involved in the pharmacokinetcs like CYP3A4 (metabolism, phase I),

GSTT1, GSTM1 (phase II), ABCB1 (membrane transporter) and in the pharmacodynamics of

oppiates OPRM1 (oppioid receptor), COMT (receptor modulator). The population in study was constituted by 62 patients with cronic pain, causated by cancer and arthrosics pathologies, undergoing pain relief therapy. We found a strong association between the carriers of T allele in C3435T polymorphism of the ABCB1 gene (P=0.03) and an encreased opiate’s analgesia response. We found, as well, borderline associations between the OPRM1, COMT and CYP3A4 alleles and therapy efficacy. Knowledge about the genotype of patients will allow a better prediction in the selection of the drug, making genetic testing an option for a better personalized analgesic treatment.

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