Association between MDR1/CYP3A4/OPRM1 gene polymorphisms and the post-caesarean fentanyl analgesic effect on Chinese women

Zhang, Jingliang; Zhang, Li; Xiao, Zhao; Shen, Shuixian; Luo, Xiaopan; Zhang, Yunlong

doi:10.1016/j.gene.2018.03.081

Cited by 25 publications

(14 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The sample size of this research was calculated based on the frequency of MDR1 genotypes. According to the allele frequency of MDR1 gene SNPs (1236C>T, 2677G>T/A, and 3435C>T) and their haplotypes previously reported in Chinese [7,20], it was required that the sample size of 108 patients showed an absolute difference of 20% in the difference of fentanyl dose (power = 80%, α = 0:05). As a result of clinical experience and preliminary experiment, absolute difference of 20% was chosen as a minimum detectable difference.…”

Section: Discussionmentioning

confidence: 99%

“…Gene polymorphism plays an important role in the pharmacokinetics and pharmacodynamics of fentanyl [5]. Drug metabolizing enzymes and targets of fentanyl are both likely affected by gene polymorphisms, which in turn affect the analgesic effect of fentanyl [6,7]. The genes contributing to drug transporters of fentanyl, however, remain largely unexplored.…”

Section: Introductionmentioning

confidence: 99%

“…Human and animal studies have shown that P-gp affects the absorption, distribution, excretion, and clinical effects of fentanyl [14][15][16]. Several authors have identified that MDR1 1236C>T and 3435C>T SNPs have significant effects on postoperative fentanyl consumption [7,17]. However, other studies cannot identify such associations [18] or obtain the opposite results [19].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

MDR1 Genotypes and Haplotypes Are Closely Associated with Postoperative Fentanyl Consumption in Patients Undergoing Radical Gastrectomy

Zhang

Tong

Wang

et al. 2021

Journal of Nanomaterials

View full text Add to dashboard Cite

Fentanyl is a powerful opioid analgesic, and its analgesic effect is greatly different among individuals. This study was aimed at exploring the effects of multidrug resistance gene-1 (MDR1) genetic variation on postoperative fentanyl consumption. A total of 135 patients, who planned to undergo radical gastrectomy with general anesthesia, were studied. The subjects received patient-controlled analgesia (PCA) by intravenous fentanyl within 48 hours after operation and maintained a numerical rating scale (NRS) score ≤ 3 . The consumption and side effects of fentanyl were recorded within 24 hours and 48 hours after the operation. Single nucleotide polymorphisms (SNPs) of all patients with MDR1 1236C>T, 2677G>T/A, and 3435C>T were screened by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or DNA sequence analysis after PCR. There was no difference in postoperative fentanyl consumption among patients having 2677G>T/A and 3435C>T polymorphisms (all P > 0.05 ). MDR1 1236C>T polymorphisms and haplotypes combined by three SNPs, however, significantly affected postoperative fentanyl consumption (all P < 0.05 ). Moreover, 1236TT genotype carriers consumed more fentanyl during 24 hours ( P = 0.038 ) and 48 hours ( P = 0.003 ) postoperatively. The MDR1 TTT haplotype carriers needed more fentanyl compared with the CGC haplotype carriers during the first 48 hours after surgery ( P = 0.017 ). Nausea, vomiting, and dizziness were not found to have significant differences among the above three SNPs and their haplotypes ( P > 0.05 ). MDR1 1236C>T polymorphism and haplotypes were factors contributing to the individual variability in postoperative fentanyl consumption.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

MDR1 Genotypes and Haplotypes Are Closely Associated with Postoperative Fentanyl Consumption in Patients Undergoing Radical Gastrectomy

Zhang

Tong

Wang

et al. 2021

Journal of Nanomaterials

View full text Add to dashboard Cite

show abstract

“…Recently, accumulating studies have demonstrated that the genetic mutations are closely associated with analgesic effects of fentanyl. [21,22] Several SNPs have been confirmed to influence postoperative fentanyl analgesia, such as CYP3A4 ∗1G, CGRP 4218T/C, UGT2B7 , rs7439366, rs4587017, rs1002849, etc. [23–25] In this study, we investigated the genetic effects of P2RX7 rs1718125 polymorphism on analgesic effects of fentanyl in patients with lung cancer after resections.…”

Section: Discussionmentioning

confidence: 99%

Correlation of P2RX7 gene rs1718125 polymorphism with postoperative fentanyl analgesia in patients with lung cancer

Chai

et al. 2019

Medicine

View full text Add to dashboard Cite

The aim of this study was to investigate the association between purinergic receptor P2X7 ( P2RX7 ) gene rs1718125 polymorphism and analgesic effect of fentanyl after surgery among patients with lung cancer in a Chinese Han population. A total of 238 patients with lung cancer who received resection were enrolled in our study. The genotype distributions of P2RX7 rs1718125 polymorphism were detected by polymerase chain reaction and direct sequencing. Postoperative analgesia was performed by patient-controlled intravenous analgesia, and the consumption of fentanyl was recorded. The postoperative pain was measured by visual analog scale (VAS). Differences in postoperative VAS score and postoperative fentanyl consumption for analgesia in different genotype groups were analyzed by analysis of variance assay. The frequencies of GG, GA, and AA genotypes were 46.22%, 44.96%, and 8.82%, respectively. After surgery, the postoperative VAS score of GA group was significantly high in the period of analepsia after general anesthesia and at 6 hours after surgery ( P = .041 and P = .030, respectively), while AA group exhibited obviously high in the period of analepsia after general anesthesia ( P < .001), at postoperative 6 hours ( P = .006) and 24 hours ( P = .016). Moreover, the patients carrying GA and AA genotypes needed more fentanyl to control pain within 48 hours after surgery ( P < .05 for all). P2RX7 gene rs1718125 polymorphism is significantly associated with postoperative pain and fentanyl consumption in patients with lung cancer.

show abstract

“…Studies showed that the patients with AA genotype had a less fentanyl consumption to achieve pain control than those carrying GG and AG genotypes during the first 24 h postoperatively in patients undergoing lower abdominal surgery or cesarean. [ 22 26 ] Moreover, in vitro study has shown reduced metabolism of fentanyl in liver microsomes of AA genotype. [ 5 ] Obviously, CYP3A4*1G polymorphism contributes to the variability in response to fentanyl.…”

Section: Discussionmentioning

confidence: 99%

Impact of CYP3A4*1G Polymorphism on Fentanyl Analgesia Assessed by Analgesia Nociception Index in Chinese Patients Undergoing Hysteroscopy

Gao

et al. 2018

Chinese Medical Journal

View full text Add to dashboard Cite

Background:The clinical efficacy of fentanyl for pain control differs greatly across individuals. The purpose of this study was to investigate the impact of CYP3A4*1G polymorphism including wild-type homozygote (CYP3A4*1/*1, GG), mutant heterozygote (CYP3A4*1/*1G, GA), and mutant homozygote (CYP3A4*1G/*1G, AA) on fentanyl analgesia in Chinese patients undergoing hysteroscopy by the assessment of analgesia nociception index (ANI).Methods:A total of 200 gynecologic patients scheduled for elective hysteroscopy under general anesthesia at Peking University People's Hospital from May to December in 2017 were enrolled in this study. Venous blood was withdrawn for genotyping of CYP3A4*1G before operation. Fentanyl 1 μg/kg was administered preoperatively followed by target-controlled infusion of propofol for induction and maintenance. Intraoperative analgesic efficacy of fentanyl was assessed by ANI monitoring at T0 (entering room), T1 (cervical dilation), T2 (start of cervical aspiration), and T3 (end of cervical aspiration) time points. The duration of propofol infusion and total dosage of propofol were recorded as well.Results:The patients were divided into three groups according to CYP3A4*1G polymorphism, including 143 in GG group, 47 in GA group, and 10 in AA group. There was no significant difference in clinical demographics among three groups. The frequency of CYP3A4*1G variant alleles accounted for 16.8% and the distribution of variant alleles was consistent with Hardy–Weinberg equilibrium. Using a multilevel model, ANI values at T1 (63.81 ± 19.61), T2 (63.63 ± 17.82), and T3 (65.68 ± 17.79) were significantly lower than that at T0 (77.16 ± 12.93) in the study population (F = 23.50, P < 0.001), suggesting that higher levels of pain at T1, T2, and T3 than T0. Patients with GG genotype showed significantly lower ANI than those with GA or AA genotypes during hysteroscopy under the same dose of fentanyl.Conclusion:CYP3A4*1G polymorphism associated with the analgesic efficacy of intraoperative fentanyl in the patients undergoing hysteroscopy under general anesthesia.

show abstract

Association between MDR1/CYP3A4/OPRM1 gene polymorphisms and the post-caesarean fentanyl analgesic effect on Chinese women

Cited by 25 publications

References 25 publications

MDR1 Genotypes and Haplotypes Are Closely Associated with Postoperative Fentanyl Consumption in Patients Undergoing Radical Gastrectomy

MDR1 Genotypes and Haplotypes Are Closely Associated with Postoperative Fentanyl Consumption in Patients Undergoing Radical Gastrectomy

Correlation of P2RX7 gene rs1718125 polymorphism with postoperative fentanyl analgesia in patients with lung cancer

Impact of CYP3A4*1G Polymorphism on Fentanyl Analgesia Assessed by Analgesia Nociception Index in Chinese Patients Undergoing Hysteroscopy

Contact Info

Product

Resources

About