Influence of (ATP)-Binding Cassette Transporter Subfamily B Member 1 (ABCB1) Gene Polymorphism on the Efficacy of Remifentanil

Abstract

Background The aim of this study was to investigate the influence of adenosine triphosphate (ATP)-binding cassette transporter subfamily B member 1 (ABCB1) gene polymorphism on the efficacy of Remifentanil. Material/Methods A total of 276 patients undergoing elective surgeries were included to collect general clinical information and detect the polymorphism of ABCB1 rs1045642 using the TaqMan-MGB probe, and they were divided into 3 groups – a genotype AA group, a genotype AG group, and a genotype GG group – based on different genotypes of ABCB1 rs1045642. Results The comparisons showed that there were no differences in sex, age, body mass index (BMI), smoking, drinking status, or ASA class among the 3 groups ( P >0.05). The genotype GG group had higher consumption of Remifentanil than the genotype AA group ( P <0.05), but the genotype AG group was not different from the genotype AA and GG groups ( P >0.05). Comparison of the surgery duration revealed no difference among the 3 groups ( P >0.05). The analepsia time, autonomous respiratory recovery time, and orientation recovery time in the genotype GG group were longer than in the genotype AA group ( P <0.05), but the genotype AG group was not different from the genotype AA and GG groups ( P >0.05). There were no differences in adverse reactions among the 3 groups ( P >0.05). Conclusions ABCB1 gene polymorphism can affect the clinical efficacy of Remifentanil.

Influence of genetic variants on remifentanil sensitivity in Chinese women

“…Furthermore, previous studies have almost focused on comparing the dose of intraoperative remifentanil, but the dose of analgesics depends largely on intraoperative hemodynamics and is interfered by sedatives, the type and time of operation. 10,28 Therefore, it is not clear that the higher consumption of remifentanil is equivalent to lower susceptibility to remifentanil completely. Considering these conditions, remifentanil was infused alone while patients were awake in our study, then we directly compared the analgesic efficacy of remifentanil.…”

“…Previous studies on remifentanil gene polymorphisms mainly involved one or two related SNPs, while our study was a screening and exploration of the possible SNPs related to remifentanil sensitivity after fully understanding the pharmacokinetic and pharmacokinetic of remifentanil. Furthermore, previous studies have almost focused on comparing the dose of intraoperative remifentanil, but the dose of analgesics depends largely on intraoperative hemodynamics and is interfered by sedatives, the type and time of operation 10,28 . Therefore, it is not clear that the higher consumption of remifentanil is equivalent to lower susceptibility to remifentanil completely.…”

“…ABCB1 gene encodes P‐glycoprotein, which can recognize and transport a variety of drugs with different structures and functions, including opioids such as fentanyl 36 . Although some studies showed that more opioid analgesics were consumed during surgery in patients carried GG genotype, 28 other studies reported different conclusions 37 . The reasons caused this diversity including differences in ethnicity, the frequency of variant and modes of remifentanil administration.…”

Effect of common OPRM1, COMT, SLC6A4, ABCB1, and CYP2B6 polymorphisms on perioperative analgesic and propofol demands on patients subjected to thyroidectomy surgery

“…The common rs1045642 polymorphism of the P glycoprotein-encoding gene ( ABCB1 C3435T) was associated with remifentanil consumption and clinical efficacy during elective surgery [ 14 ], and with the stabilizing effect of the drug on the hemodynamics of women undergoing cesarian section, as well as on the adaptation of their newborn babies [ 15 ]. In addition, ABCB1 C3435T was recently shown to affect heat-pain threshold in opioid-free adults with chronic pain [ 16 ].…”