CAJ | 학술논문

背景芬太尼属中枢性麻醉镇痛药,临床上广泛用于急、慢性疼痛的治疗.研究发现芬太尼个体差异大,且与遗传因素有关. 目的了解影响芬太尼个体差异性的相关因素及其研究进展,为临床实现芬太尼治疗方案的个体化提供依据. 内容综述近年研究较多的芬太尼个体差异性的影响因素——儿茶酚胺氧位甲基转移酶(catecholamine-O-methytransferase,COMT)、μ阿片受体1(opioid receptorμ1,OPRM1)、细胞色素(cytochrome,CY)P450、CYP3A4/5和P精蛋白(P-glycoprotein,P-gp)基因多态性间的相互作用. 趋向芬太尼的个体化治疗依然任重而道远,遗传因素与环境因素相互作用、表观遗传学、小RNA调控将成为未来研究热点.
배경 분태니속중추성마취진통약,림상상엄범용우급、만성동통적치료.연구발현분태니개체차이대,차여유전인소유관. 목적 료해영향분태니개체차이성적상관인소급기연구진전,위림상실현분태니치료방안적개체화제공의거. 내용 종술근년연구교다적분태니개체차이성적영향인소——인다분알양위갑기전이매(catecholamine-O-methytransferase,COMT)、μ아편수체1(opioid receptorμ1,OPRM1)、세포색소(cytochrome,CY)P450、CYP3A4/5화P정단백(P-glycoprotein,P-gp)기인다태성간적상호작용. 추향 분태니적개체화치료의연임중이도원,유전인소여배경인소상호작용、표관유전학、소RNA조공장성위미래연구열점.
Background Fentanyl is widely used in acute postsurgical and chronic pain.Interindividual variability in response to fentanyl is a significant challenge in the management of pain.Considerable evidence concerning a sound genetic background of this human intervariability has prompted research on the field of a personalized therapy.And genetic polymorphisms of catecholamine-O-methytransferase (COMT),opioid receptor μ 1 (OPRM 1),cytochrome (CY) P450,CYP3A4/5 and P-glycoprotein (P-gp) are studied mostly.Objective To summarize pharmacogenetic data associated with fentanyl frequently encountered in managed care settings.Content This review focuses on findings related to pharmacogenetics of fentanyl,and highlights authors' views on future clinical implications of pharmacogenetics.Trend Personalized therapy of fentanyl still has a long way to go.Future studies may be focused on interaction of environmental and genetic factors,epigenetics and the regulation of microRNA.