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Kaya-Akyüzlü D, Özkan-Kotiloğlu S, Danışman M, Bal C. OPRM1 rs2075572 has potential to affect plasma buprenorphine level in opioid users, but not OPRM1 rs562859. Neurosci Lett 2024; 834:137846. [PMID: 38821204 DOI: 10.1016/j.neulet.2024.137846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/02/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
OPRM1 gene encoding mu-opioid receptor (MOR) is the primary candidate gene for buprenorphine (BUP) pharmacogenetics. OPRM1 undergoes alternative splicing leading to multiple MOR subtypes. Thus, in the current study 2 SNPs (rs1799972 and rs562859) were selected due to evidence for their contribution to alternative splicing of OPRM1. The effects of 2 SNPs of OPRM1 gene on plasma buprenorphine and norbuprenorphine levels in a sample of 233 OUD patients receiving BUP/naloxone were examined. Polymorphisms were analyzed by PCR and RFLP. BUP and norbuprenorphine concentrations in plasma were measured by LC-MS/MS. OPRM1 rs2075572 GC + CC (0.12 ng/ml) had significantly higher plasma BUP level compared to GG (0.084 ng/ml) (p = 0.043). Although there was not a statistically significant difference between OPRM1 rs562859 genotypes (p = 0.46), patients with OPRM1 rs562859 CT + TT had higher plasma BUP and BUP-related values as compared to those with CC. In conclusion, the effect of OPRM1 rs2075572 on BUP levels in opioid users' plasma was shown in a Caucasian population for the first time. On the other hand, OPRM1 rs562859 seems not to influence the BUP pharmacology.
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Affiliation(s)
| | - Selin Özkan-Kotiloğlu
- Kırşehir Ahi Evran University, Faculty of Science and Art, Department of Molecular Biology and Genetics, Kırşehir, Turkey.
| | - Mustafa Danışman
- Ankara Training and Research Hospital AMATEM Clinic, Ankara, Turkey
| | - Ceylan Bal
- Ankara Yıldırım Beyazıt University, Department of Medical Biochemistry, Ankara, Turkey
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2
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Boroń A, Suchanecka A, Chmielowiec K, Śmiarowska M, Chmielowiec J, Strońska-Pluta A, Recław R, Grzywacz A. OPRM1 Gene Polymorphism in Women with Alcohol Use Disorder. Int J Mol Sci 2024; 25:3067. [PMID: 38474311 DOI: 10.3390/ijms25053067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
The main aims of the present study were to explore the relationship of the OPRM1 gene rs1074287 polymorphism in alcohol-dependent women with their personality traits and to try to find out whether any specific features may influence alcohol cravings and be a prognostic for alcohol dependency and treatment in AUD women. Our study found a notable correlation between openness and the interaction of the ORIM1 gene and AUD. The alcohol use disorder subjects with genotype AG showed a higher level of openness compared to the control group with genotypes AG (p = 0.0001) and AA (p = 0.0125). The alcohol use disorder subjects with the AA genotype displayed higher levels of openness than the control group with genotype AG (p = 0.0271). However, the alcohol use disorder subjects with the AA genotype displayed lower levels of openness than the control group with genotype GG (p = 0.0212). Our study indicates that openness as a personality trait is correlated with the OPRM1 gene rs1074287 polymorphism in alcohol-dependent women. These are the first data and results exploring such a relationship between opioid and alcohol pathways and the mental construction of AUD women. Personality traits such as openness to experience and neuroticism might play major roles in the addiction mechanism, especially in genetically predisposed females, independent of the reward system involved in the emotional disturbances that coexist with anxiety and depression.
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Affiliation(s)
- Agnieszka Boroń
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland
| | - Aleksandra Suchanecka
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland
| | - Krzysztof Chmielowiec
- Department of Hygiene and Epidemiology, Collegium Medicum, University of Zielona Góra, 28 Zyty St., 65-045 Zielona Góra, Poland
| | | | - Jolanta Chmielowiec
- Department of Hygiene and Epidemiology, Collegium Medicum, University of Zielona Góra, 28 Zyty St., 65-045 Zielona Góra, Poland
| | - Aleksandra Strońska-Pluta
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland
| | - Remigiusz Recław
- Foundation Strong in the Spirit, 60 Sienkiewicza St., 90-058 Łódź, Poland
| | - Anna Grzywacz
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland
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3
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Eacret D, Manduchi E, Noreck J, Tyner E, Fenik P, Dunn AD, Schug J, Veasey SC, Blendy JA. Mu-opioid receptor-expressing neurons in the paraventricular thalamus modulate chronic morphine-induced wake alterations. Transl Psychiatry 2023; 13:78. [PMID: 36869037 PMCID: PMC9984393 DOI: 10.1038/s41398-023-02382-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023] Open
Abstract
Disrupted sleep is a symptom of many psychiatric disorders, including substance use disorders. Most drugs of abuse, including opioids, disrupt sleep. However, the extent and consequence of opioid-induced sleep disturbance, especially during chronic drug exposure, is understudied. We have previously shown that sleep disturbance alters voluntary morphine intake. Here, we examine the effects of acute and chronic morphine exposure on sleep. Using an oral self-administration paradigm, we show that morphine disrupts sleep, most significantly during the dark cycle in chronic morphine, with a concomitant sustained increase in neural activity in the Paraventricular Nucleus of the Thalamus (PVT). Morphine binds primarily to Mu Opioid Receptors (MORs), which are highly expressed in the PVT. Translating Ribosome Affinity Purification (TRAP)-Sequencing of PVT neurons that express MORs showed significant enrichment of the circadian entrainment pathway. To determine whether MOR + cells in the PVT mediate morphine-induced sleep/wake properties, we inhibited these neurons during the dark cycle while mice were self-administering morphine. This inhibition decreased morphine-induced wakefulness but not general wakefulness, indicating that MORs in the PVT contribute to opioid-specific wake alterations. Overall, our results suggest an important role for PVT neurons that express MORs in mediating morphine-induced sleep disturbance.
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Affiliation(s)
- Darrell Eacret
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elisabetta Manduchi
- Department of Genetics and Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Julia Noreck
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Emma Tyner
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Polina Fenik
- Center for Sleep and Circadian Neurobiology and Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Amelia D Dunn
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jonathan Schug
- Department of Genetics and Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Sigrid C Veasey
- Center for Sleep and Circadian Neurobiology and Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Julie A Blendy
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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4
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Xie X, Gu J, Zhuang D, Zhou Y, Chen X, Shen W, Li L, Liu Y, Xu W, Hong Q, Xu Z, Chen W, Zhou W, Liu H. Association between rs1799971 in the mu opioid receptor gene and methadone maintenance treatment response. J Clin Lab Anal 2022; 36:e24750. [PMID: 36305091 PMCID: PMC9701885 DOI: 10.1002/jcla.24750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/28/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Genetic variations can affect individual response to methadone maintenance treatment (MMT) for heroin addiction. The A118G variant (rs1799971) in the mu opioid receptor gene (OPRM1) is a potential candidate single nucleotide polymorphism (SNP) for personalized MMT. This study determined whether rs1799971 is related to MMT response or dose. METHODS We recruited 286 MMT patients from a Han Chinese population. The rs1799971 genotype was determined via TaqMan genotyping assay. The genetic effect of this SNP on MMT response or dose was evaluated using logistic regression. A meta-analysis was performed to merge all available data to evaluate the role of rs1799971 in MMT using RevMan 5.3 software. RESULTS No statistical significance was observed in the association between the OPRM1 rs1799971 and MMT response or dose in our Chinese cohort. Meta-analysis indicated that the OPRM1 A118G variation was not significantly associated with MMT response or dose requirement. CONCLUSION The results suggest that rs1799971 in OPRM1 might not play a critical role alone in influencing MMT response or dose.
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Affiliation(s)
- Xiaohu Xie
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Jun Gu
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Dingding Zhuang
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Yun Zhou
- School of Medicine Ningbo University Ningbo China
| | - Xiaoyu Chen
- School of Medicine Ningbo University Ningbo China
| | - Wenwen Shen
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Longhui Li
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Yue Liu
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Wenjin Xu
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Qingxiao Hong
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Zemin Xu
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Weisheng Chen
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
| | - Wenhua Zhou
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
- School of Medicine Ningbo University Ningbo China
| | - Huifen Liu
- Key Laboratory of Addiction Research of Zhejiang Province Ningbo Kangning Hospital Ningbo China
- School of Medicine Ningbo University Ningbo China
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5
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Omarmeli V, Sharafshah A, Albonaim A, Keshavarz P. A study on methylation of two CpG islands of MAOA gene promoter among opium-addicted males undergoing methadone treatment. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2022; 41:841-850. [PMID: 35759647 DOI: 10.1080/15257770.2022.2085291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/23/2022] [Accepted: 05/29/2022] [Indexed: 06/15/2023]
Abstract
The association between methylation of MAOA gene promoter and alcohol and nicotine dependence has been demonstrated in women but not in men yet. Antisocial personality disorder (ASPD) and substance use disorders (SUD) are two types of disorders that could highly be influenced by methylation-induced changes in MAOA function. The aim of the current study is to investigate the effect of opioid addiction on methylation of MAOA gene promoter in males. DNA was extracted from the whole blood of all samples (29 opium-addicted individuals undergoing methadone treatment and 28 healthy people) according to the extraction protocol, followed by treating these samples with bisulfite kits. The investigated region including two CpG islands in the promoter region of MAOA gene contained 35 CpG dinucleotides investigated through Sanger sequencing method. The frequency of methylation at two CpG islands of MAOA gene promoter regions was equal to zero among addicted individuals undergoing methadone treatment and healthy peoples. Then, comparing methylation levels among the study group is not applicable. In conclusion, there was no association between opium addiction and methylation of the MAOA promoter regions in opium-addicted male undergoing methadone treatment.
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Affiliation(s)
- Vahid Omarmeli
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Sharafshah
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Albonaim
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Parvaneh Keshavarz
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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6
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Association of the D-amino acid oxidase gene with methadone dose in heroin dependent patients under methadone maintenance treatment. J Hum Genet 2022; 67:273-278. [PMID: 34983973 DOI: 10.1038/s10038-021-01008-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 11/08/2022]
Abstract
Methadone is a synthetic opioid used for the maintenance treatment (MMT) of heroin dependence. It primarily binds to the μ-opioid receptor (MOR; with its gene, namely OPRM1). Methadone is also an N-methyl-D-aspartate (NMDA) receptor antagonist. The role of NMDA receptor in the regulatory mechanisms of methadone dosage in heroin dependent patients is so far not clear. D-amino acid oxidase (DAO) is an important enzyme that indirectly activates the NMDA receptor through its effect on the D-serine level. To test the hypothesis that genetic polymorphisms in the DAO gene are associated with methadone treatment dose and responses, we selected four single nucleotide polymorphisms (SNPs) in DAO from the literature reports of the Taiwanese population. SNPs were genotyped in 344 MMT patients. In this study, we identified a functional SNP rs55944529 in the DAO gene that reveals a modest but significant association with the methadone dosage in the recessive model of analysis (P = 0.003) and plasma concentrations (P = 0.003) in MMT patients. However, it did not show association with plasma methadone concentration in multiple linear regression analysis. It is also associated with the methadone adverse reactions of dry mouth (P = 0.002), difficulty with urination (P = 0.0003) in the dominant model, and the withdrawal symptoms of yawning (P = 0.005) and gooseflesh skin (P = 0.004) in the recessive model. Our results suggest a role of the indirect regulatory mechanisms of the NMDA reporter, possibly via the DAO genetic variants, in the methadone dose and some adverse reactions in MMT patients.
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7
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Graham DP, Harding MJ, Nielsen DA. Pharmacogenetics of Addiction Therapy. Methods Mol Biol 2022; 2547:437-490. [PMID: 36068473 DOI: 10.1007/978-1-0716-2573-6_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Drug addiction is a serious relapsing disease that has high costs to society and to the individual addicts. Treatment of these addictions is still in its nascency, with only a few examples of successful therapies. Therapeutic response depends upon genetic, biological, social, and environmental components. A role for genetic makeup in the response to treatment has been shown for several addiction pharmacotherapies with response to treatment based on individual genetic makeup. In this chapter, we will discuss the role of genetics in pharmacotherapies, specifically for cocaine, alcohol, and opioid dependences. The continued elucidation of the role of genetics should aid in the development of new treatments and increase the efficacy of existing treatments.
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Affiliation(s)
- David P Graham
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Mark J Harding
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David A Nielsen
- Michael E. DeBakey Veterans Affairs Medical Center, and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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8
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Magarbeh L, Gorbovskaya I, Le Foll B, Jhirad R, Müller DJ. Reviewing pharmacogenetics to advance precision medicine for opioids. Biomed Pharmacother 2021; 142:112060. [PMID: 34523422 DOI: 10.1016/j.biopha.2021.112060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Adequate opioid prescribing is critical for therapeutic success of pain management. Despite the widespread use of opioids, optimized opioid therapy remains unresolved with risk of accidental lethal overdosing. With the emergence of accumulating evidence linking genetic variation to opioid response, pharmacogenetic based treatment recommendations have been proposed. OBJECTIVE The aim of this review is to evaluate pharmacogenetic evidence and provide an overview on genes involved in the pharmacokinetics and pharmacodynamics of opioids. METHODS For this review, a systematic literature search of published articles was used in PubMed®, with no language restriction and between the time period of January 2000 to December 2020. We reviewed randomized clinical studies, study cohorts and case reports that investigated the influence of genetic variants on selected opioid pharmacokinetics and pharmacodynamics. In addition, we reviewed current CPIC clinical recommendations for pharmacogenetic testing. RESULTS Results of this review indicate consistent evidence supporting the association between selected genetic variants of CYP2D6 for opioid metabolism. CPIC guidelines include recommendations that indicate the avoidance of tramadol use, in addition to codeine, in CYP2D6 poor metabolizers and ultrarapid metabolizers, and to monitor intermediate metabolizers for less-than-optimal response. While there is consistent evidence for OPRM1 suggesting increased postoperative morphine dosing requirements in A118G G-allele carriers, the clinical relevance remains limited. CONCLUSION There is emerging evidence of clinical relevance of CYP2D6 and, to a lesser extent, OPRM1 polymorphism in personalized opioid drug dosing. As a result, first clinics have started to implement pharmacogenetic guidelines for CYP2D6 and codeine.
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Affiliation(s)
- Leen Magarbeh
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Ilona Gorbovskaya
- Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Bernard Le Foll
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada; Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Acute Care Program, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Reuven Jhirad
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Office of the Chief Coroner and Ontario Forensic Pathology Service, Toronto, ON, Canada
| | - Daniel J Müller
- Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Institute of Medical Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada.
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9
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Wang D, Yee BJ, Grunstein RR, Chung F. Chronic Opioid Use and Central Sleep Apnea, Where Are We Now and Where To Go? A State of the Art Review. Anesth Analg 2021; 132:1244-1253. [PMID: 33857966 DOI: 10.1213/ane.0000000000005378] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Opioids are commonly used for pain management, perioperative procedures, and addiction treatment. There is a current opioid epidemic in North America that is paralleled by a marked increase in related deaths. Since 2000, chronic opioid users have been recognized to have significant central sleep apnea (CSA). After heart failure-related Cheyne-Stokes breathing (CSB), opioid-induced CSA is now the second most commonly seen CSA. It occurs in around 24% of chronic opioid users, typically after opioids have been used for more than 2 months, and usually corresponds in magnitude to opioid dose/plasma concentration. Opioid-induced CSA events often mix with episodes of ataxic breathing. The pathophysiology of opioid-induced CSA is based on dysfunction in respiratory rhythm generation and ventilatory chemoreflexes. Opioids have a paradoxical effect on different brain regions, which result in irregular respiratory rhythm. Regarding ventilatory chemoreflexes, chronic opioid use induces hypoxia that appears to stimulate an augmented hypoxic ventilatory response (high loop gain) and cause a narrow CO2 reserve, a combination that promotes respiratory instability. To date, no direct evidence has shown any major clinical consequence from CSA in chronic opioid users. A line of evidence suggested increased morbidity and mortality in overall chronic opioid users. CSA in chronic opioid users is likely to be a compensatory mechanism to avoid opioid injury and is potentially beneficial. The current treatments of CSA in chronic opioid users mainly focus on continuous positive airway pressure (CPAP) and adaptive servo-ventilation (ASV) or adding oxygen. ASV is more effective in reducing CSA events than CPAP. However, a recent ASV trial suggested an increased all-cause and cardiovascular mortality with the removal of CSA/CSB in cardiac failure patients. A major reason could be counteracting of a compensatory mechanism. No similar trial has been conducted for chronic opioid-related CSA. Future studies should focus on (1) investigating the phenotypes and genotypes of opioid-induced CSA that may have different clinical outcomes; (2) determining if CSA in chronic opioid users is beneficial or detrimental; and (3) assessing clinical consequences on different treatment options on opioid-induced CSA.
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Affiliation(s)
- David Wang
- From the Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia
| | - Brendon J Yee
- From the Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia
| | - Ronald R Grunstein
- From the Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, Australia
| | - Frances Chung
- Department of Anesthesiology and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
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10
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Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, Tan SC, Mohamad N, Ismail R. Influence of DRD2 Polymorphisms on the Clinical Outcomes of Opioiddependent Patients on Methadone Maintenance Therapy. J Pharm Bioallied Sci 2021; 12:S787-S803. [PMID: 33828379 PMCID: PMC8021064 DOI: 10.4103/jpbs.jpbs_248_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/21/2020] [Accepted: 03/08/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction: Dopamine receptor D2 (DRD2) is one of the dopamine receptors that have been studied in relation to opioid dependence. It is possible, therefore, that DRD2 gene (DRD2) polymorphisms influence treatment outcomes of patients with opioid dependence. The objective of this study was to investigate the influence of DRD2 polymorphisms on the clinical outcomes of opioid-dependent patients on methadone maintenance therapy (MMT). Materials and Methods: Patients with opioid dependence (n = 148) were recruited from MMT clinics. Pain sensitivity, severity of the opiate withdrawal syndrome, and sleep quality were assessed using cold pressor test (CPT), Subjective Opiate Withdrawal Scale (SOWS-M), and Pittsburgh Sleep Quality Index (PSQI)-Malay, respectively. Deoxyribonucleic acid (DNA) was extracted from whole blood, and then was used for genotyping of Val96Ala, Leu141Leu, Val154Ile, Pro310Ser, Ser311Cys, TaqI A, -141C Ins/Del, and A-241G polymorphisms. Results: Among 148 patients, 8.1% (n = 12), 60.8% (n = 90), 27.7% (n = 41), and 29.1% (n = 43) had at least one risk allele for Ser311Cys, TaqI A, -141C Ins/Del, and A-241G polymorphisms, respectively. There were no significant differences in pain responses (pain threshold, tolerance, and intensity), SOWS, and PSQI scores between DRD2 polymorphisms. Conclusion: The common DRD2 polymorphisms are not associated with pain sensitivity, severity of the opiate withdrawal syndrome, and sleep quality in patients with opioid dependence on MMT. However, this may be unique for Malays. Additional research should focus on investigating these findings in larger samples and different ethnicity.
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Affiliation(s)
- Zalina Zahari
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin (UniSZA), Besut Campus, Terengganu, Malaysia.,Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Chee Siong Lee
- Emergency and Trauma Department, Hospital Sultanah Aminah, Johor, Malaysia
| | - Muslih Abdulkarim Ibrahim
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia.,Department of Pharmacology and Toxicology, College of Pharmacy, Hawler Medical University, Hawler, Iraq
| | - Nurfadhlina Musa
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia.,Human Genome Center, School of Medical Sciences, Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia.,Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Soo Choon Tan
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | - Nasir Mohamad
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia.,Centre for Research in Addiction (CentRenA), Universiti Sultan Zainal Abidin (UniSZA), Gong Badak Campus, Terengganu, Malaysia
| | - Rusli Ismail
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kelantan, Malaysia.,Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Medical Campus, Terengganu, Malaysia
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11
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Akbari A, Kheradmand A, Sina M, Ahmadiani A, Asadi S. OPRM1 and CYP3A4 association with methadone dose in Iranian patients undergoing methadone maintenance therapy. J Addict Dis 2021; 39:357-362. [PMID: 33682628 DOI: 10.1080/10550887.2021.1886566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Investigations proposed that genetic polymorphisms within proteins in methadone pharmacokinetic and pharmacodynamics are critical factors in determination of methadone dose in methadone maintenance therapy (MMT). OBJECTIVE This study aimed to assess the associations between two polymorphisms, CYP3A4 (rs2740574) and OPRM1 (rs1799971), with dose of methadone in Iranian patients undergoing MMT. METHODS A total of 124 Iranian male subjects aged 18-65 years old who were confirmed to be addicted by the addiction diagnostic tests and underwent MMT were assessed. Patients were divided into three groups of low (less than 40 mg/day), moderate (more than 40 mg/day and less than 110 mg/day) and high (more than 110 mg/day) methadone dose consumption. DNAs of included patients were extracted from their blood samples and were assessed for CYP3A4 and OPRM1 polymorphisms. RESULTS Results showed that there was no significant association between the studied polymorphisms and methadone dose in Iranian addicted patients underwent MMT (P > 0.05). CONCLUSIONS CYP3A4 and OPRM1 single variations cannot explain variability in methadone dosage in MMT. Studying the interactions of more genetic factors in larger samples may elucidate factors influencing the required dose of methadone and better individualized therapy.
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Affiliation(s)
- Ahmad Akbari
- Department of Psychiatry, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kheradmand
- Department of psychiatry, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzie Sina
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abolhassan Ahmadiani
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sareh Asadi
- Neurobiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Rowsell L, Wu JGA, Yee BJ, Wong KKH, Sivam S, Somogyi AA, Grunstein RR, Wang D. The effect of acute morphine on sleep in male patients suffering from sleep apnea: Is there a genetic effect? An RCT Study. J Sleep Res 2020; 30:e13249. [PMID: 33319444 DOI: 10.1111/jsr.13249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 01/11/2023]
Abstract
Questionnaire-based studies have suggested genetic differences in sleep symptoms in chronic opioid users. The present study aims to investigate if there is a genetic effect on sleep architecture and quantitative electroencephalogram (EEG) in response to acute morphine. Under a randomized, double-blind, placebo-controlled, crossover design, 68 men with obstructive sleep apnea undertook two overnight polysomnographic studies conducted at least 1 week apart. Each night they received either 40 mg of controlled-release morphine or placebo. Sleep architecture and quantitative EEG were compared between conditions. Blood was sampled before sleep and on the next morning for genotyping and pharmacokinetic analyses. We analysed three candidate genes (OPRM1 [rs1799971, 118 A > G], ABCB1[rs1045642, 3435 C > T] and HTR3B [rs7103572 C > T]). We found that morphine decreased slow wave sleep and rapid eye movement sleep and increased stage 2 sleep. Those effects were less in subjects with HTR3B CT/TT than in those with CC genotype. Similarly, sleep onset latency was shortened in the ABCB1 CC subgroup compared with the CT/TT subgroup. Total sleep time was significantly increased in ABCB1 CC but not in CT/TT subjects. Sleep apnea and plasma morphine and metabolite concentration were not confounding factors for these genetic differences in sleep. With morphine, patients had significantly more active/unstable EEG (lower delta/alpha ratio) during sleep. No genetic effects on quantitative EEG were detected. In summary, we identified two genes (HTR3B and ABCB1) with significant variation in the sleep architecture response to morphine. Morphine caused a more active/unstable EEG during sleep. Our findings may have relevance for a personalized medicine approach to targeted morphine therapy.
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Affiliation(s)
- Luke Rowsell
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Sydney, Australia
| | - Justin Guang-Ao Wu
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Sydney, Australia
| | - Brendon J Yee
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital (work performed), Sydney Local Health District, Camperdown, Australia
| | - Keith K H Wong
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital (work performed), Sydney Local Health District, Camperdown, Australia
| | - Sheila Sivam
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital (work performed), Sydney Local Health District, Camperdown, Australia
| | - Andrew A Somogyi
- Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Ronald R Grunstein
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital (work performed), Sydney Local Health District, Camperdown, Australia
| | - David Wang
- Centre for Integrated Research and Understanding of Sleep (CIRUS), Woolcock Institute of Medical Research, Sydney Medical School, the University of Sydney, Sydney, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital (work performed), Sydney Local Health District, Camperdown, Australia
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13
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Packiasabapathy S, Aruldhas BW, Horn N, Overholser BR, Quinney SK, Renschler JS, Sadhasivam S. Pharmacogenomics of methadone: a narrative review of the literature. Pharmacogenomics 2020; 21:871-887. [PMID: 32705966 DOI: 10.2217/pgs-2020-0040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: Methadone, a synthetic opioid with longer duration of action and lower abuse potential compared with morphine, is used to prevent opioid withdrawal, as well as to manage chronic and acute surgical pain. The variability in response to methadone has been widely recognized. The purpose of this article is to review the literature on the pharmacogenetic factors underlying this variability. Materials & methods: This is a narrative overview of the literature on the genetic variants affecting pharmacodynamics and pharmacokinetics of methadone, retrieved from searches of databases such as PubMed and google scholar. Discussion: Clinical responses to methadone may be affected by genetic variants in the opioidergic, dopaminergic and neurotrophic pathways. Polymorphisms in genes related to disposition and elimination of methadone alter the pharmacokinetics, and possibly pharmacodynamics of methadone. Cytochrome P450 enzymes and P-glycoprotein variants contribute to the interindividual variability in methadone pharmacokinetics. Evidence for single gene variants affecting methadone response remains weak. Multiple genetic variants must be considered in conjunction to improve predictive ability. Conclusion: Evidence remains scarce at this time, to recommend pharmacogenetic testing before methadone administration. Well-powered clinical studies are needed with population pharmacokinetic-pharmacodynamic modeling and multigenetic signature-based predictions to enable tailored use of methadone in clinical practice.
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Affiliation(s)
- Senthil Packiasabapathy
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Blessed W Aruldhas
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Department of Pharmacology & Clinical Pharmacology, Christian Medical College, Vellore, 632002, India
| | - Nicole Horn
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Brian R Overholser
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN 47907, USA
| | - Sara K Quinney
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Department of Obstetrics & Gynecology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.,Center for Computational Biology & Bioinformatics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Janelle S Renschler
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Senthilkumar Sadhasivam
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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14
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Role of OPRM1, clinical and anthropometric variants in neonatal pain reduction. Sci Rep 2020; 10:7091. [PMID: 32341423 PMCID: PMC7184594 DOI: 10.1038/s41598-020-63790-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 03/30/2020] [Indexed: 12/13/2022] Open
Abstract
An increased awareness on neonatal pain-associated complications has led to the development of pain scales adequate to assess the level of pain experienced by newborns such as the ABC score. A commonly used analgesic procedure is to administer a 33% oral dextrose solution to newborns prior to the painful intervention. Although this procedure is very successful, not in all subjects it reaches complete efficacy. A possible explanation for the different response to the treatment could be genetic variability. We have investigated the genetic variability of the OPRM1 gene in 1077 newborns in relation to non-pharmacologic pain relief treatment. We observed that the procedure was successful in 966 individuals and there was no association between the genotypes and the analgesic efficacy when comparing individuals that had an ABC score = 0 and ABC score >0. However, considering only the individuals with ABC score>0, we found that the homozygous carriers of the G allele of the missense variant SNP rs1799971 (A118G) showed an interesting association with higher ABC score. We also observed that individuals fed with formula milk were more likely to not respond to the analgesic treatment compared to those that had been breastfed.
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15
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Chrobok AI, Krause D, Winter C, Plörer D, Martin G, Koller G, Adorjan K, Canolli M, Adam R, Wagner EM, Peles E, Paul D, Vogel T, Pogarell O. Sleeping Patterns in Patients with Opioid Use Disorder: Effects of Opioid Maintenance Treatment and Detoxification. J Psychoactive Drugs 2020; 52:203-210. [PMID: 32299305 DOI: 10.1080/02791072.2020.1751900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of the study was to explore whether abstinent patients on recent opioid detoxification or on opioid maintenance treatment suffer from sleeping problems. 199 patients on opioid maintenance treatment (methadone, diacetylmorphine and buprenorphine) or recent opioid detoxification were included in this exploratory cross-sectional study. We used the Pittsburgh Sleep Quality Index (PSQI) and the Regensburger Insomnia Scale (RIS) in order to assess potential sleeping problems. There was a significant effect of the condition "opioid maintenance" or "recent opioid detoxification" on the total score of PSQI and RIS. All opioid maintenance drugs used by the study population were associated with more sleeping problems compared to the detoxification group when calculated with RIS values. Recently abstinent patients (opioid detoxification) displayed significantly fewer sleep disturbances than opioid-maintained patients. Since sleeping problems can seriously impair treatment success and quality of life, screening for sleep disturbances and their subsequent treatment is of pronounced relevance.
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Affiliation(s)
- Agnieszka I Chrobok
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Daniela Krause
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Catja Winter
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Diana Plörer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Gabriele Martin
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Minavere Canolli
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Roland Adam
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Elias M Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
| | - Einat Peles
- Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Dietmar Paul
- Opioid Addiction Outpatient Clinic, Department of Addiction, Buergerhospital , Frankfurt/Main, Germany
| | - Thomas Vogel
- Opioid Addiction Outpatient Clinic, Department of Addiction, Buergerhospital , Frankfurt/Main, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich, Germany
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16
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Zhang Q, Shi M, Tang H, Zhong H, Lu X. κ Opioid Receptor 1 Single Nucleotide Polymorphisms were Associated with the Methadone Dosage. Genet Test Mol Biomarkers 2020; 24:17-23. [PMID: 31940240 DOI: 10.1089/gtmb.2019.0159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: Heroin use disorder (HUD) is a complex brain disease that includes multiple phenotypes. Heroin acts primarily as a mu-opioid receptor (OPRM1) agonist. The κ opioid receptor 1 (OPRK1) is critically involved in abstinence and remission. Multiple studies confirm that the OPRM1 and OPRK1 genes are associated with HUD. However, their relationship with the addictive phenotype is still unclear. This study was designed to identify the genetic polymorphisms within OPRM1 and OPRK1 with six HUD phenotypes. Methods: A total of 801 patients with HUD were recruited from the Methadone Maintenance Treatment Program in Xi'an. We identified eight potential functional single nucleotide polymorphisms (SNPs) in the two genes that were genotyped using SNaPshot SNP technology. We then performed a case-control association analysis, investigated particular disease phenotypes, and assessed the extent of epistasis among the variants of the two genes. Results: The OPRK1 rs3802279, rs3802281, and rs963549 genotypes were significantly associated with methadone dosage analyzed by Pearson's chi-square test or binary logistic regression to correct for covariates. The rs3802279 CC, rs3802281 TT, and rs963549 CC genotype carriers required a lower methadone maintenance dose per day. Multifactor dimensionality reduction analysis indicated strong interactions between sex and OPRK1 rs963549. The results of the OPRM1 genotyping did not reveal any associations with the various HUD phenotypes. Conclusion: These findings support an important role of the OPRK1 polymorphism in determining the daily methadone dose and may guide future studies in identifying additional genetic risk factors for HUD.
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Affiliation(s)
- Qian Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Minghai Shi
- Department of Radiology, Affiliated Hospital of Ningxia Medical University, Yinchuan, China
| | - Hua Tang
- Department of Gastroenterology, Tangdou Hospital, Air Force Medical University, Xi'an, China
| | - Huijun Zhong
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
| | - Xiaohong Lu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan, China
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17
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Genetic polymorphisms in the opioid receptor delta 1 (OPRD1) gene are associated with methadone dose in methadone maintenance treatment for heroin dependence. J Hum Genet 2020; 65:381-386. [PMID: 31907389 DOI: 10.1038/s10038-019-0718-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/04/2019] [Accepted: 12/19/2019] [Indexed: 12/28/2022]
Abstract
Delta opioid receptor (DOR) is well known to be involved in heroin dependence. This study tested the hypothesis that single nucleotide polymorphisms (SNPs) in the opioid receptor delta 1 (OPRD1) gene coding region are associated with treatment responses in a methadone maintenance therapy (MMT) cohort in Taiwan. Three hundred forty-four MMT patients were recruited. Diastolic/systolic blood pressure, heart rate, methadone dosage, and plasma concentrations of methadone were recorded. Twenty-five SNPs located within the OPRD1 genetic region were selected and genotyped from the genomic DNA of all 344 participants. After pairwise tagger analyses, tagger SNP rs204047 showed a significant association with methadone dosage (P = 0.0019), and tagger SNPs rs204047 and rs797397 were significantly associated with plasma R, S-methadone concentrations (P < 0.0006) in patients tested negative in the urine morphine test, which indicated patients with a better response to MMT. The major genotype carriers showed a higher methadone dosage and higher plasma concentrations of R, S-methadone than the minor genotype carriers. The results indicated that OPRD1 genetic variants were associated with methadone dosage and methadone plasma concentration in MMT patients with a negative morphine test result.
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18
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Tolami HF, Sharafshah A, Tolami LF, Keshavarz P. Haplotype-Based Association and In Silico Studies of OPRM1 Gene Variants with Susceptibility to Opioid Dependence Among Addicted Iranians Undergoing Methadone Treatment. J Mol Neurosci 2019; 70:504-513. [PMID: 31853823 DOI: 10.1007/s12031-019-01443-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 04/23/2019] [Indexed: 12/20/2022]
Abstract
The associations of OPRM1 gene variants with opioid dependence have been demonstrated. This study investigated the association of rs495491, rs1799971 (A118G), rs589046, and rs10457090 variants of OPRM1 gene with opium dependence and their haplotypes among addicted individuals undergoing methadone treatment. Moreover, we investigated whether any of these variants were associated with libido dysfunction or insomnia among addicted people. A total of 404 individuals were genotyped by amplification refractory mutation system (ARMS) PCR. In silico studies were designed through homology modeling of A118G structures (N40 and D40) and docked with 41 FDA-approved drugs of OPRM1 protein by SWISS-MODEL, COACH, MolProbity, ProSA, Errat, Glide XP, and Autodock 4. Results revealed that rs495491, A118G, rs589046, and rs10457090 were significantly associated with opium dependence under recessive (P = 6.66E-10), dominant (P = 0.017), co-dominant (P = 0.001), and recessive (P = 9.28E-6) models of inheritance, respectively. Further analyses indicated three significant haplotypes including A-A-A-C (P-permutation < 1E-9), G-G-A-C (P-permutation = 0.04), and G-A-G-C (P-permutation = 8.69E-4). Genotype-phenotype associations of OPRM1 variants with insomnia and libido dysfunction showed no significant association. Docking showed the higher binding affinity of N40 rather than D40 model; however, methadone and morphine were bonded with D40 structure more powerful. Consequently, rs495491, A118G, rs589046, and rs10457090 were associated with opioid dependence among Iranians; also, A118G might be the most remarkable marker of OPRM1 owing to its vital structural roles.
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Affiliation(s)
- Hedyeh Fazel Tolami
- Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Sharafshah
- Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Laleh Fazel Tolami
- Medical and Emergency Management Center of Guilan, Guilan University of Medical Sciences, Rasht, Iran
| | - Parvaneh Keshavarz
- Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
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19
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Factors Associated with Sleep Disorders among Methadone-Maintained Drug Users in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224315. [PMID: 31698771 PMCID: PMC6887969 DOI: 10.3390/ijerph16224315] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 12/18/2022]
Abstract
Sleep quality among heroin-dependent patients receiving methadone maintenance treatment (MMT) is not fully investigated in Vietnam. This study explored the prevalence of poor sleep quality in methadone-maintained patients and associated factors. This cross-sectional included 395 MMT patients at three clinics in Nam Dinh province, Vietnam. The Pittsburgh Sleep Quality Index (PSQI) was employed to measure patients’ sleep quality. Sociodemographic, clinical, behavioral, psychological, and social support characteristics were collected. Multivariate Logistic and Generalized Linear Regression models were applied to identify associated factors. Among 395 patients, 26.6% had poor sleep quality according to the PSQI scale. People having jobs were less likely to have poor sleep quality and lower PSQI scores compared to unemployed patients. Those having spouses had lower PSQI scores than single patients. High depression, anxiety, and stress scores were associated with poor sleep quality and high PSQI scores. A longer duration of MMT increased the likelihood of experiencing poor sleep quality. Patients smoking tobacco daily or concurrently using drugs had lower PSQI scores than those that did not. This study highlights a moderate prevalence of poor sleep quality among Vietnamese MMT patients. Regular evaluation, appropriate psychological management, and social support, as well as the provision of employment opportunities, potentially improve the sleep quality of methadone-maintained patients.
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20
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Zhao S, Chen F, Feng A, Han W, Zhang Y. Risk Factors and Prevention Strategies for Postoperative Opioid Abuse. Pain Res Manag 2019; 2019:7490801. [PMID: 31360271 PMCID: PMC6652031 DOI: 10.1155/2019/7490801] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 06/25/2019] [Indexed: 02/06/2023]
Abstract
Worldwide, 80% of patients who undergo surgery receive opioid analgesics as the fundamental agent for pain relief. However, the irrational use of opioids leads to excessive drug dependence and drug abuse, resulting in an increased mortality rate and huge economic loss. The crisis of opioid overuse remains a great challenge. In this review, we summarize several key factors in opioid abuse, including race, region, income, genetic factors, age and gender, smoking and alcohol abuse, history of chronic pain and analgesic drug abuse, surgery, neuropsychiatric illness, depression and antidepressant use, human factors, national policies, hospital regulations, and health insurance under treatment of pain. Furthermore, we present several prevention strategies, such as perioperative measures, opioid substitutes, treatment of the primary illness, emotional regulation, use of opioid antagonists, efforts of the state, hospitals, doctors and pharmacy benefit managers, gene therapy, and vaccines. Greater understanding and better assessment are required of the risks associated with opioid abuse to ensure the safety and analgesic effects of pain treatment after surgery.
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Affiliation(s)
- Shuai Zhao
- Department of Anesthesiology, First Hospital of Jilin University, Changchun, China
| | - Fan Chen
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Anqi Feng
- Department of Anesthesiology, Second Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Han
- Department of Anesthesiology, First Hospital of Jilin University, Changchun, China
| | - Yuan Zhang
- Department of Anesthesiology, First Hospital of Jilin University, Changchun, China
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21
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Peng S, Jiang H, Du J, Lin S, Pan S, Yu S, Zhao M. Methadone Dosage and Plasma Levels, SNPs of OPRM1 Gene and Age of First Drug Use Were Associated With Outcomes of Methadone Maintenance Treatment. Front Genet 2018; 9:450. [PMID: 30420869 PMCID: PMC6216325 DOI: 10.3389/fgene.2018.00450] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 09/18/2018] [Indexed: 01/25/2023] Open
Abstract
Objective: To explore the association between methadone dosage, plasma drug concentration, SNPs of μ-opioid receptor gene (OPRM1), ATP-binding cassette subfamily B member 1 gene (ABCB1), and methadone maintenance treatment (MMT) response. Method: A total of 240 Chinese Han participants receiving MMT were recruited from Shanghai. Nine single nucleotide polymorphisms (SNPs) of the OPRM1 gene and three SNPs of the ABCB1 gene were genotyped, plasma methadone concentration was detected, and a morphine urine test was taken from all subjects. Results: Methadone dosage, plasma methadone concentration, and negative rate of morphine urine test of retention participants were significantly higher, although the addiction severity index (ASI) was not significantly different between the two groups. A allele and AA genotype carriers of rs562859 (OPRM1 gene) had better compliance of MMT, and AA genotype carriers had a higher negative rate of morphine urine test. However, the difference was not significant after adjusting influence factors (age, sex, and methadone dosage). GG genotype carriers of rs3192723 (OPRM1 gene) had a significantly lower negative rate of morphine urine test, and the difference was still significant after adjusting influence factors. Logistic regression analysis showed that methadone-free trough concentration (OR = 0.910, p = 0.023) and AA genotype of rs526859 (OR = 0.580, p = 0.037) were associated with better compliance of MMT. After Bonferroni correction, only free trough concentration of methadone was negatively correlated with MMT compliance. The SNPs rs6912029 (OR = 0.021, p = 0.066) and rs6902403 (OR = 0.910, p = 0.007) of the OPRM1 gene, age at first use (OR = 1.118, p = 0.005), and average methadone dosage (OR = 1.033, p = 0.045) were associated with MMT effect. After Bonferroni correction, average methadone dosage was no longer correlated with MMT effect. Conclusion: Dosage of methadone, plasma methadone concentration, several SNPs (rs3192723, rs6912029, rs6902403) of the OPRM1 gene, and age of first drug use were associated with better MMT outcomes.
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Affiliation(s)
- Sufang Peng
- The Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifeng Jiang
- The Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Du
- The Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuxing Lin
- The Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shujun Pan
- The Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shunying Yu
- The Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhao
- The Collaborative Innovation Center for Brain Science, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
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22
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Wang SC, Chung RH, Kuo HW, Liu TH, Fang CP, Liu SC, Liu CC, Tsou HH, Chen ACH, Liu YL. GRK5 Is Associated with the Regulation of Methadone Dosage in Heroin Dependence. Int J Neuropsychopharmacol 2018; 21:910-917. [PMID: 30060048 PMCID: PMC6165957 DOI: 10.1093/ijnp/pyy066] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/24/2018] [Accepted: 07/25/2018] [Indexed: 12/25/2022] Open
Abstract
Background There is no countable biomarker for opioid dependence treatment responses thus far. In this study, we recruited Taiwanese methadone maintenance treatment patients to search for genes involving the regulatory mechanisms of methadone dose by genome-wide association analyses. Methods A total of 344 Taiwanese methadone maintenance treatment patients were included in a genome-wide association study. The involvement of GRK5 in opioid dependence was then further confirmed by gene expression study on lymphoblastoid cell lines derived from 3 independent age- and gender-matched groups: methadone maintenance treatment patients, medication-free former heroin abusers, and normal controls. Results The results indicated that GRK5, the gene encoding an enzyme related to μ-opioid receptor desensitization, is associated with methadone dose by additive model of gene-based association analysis (P=6.76×10-5). We found that 6 of the 55 single nucleotide polymorphisms from the genome-wide genotype platform and 2 single nucleotide polymorphisms from the 29 additionally selected single nucleotide polymorphisms were significantly associated with methadone maintenance dose in both genotype and allele type (P ≤ .006), especially in patients who tested negative in the urine morphine test. The levels of GRK5 gene expression were similar between methadone maintenance treatment patients and medication-free former heroin abusers. However, the normal controls showed a significantly lower level of GRK5 gene expression than the other groups (P=.019). Conclusions The results suggested an important role for GRK5 in the regulatory mechanisms of methadone dose and course of heroin dependence.
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Affiliation(s)
- Sheng-Chang Wang
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Ren-Hua Chung
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsiang-Wei Kuo
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Tung-Hsia Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Chiu-Ping Fang
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Shu Chih Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Chia-Chen Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsiao-Hui Tsou
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
| | - Andrew C H Chen
- Department of Psychiatry, the Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York
- The Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine at Hofstra University, Manhasset, New York
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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23
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Zahari Z, Ibrahim MA, Musa N, Tan SC, Mohamad N, Ismail R. Sleep quality and OPRM1 polymorphisms: a cross-sectional study among opioid-naive individuals. BRAZ J PHARM SCI 2018. [DOI: 10.1590/s2175-97902018000117217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Zalina Zahari
- Universiti Sultan Zainal Abidin, Malaysia; Universiti Sains Malaysia, Malaysia
| | | | | | | | - Nasir Mohamad
- Universiti Sains Malaysia, Malaysia; Universiti Sultan Zainal Abidin, Malaysia
| | - Rusli Ismail
- Universiti Sains Malaysia, Malaysia; Universiti Sultan Zainal Abidin, Malaysia
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24
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Oueslati B, Moula O, Ghachem R. The impact of OPRM1's genetic polymorphisms on methadone maintenance treatment in opioid addicts: a systematic review. Pharmacogenomics 2018; 19:741-747. [DOI: 10.2217/pgs-2018-0017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aim: Methadone is a long-acting opioid receptor agonist. It is prescribed to patients with opioid-related use disorders. The OPRM1 gene encodes for methadone's main receptor. It appears that polymorphisms in OPRM1 may affect the efficacy of methadone maintenance treatment (MMT). Objective: Our purpose was to identify all relevant published papers dealing with the impact ofOPRM1's SNPs on MMT's efficacy and to summarize results in order to evaluate the relevance of conducting pretherapeutic genotyping in opioid addicts prior to the onset of MMT. Methods: MEDLINE, PsychINFO and Scopus databases were systematically searched up to 1 January 2018 with no year restrictions using the following keyword combination (MMT) AND (mu or OPRM or mu opioid receptors or SNP or polymorphism or gene). Endpoint of the included studies had to be the impact of OPRM1 gene polymorphisms on the efficacy of MMT and/or methadone required doses during MMT. All abstracts were reviewed to assess papers’ relevance. Studies conducted on animals and duplicate papers were excluded. Results: Our literature search identified 438 articles. Eight of them were included in our systematic review. The total number of included participants was equal to 2170, of whom 1718 underwent MMT. One study reported results of a randomized controlled trial. Three were designed as case–control studies and four as cross-sectional studies. rs1799971 (A118G) was the most studied allele. Results were divergent. Other SNPs might affect MMT's efficacy, however they were scarcely studied. Conclusion: Genotyping patients with opioid-related use disorders is a promising way to reach a better outcome in patients willing to be on MMT. Focusing on OPRM1 solely should be balanced since polymorphisms in other genes implicated in methadone pharmacodynamics and/or pharmacokinetics may conjunctly affect the efficacy of MMT. Recommendations cannot be enunciated for the moment.
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Affiliation(s)
- Bilel Oueslati
- Psychiatry Department, Razi Hospital, Manouba, Tunisia
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Olfa Moula
- Psychiatry Department, Razi Hospital, Manouba, Tunisia
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Rim Ghachem
- Psychiatry Department, Razi Hospital, Manouba, Tunisia
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
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25
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Abstract
Opioid use disorder (OUD) is a significant health problem in the United States and many other countries. A combination of issues, most notably increased prescription of opioid analgesics, has resulted in climbing rates of opioid abuse and overdose over the last decade. This ongoing epidemic has produced a growing population of patients requiring treatment for OUD. Medications such as methadone and buprenorphine have well documented success rates in treating the disorder compared with placebo. However, significant percentages of the population still fail to maintain abstinence or reduce illicit opioid use while using such medications. Genetic variation may play a role in this variability in outcome through pharmacokinetic or pharmacodynamic effects on OUD medications, or by affecting the rate of negative side effects and adverse events. This review focuses on the existing literature on the pharmacogenetics of OUD treatment, with specific focus on medication metabolism, treatment outcomes, and adverse events.
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26
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Blum K, Gondré-Lewis MC, Baron D, Thanos PK, Braverman ER, Neary J, Elman I, Badgaiyan RD. Introducing Precision Addiction Management of Reward Deficiency Syndrome, the Construct That Underpins All Addictive Behaviors. Front Psychiatry 2018; 9:548. [PMID: 30542299 PMCID: PMC6277779 DOI: 10.3389/fpsyt.2018.00548] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 10/12/2018] [Indexed: 12/21/2022] Open
Affiliation(s)
- Kenneth Blum
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA, United States.,Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University, Dayton, OH, United States.,University of Vermont College of Medicine, Burlington, VM, United States.,Division of Addictive Services, Dominion Diagnostics, LLC, North Kingston, RI, United States.,Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Institute of Psychology, University of Eötvös Loránd, Budapest, Hungary.,Department of Clinical Neurology, Path Foundation, New York, NY, United States.,Division of Neuroscience and Addiction Therapy, Summit Estate Recovery Center, Los Gatos, CA, United States.,Department of Neurogenetics Research and Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, United States.,National Human Genome Center, Howard University, Washington, DC, United States
| | - Marjorie C Gondré-Lewis
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Department of Anatomy, Howard University College of Medicine, Washington, DC, United States.,Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical and Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - David Baron
- Graduate College of Biomedical Sciences, Western University of Health Sciences, Pomona, CA, United States.,Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States
| | - Panayotis K Thanos
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical and Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States.,Department of Psychology, University at Buffalo, Buffalo, NY, United States
| | - Eric R Braverman
- Department of Clinical Neurology, Path Foundation, New York, NY, United States
| | - Jennifer Neary
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States
| | - Igor Elman
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Department of Psychiatry, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Rajendra D Badgaiyan
- Division of Precision Addiction Management, Geneus Health, LLC, San Antonio, TX, United States.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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27
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Li DJ, Chung KS, Wu HC, Hsu CY, Yen CF. Predictors of sleep disturbance in heroin users receiving methadone maintenance therapy: a naturalistic study in Taiwan. Neuropsychiatr Dis Treat 2018; 14:2853-2859. [PMID: 30464470 PMCID: PMC6208868 DOI: 10.2147/ndt.s177370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Sleep disturbance is a major health concern for heroin users receiving methadone maintenance treatment (MMT). The present study was aimed to investigate the predictors for new-onset clinically predominant sleep disturbance (CPSD) among heroin users receiving MMT. METHODS This 2-year retrospective study included 152 individuals (127 males and 25 females) with heroin use disorder who visited our MMT clinics for the first time. A univariate Cox proportional hazards regression model (Cox model) was used to estimate the potential factors of subsequent CPSD, followed by a multivariate Cox model to identify significant predictors of CPSD after adjusting for other covariates. RESULTS Twenty-nine (19.1%) participants developed CPSD during the 2-year period. After forward selection in the Cox model, earlier age at onset of heroin exposure (OR=0.95; P=0.044), lower attendance rate (OR =0.04; P=0.03), greater maximum dose of methadone (OR =1.01; P=0.022), and shorter time to maximum methadone dose (OR =0.98; P=0.007) were significantly associated with new-onset CPSD. CONCLUSION We identified predictors that were significantly associated with new-onset CPSD, and clinicians should be aware of sleep disturbance in heroin users receiving MMT with these risk factors. Future studies are necessary to verify our findings and extend the applicability.
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Affiliation(s)
- Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan,
| | - Kuan-Shang Chung
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Hung-Chi Wu
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chih-Yao Hsu
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Cheng-Fang Yen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, .,Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan,
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28
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29
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Kringel D, Ultsch A, Zimmermann M, Jansen JP, Ilias W, Freynhagen R, Griessinger N, Kopf A, Stein C, Doehring A, Resch E, Lötsch J. Emergent biomarker derived from next-generation sequencing to identify pain patients requiring uncommonly high opioid doses. THE PHARMACOGENOMICS JOURNAL 2017; 17:419-426. [PMID: 27139154 PMCID: PMC5637232 DOI: 10.1038/tpj.2016.28] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 11/05/2015] [Accepted: 11/13/2015] [Indexed: 12/14/2022]
Abstract
Next-generation sequencing (NGS) provides unrestricted access to the genome, but it produces 'big data' exceeding in amount and complexity the classical analytical approaches. We introduce a bioinformatics-based classifying biomarker that uses emergent properties in genetics to separate pain patients requiring extremely high opioid doses from controls. Following precisely calculated selection of the 34 most informative markers in the OPRM1, OPRK1, OPRD1 and SIGMAR1 genes, pattern of genotypes belonging to either patient group could be derived using a k-nearest neighbor (kNN) classifier that provided a diagnostic accuracy of 80.6±4%. This outperformed alternative classifiers such as reportedly functional opioid receptor gene variants or complex biomarkers obtained via multiple regression or decision tree analysis. The accumulation of several genetic variants with only minor functional influences may result in a qualitative consequence affecting complex phenotypes, pointing at emergent properties in genetics.
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MESH Headings
- Analgesics, Opioid/administration & dosage
- Analgesics, Opioid/therapeutic use
- Biomarkers, Pharmacological/analysis
- Chronic Pain/drug therapy
- Chronic Pain/genetics
- Dose-Response Relationship, Drug
- Genotype
- High-Throughput Nucleotide Sequencing
- Humans
- Pharmacogenomic Testing
- Pharmacogenomic Variants
- Receptors, Opioid/genetics
- Receptors, Opioid, delta/genetics
- Receptors, Opioid, kappa/genetics
- Receptors, Opioid, mu/genetics
- Receptors, sigma/genetics
- Sigma-1 Receptor
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Affiliation(s)
- D Kringel
- Institute of Clinical Pharmacology, Goethe-University, Frankfurt am Main, Germany
| | - A Ultsch
- DataBionics Research Group, University of Marburg, Marburg, Germany
| | - M Zimmermann
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - W Ilias
- Department of Anaesthesiology and Intensive Care Medicine, Vienna, Austria
| | - R Freynhagen
- Zentrum für Anästhesiologie, Intensivmedizin, Schmerztherapie & Palliativmedizin, Benedictus Krankenhaus Tutzing, Tutzing, Germany
- Klinik für Anästhesiologie, Technische Universität München, München, Germany
| | - N Griessinger
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
| | - A Kopf
- Department of Anesthesiology and Critical Care Medicine, Freie Universität Berlin–Charité, Berlin, Germany
| | - C Stein
- Department of Anesthesiology and Critical Care Medicine, Freie Universität Berlin–Charité, Berlin, Germany
| | - A Doehring
- Institute of Clinical Pharmacology, Goethe-University, Frankfurt am Main, Germany
| | - E Resch
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology TMP, Frankfurt am Main, Germany
| | - J Lötsch
- Institute of Clinical Pharmacology, Goethe-University, Frankfurt am Main, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology TMP, Frankfurt am Main, Germany
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30
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Albonaim A, Fazel H, Sharafshah A, Omarmeli V, Rezaei S, Ajamian F, Keshavarz P. Association of OPRK1 gene polymorphisms with opioid dependence in addicted men undergoing methadone treatment in an Iranian population. J Addict Dis 2017; 36:227-235. [DOI: 10.1080/10550887.2017.1361724] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ali Albonaim
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences/University of Guilan, Rasht, Iran
| | - Hedyeh Fazel
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Sharafshah
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences/University of Guilan, Rasht, Iran
| | - Vahid Omarmeli
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences/University of Guilan, Rasht, Iran
| | - Sajjad Rezaei
- Department of Psychology, University of Guilan, Rasht, Iran
| | - Farzam Ajamian
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
| | - Parvaneh Keshavarz
- Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Guilan, Rasht, Iran
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31
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Sharafshah A, Fazel H, Albonaim A, Omarmeli V, Rezaei S, Mirzajani E, Ajamian F, Keshavarz P. Association of OPRD1 Gene Variants with Opioid Dependence in Addicted Male Individuals Undergoing Methadone Treatment in the North of Iran. J Psychoactive Drugs 2017. [DOI: 10.1080/02791072.2017.1290303] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Alireza Sharafshah
- Master’s Student, Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Master’s Student, Genetic Laboratory, Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
| | - Hedyeh Fazel
- Master’s Student, Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Albonaim
- Master’s Student, Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Master’s Student, Genetic Laboratory, Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
| | - Vahid Omarmeli
- Master’s Student, Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Master’s Student, Genetic Laboratory, Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
| | - Sajjad Rezaei
- Assistant Professor, Department of Psychology, University of Guilan, Rasht, Iran
| | - Ebrahim Mirzajani
- Assistant Professor, Department of Biochemistry and Biophysics, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Farzam Ajamian
- Assistant Professor in Molecular Genetics and Engineering, Department of Biology, Faculty of Sciences (FA), University of Guilan, Rasht, Iran
| | - Parvaneh Keshavarz
- Associate Professor, Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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32
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Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, Tan SC, Mohamad N, Ismail R. The AC/AG Diplotype for the 118A>G and IVS2 + 691G>C Polymorphisms of OPRM1 Gene is Associated with Sleep Quality Among Opioid-Dependent Patients on Methadone Maintenance Therapy. Pain Ther 2016; 5:43-54. [PMID: 26792136 PMCID: PMC4912965 DOI: 10.1007/s40122-016-0044-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Indexed: 12/17/2022] Open
Abstract
Introduction Methadone is a full agonist of the opioid receptor mu 1 which is encoded by the OPRM1 gene. Sleep disorders were frequently reported by opioid-dependent patients during methadone maintenance therapy (MMT). It is possible, therefore, that genetic polymorphisms in OPRM1 influence sleep quality among patients on MMT. This study investigated the association of OPRM1 polymorphisms with sleep quality among opioid-dependent patients on MMT. Methods The sleep quality of 165 male opioid-dependent patients receiving MMT was evaluated using the Pittsburgh Sleep Quality Index (PSQI). DNA was extracted from whole blood and subjected to polymerase chain reaction (PCR) genotyping. Results Patients with IVS2 + 691 CC genotype had higher PSQI scores [mean (SD) = 5.73 (2.89)] compared to those without the IVS2 + 691 CC genotype (IVS2 + 691 GG/GC genotype) [4.92 (2.31)], but the difference did not reach statistical significance (p = 0.081). Patients with combined 118 AA genotype and IVS2 + 691 GC genotype (AC/AG diplotype) had significantly lower PSQI scores [mean (SD) = 4.25 (2.27)] compared to those without the diplotype [5.68 (2.77)] (p = 0.018). Conclusion Our study indicates that the AC/AG diplotype for the 118A>G and IVS2 + 691G>C polymorphisms of OPRM1 gene is associated with better sleep quality among males with opioid dependence on MMT.
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Affiliation(s)
- Zalina Zahari
- Department of Pharmacy, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia. .,Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.
| | - Chee Siong Lee
- Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia
| | - Muslih Abdulkarim Ibrahim
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Department of Pharmacology and Toxicology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Nurfadhlina Musa
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia
| | - Soo Choon Tan
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia
| | - Nasir Mohamad
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia
| | - Rusli Ismail
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
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33
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Zahari Z, Lee CS, Ibrahim MA, Musa N, Yasin MAM, Lee YY, Tan SC, Mohamad N, Ismail R. The Opposing Roles of IVS2+691 CC Genotype and AC/AG Diplotype of 118A>G and IVS2+691G>C of OPRM1 Polymorphisms in Cold Pain Tolerance Among Opioid-Dependent Malay Males on Methadone Therapy. Pain Ther 2015; 4:179-96. [PMID: 26581429 PMCID: PMC4676768 DOI: 10.1007/s40122-015-0041-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Indexed: 11/13/2022] Open
Abstract
Introduction We recently reported that a majority of opioid-dependent Malay males on methadone therapy are cold pain sensitive. It is postulated that common OPRM1 polymorphisms may be responsible. This study investigated the association between 118A>G (dbSNP rs1799971) and IVS2+691G>C (dbSNP rs2075572) variants on cold pain responses among opioid-dependent Malay males on methadone maintenance therapy. Methods Cold pain responses including pain threshold, pain tolerance, and pain intensity were measured using the cold pressor test. DNA was extracted from the venous blood before polymerase chain reaction genotyping. Repeated measures analysis of variance was used to compare the cold pain responses and OPRM1 polymorphisms (118A>G and IVS2+691G>C) using models including genotype dominant and recessive models, allelic additive models, and analysis of haplotypes and diplotypes. Results A total of 148 participants were recruited. With the recessive model, those with IVS2+691 homozygous CC genotype had a shorter cold pain tolerance time than those without CC genotype (i.e., GG/GC genotype; 29.81 vs. 43.08 s, respectively, P = 0.048). On the other hand, with diplotype analysis, participants with combined homozygous 118 AA genotype and heterozygous IVS2+691 GC genotype (i.e., AC/AG diplotype) had a longer cold pain tolerance time than those without this diplotype (49.34 vs. 31.48 s, respectively, P = 0.043). Cold pain threshold was not associated with any of the 118A>G and IVS2+691G>C variations despite being analyzed using various models (all P > 0.05). Conclusion The IVS2+691 CC genotype and AC/AG diplotype of 118A>G and IVS2+691G>C seem to have opposing roles in pain tolerance among opioid-dependent Malay males on methadone therapy. Haplotypes of OPRM1 may be associated with altered binding affinity. Electronic supplementary material The online version of this article (doi:10.1007/s40122-015-0041-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zalina Zahari
- Department of Pharmacy, Hospital Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia. .,Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.
| | - Chee Siong Lee
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Department of Emergency Medicine, School of Medical Sciences, USM, Kota Bharu, Kelantan, Malaysia
| | - Muslih Abdulkarim Ibrahim
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Department of Pharmacology and Toxicology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Nurfadhlina Musa
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Department of Psychiatry, School of Medical Sciences, USM, Kota Bharu, Kelantan, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Soo Choon Tan
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia
| | - Nasir Mohamad
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia
| | - Rusli Ismail
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
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Zeng Y, Yang J, Du J, Pu X, Yang X, Yang S, Yang T. Strategies of Functional Foods Promote Sleep in Human Being. ACTA ACUST UNITED AC 2015; 9:148-155. [PMID: 26005400 PMCID: PMC4440346 DOI: 10.2174/1574362410666150205165504] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 02/07/2023]
Abstract
Sleep is a vital segment of life, however, the mechanisms of diet promoting sleep are
unclear and are the focus of research. Insomnia is a general sleep disorder and functional foods are
known to play a key role in the prevention of insomnia. A number of studies have demonstrated that
major insomnia risk factors in human being are less functional foods in dietary. There are higher
functional components in functional foods promoting sleep, including tryptophan, GABA, calcium,
potassium, melatonin, pyridoxine, L-ornithine and hexadecanoic acid; but wake-promoting neurochemical
factors include serotonin, noradrenalin, acetylcholine, histamine, orexin and so on. The factors promoting sleep in human
being are the functional foods include barley grass powder, whole grains, maca, panax, Lingzhi, asparagus powder,
lettuce, cherry, kiwifruits, walnut, schisandra wine, and milk; Barley grass powder with higher GABA and calcium, as
well as potassium is the most ideal functional food promoting sleep, however, the sleep duration for modern humans is
associated with food structure of ancient humans. In this review, we put forward possible mechanisms of functional
components in foods promoting sleep. Although there is clear relevance between sleep and diet, their molecular
mechanisms need to be studied further.
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Affiliation(s)
- Yawen Zeng
- Biotechnology and Genetic Resources Institute, Yunnan Academy of Agricultural Sciences, Kunming 650205, P.R. China
| | - Jiazhen Yang
- Biotechnology and Genetic Resources Institute, Yunnan Academy of Agricultural Sciences, Kunming 650205, P.R. China; ; Kuming Tiankang Science & Technology Limited Company, Kunming 650231, P.R. China
| | - Juan Du
- Biotechnology and Genetic Resources Institute, Yunnan Academy of Agricultural Sciences, Kunming 650205, P.R. China
| | - Xiaoying Pu
- Biotechnology and Genetic Resources Institute, Yunnan Academy of Agricultural Sciences, Kunming 650205, P.R. China
| | - Xiaomen Yang
- Biotechnology and Genetic Resources Institute, Yunnan Academy of Agricultural Sciences, Kunming 650205, P.R. China
| | - Shuming Yang
- Biotechnology and Genetic Resources Institute, Yunnan Academy of Agricultural Sciences, Kunming 650205, P.R. China
| | - Tao Yang
- Biotechnology and Genetic Resources Institute, Yunnan Academy of Agricultural Sciences, Kunming 650205, P.R. China
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Zahari Z, Lee CS, Tan SC, Mohamad N, Lee YY, Ismail R. Relationship between cold pressor pain-sensitivity and sleep quality in opioid-dependent males on methadone treatment. PeerJ 2015; 3:e839. [PMID: 25870765 PMCID: PMC4393806 DOI: 10.7717/peerj.839] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/25/2015] [Indexed: 01/03/2023] Open
Abstract
Aim. Poor sleep quality due to pain has been reported among opioid-dependent male patients on methadone maintenance therapy (MMT) but objective pain data are lacking. This study aimed to investigate the rate of pain-sensitivity using cold pressor test (CPT) and the relationship between pain-sensitivity and sleep quality in this population. Methods. A total of 168 male participants were included into the study. Objective pain-tolerance was evaluated at 0 h and at 24 h after the first CPT. Malay version of the Pittsburgh Sleep Quality Index (PSQI) and the subjective opiate withdrawal scale (SOWS) questionnaires were administered to evaluate the quality of sleep and withdrawal symptoms, respectively. Results. The mean age of study participants was 37.22 (SD 6.20) years old. Mean daily methadone dose was 76.64 (SD 37.63) mg/day, mean global PSQI score was 5.47 (SD 2.74) and mean averaged SOWS score was 5.43 (SD 6.91). The averaged pain-tolerance time ranged from 7 to 300 s with a mean time of 32.16 (SE 2.72) s, slightly below the cut-off score of 37.53 s. More specifically, 78.6% (n = 132) of participants were identified as pain-sensitive (averaged pain-tolerance time ≤37.53 s), and 36 (21.4%) participants were pain-tolerant (averaged pain-tolerance time >37.53 s). The pain-sensitive group reported poorer sleep quality with mean (SD) PSQI of 5.78 (2.80) compared with the pain-tolerant group with mean (SD) PSQI of 4.31 (2.18) (p = 0.005). With analysis of covariance, pain-sensitive group was found to have higher global PSQI scores (adjusted mean 5.76, 95% CI 5.29; 6.22) than pain-tolerant participants (adjusted mean 4.42, 95% CI 3.52; 5.32) (p = 0.010). Conclusions. Majority of opioid-dependent male patients on methadone treatment are pain-sensitive with CPT. Poor sleep quality is associated with cold pressor pain-sensitivity. Pain and sleep complaints in this male population should not be overlooked.
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Affiliation(s)
- Zalina Zahari
- Department of Pharmacy, Hospital Universiti Sains Malaysia , Kubang Kerian, Kelantan , Malaysia ; Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia , Kubang Kerian, Kelantan , Malaysia
| | - Chee Siong Lee
- Department of Emergency Medicine, School of Medical Sciences , Kubang Kerian, Kelantan , Malaysia
| | - Soo Choon Tan
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia , Kubang Kerian, Kelantan , Malaysia
| | - Nasir Mohamad
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia , Kubang Kerian, Kelantan , Malaysia ; Faculty of Medicine & Health Sciences, Universiti Sultan Zainal Abidin , Kuala Terengganu, Terengganu , Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia , Kubang Kerian, Kelantan , Malaysia
| | - Rusli Ismail
- Pharmacogenetics and Novel Therapeutics Cluster, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia , Kubang Kerian, Kelantan , Malaysia ; Centre of Excellence for Research in AIDS (CERiA), University of Malaya , Kuala Lumpur , Malaysia
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Bauer IE, Soares JC, Nielsen DA. The role of opioidergic genes in the treatment outcome of drug addiction pharmacotherapy: A systematic review. Am J Addict 2015; 24:15-23. [DOI: 10.1111/ajad.12172] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 08/21/2014] [Accepted: 10/01/2014] [Indexed: 12/25/2022] Open
Affiliation(s)
- Isabelle E. Bauer
- Department of Psychiatry and Behavioral Science; University of Texas Health Sciences Center; Houston Texas
| | - Jair C. Soares
- Department of Psychiatry and Behavioral Science; University of Texas Health Sciences Center; Houston Texas
| | - David A. Nielsen
- Menninger Department of Psychiatry and Behavioral Sciences; Baylor College of Medicine and the Michael E. DeBakey Veterans Affairs Medical Center; Houston Texas
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Somogyi AA, Barratt DT, Ali RL, Coller JK. Pharmacogenomics of methadone maintenance treatment. Pharmacogenomics 2014; 15:1007-27. [DOI: 10.2217/pgs.14.56] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Methadone is the major opioid substitution therapy for opioid dependence. Dosage is highly variable and is often controlled by the patient and prescriber according to local and national policy and guidelines. Nevertheless many genetic factors have been investigated including those affecting its metabolism (CYP2B6-consistent results), efflux transport (P-gp-inconsistent results), target μ-opioid receptor (μ-opioid receptor-inconsistent results) and a host of other receptors (DRD2) and signaling elements (GIRK2 and ARRB2; not replicated). None by themselves have been able to substantially explain dosage variation (the major but not sole end point). When multiple genes have been combined such as ABCB1, CYP2B6, OPRM1 and DRD2 a greater contribution to dosage variation was found but not as yet replicated. As stabilization of dosage needs to be made rapidly, it is imperative that larger internationally based studies be instigated so that genetic contribution to dosage can be properly assessed, which may or may not tailor to different ethnic groups and each country’s policy towards an outcome that benefits all.
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Affiliation(s)
- Andrew A Somogyi
- Discipline of Pharmacology, School of Medical Sciences, Faculty of Health Sciences, University of Adelaide, Adelaide 5005, Australia
- Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, 5005, Australia
| | - Daniel T Barratt
- Discipline of Pharmacology, School of Medical Sciences, Faculty of Health Sciences, University of Adelaide, Adelaide 5005, Australia
| | - Robert L Ali
- Discipline of Pharmacology, School of Medical Sciences, Faculty of Health Sciences, University of Adelaide, Adelaide 5005, Australia
- DASSA World Health Organization Collaborating Centre for Research in the Treatment of Drug & Alcohol Problems, School of Medical Sciences, Faculty of Health Sciences, University of Adelaide, Adelaide 5005, Australia
| | - Janet K Coller
- Discipline of Pharmacology, School of Medical Sciences, Faculty of Health Sciences, University of Adelaide, Adelaide 5005, Australia
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The association of genetic polymorphisms in the κ-opioid receptor 1 gene with body weight, alcohol use, and withdrawal symptoms in patients with methadone maintenance. J Clin Psychopharmacol 2014; 34:205-11. [PMID: 24525640 DOI: 10.1097/jcp.0000000000000082] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Methadone is a synthetic opioid that binds to the κ-opioid receptor with a low affinity. This study tested the hypotheses that the genetic polymorphisms in the κ-opioid receptor 1 (OPRK1) gene region are associated with methadone treatment responses in a Taiwan methadone maintenance treatment (MMT) cohort. Seventeen single nucleotide polymorphisms (SNPs) in OPRK1 were selected and genotyped on DNA of 366 MMT patients. Six SNPs from rs7843965 to rs1051660 (intron 2 to exon 2) were significantly associated with body weight (P < 0.007). A haplotype of 4 SNPs rs7832417-rs16918853-rs702764-rs7817710 (exon 4 to intron 3) was associated with bone or joint aches (P ≤ 0.004) and with the amount of alcohol use (standard drinks per day; global P < 0.0001). The haplotype rs10958350-rs7016778-rs12675595 was associated with gooseflesh skin (global P < 0.0001), yawning (global P = 0.0001), and restlessness (global P < 0.0001) withdrawal symptoms. The findings suggest that genetic polymorphisms in OPRK1 were associated with the body weight, alcohol use, and opioid withdrawal symptoms in MMT patients.
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Abstract
Pharmacogenomics is research to study the drug treatment responses in subgroups of patients according to their genetic variants or genetic expression information. Methadone maintenance treatment, which is usually prescribed for patients with heroin dependence, was launched in Taiwan by the government in 2006. In this study, 366 patients who had taken methadone continually in the previous 7 days were examined. Data from administration of the Treatment Outcomes Profile (TOP), Severity of Dependence Scale (SDS), Clinical Opioid Withdrawal Scale (COWS), and Treatment Emergent Symptoms Scale (TESS) were obtained from patients' report records. Genes encoding the liver cytochrome P-450 (CYP) enzymes that are involved with the metabolism of methadone (CYP2B6, 3A4 and 2C19) were selected and genotyped in this cohort. We found that the SNPs on CYP2B6 were associated with plasma S-methadone concentration; SNPs on CYP3A4 were associated with withdrawal symptoms and side effects; and SNPs on CYP2C19 were associated with methadone dose. SNPs in the genes encoding the morphine phase II metabolic enzyme, UGT2B7, were associated with withdrawal symptom scores. In pharmacodynamic genes, the SNPs on OPRM1 were associated with insomnia and change in libido side effects. We conclude that SNP markers may be useful for future methadone dosage adjustment and to reduce adverse reactions.
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Abstract
This paper is the thirty-fifth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2012 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration and thermoregulation (Section 16); and immunological responses (Section 17).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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Crist RC, Berrettini WH. Pharmacogenetics of OPRM1. Pharmacol Biochem Behav 2013; 123:25-33. [PMID: 24201053 DOI: 10.1016/j.pbb.2013.10.018] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 09/19/2013] [Accepted: 10/23/2013] [Indexed: 12/23/2022]
Abstract
Pharmacogenetic research has the potential to explain the variation in treatment efficacy within patient populations. Understanding the interaction between genetic variation and medications may provide a method for matching patients to the most effective therapeutic options and improving overall patient outcomes. The OPRM1 gene has been a target of interest in a large number of pharmacogenetic studies due to its genetic and structural variation, as well as the role of opioid receptors in a variety of disorders. The mu-opioid receptor (MOR), encoded by OPRM1, naturally regulates the analgesic response to pain and also controls the rewarding effects of many drugs of abuse, including opioids, nicotine, and alcohol. Genetic variants in OPRM1, particularly the non-synonymous polymorphism A118G, have been repeatedly associated with the efficacy of treatments for pain and various types of dependence. This review focuses on the current understanding of the pharmacogenetic impact of OPRM1, primarily with regard to the treatment of pain and addiction.
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Affiliation(s)
- Richard C Crist
- Center for Neurobiology and Behavior, Department of Psychiatry, University of Pennsylvania School of Medicine, 125 South 31st St., Philadelphia, PA 19104, United States.
| | - Wade H Berrettini
- Center for Neurobiology and Behavior, Department of Psychiatry, University of Pennsylvania School of Medicine, 125 South 31st St., Philadelphia, PA 19104, United States
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Wu SL, Wang SC, Tsou HH, Kuo HW, Ho IK, Liu SW, Hsu YT, Chang YS, Liu YL. Hepatitis C virus infection influences the S-methadone metabolite plasma concentration. PLoS One 2013; 8:e69310. [PMID: 23935979 PMCID: PMC3720619 DOI: 10.1371/journal.pone.0069310] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 06/07/2013] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Heroin-dependent patients typically contract hepatitis C virus (HCV) at a disproportionately high level due to needle exchange. The liver is the primary target organ of HCV infection and also the main organ responsible for drug metabolism. Methadone maintenance treatment (MMT) is a major treatment regimen for opioid dependence. HCV infection may affect methadone metabolism but this has rarely been studied. In our current study, we aimed to test the hypothesis that HCV may influence the methadone dosage and its plasma metabolite concentrations in a MMT cohort from Taiwan. METHODS A total of 366 MMT patients were recruited. The levels of plasma hepatitis B virus (HBV), HCV, human immunodeficiency virus (HIV) antibodies (Ab), liver aspartate aminotransferase (AST) and alanine aminotransferase (ALT), as well as methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) were measured along with the urine morphine concentration and amphetamine screening. RESULTS Of the 352 subjects in our cohort with HCV test records, 95% were found to be positive for plasma anti-HCV antibody. The liver functional parameters of AST (Wilcoxon Rank-Sum test, P = 0.02) and ALT (Wilcoxon Rank-Sum test, P = 0.04), the plasma methadone concentrations (Wilcoxon Rank-Sum test, P = 0.043) and the R-enantiomer of methadone concentrations (Wilcoxon Rank-Sum test, P = 0.032) were significantly higher in the HCV antibody-positive subjects than in the HCV antibody-negative patients, but not the S-EDDP/methadone dose ratio. The HCV levels correlated with the methadone dose (β= 14.65 and 14.13; P = 0.029 and 0.03) and the S-EDDP/methadone dose ratio (β= -0.41 and -0.40; P = 0.00084 and 0.002) in both univariate and multivariate regression analyses. CONCLUSIONS We conclude that HCV may influence the methadone dose and plasma S-EDDP/methadone dose ratio in MMT patients in this preliminary study.
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Affiliation(s)
- Shiow-Ling Wu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Center for Research and Diagnostics, Centers for Disease Control, Department of Health, Executive Yuan, Taipei, Taiwan
| | - Sheng-Chang Wang
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Hsiao-Hui Tsou
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Hsiang-Wei Kuo
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Ing-Kang Ho
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
- Center for Drug Abuse and Addiction, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
| | - Sheng-Wen Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Ya-Ting Hsu
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Yao-Sheng Chang
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Yu-Li Liu
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
- Graduate Institute of Drug Safety, China Medical University, Taichung, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- * E-mail:
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Hajj A, Khabbaz L, Laplanche JL, Peoc’h K. Pharmacogenetics of opiates in clinical practice: the visible tip of the iceberg. Pharmacogenomics 2013; 14:575-85. [DOI: 10.2217/pgs.13.13] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Opioids are the cornerstone of analgesic therapy and are used as a substitution therapy for opiate addiction. Interindividual variability in response to opioids is a significant challenge in the management of pain and substitution. Therefore, treatment with opioids requires a careful individualization of dosage to achieve an appropriate balance of efficacy and adverse effects and, consequently, avoid toxicity, particularly respiratory depression, sedation and for some, cardiac ventricular fibrillations. Many studies have investigated the association between genetic factors and the variability of response to opioids. Variants in genes encoding proteins implied in opioid pharmacokinetics (absorption, distribution, metabolism, excretion and toxicity), together with those implied in opioids direct and indirect pharmacodynamics (genes of opioid receptors and monoaminergic systems), are the most studied. Many association studies have not been replicated. The purpose of this article is to summarize pharmacogenetic data associated with some opioids frequently encountered in managed care settings.
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Affiliation(s)
- Aline Hajj
- Laboratoire de Pharmacologie Clinique et Pharmacocinétique, Faculté de Pharmacie, Université Saint Joseph, Beyrouth, Liban, Lebanon
| | - Lydia Khabbaz
- Laboratoire de Pharmacologie Clinique et Pharmacocinétique, Faculté de Pharmacie, Université Saint Joseph, Beyrouth, Liban, Lebanon
| | - Jean-Louis Laplanche
- Service de Biochimie et de Biologie moléculaire, Hôpital Lariboisière, AP-HP, Paris, France
- INSERMU705/UMR8206 & Laboratoire de Biologie Cellulaire, Université Paris Descartes, 6 Avenue de l’Observatoire, 75006 Paris, France
| | - Katell Peoc’h
- INSERMU705/UMR8206 & Laboratoire de Biologie Cellulaire, Université Paris Descartes, 6 Avenue de l’Observatoire, 75006 Paris, France
- Service de Biochimie et de Biologie moléculaire, Hôpital Lariboisière, AP-HP, Paris, France.
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OPRM1 genetic polymorphisms are associated with the plasma nicotine metabolite cotinine concentration in methadone maintenance patients: a cross sectional study. J Hum Genet 2012; 58:84-90. [DOI: 10.1038/jhg.2012.139] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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