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Liang S, He Z, Liang Z, Wang K, Du B, Guo R, Li P. Prunus persica (L.) Batsch blossom soluble dietary fiber synergia polyphenol improving loperamide-induced constipation in mice via regulating stem cell factor/C-kit, NF-κB signaling pathway and gut microbiota. Food Res Int 2024; 192:114761. [PMID: 39147543 DOI: 10.1016/j.foodres.2024.114761] [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: 06/11/2024] [Accepted: 07/10/2024] [Indexed: 08/17/2024]
Abstract
This study aimed to investigate the ameliorating effects of peach blossom soluble dietary fiber (PBSDF) and polyphenol (PBP) combinations on loperamide (Lop)-induced constipation in mice, together with the possible mechanism of action. The results demonstrated that the combined use of PBSDF and PBP could synergistically accelerate the gastrointestinal transit rate and gastric emptying rate, shorten first red fecal defecation time, accelerate the frequency of defecation, regulate the abnormal secretion of gastrointestinal neurotransmitters and pro-inflammatory cytokines, and down-regulate the expressions of AQP3 and AQP8. Western blotting and RT-qPCR analysis confirmed that PBSDF + PBP up-regulated the protein and mRNA expressions of SCF and C-kit in SCF/C-kit signaling pathway, and down-regulated pro-inflammatory mediator expressions in NF-κB signaling pathway. 16S rRNA sequencing showed that the diversity of gut microbiota and the relative abundance of specific strains, including Akkermansia, Bacteroides, Ruminococcus, Lachnospiraceae_NK4A136_group, and Turicibacter, rehabilitated after PBSDF + PBP intervention. These findings suggested that the combination of a certain dose of PBSDF and PBP had a synergistic effect on attenuating Lop-induced constipation, and the synergistic mechanism in improving constipation might associated with the regulating NF-κB and SCF/C-kit signaling pathway, and modulating the specific gut strains on constipation-related systemic types. The present study provided a novel strategy via dietary fiber and polyphenol interactions for the treatment of constipation.
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Affiliation(s)
- Shan Liang
- College of Food Science, South China Agricultural University, Guangzhou 510642, China
| | - Zhipeng He
- College of Food Science, South China Agricultural University, Guangzhou 510642, China
| | - Ziping Liang
- College of Food Science, South China Agricultural University, Guangzhou 510642, China
| | - Kun Wang
- College of Food Science, South China Agricultural University, Guangzhou 510642, China
| | - Bing Du
- College of Food Science, South China Agricultural University, Guangzhou 510642, China
| | - Rongxiang Guo
- College of Food Science, South China Agricultural University, Guangzhou 510642, China
| | - Pan Li
- College of Food Science, South China Agricultural University, Guangzhou 510642, China.
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Philip J, Wong A, Pasanen L, Somogyi AA, Rubio J, Klepstad P, Collins A, Gibbs P, Le B. Establishing a Longitudinal Opioid Pharmacogenomic Registry for Cancer Patients: Feasibility and Acceptability. J Palliat Med 2023; 26:411-417. [PMID: 36493378 DOI: 10.1089/jpm.2022.0385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: Individual genetic variation can affect both pain expression and opioid response. Large cohort datasets are required to validate evidence influencing genomic factors in opioid response. This study examined the feasibility of establishing an opioid pharmacogenomics registry for cancer patients containing longitudinal matched clinical, symptom, pharmacological, and genomic data, with an a priori feasibility target of 50 participants within 12 months. Methods: Consecutive patients with advanced cancer receiving opioids across five palliative care services were recruited. Clinical data (demographics, pain data, adverse effects, medications) and blood (DNA, RNA, pharmacokinetics) were collected over two time points. Patient and clinician qualitative interviews were conducted to assess acceptability. This study was approved by the SVHA Ethics Committee, Melbourne, Australia (HREC 252/18). Results: Enrollment for the registry was deemed feasible. Fifty-eight participants were recruited (median age 63.7, 45% female, 83% complete data), with the most frequent diagnosis being lung cancer (n = 18, 33%) and oxycodone the most frequently prescribed opioid (n = 30, 52%). Qualitative data indicated positive engagement from both patients and clinicians. Conclusion: Establishing a longitudinal opioid pharmacogenomic registry in patients with cancer receiving palliative care is feasible and readily acceptable.
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Affiliation(s)
- Jennifer Philip
- Department of Medicine, University of Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Aaron Wong
- Department of Medicine, University of Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Leeanne Pasanen
- Palliative Care Service, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Andrew A Somogyi
- Discipline of Pharmacology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Justin Rubio
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Fitzroy, Victoria, Australia
| | - Pal Klepstad
- Department Intensive Care Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Anna Collins
- Department of Medicine, University of Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Peter Gibbs
- Personalised Oncology Division, Walter Eliza Hall Institute, University of Melbourne, Fitzroy, Victoria, Australia
| | - Brian Le
- Department of Medicine, University of Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Fitzroy, Victoria, Australia
- Palliative Care Service, Royal Melbourne Hospital, Parkville, Victoria, Australia
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Zhang G, Hou Y. Screening for aberrantly methylated and differentially expressed genes in nonalcoholic fatty liver disease of hepatocellular carcinoma patients with cirrhosis. World J Surg Oncol 2022; 20:364. [PMCID: PMC9673405 DOI: 10.1186/s12957-022-02828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background
Nonalcoholic fatty liver disease (NAFLD) as the leading chronic liver disease worldwide causes hepatic fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The aim of this study was to find potential aberrantly methylated and differentially expressed genes in NAFLD of HCC patients with cirrhosis.
Methods
DNA methylation data, mRNA expression data, and the corresponding clinical information of HCC were downloaded from the Cancer Genome Atlas (TCGA, tissue sample) database. HCC patients with cirrhosis were divided into two groups according to the presence of NAFLD. The differentially expressed genes (DEGs) and differentially methylated genes (DMGs) were obtained.
Results
By overlapping 79 up-regulated genes and 1020 hypomethylated genes, we obtained 5 hypomethylated-highly expressed genes (HypoHGs). By overlapping 365 down-regulated genes and 481 hypermethylated genes, we identified 13 hypermethylated-lowly expressed genes (Hyper-LGs). Survival analysis of these 18 MDEGs indicated that the expression of DGKK and HOXD9 was significantly correlated with the overall survival time of NAFLD patients.
Conclusions
We identified several candidate genes whose expressions were regulated by DNA methylation of NAFLD of HCC with cirrhosis, which may provide a new field in understanding the clinical pathological mechanism of NAFLD of HCC with cirrhosis.
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Genetic and Clinical Factors Associated with Opioid Response in Chinese Han Patients with Cancer Pain: An Exploratory Cross-Sectional Study. Pain Ther 2022; 11:269-288. [PMID: 35107781 PMCID: PMC8861215 DOI: 10.1007/s40122-022-00353-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/14/2022] [Indexed: 12/20/2022] Open
Abstract
Introduction Studies have shown that genetic variation and environmental factors are associated with individual differences in therapeutic efficacy and side effects of opioids. However, the focus of these studies has been on a single factor of single-nucleotide polymorphisms (SNPs) or haplotypes, for which results have rarely been validated. For complex traits, such as cancer pain and opioid response, interactions between multiple genetic variation and environmental factors need to be considered to explain the opioid individual differences. Methods We conducted an exploratory two-stage cross-sectional study with 1027 Chinese patients who were taking strong opioid medications for their cancer pain, and genotyped 110 SNPs to explore the association of SNPs, haplotypes, gene–gene and gene–environment interactions with opioid dose, pain relief, and opioid-induced constipation. Results Due to the failure to meet Benjamini–Hochberg criteria in the discovery stage or to be validated in replication stage, no association was found between SNPs, haplotypes, paired SNP–SNP interactions or multi-dimensional gene–gene interactions and opioid response. However, for gene–environment interactions, optimal models have been constructed in all phenotypes of opioid response. Conclusions This study reveals for the first time that construction of multidimensional gene–environment interactions enables better interpretations of the effect of genetic variation and environmental factors on the opioid response in patients with cancer pain. Trial registration Chictr.org.cn, identifier, ChiCTR2000033576. Supplementary Information The online version contains supplementary material available at 10.1007/s40122-022-00353-5.
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Chen H, Zhang C, Zhou Q, Guo Y, Ren Z, Yu Z. Integrated Bioinformatic Analysis Identifies TIPIN as a Prognostic Biomarker in Hepatocellular Carcinoma. DISEASE MARKERS 2022; 2022:5764592. [PMID: 35082931 PMCID: PMC8786536 DOI: 10.1155/2022/5764592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 12/23/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Gene expression and DNA methylation analyses have long been used to identify cancer markers. However, a combination analysis of the gene expression and DNA methylation has yet to be performed to identify potential biomarkers of hepatocellular carcinoma (HCC). METHODS By matching gene expression profiles and promoter methylation data in The Cancer Genome Atlas (TCGA), genes with discrepant expression as well as genes with differential promoter methylation were identified. High-expression genes with low promoter methylation were defined as epigenetically induced (EI), while low-expression genes with high promoter methylation were defined as epigenetically suppressed (ES). The human protein interaction network was further integrated to construct the EI/ES gene interaction network, and the key genes in the subnet were identified as potential HCC biomarkers. The expression differences and prognostic values were verified in TCGA and Gene Expression Omnibus (GEO) databases, as well as with tissue chip technology. RESULTS Four key genes were identified: TIPIN, RBM15B, DUSP28, and TRIM31, which demonstrated the differential gene expression and prognostic value in TCGA and GEO databases. Tissue microarray analysis (TMA) revealed that TIPIN levels were altered in HCC. The upregulated TIPIN expression was associated with worse overall survival. Univariate and multivariate analyses showed that the TIPIN expression was an independent predictor of HCC. CONCLUSION TIPIN might be a potential novel prognostic biomarker for HCC.
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Affiliation(s)
- Hui Chen
- Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chunting Zhang
- Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qianmei Zhou
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanan Guo
- Department of Infectious Diseases, Zhengzhou Central Hospital, Zhengzhou, China
| | - Zhigang Ren
- Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zujiang Yu
- Precision Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Opioid-induced constipation in patients with cancer: a "real-world," multicentre, observational study of diagnostic criteria and clinical features. Pain 2021; 162:309-318. [PMID: 32701649 DOI: 10.1097/j.pain.0000000000002024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate opioid-induced constipation (OIC) in a large cohort of "real-world" patients with cancer; the objectives were to determine the prevalence of OIC, the utility of a simple screening question, the accuracy of the Rome IV diagnostic criteria, the clinical features of OIC (physical and psychological), and the impact of OIC (quality of life). One thousand patients with cancer were enrolled in the study, which involved completion of the Rome IV diagnostic criteria for OIC, the Bowel Function Index, the Patient Assessment of Constipation Quality of Life questionnaire, and the Memorial Symptom Assessment Scale-Short Form. Participants also underwent a thorough clinical assessment by an experienced clinician (ie, "gold-standard" assessment of OIC). Fifty-nine percent of patients were clinically assessed as having OIC, 2.5% as having another cause of constipation, and 19% as not having constipation but were taking regular laxatives. The simple screening question produced a number of false-negative results (19% of patients), whereas the Rome IV diagnostic criteria had an accuracy of 81.9%. Patients with OIC had more symptoms overall, higher Memorial Symptom Assessment Scale-Short Form subscale scores (and total score), and higher Patient Assessment of Constipation Quality of Life questionnaire subscale scores (and the overall score). Opioid-induced constipation was not associated with demographic factors, cancer diagnosis, performance status, or opioid equivalent dosage: OIC was associated with opioid analgesic, with patients receiving tramadol and transdermal buprenorphine having less constipation. The study confirms that OIC is common among patients with cancer pain and is associated with a spectrum of physical symptoms, a range of psychological symptoms, and an overall deterioration in the quality of life.
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Yan T, Su J, Zhou L, Zhang L. Polymorphisms of 5-hydroxytryptamine receptor type 3B gene and clinical characteristics for vomiting after breast surgery in chinese han female population. J Clin Pharm Ther 2021; 46:936-941. [PMID: 33605481 DOI: 10.1111/jcpt.13386] [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: 09/24/2020] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 01/04/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE The 5-hydroxytryptamine type 3B receptor (HTR3B) is involved in postoperative vomiting. We aimed to investigate whether genomic variations of rs1176744 and rs1672717 in HTR3B are associated with postoperative vomiting (POV) in the Chinese Han female population after surgery. METHODS Five hundred and sixty-eight female patients classified as ASA I-II undergoing breast surgery under standard general anaesthesia were enrolled in the study. Episodes of POV in the first 24 h after surgery were recorded. Targeted single nucleotide polymorphisms (SNPs) in the HTR3B gene were identified by genotyping using the SNPscanTM technique. Univariate and multivariate analyses were conducted to investigate the association between SNPs and POV. RESULTS We eventually analysed 407 subjects undergoing breast surgery under general anaesthesia. Of these, 104(25.6%) patients suffered POV within 24 h after surgery. In the multivariate logistic regression analysis, we found that age≥50 years (p = 0.012) and longer duration of surgery (p = 0.019) were independent risk factors for POV. Simultaneously, in the dominant model of rs1672717, compared with the AA genotype, GG+GA carriers suffered more POV (OR=1.669, p = 0.038). However, the use of atropine reduced the incidence of POV in our study (p = 0.019). WHAT IS NEW AND CONCLUSION Our investigation demonstrated that polymorphism of rs1672717 (HTR3B) may be a genetic risk factor for developing POV. TRIAL REGISTRATION clinicaltrials.gov identifier: NCT03705026.
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Affiliation(s)
- Ting Yan
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jiansheng Su
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Linying Zhou
- Electron Microscopy Lab of Public Technology Service Center, Fujian Medical University, Fuzhou, China
| | - Liangcheng Zhang
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
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Bobrova OP, Zyryanov SK, Shnayder NA, Petrova MM. Predicting Opioid Therapy Safety In Pancreatic Cancer Patients. RUSSIAN OPEN MEDICAL JOURNAL 2020. [DOI: 10.15275/rusomj.2020.0417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background — Obligatory use of strong opioids for treating chronic pain syndrome in patients with pancreatic cancer provides the implementation of opioid-associated adverse reactions. Genetic and non-genetic risk factors are predictive of the opioid therapy safety. Contemporary methods of information analysis allow using prognostic risk models for practical application. Objective — Identification of significant risk factors for the development of opioid-associated adverse drug reactions in patients with chronic pain syndrome against the background of pancreatic cancer. Material and Methods — The study included 90 patients with chronic pain against the background of pancreatic cancer, randomized at a ratio of 1: 1. Group 1 received morphine sulfate (MS), group 2 received fentanyl transdermal therapeutic system (FTTS) with standard adjuvant therapy (ketoprofen, diazepam, amitriptyline). To assess pain level, the 10-point Digital Rating Scale, the Visual Analogue Scale and the pain questionnaires were used. The assessment of the treatment safety was conducted by the Naranjo Scale. Assessment of prognostic genetic and non-genetic factors was carried out using ROC analysis with calculation of AUC (the area under the ROC-curve). Results — Prognostic models of good quality were determined with the optimal ratio of sensitivity and specificity for the influence of genetic and non-genetic risk factors on the development of opioid-associated adverse drug reactions (OA-ADRs) in comparison groups. Various prognostic factors, complementing each other, were identified in the comparison groups. Conclusion — The following OA-ADRs predicting factors were identified: for FTTS-associated nausea and vomiting – age and carriage of rs7438135 AG genotype of UGT2B7 gene; for local reactions – the sum of points on the ESAS scale and carriage of rs7438135 AA genotype of UGT2B7 gene; for difficulty urinating – the level of glomerular filtration rate; for neurotoxicity – the level of AST and bilirubin, and the carriage of rs1128503 GG genotype of ABCB1 gene; for pruritus – carriage of rs1045642642 AA genotype of ABCB1 gene. The prognostic factors for the implementation of MS-associated neurotoxicity were age and comorbidity; for dry mouth was predicted best from the sum of points on the MMCE scale; weakness was predicted by the carriage of rs7668258 TT genotype of UGT2B7 gene.
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Development of an immune gene prognostic classifier for survival prediction and respond to immunocheckpoint inhibitor therapy/chemotherapy in endometrial cancer. Int Immunopharmacol 2020; 86:106735. [DOI: 10.1016/j.intimp.2020.106735] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/08/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023]
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Liu A, Wu Q, Peng D, Ares I, Anadón A, Lopez-Torres B, Martínez-Larrañaga MR, Wang X, Martínez MA. A novel strategy for the diagnosis, prognosis, treatment, and chemoresistance of hepatocellular carcinoma: DNA methylation. Med Res Rev 2020; 40:1973-2018. [PMID: 32525219 DOI: 10.1002/med.21696] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 04/29/2020] [Accepted: 05/17/2020] [Indexed: 12/11/2022]
Abstract
The cancer mortality rate of hepatocellular carcinoma (HCC) is the second highest in the world and the therapeutic options are limited. The incidence of this deadly cancer is rising at an alarming rate because of the high degree of resistance to chemo- and radiotherapy, lack of proper, and adequate vaccination to hepatitis B, and lack of consciousness and knowledge about the disease itself and the lifestyle of the people. DNA methylation and DNA methylation-induced epigenetic alterations, due to their potential reversibility, open the access to develop novel biomarkers and therapeutics for HCC. The contribution to these epigenetic changes in HCC development still has not been thoroughly summarized. Thus, it is necessary to better understand the new molecular targets of HCC epigenetics in HCC diagnosis, prevention, and treatment. This review elaborates on recent key findings regarding molecular biomarkers for HCC early diagnosis, prognosis, and treatment. Currently emerging epigenetic drugs for the treatment of HCC are summarized. In addition, combining epigenetic drugs with nonepigenetic drugs for HCC treatment is also mentioned. The molecular mechanisms of DNA methylation-mediated HCC resistance are reviewed, providing some insights into the difficulty of treating liver cancer and anticancer drug development.
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Affiliation(s)
- Aimei Liu
- National Reference Laboratory of Veterinary Drug Residues and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University (HZAU), Wuhan, China
| | - Qinghua Wu
- College of Life Science, Yangtze University, Jingzhou, China.,Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Dapeng Peng
- National Reference Laboratory of Veterinary Drug Residues and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University (HZAU), Wuhan, China
| | - Irma Ares
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Research Institute Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Arturo Anadón
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Research Institute Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Bernardo Lopez-Torres
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Research Institute Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - María-Rosa Martínez-Larrañaga
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Research Institute Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Xu Wang
- National Reference Laboratory of Veterinary Drug Residues and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University (HZAU), Wuhan, China.,Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Research Institute Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - María-Aránzazu Martínez
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Research Institute Hospital 12 de Octubre (i+12), Universidad Complutense de Madrid (UCM), Madrid, Spain
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Valenta S, Spichiger E, Paul SM, Rabow MW, Plano Clark VL, Schumacher KL, Miaskowski C. A Longitudinal Study of Predictors of Constipation Severity in Oncology Outpatients With Unrelieved Pain. J Pain Symptom Manage 2020; 59:9-19.e1. [PMID: 31494176 DOI: 10.1016/j.jpainsymman.2019.08.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 11/15/2022]
Abstract
CONTEXT Although constipation is a common symptom in oncology patients, it often goes unrecognized and untreated. In addition, little is known about characteristics associated with interindividual differences in constipation severity. OBJECTIVES To describe prevalence, characteristics, and management of constipation; evaluate interindividual differences in constipation severity over 10 weeks; and identify demographic, clinical, and symptom characteristics associated with higher constipation severity scores. METHODS In this prospective, longitudinal study, 175 oncology patients with unrelieved pain were recruited from eight outpatient cancer settings in the U.S. Patients completed demographic and symptom questionnaires at enrollment. Constipation severity was evaluated over 10 weeks using the Constipation Assessment Scale (CAS). Hierarchical linear modeling was used to identify characteristics associated with higher CAS scores. RESULTS At enrollment, 70.1% of the patients reported constipation [i.e., CAS score of >2; mean CAS score: 3.72 (±3.11)]. While over the first week of the study patients used one to two constipation treatments per day, a large amount of interindividual variability was found in CAS scores. Higher percentage of days with no bowel movement, higher number of constipation treatments, higher state anxiety scores, and higher analgesic side effects scores were associated with higher CAS scores at enrollment. Higher percentage of days with no bowel movement was associated with interindividual differences in the trajectories of constipation. CONCLUSION Our findings underscore the high prevalence of and large amount of interindividual variability in constipation severity. The characteristics associated with worse CAS scores can assist clinicians to identify high-risk patients and initiate prompt interventions.
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Affiliation(s)
- Sabine Valenta
- Nursing Science, Department Public Health, University of Basel, Basel, Switzerland; Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Elisabeth Spichiger
- Nursing Science, Department Public Health, University of Basel, Basel, Switzerland; Directorate of Nursing, Medical-Technical and Medical-Therapeutic Areas, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Steven M Paul
- School of Nursing, University of California San Francisco, California, San Francisco, USA
| | - Michael W Rabow
- School of Medicine, University of California San Francisco, California, San Francisco, USA
| | - Vicki L Plano Clark
- School of Education-Research Methods, University of Cincinnati, Cincinnati, Ohio, USA
| | - Karen L Schumacher
- School of Nursing, University of California San Francisco, California, San Francisco, USA
| | - Christine Miaskowski
- School of Nursing, University of California San Francisco, California, San Francisco, USA.
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Davies A, Leach C, Caponero R, Dickman A, Fuchs D, Paice J, Emmanuel A. MASCC recommendations on the management of constipation in patients with advanced cancer. Support Care Cancer 2019; 28:23-33. [DOI: 10.1007/s00520-019-05016-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/30/2019] [Indexed: 12/16/2022]
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Ahmed S, Choudhry Z, Bhatti JA. Impact of genetic polymorphisms on opioid misuse: a scoping review. Pharmacogenomics 2019; 20:685-703. [DOI: 10.2217/pgs-2018-0180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
We conducted a scoping review on genetic polymorphisms associated with opioid intake-related adverse patient outcomes including behavioral, physiological and clinical outcomes. We searched for studies on Medline®, EMBASE®, CINAHL®, Psychinfo® and SNPedia® from January 2006 to January 2018. Our study identified 33 genes and 71 SNPs associated with opioid-intake related adverse patient outcomes: four studies showing associations of nine SNPs with clinical events (e.g., arrhythmia, length of stay and deaths); six studies showing associations of 13 SNPs with respiratory depression and 25 studies showing associations of 50 SNPs with opioid misuse behaviors. Available pharmacogenetic-tests covered polymorphisms associated with opioids metabolism and ignored polymorphisms associated with opioids transport, receptor-binding and signaling that were linked with respiratory depression and misuse behaviors.
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Affiliation(s)
- Sanjida Ahmed
- Sunnybrook Research Institute, Evaluative Clinical Sciences, G1-06, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
| | - Zia Choudhry
- Sunnybrook Research Institute, Evaluative Clinical Sciences, G1-06, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
| | - Junaid A Bhatti
- Sunnybrook Research Institute, Evaluative Clinical Sciences, G1-06, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
- University of Toronto, Department of Surgery, 149 College Street, 5th Floor, Toronto, ON, M5T 1P5, Canada
- Institute for Clinical Evaluative Sciences, G1-06, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada
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Kaski SW, Brooks S, Wen S, Haut MW, Siderovski DP, Berry JH, Lander LR, Setola V. Four single nucleotide polymorphisms in genes involved in neuronal signaling are associated with Opioid Use Disorder in West Virginia. J Opioid Manag 2019; 15:103-109. [PMID: 31057342 DOI: 10.5055/jom.2019.0491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective Pilot study to assess utility in opioid use disorder (OUD) of a panel of single nucleotide polymorphisms in genes previously related to substance use disorder (SUD) and/or phenotypes that predispose individuals to OUD/SUD. Design Genetic association study. Setting West Virginia University's Chestnut Ridge Center Comprehensive Opioid Abuse Treatment (COAT) clinic for individuals diagnosed with OUD. Patients Sixty patients 18 years of age or older with OUD undergoing medication (buprenorphine/naloxone)-assisted treatment (MAT); all sixty patients recruited contributed samples for genetic analysis. Outcome Measures Minor allele frequencies for single nucleotide polymorphisms. Results Four of the fourteen single nucleotide polymorphisms examined were present at frequencies that are statistically significantly different than in a demographically-matched general population. Conclusions For the purposes of testing WV individuals via genetic means for predisposition to OUD, at least four single nucleotide polymorphisms in three genes are likely to have utility in predicting susceptibility. Additional studies with larger populations will need to be conducted to confirm these results before use in a clinical setting.
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Affiliation(s)
- Shane W Kaski
- Department of Physiology & Pharmacology, West Virginia University School of Medicine, Morgantown, WV
| | | | - Sijin Wen
- Department of Biostatistics, West Virginia University School of Public Health, Morgantown, WV
| | - Marc W Haut
- Department of Behavioral Medicine & Psychiatry, West Virginia University School of Medicine, Morgantown, WV
| | - David P Siderovski
- Department of Physiology & Pharmacology, West Virginia University School of Medicine, Morgantown, WV
| | - James H Berry
- Chestnut Ridge Center and Inpatient Acute Dual Diagnosis Program, West Virginia University School of Medicine, Morgantown, WV
| | - Laura R Lander
- West Virginia University School of Medicine, Morgantown, WV
| | - Vincent Setola
- Departments of Behavioral Medicine & Psychiatry, Neuroscience, and Physiology & Pharmacology, West Virginia University School of Medicine, Morgantown, WV
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15
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Sun LL, Jiang HB, Liu BY, Li WD, Du AL, Luo XQ, Li XQ. Effects of rhein on intestinal transmission, colonic electromyography and expression of aquaporin-3 by colonic epithelium cells in constipated mice. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2018; 11:614-623. [PMID: 31938147 PMCID: PMC6958053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 12/12/2017] [Indexed: 06/10/2023]
Abstract
Constipation is one of the most common gastrointestinal diseases in the world. This study was to investigate the effects of rhein on intestinal transmission and colonic electromyography and expression of aquaporin-3 (AQP3) in the colonic mucosa of mice with constipation. The mouse model of constipation was established using the compound diphenoxylate. The first defecation time, the number of stools in the initial 6 hours and the promoting rate of eosin were measured as the bowel transit function. The BL-420F system was used to compare changes in the myoelectrical signals in the colons of the mice. Immunohistochemical analysis was used to detect the expression of AQP3 in the colonic mucosa of mice. Rhein had an obvious effect on the first defecation time and the number of red stool in the initial 6 hours. The first defecation time is reduced, and the number of red stools in 6 hours and the promoting rate of the small intestine were significantly increased after the treatment of rhein. In the rhein group, the slow-wave frequency and slow-wave amplitude of colonic myoelectrical activity were increased, and the mean optical density of AQP3 in the colonic mucosa and the area of positive expression were decreased. In conclusion, rhein can improve motor function and colonic electromyography of constipation mice, and reduce expression of AQP3 in the colonic mucosa, thereby relieving the symptoms of constipation effectively.
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Affiliation(s)
- Li-Li Sun
- Department of Vascular Surgery, The Second Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Hong-Bo Jiang
- The Third Affiliated Hospital of Xinxiang Medical UniversityXinxiang, Henan, China
| | - Bo-Yu Liu
- The Third Affiliated Hospital of Xinxiang Medical UniversityXinxiang, Henan, China
| | - Wen-Dong Li
- Department of Vascular Surgery, The Second Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
| | - Ai-Lin Du
- Department of Physiology and Neurobiology, Xinxiang Medical UniversityXinxiang, Henan, China
| | - Xiao-Qiu Luo
- Department of Physiology and Neurobiology, Xinxiang Medical UniversityXinxiang, Henan, China
| | - Xiao-Qiang Li
- Department of Vascular Surgery, The Second Affiliated Hospital of Soochow UniversitySuzhou, Jiangsu, China
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16
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Lee KH, Kim TW, Kang JH, Kim JS, Ahn JS, Kim SY, Yun HJ, Eum YJ, Koh SA, Kim MK, Hong YS, Kim JE, Lee GW. Efficacy and safety of controlled-release oxycodone/naloxone versus controlled-release oxycodone in Korean patients with cancer-related pain: a randomized controlled trial. CHINESE JOURNAL OF CANCER 2017; 36:74. [PMID: 28893309 PMCID: PMC5594448 DOI: 10.1186/s40880-017-0241-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 09/01/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Controlled-release oxycodone/naloxone (OXN-CR) maintains the effect of opioid-induced analgesia through oxycodone while reducing the occurrence rate of opioid-induced constipation through naloxone. The present study was designed to assess the non-inferiority of OXN-CR to controlled-release oxycodone (OX-CR) for the control of cancer-related pain in Korean patients. METHODS In this randomized, open-labeled, parallel-group, phase IV study, we enrolled patients aged 20 years or older with moderate to severe cancer-related pain [numeric rating scale (NRS) pain score ≥4] from seven Korean oncology/hematology centers. Patients in the intention-to-treat (ITT) population were randomized (1:1) to OXN-CR or OX-CR groups. OXN-CR was administered starting at 20 mg/10 mg per day and up-titrated to a maximum of 80 mg/40 mg per day for 4 weeks, and OX-CR was administered starting at 20 mg/day and up-titrated to a maximum of 80 mg/day for 4 weeks. The primary efficacy endpoint was the change in NRS pain score from baseline to week 4, with non-inferiority margin of -1.5. Secondary endpoints included analgesic rescue medication intake, patient-reported change in bowel habits, laxative intake, quality of life (QoL), and safety assessments. RESULTS Of the ITT population comprising 128 patients, 7 with missing primary efficacy data and 4 who violated the eligibility criteria were excluded from the efficacy analysis. At week 4, the mean change in NRS pain scores was not significantly different between the OXN-CR group (n = 58) and the OX-CR group (n = 59) (-1.586 vs. -1.559, P = 0.948). The lower limit of the one-sided 95% confidence interval (-0.776 to 0.830) for the difference exceeded the non-inferiority margin (P < 0.001). The OXN-CR and OX-CR groups did not differ significantly in terms of analgesic rescue medication intake, change in bowel habits, laxative intake, QoL, and safety assessments. CONCLUSIONS OXN-CR was non-inferior to OX-CR in terms of pain reduction after 4 weeks of treatment and had a similar safety profile. Studies in larger populations of Korean patients with cancer-related pain are needed to further investigate the effectiveness of OXN-CR for long-term pain control and constipation alleviation. Trial registration ClinicalTrials.gov NCT01313780, registered March 8, 2011.
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Affiliation(s)
- Kyung-Hee Lee
- Department of Hematology-Oncology, Yeungnam University Medical Center, Daegu, 42415 South Korea
| | - Tae Won Kim
- Department of Oncology, Asan Medical Center, University of Ulsan, Seoul, 05505 South Korea
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul, 138-736 South Korea
| | - Jung-Hun Kang
- Department of Hematology-Oncology, Gyeongsang National University Hospital, Jinju, 52727 South Korea
| | - Jin-Soo Kim
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, 07061 South Korea
| | - Jin-Seok Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul, 06351 South Korea
| | - Sun-Young Kim
- Department of Hematology-Oncology, National Cancer Center, Ilsan, 10408 South Korea
| | - Hwan-Jung Yun
- Department of Hematology-Oncology, Chungnam National University Hospital, Daejeon, 35015 South Korea
| | - Young-Jun Eum
- Medical Affairs, Mundipharma Korea Ltd, Seoul, 04637 South Korea
| | - Sung Ae Koh
- Department of Hematology-Oncology, Yeungnam University Medical Center, Daegu, 42415 South Korea
| | - Min Kyoung Kim
- Department of Hematology-Oncology, Yeungnam University Medical Center, Daegu, 42415 South Korea
| | - Yong Sang Hong
- Department of Oncology, Asan Medical Center, University of Ulsan, Seoul, 05505 South Korea
| | - Jeong Eun Kim
- Department of Oncology, Asan Medical Center, University of Ulsan, Seoul, 05505 South Korea
| | - Gyeong-Won Lee
- Department of Hematology-Oncology, Gyeongsang National University Hospital, Jinju, 52727 South Korea
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17
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Matic M, Jongen JL, Elens L, de Wildt SN, Tibboel D, Sillevis Smitt PA, van Schaik RH. Advanced cancer pain: the search for genetic factors correlated with interindividual variability in opioid requirement. Pharmacogenomics 2017; 18:1133-1142. [PMID: 28745577 DOI: 10.2217/pgs-2017-0060] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To assess association between genetic variants and opioid requirement in cancer patients. MATERIALS & METHODS A prospective observational trial of 243 advanced cancer patients with inadequate analgesia treated by the palliative care team was analyzed for ABCB1, ARRB2, COMT, GCH1, IL1RN, KCNJ6, OPRM1, RHBDF2, SCN9A and Stat6 polymorphisms. RESULTS For patients carrying OPRM1 118AG/GG and COMT 472GG (Val158Val) or these genotypes alone, a significant higher median percentage dose increase was observed (95.2% [32.8-345]) compared with OPRM1 118AA and COMT 472GA/AA (158Met allele carriers; 48.5% [0-98.8]; p = 0.0016). No associations were found with morphine equivalent dose after consultation palliative care team or ketamine use. CONCLUSION Patients with the combined OPRM1 118AG/GG and COMT 472GG genotype required 50% higher dose increase for sufficient analgesia.
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Affiliation(s)
- Maja Matic
- Department of Clinical Chemistry, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Pediatric Surgery, Erasmus MC - University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Joost Lm Jongen
- Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Laure Elens
- Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.,Louvain Centre for Toxicology & Applied Pharmacology (LTAP), Institut de Recherche Expérimentale et clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Saskia N de Wildt
- Department of Pediatric Surgery, Erasmus MC - University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Pharmacology & Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick Tibboel
- Department of Pediatric Surgery, Erasmus MC - University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Peter Ae Sillevis Smitt
- Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ron Hn van Schaik
- Department of Clinical Chemistry, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
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18
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Skorpen F, von Hofacker S, Bjørngaard M, Skogholt AH, Dale O, Kaasa S, Klepstad P. The rare Arg181Cys mutation in the μ opioid receptor can abolish opioid responses. Acta Anaesthesiol Scand 2016; 60:1084-91. [PMID: 27113810 DOI: 10.1111/aas.12739] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/07/2016] [Accepted: 04/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Genetic variability contributes to variable clinical response to opioids. This study emerged from the observation of three Norwegian patients who showed no or extraordinary poor response to very high doses of opioids. We suspected a genetic defect and applied a 'most likely candidate gene' approach to investigate this possibility. METHODS DNA sequencing was used to search for mutations in coding regions of the OPRM1 gene, encoding the μ opioid receptor (hMOR), in one patient. The remaining two patients, and two cohorts comprising 2158 European cancer pain patients and 600 Norwegian healthy volunteers, respectively, were genotyped using a custom-made TaqMan SNP allelic discrimination assay. RESULTS DNA sequencing disclosed a homozygous, inactivating Arg181Cys mutation in hMOR in the patient who showed no effects from opioids. The two patients with poor effect from very high doses of opioids were both heterozygous for the mutation. Six heterozygous patients identified among the European cancer patients all used high doses of opioids and/or reported inferior effect on their pain. About one in every 100 Norwegians is heterozygous for the mutation. CONCLUSIONS The Arg181Cys mutation occurs at clinically relevant frequencies and produces a signaling dead hMOR which may abolish or significantly reduce opioid effects in affected individuals. Anesthesiologists and practitioners in pain medicine should be aware of this mutation as a possible explanation for inefficiency of opioids and consider genotyping in relevant cases. Individuals homozygous for the mutation may need a highly personalized approach to pain therapy.
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Affiliation(s)
- F. Skorpen
- Department of Laboratory Medicine; Children's and Women's Health; Faculty of Medicine; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- European Palliative Care Research Center; Faculty of Medicine; Norwegian University of Science and Technology (NTNU); Trondheim Norway
| | - S. von Hofacker
- Regional Centre of Excellence for Palliative Care, Western Norway; Haukeland University Hospital; Bergen Norway
- Sunniva Centre for Palliative Care; Haraldsplass Deaconess Hospital; Bergen Norway
| | - M. Bjørngaard
- Department of Anaesthesiology and Intensive Care Medicine; Volda Hospital; Volda Norway
| | - A. H. Skogholt
- Department of Laboratory Medicine; Children's and Women's Health; Faculty of Medicine; Norwegian University of Science and Technology (NTNU); Trondheim Norway
| | - O. Dale
- Department of Research and Innovation; St. Olav's University Hospital; Trondheim Norway
- Department of Circulation and Medical Imaging; Faculty of Medicine; Norwegian University of Science and Technology (NTNU); Trondheim Norway
| | - S. Kaasa
- European Palliative Care Research Center; Faculty of Medicine; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Oncology; St Olav's University Hospital; Trondheim Norway
| | - P. Klepstad
- Department of Circulation and Medical Imaging; Faculty of Medicine; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Anaesthesiology and Intensive Care Medicine; St Olav's University Hospital; Trondheim Norway
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19
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Oosten AW, Matic M, van Schaik RH, Look MP, Jongen JL, Mathijssen RH, van der Rijt CC. Opioid treatment failure in cancer patients: the role of clinical and genetic factors. Pharmacogenomics 2016; 17:1391-403. [PMID: 27472837 DOI: 10.2217/pgs-2016-0082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AIM To identify clinical and genetic factors associated with outcome of opioid treatment. PATIENTS & METHODS We performed an exploratory analysis in a cohort of 353 patients treated with fentanyl, morphine, oxycodone and/or hydromorphone for cancer-related pain, exploring selected clinical and pharmacogenetic factors for a correlation with treatment failure for all and per type of opioid. RESULTS Use of adjuvant pain medication, intensity of pain at rest and age were associated with treatment failure in the various cohorts. Only the genetic variants rs12948783 (RHBDF2) and rs7016778 (OPRK1) correlated statistically significant in univariate, but not in multivariable analysis. CONCLUSION Several clinical and genetic factors were identified that warrant further study to clarify their role and use in opioid treatment.
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Affiliation(s)
- Astrid W Oosten
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Maja Matic
- Department of Clinical Chemistry, Erasmus MC, Rotterdam, The Netherlands.,Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Ron H van Schaik
- Department of Clinical Chemistry, Erasmus MC, Rotterdam, The Netherlands
| | - Maxime P Look
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Joost L Jongen
- Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Ron H Mathijssen
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Carin C van der Rijt
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.,Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
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20
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Gervais C, Ducrotté P, Piche T, Di Palma M, Jovenin N, Scotté F. [Constipation and cancer: Current strategies]. Bull Cancer 2016; 103:794-804. [PMID: 27341746 DOI: 10.1016/j.bulcan.2016.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/17/2016] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
Abstract
Digestive disorders, in particular constipation, are symptoms very often reported by cancer patients as having a major impact on their quality of life. An accurate diagnosis of bowel delayed transit and defecation disorders is required to best adapt therapeutic management. Constipation associated with cancer may be related to several causes, which can be placed in three nosological categories that sometimes overlap: chronic constipation prior to cancer and having its own evolution; constipation related to the cancer condition, in particular the occlusive syndrome, and constipation induced by cancer therapies. The stricter application of diet and lifestyle measures is often necessary and sometimes sufficient. Laxative drug treatments come under various galenic forms and administration routes and must be selected according to the clinical features of constipation. Surgical management can be indicated in case of ileus or pelvic static disorders. In the case of refractory constipation induced by opioids and within the framework of palliative care to treat an advanced pathology, a peripheral morphinic antagonist can offer fast symptom relief. A way forward to improve the patients' quality of life could be to identify the contributing factors (in particular, genetic factors) to determine which patients are the more at risk and anticipate their management.
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Affiliation(s)
- Claire Gervais
- AP-HP, hôpital européen Georges-Pompidou, service d'oncologie médicale-unité fonctionnelle de soins de support, 20, rue Leblanc, 75015 Paris, France.
| | - Philippe Ducrotté
- CHU de Rouen, Inserm UMR 1073, hôpital Charles-Nicolle, service d'hépato-gastro-entérologie et nutrition, 1, rue de Germont, 76031 Rouen cedex, France
| | - Thierry Piche
- CHU de Nice, EA Inserm 6302, hôpital de l'Archet 2, service de gastro-entérologie et oncologie digestive, 151, route St-Antoine-de-Ginestière, CS 23079, 06202 Nice cedex 3, France
| | - Mario Di Palma
- Unicancer, Institut Gustave-Roussy, département ambulatoire, 114, rue Edouard-Vaillant, 94800 Villejuif cedex, France
| | - Nicolas Jovenin
- Unicancer, Institut Jean-Godinot, département d'oncologie médicale, 1, avenue du Général-Koenig, CS 80014, 51726 Reims cedex, France; Centre hospitalier de Saint-Dizier, cancérologie transversale, 1, rue Albert-Schweitzer, CS 10001, 52115 Saint-Dizier cedex, France; Clinique François I(er), service d'oncologie médicale, 12, rue François I(er), 52122 Saint-Dizier, France
| | - Florian Scotté
- AP-HP, hôpital européen Georges-Pompidou, service d'oncologie médicale-unité fonctionnelle de soins de support, 20, rue Leblanc, 75015 Paris, France
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22
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Klepstad P, Skorpen F. Genetic variability of pain - A patient focused end-point. Scand J Pain 2016; 10:13-14. [PMID: 28361764 DOI: 10.1016/j.sjpain.2015.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Pål Klepstad
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs Hospital, Department of Anaesthesiology and Intensive Care Medicine, Trondheim, Norway
| | - Frank Skorpen
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology (NTNU),Trondheim, Norway
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