Opioid response in paediatric cancer patients and the Val158Met polymorphism of the human catechol-O-methyltransferase (COMT) gene: An Italian study on 87 cancer children and a systematic review
| Autor: | Alessandra Pugi, Sabrina Giglio, Giada Crescioli, Alessandro Mugelli, Niccolò Lombardi, Ersilia Lucenteforte, Roberto Barale, Laura Giunti, Laura Vagnoli, Andrea Messeri, Maria Luisa Coniglio, Maurizio Aricò, Valentina Maggini, Lisa Giovannelli, Alfredo Vannacci, Roberto Bonaiuti, Valentina Cetica |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Oncology Male Cancer Research Cohort Studies 0302 clinical medicine Surgical oncology Medicine Cancer pain Child Children Pain Measurement Morphine lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Analgesics Opioid Italy 030220 oncology & carcinogenesis Child Preschool Cohort Genetic polymorphisms Opioid Systematic review Female rs4680 medicine.drug Research Article medicine.medical_specialty Adolescent Genotype Catechol O-Methyltransferase Polymorphism Single Nucleotide lcsh:RC254-282 03 medical and health sciences Internal medicine Genetics Humans Allele Catechol-O-methyl transferase Dose-Response Relationship Drug business.industry Infant Newborn Infant 030104 developmental biology business |
| Zdroj: | BMC Cancer, Vol 19, Iss 1, Pp 1-14 (2019) BMC Cancer |
| Popis: | Background Genetic polymorphisms in genes involved in pain modulation have been reported to be associated to opioid efficacy and safety in different clinical settings. Methods The association between COMT Val158Met polymorphism (rs4680) and the inter-individual differences in the response to opioid analgesic therapy was investigated in a cohort of 87 Italian paediatric patients receiving opioids for cancer pain (STOP Pain study). Furthermore, a systematic review of the association between opioid response in cancer patients and the COMT polymorphism was performed in accordance with the Cochrane Handbook and the Prisma Statement. Results In the 87 paediatric patients, pain intensity (total time needed to reach the lowest possible level) was significantly higher for G/G than A/G and A/A carriers (p-value = 0.042). In the 60 patients treated only with morphine, the mean of total dose to reach the same pain intensity was significantly higher for G/G than A/G and A/A carriers (p-value = 0.010). Systematic review identified five studies on adults, reporting that opioid dose (mg after 24 h of treatment from the first pain measurement) was higher for G/G compared to A/G and A/A carriers. Conclusions Present research suggests that the A allele in COMT polymorphism could be a marker of opioid sensitivity in paediatric cancer patients (STOP Pain), as well as in adults (Systematic Review), indicating that the polymorphism impact could be not age-dependent in the cancer pain context. Trial registration Registration number: CRD42017057831. Electronic supplementary material The online version of this article (10.1186/s12885-019-5310-4) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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