Genetics and opioids: new data gives insight into opioid analgesia

Pl Klepstad

Vol 3, No 2 (2004): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2004-04-09

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Genetics and opioids: new data gives insight into opioid analgesia

Pl Klepstad

Advances in Palliative Medicine 2004;3(2):91-100.

Vol 3, No 2 (2004): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2004-04-09

Abstract

The doses of opioids needed for pain relief vary between individuals. This individual variability of opioid efficacy suggests that the patient’s genetic disposition influences the response to opioids. Given the complexity of morphine pharmacology, variability may be caused by several genes. Candidate genes are those related to morphine pharmacokinetics, to mu-opioid receptors and to the BBB transport of morphine through multidrug resistance transporters. Genes related to biological systems modifying opioid analgesia may also alter the efficacy of morphine. This short review presents results from some selected studies which investigate the relationship between opioid pharmacology and genetics with the emphasis on studies in volunteers or patients receiving morphine. The results obtained so far strongly argue that opioid efficacy is partly related to inborn properties caused by genetic variability related to opioid metabolism, opioid receptors and opioid transporters.