OPRMl基因之多樣性與臨床疼痛治療

Genetic Polymorphisms of OPRMl are Attractive to Clinical Pain Therapy

嗎啡類藥物產生疼痛控制、成癮等藥理學作用的途逕，主要是經過三種不同的嗎啡受體，其中包括mu－嗎啡受體（MOR）。OPRMl基因是已知製造三種mu－嗎啡受體之一的MOR-1的基因，位於染色體6q上，有250kb大。OPRMl基因在人類族群中之多樣性相當顯著，其中最常見的All8G單基因多樣性（SNP）與相當多的臨床變化有關。為了推動對於此一SNP的相關研究，我們針對這一變異點的近期重要發現，做了這篇深入的綜論。結論是：這是一個值得多加研究的主題，在配合發展出快速基因篩檢的方法後，有相當潛力成為應用藥物基因學於臨床疼痛治療的與範。

Pharmacological actions of the opioid system which controls pain, reward and addictive behaviors are through three opioid receptors, including mu-opioid receptors (MORs). The OPRMl encoding MOR-1, one of three known variants of the MORs, spans over 250 kb on chromosome 6q. Genetic polymorphisms of OPRMl are practically diverse across human races and an All 8G transition, the most prevalent single nucleotide polymorphism (SNP) in OPRMl, is associated with many clinical findings. To promote further investigation of an association of OPRMl mutations with altered opioid effects, we progressively reviewed advanced reports for its polymorphisms within recent years. In conclusion, with the current information available, the addition of more OPRM l polymorphisms in the context of ethnic differences should be investigated. New and easy detection methods for SNPs of OPRMl are helpful for rapid high-throughput scanning. It appears that the development of pharmacogenetically guided pain therapy will be more obvious when the complete and clear OPRMl genotype addresses.