Personalized Pain Therapy : Is the answer in the genes?
Individuele pijnbehandeling : Zijn de genen het antwoord?
The experience of pain is very subjective and multidimensional, displaying substantial variability between individuals even when exposed to an identical pain-evoking stimulus. Differences in gender, age, ethnicity and anxiety level are among the known factors that contribute to this interindividual variability in the experience of pain. In the present setting, with the exception of age, neither the choice of analgesics nor the doses selected are based on these factors. In the recent years, genetic variation in genes involved in the disposition of analgesics as well as genes responsible for the analgesic effect itself has been suggested to play an important role in variation in response. An overview with the most potential candidate polymorphisms for application in clinical practice is provided in this thesis. The role of candidate genes is validated in adult postoperative and cancer cohorts. As opposite to adults, data on the relevance of PGx for pain treatment in the pediatric population is limited. Since found genotype-phenotype associations are not directly translatable to (the youngest) children due to the influence of developmental changes on the phenotypic activity, also this research is presented.
|Keywords||Pharmacogenetics, pain, opioid, adult, children, newborn, cancer, post-operative, experimental, thermal, morphine, tramadol|
|Promotor||R.H.N. van Schaik (Ron) , D. Tibboel (Dick) , S.N. de Wildt (Saskia)|
|Publisher||Erasmus University Rotterdam|
|Note||For copyright reasons there is a (partial) embargo on this dissertation|
Matić, M. (2017, June 27). Personalized Pain Therapy : Is the answer in the genes?. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/100319