Ağrı ve Genetik
Özet
Nüfusun %20'sin de akut veya kronik tedavi girişimlerine rağmen ağrı tedavisinde istenilen düzeye ulaşılamamaktadır. Ağrının patofizyolojisi, tedavilerin etkinlikleri, güvenilirlikleri ile ilgili çalışmalar devam etmektedir. Son yıllarda genetik alanda ağrı ve genetik bağlantı analizi ile ilişkili çalışmalar devam etmektedir. Ağrı üzerine genetik çalışmalarda özellikle ikiz çalışmaları önemli yer tutmaktadır. Monozigot ve dizigot ikizlerdeki çalışmalar ile hayvan deneyleri üzerindeki çalışmalar ağrı ile genetik arasındaki bağlantının tespitinde önemli yere sahiptir. Migren, kas iskelet sistem ağrıları, nöropatik ve visseral ağrıların genetik ile ilişkileri ispatlanmıştır. Opioidlerin analjezik etkinliklerine catechol-O-methyltransferase (COMT) geninin etkisi sonucu opioid dozu ve analjezik etki arasındaki ilişki ön plana çıkmaktadır. İleride özellikle farmakogenetik çalışmalar sayesinde kişiye özel tedavi ile uygun analjeziklerin, uygun dozda ve uygun pozolojide verilmesi mümkün olabilecektir.
Pain, which affects 20% of the population, cannot reach the desired level despite acute or chronic treatment attempts. Studies on the pathophysiology of pain, the effectiveness and reliability of treatments are ongoing. In recent years, studies in the field of genetics, genetic linkage analysis, genes and related studies have been ongoing. Twin studies are especially important in genetic studies on pain. Studies on monozygotic and dizygotic twins and animal experiments have an important place in determining the connection between pain and genetics. Genetic relationships with migraine, musculoskeletal pain, neuropathic and visceral pain have been proven. The relationship between opioid dose and analgesic effect comes to the forefront as a result of the analgesic activities of opioids and the effect of the catechol O methyl transferase (COMT) gene. Especially with pharmacogenetic studies, personalized treatment and appropriate analgesic administration at appropriate doses and appropriate dosages will be possible in the future.
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