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Int. J. Mol. Sci. 2018, 19(6), 1707; https://doi.org/10.3390/ijms19061707

The Role of Genetic Polymorphisms in Chronic Pain Patients

1
Department of Anesthesiology, Advocate Illinois Masonic Medical Center, 836 W. Wellington Ave. Suite 4815, Chicago, IL 60657, USA
2
Department of Anesthesiology, College of Medicine, University of Illinois, Chicago, IL 60612, USA
3
Department of Surgery, College of Medicine, University of Illinois, Chicago, IL 60612, USA
*
Author to whom correspondence should be addressed.
Received: 27 April 2018 / Revised: 23 May 2018 / Accepted: 1 June 2018 / Published: 8 June 2018
(This article belongs to the Special Issue Cytochromes P450: Drug Metabolism and Bioactivation)
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Abstract

It is estimated that the total annual financial cost for pain management in the U.S. exceeds 100 billion dollars. However, when indirect costs are included, such as functional disability and reduction in working hours, the cost can reach more than 300 billion dollars. In chronic pain patients, the role of pharmacogenetics is determined by genetic effects on various pain types, as well as the genetic effect on drug safety and efficacy. In this review article, we discuss genetic polymorphisms present in different types of chronic pain, such as fibromyalgia, low back pain, migraine, painful peripheral diabetic neuropathy and trigeminal neuralgia. Furthermore, we discuss the role of CYP450 enzymes involved in metabolism of drugs, which have been used for treatment of chronic pain (amitriptyline, duloxetine, opioids, etc.). We also discuss how pharmacogenetics can be applied towards improving drug efficacy, shortening the time required to achieve therapeutic outcomes, reducing risks of side effects, and reducing medical costs and reliance upon polypharmacy. View Full-Text
Keywords: genetic polymorphisms; chronic pain; low back pain; fibromyalgia; migraine; neuropathic pain; pain medications genetic polymorphisms; chronic pain; low back pain; fibromyalgia; migraine; neuropathic pain; pain medications
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Knezevic, N.N.; Tverdohleb, T.; Knezevic, I.; Candido, K.D. The Role of Genetic Polymorphisms in Chronic Pain Patients. Int. J. Mol. Sci. 2018, 19, 1707.

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