Genetic variations of morphine transporters: prevalence of polymorphisms of the ABCB1 gene among oncology patients of palliative profile

Khaitovich E.D., Shikh E.V., Ibragimov A.N., Gergel M.A., Borisov A.S., Kazakov R.E.

1) I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 2) Moscow Multidisciplinary Center for Palliative Care, Moscow Healthcare Department, Moscow, Russia; 3) Scientific Center for Expertise of Medical Products, Moscow, Russia

Objective: Assessment of the prevalence of clinically significant single nucleotide polymorphisms of the ABCB1 gene (rs1128503, rs2032582, rs1045642) in palliative cancer patients receiving morphine in order to substantiate the prospects of a pharmacogenetic approach to personalized analgesic therapy.
Materials and methods: The study included 86 patients with cancer in the palliative stage and receiving morphine, as well as 100 control patients without cancer. Genotyping of ABCB1 polymorphisms was performed using real-time polymerase chain reaction. The dynamics of pain syndrome was also assessed using a visual analog scale (VAS) at three stages of therapy.
Results: A high frequency of heterozygous CT variants for rs1128503 and rs1045642 polymorphisms was established. VAS analysis showed a decrease in pain syndrome from 8 to 2 points after the start of morphine therapy, which confirms its effectiveness.
Conclusion: ABCB1 gene polymorphisms may play a significant role in the variability of response to morphine in cancer patients. The obtained data emphasize the need for further research to develop personalized pain relief strategies taking into account genetic characteristics.

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About the Authors

E.D. Khaitovich, Postgraduate Student, Department of Clinical Pharmacology and Propaedeutics of Internal Medicine, Clinical Pharmacologist,
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; eukhad@gmail.com, ORCID: https://orcid.org/0000-0003-2629-9250 (corresponding author)
E.V. Shikh, Dr. Sci. (Med.), Professor, Corr. Member of the RAS, Head of the Department of Clinical Pharmacology and Propaedeutics of Internal Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; chih@mail.ru, ORCID: https://orcid.org/0000-0001-6589-7654
R.E. Kazakov, Cand. Sci. (Biol.), Leading Researcher, Moscow Multidisciplinary Center for Palliative Care, Moscow Healthcare Department, Moscow, Russia; ORCID: https://orcid.org/0000-0003-0802-4229
A.N. Ibragimov, Chief Physician, Moscow Multidisciplinary Center for Palliative Care, Moscow Healthcare Department, Moscow, Russia
M.A. Gergel, Palliative Care Physician, Scientific Center for Expertise of Medical Products, Moscow, Russia
A.S. Borisov, Palliative Care Physician, Moscow Multidisciplinary Center for Palliative Care, Moscow Healthcare Department, Moscow, Russia

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