ABSTRACT
Pharmacogenetics, the genetic influence on the interpersonal variability in drug response, has enabled tailored pharmacotherapy and emerging 'personalized medicine.' Although oncology spearheaded the clinical implementation of personalized medicine, other specialties are rapidly catching up. In anesthesia, classical examples of genetically mediated idiosyncratic reactions have been long known (e.g., malignant hyperthermia and prolonged apnea after succinylcholine). The last two decades have witnessed an expanding body of pharmacogenetic evidence in anesthesia. This review highlights some of the prominent pharmacogenetic associations studied in anesthesia and pain management, with special focus on pediatric anesthesia.
Subject(s)
Anesthesia/methods , Pain Management/methods , Pain/drug therapy , Succinylcholine/therapeutic use , Anesthesiology/trends , Apnea/chemically induced , Apnea/genetics , Apnea/pathology , Child , Child, Preschool , Humans , Malignant Hyperthermia/etiology , Malignant Hyperthermia/genetics , Malignant Hyperthermia/pathology , Pain/genetics , Pain/pathology , Pediatrics , Precision Medicine , Succinylcholine/adverse effectsABSTRACT
Epigenetic mechanisms are increasingly implicated in chronic pain pathology. In this study, we demonstrate that the novel epigenetic mark 5-hydroxymethylcytosine (5hmC) is present in dorsal root ganglia (DRG) neurons and glia, and its levels increase following nerve injury. Furthermore, we show that the 5hmC-generating Ten-eleven translocation 1-3 (TET1-3) proteins are expressed in a cell-type specific manner in the DRG, with Tet3 displaying differential upregulation after injury, suggesting a potential role in neuropathic pain.
