MỐI LIÊN QUAN GIỮA ĐA HÌNH ĐƠN GEN ABCB1 VỚI LIỀU ĐIỀU TRỊ METHADONE THAY THẾ Ở BỆNH NHÂN NGHIỆN CHẤT DẠNG THUỐC PHIỆN

Abstract

Methadone is an opioid pain reliever used to treat patients with opioid addiction. However, It is difficult to determine the dose of methadone because of the large variability in response to treatment among individuals. Methadone is transported into cells through the P-glycoprotein (P-pg) protein, which is encoded by the ABCB1 (MRD1) gene. In many studies show that this gene was a highly polymorphic with many genetic variations. These genetic variants were important role in the expression of P-glycoprotein so as affected to methadone metabolism. Objective: This study was performed to identify single nucleotide polymorphisms 1236C>T (dbSNP rs1128503), 2677G>T/A (dbSNP rs2032582), and 3435C>T (dbSNP rs1045642) of the ABCB1 gene in patients with substance abuse opiates for methadone replacement therapy and to assess the relationship with baseline dose. Material and methods: 400 opiate-addicted patients receiving methadone treatment were identified for single nucleotide polymorphisms by Sanger gene sequencing. Results: The individuals carrying the T variant of the single nucleotide polymorphism 3435C>T (dbSNP rs1045642) has methadon dose higher 1,556 times more than individuals without this variant (dbSNP rs1045642) in group which received methadone dose ≥ 90 mg/day (OR: 1,556, p=0.032). Conclusion: There is an association between the ABCB1 gene variant and the dose of methadone replacement therapy. Genotyping of the ABCB1 gene in opiate-addicted patients receiving methadone replacement therapy may help individualize treatment.