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Polymorphism in the interleukin-1 receptor antagonist gene is associated with serum interleukin-1 receptor antagonist concentrations and postoperative opioid consumption
Journal article   Open access   Peer reviewed

Polymorphism in the interleukin-1 receptor antagonist gene is associated with serum interleukin-1 receptor antagonist concentrations and postoperative opioid consumption

Keith A Candiotti, Zongqi Yang, Richard Morris, Jinfeng Yang, Nicolas A Crescimone, Greys C Sanchez, Vincent Bird, Raymond Leveillee, Yiliam Rodriguez, Huanliang Liu, …
Anesthesiology (Philadelphia), v 114(5), pp 1162-1168
May 2011
DOI: https://doi.org/10.1097/ALN.0b013e318216e9cb
PMID: 21455057
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1097/aln.0b013e318216e9cbView
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open
url
https://doi.org/10.1097/ALN.0b013e318216e9cbView
Published, Version of Record (VoR) Open

Abstract

Analgesics, Opioid - administration & dosage Analgesics, Opioid - therapeutic use Female Follow-Up Studies Humans Interleukin 1 Receptor Antagonist Protein - blood Interleukin 1 Receptor Antagonist Protein - genetics Male Middle Aged Morphine - administration & dosage Morphine - therapeutic use Nephrectomy Pain Measurement Pain, Postoperative - drug therapy Pain, Postoperative - genetics Polymerase Chain Reaction Polymorphism, Genetic - genetics Postoperative Period
The interleukin-1 receptor antagonist (IL-1Ra) is the principal determinant of IL-1β bioactivity within the IL-1 gene cluster, regulating IL-1α and IL-1β release. This study was designed to determine whether polymorphisms of the IL-1Ra gene (IL1RN) produce clinically measurable differences in serum IL-1Ra concentrations and opioid consumption in the postoperative period. Opioid consumption and pain scores were evaluated in 96 patients undergoing a nephrectomy. DNA was extracted from all patients, and the genotypes of IL1RN were determined by polymerase chain reaction amplification of the variable number of tandem repeats of 86 base pairs in intron 2 of IL1RN. The concentrations of serum IL-1Ra concentrations at baseline and at 24 h postoperatively in 58 subjects were measured. Differences in opioid consumption among the three genotype groups (IL1RN*1 homozygotes and *2 and *3 carriers) were statistically significant in the first and second 12-h postoperative periods (P = 0.010). The IL1RN*2 carrier group consumed 43% (95% CI, 38-48%) less opioids in the first 24 h after surgery than the IL1RN*1 homozygote group (P = 0.003). Differences in the serum IL-1Ra concentration among the three genotype groups were statistically significant at 24 h postoperatively (P = 0.003), with IL1RN*2 carriers having the highest serum IL-1Ra concentrations. The variable number of tandem repeats in intron 2 of IL1RN may contribute to interindividual variations in opioid consumption in the first 24 h after surgery. Patients homozygous for the IL1RN*1 allele have lower concentrations of IL-1Ra and require higher doses of opioids postoperatively than patients carrying at least one IL1RN*2 allele.

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Anesthesiology
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