Pedro López-Morales1,2, Diego Flores-Funes3,4,5,6, Elena González Sánchez-Migallón1,2,7, Ramón José Lirón-Ruiz1,2,7, José Luis Aguayo-Albasini1,2,8. 1. Faculty of Medicine, IMIB-Arrixaca, "Mare Nostrum" International Excellence Campus, University of Murcia, Murcia, Spain. 2. Department of Surgery, Morales Meseguer General University Hospital, Murcia, Spain. 3. Faculty of Medicine, IMIB-Arrixaca, "Mare Nostrum" International Excellence Campus, University of Murcia, Murcia, Spain. diego.ff90@gmail.com. 4. Department of Surgery, Morales Meseguer General University Hospital, Murcia, Spain. diego.ff90@gmail.com. 5. Department of General and Digestive Surgery, Morales Meseguer General University Hospital, Murcia, Spain. diego.ff90@gmail.com. 6. Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario Morales Meseguer, Avenida Marqués de los Vélez, S/N, 30008, Murcia, Spain. diego.ff90@gmail.com. 7. Department of General and Digestive Surgery, Morales Meseguer General University Hospital, Murcia, Spain. 8. General and Digestive Department, Morales Meseguer General University Hospital, Murcia, Spain.
Abstract
BACKGROUND: In previous studies, there seems to be a relationship between different genetic polymorphisms and postoperative nausea and vomiting (PONV). We perform a systematic review of the current literature about the relationship between genetic polymorphisms and the presence of PONV. METHODS: Two bibliographic searches were carried out in three databases (PubMed, Web of Science, and Scopus) of studies, preferably prospective, about PONV following abdominal surgery. It was completed with a backward citation searching. A total of 73 articles were found of which 6 were selected after their critical lecture using CASPe network criteria. Relative frequency and relative risk were taken in each study according to the polymorphism. RESULTS: Studies about 5-HT3B gene receptor polymorphisms, ABCB1 transporter, and dopamine D2 receptor showed a significant association with the presence of PONV (p = 0.02, 0.01, and 0.034 respectively). In relation to cytochrome P-450 2D6 (CYP2D6) polymorphisms, two of the three analysed articles showed a significant association with postoperative vomiting (p = 0.007). CONCLUSION: Genetic polymorphisms could play an important role in PONV. The AAG deletion in both alleles of the 5-HT3B receptor gene, the Taq IA polymorphism of the dopamine D2 receptor, and the presence of three or more functional alleles of CYP2D6 seem to be related with a higher incidence of PONV, especially in the first 24 h after surgery. The 2677TT and 3435TT genotypes of the ABCB1 transporter could reduce the PONV due to their association with a greater effectiveness of ondansetron. However, new quality studies are needed to consider this relationship.
BACKGROUND: In previous studies, there seems to be a relationship between different genetic polymorphisms and postoperative nausea and vomiting (PONV). We perform a systematic review of the current literature about the relationship between genetic polymorphisms and the presence of PONV. METHODS: Two bibliographic searches were carried out in three databases (PubMed, Web of Science, and Scopus) of studies, preferably prospective, about PONV following abdominal surgery. It was completed with a backward citation searching. A total of 73 articles were found of which 6 were selected after their critical lecture using CASPe network criteria. Relative frequency and relative risk were taken in each study according to the polymorphism. RESULTS: Studies about 5-HT3B gene receptor polymorphisms, ABCB1 transporter, and dopamine D2 receptor showed a significant association with the presence of PONV (p = 0.02, 0.01, and 0.034 respectively). In relation to cytochrome P-450 2D6 (CYP2D6) polymorphisms, two of the three analysed articles showed a significant association with postoperative vomiting (p = 0.007). CONCLUSION: Genetic polymorphisms could play an important role in PONV. The AAG deletion in both alleles of the 5-HT3B receptor gene, the Taq IA polymorphism of the dopamine D2 receptor, and the presence of three or more functional alleles of CYP2D6 seem to be related with a higher incidence of PONV, especially in the first 24 h after surgery. The 2677TT and 3435TT genotypes of the ABCB1 transporter could reduce the PONV due to their association with a greater effectiveness of ondansetron. However, new quality studies are needed to consider this relationship.
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