Relationship between CYP2B6*6 and cold pressor pain sensitivity in opioid dependent patients on methadone maintenance therapy (MMT).

Abstract

BACKGROUND:

CYP2B6 polymorphisms contribute to inter-individual variations in pharmacokinetics of methadone. Increased pain sensitivity is frequently reported by opioid dependent patients on methadone maintenance therapy (MMT). It is possible, therefore, that genetic polymorphisms in CYP2B6, which affects the metabolism of methadone, influence pain sensitivity among patients on MMT. This study investigated CYP2B6 polymorphisms and pain sensitivity in this group.

METHODS:

The cold pressor pain responses of 148 opioid dependent patients receiving MMT were evaluated using the cold pressor test (CPT). DNA was extracted from whole blood and subjected to polymerase chain reaction (PCR)-genotyping.

RESULTS:

Of the 148 subjects, 77 (52.0%) were carriers of CYP2B6*6 allele. CYP2B6*6 allele carriers had shorter cold pain threshold and pain tolerance times than non-carriers of CYP2B6*6 allele (21.05s vs 33.69s, p=0.036 and 27.15s vs 44.51s, p=0.020, respectively). Pain intensity scores of the CYP2B6*6 allele carriers was 67.55, whereas that of the CYP2B6*6 allele non-carriers was 64.86 (p=0.352).

CONCLUSION:

Our study indicates that the CYP2B6*6 allele is associated with a lower pain threshold and lower pain tolerance among males with opioid dependence on MMT. The CYP2B6*6 allele may provide a mechanistic explanation for clinical observations of heightened pain sensitivity among opioid dependent patients receiving MMT.

• Authors: Zalina Zahari, Chee Siong Lee, Muslih Abdulkarim Ibrahim, Nurfadhlina Musa, Mohd Azhar Mohd Yasin, Yeong Yeh Lee, Soo Choon Tan, Nasir Mohamad, Rusli Ismail
• Journal: Drug and alcohol dependence (Drug Alcohol Depend) Vol. 165 Pg. 143-50 (Aug 01 2016) ISSN: 1879-0046 [Electronic] Ireland
• PMID: 27289271 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Analgesics, Opioid
• Cytochrome P-450 CYP2B6
• Methadone

Topics

• Adult
• Alleles
• Analgesics, Opioid (therapeutic use)
• Cytochrome P-450 CYP2B6 (genetics)
• Genotype
• Heterozygote
• Humans
• Male
• Methadone (blood, pharmacokinetics, therapeutic use)
• Opiate Substitution Treatment
• Opioid-Related Disorders (drug therapy)
• Pain (drug therapy, genetics)
• Pain Threshold (drug effects)
• Polymorphism, Genetic