1. A review of possible biomarkers for opioid tolerance.
- Author
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Brandt, Helene Buchardt, Sinning, Steffen, Hasselstrøm, Jørgen Bo, and Andersen, Charlotte Uggerhøj
- Subjects
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BIOMARKERS , *OPIOID abuse , *AUTOPSY , *METHYLATION , *PUROMYCIN - Abstract
Knowledge of opioid tolerance in a deceased person is important for distinguishing between therapeutic and toxic opioid concentrations for that particular individual when interpreting postmortem toxicological results. However, no biomarkers for opioid tolerance are currently available. This review aimed to study the existing literature on mechanisms or changes in signaling pathways related to chronic opioid use, which could be relevant for further studies to identify biomarkers for opioid tolerance. We performed a systematic literature search using the PRISMA 2020 guidelines using the MeSH terms "opioid tolerance AND biomarkers" in PubMed, Embase, WebofScience, and the Cochrane library. A review of the search results yielded seven studies on animal models or humans, identifying and evaluating thirteen possible biomarkers in terms of specificity for changes induced by opioids and other aspects to be considered as potential biomarkers. We evaluated nine potential biomarkers as unlikely to be specific for opioid tolerance, and one had contradictory results in terms of upregulation or downregulation. However, methylation of the promoter region of the μ-opioid receptor gene, increased activity of soluble puromycin-sensitive aminopeptidase, altered miRNA profile, or other multiple component profiling may be interesting to study further as biomarkers for opioid tolerance in forensic postmortem cases. • Biomarkers for opioid tolerance could assist interpretation of postmortem opioid concentrations. • Through a thorough literature review we identified several possible biomarkers. • The majority of identified biomarkers were most likely not specific for opioid tolerance. • Methylation of the μ-opioid receptor gene and activity of soluble puromycin-sensitive aminopeptidase may be interesting. • Altered miRNA profile, or other multiple component profiling may be interesting to study further as well. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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