101. Opioid Receptor Polymorphism A118G Associated with Clinical Severity in a Drug Overdose Population
- Author
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Manini, AF, Jacobs, MM, Vlahov, D, and Hurd, YL
- Subjects
Pharmacology and Pharmaceutical Sciences ,Biomedical and Clinical Sciences ,Clinical Research ,Brain Disorders ,Substance Misuse ,Pain Research ,Drug Abuse (NIDA only) ,Genetics ,2.1 Biological and endogenous factors ,Aetiology ,Good Health and Well Being ,Adult ,Alternative Splicing ,Amino Acid Substitution ,Benzodiazepines ,Cohort Studies ,Drug Overdose ,Female ,Follow-Up Studies ,Genetic Association Studies ,Genetic Predisposition to Disease ,Heart Arrest ,Humans ,Male ,Narcotics ,Pilot Projects ,Polymorphism ,Single Nucleotide ,Prospective Studies ,Receptors ,Opioid ,mu ,Respiratory Insufficiency ,Severity of Illness Index ,Sympathomimetics ,United States ,Opioid receptor ,Polymorphism ,Overdose ,Addiction ,Cardiac arrest ,Clinical Sciences ,Clinical sciences ,Pharmacology and pharmaceutical sciences - Abstract
Genetic variations in the human mu-opioid receptor gene (OPRM1) mediate individual differences in response to pain and opiate addiction. We studied whether the common A118G (rs1799971) mu-opioid receptor single nucleotide polymorphism (SNP) was associated with overdose severity in humans. In addition, we examined an SNP responsible for alternative splicing of OPRM1 (rs2075572). We assessed allele frequencies of the above SNPs and associations with clinical severity in patients presenting to the emergency department (ED) with acute drug overdose. This work was designed as an observational cohort study over a 12-month period at an urban teaching hospital. Participants consisted of consecutive adult ED patients with suspected acute drug overdose for whom discarded blood samples were available for analysis. Specimens were linked with clinical variables (demographics, urine toxicology screens, clinical outcomes) then deidentified prior to genetic SNP analysis. Blinded genotyping was performed after standard DNA purification and whole genome amplification. In-hospital severe outcomes were defined as either respiratory arrest (RA; defined by mechanical ventilation) or cardiac arrest (CA; defined by loss of pulse). We analyzed 179 patients (61% male, median age 32) who overall suffered 15 RAs and four CAs, of whom three died. The 118G allele conferred 5.3-fold increased odds of CA/RA (p
- Published
- 2013