{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:32:35Z","timestamp":1791905555416,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2004,10,25]],"date-time":"2004-10-25T00:00:00Z","timestamp":1098662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2004,11]]},"abstract":"<jats:p><jats:bold>Background:\u2002<\/jats:bold> Dispositions for genes encoding opioid receptors may explain some variability in morphine efficacy. Experimental studies show that morphine and morphine\u20106\u2010glucuronide are less effective in individuals carrying variant alleles caused by the 118\u2003A\u2003&gt;\u2003G polymorphism in the \u00b5\u2010opioid receptor gene (<jats:italic>OPRM1<\/jats:italic>). The purpose of the study was to investigate whether this and other genetic polymorphisms in <jats:italic>OPRM1<\/jats:italic> influence the efficacy of morphine in cancer pain patients.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> We screened 207 cancer pain patients on oral morphine treatment for four frequent <jats:italic>OPRM1<\/jats:italic> gene polymorphisms. The polymorphisms were the \u2212172 G\u2003&gt;\u2003T polymorphism in the 5\u2032untranslated region of exon 1, the 118\u2003A\u2003&gt;\u2003G polymorphism in exon 1, and the IVS2\u2003+\u200331 G\u2003&gt;\u2003A and IVS2\u2003+\u2003691 G\u2003&gt;\u2003C polymorphisms, both in intron 2. Ninety\u2010nine patients with adequately controlled pain were included in an analysis comparing morphine doses and serum concentrations of morphine and morphine metabolites in the different genotypes for the <jats:italic>OPRM1<\/jats:italic> polymorphisms.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> No differences related to the \u2212172 G\u2003&gt;\u2003T, the IVS2\u2003+\u200331 G\u2003&gt;\u2003A and the IVS2\u2003+\u2003691 G\u2003&gt;\u2003C polymorphisms were observed. Patients homozygous for the variant G allele of the 118\u2003A\u2003&gt;\u2003G polymorphism (n\u2003=\u20034) needed more morphine to achieve pain control, compared to heterozygous (n\u2003=\u200317) and homozygous wild\u2010type (n\u2003=\u200378) individuals. This difference was not explained by other factors such as duration of morphine treatment, performance status, time since diagnosis, time until death, or adverse symptoms.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Patients homozygous for the 118 G allele of the \u00b5\u2010opioid receptor need higher morphine doses to achieve pain control. Thus, genetic variation at the gene encoding the \u00b5\u2010opioid receptor contributes to variability in patients' responses to morphine.<\/jats:p>","DOI":"10.1111\/j.1399-6576.2004.00517.x","type":"journal-article","created":{"date-parts":[[2004,10,25]],"date-time":"2004-10-25T13:38:51Z","timestamp":1098711531000},"page":"1232-1239","source":"Crossref","is-referenced-by-count":330,"title":["The 118\u2003A\u2003&gt;\u2003G polymorphism in the human \u00b5\u2010opioid receptor gene may increase morphine requirements in patients with pain caused by malignant disease"],"prefix":"10.1111","volume":"48","author":[{"given":"P.","family":"Klepstad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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