| Project/Area Number |
20K17795
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 55050:Anesthesiology-related
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| Research Institution | Showa University |
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Principal Investigator |
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| Project Period (FY) |
2020-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2021: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Fiscal Year 2020: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | がん性疼痛 / オピオイド鎮痛薬 / リスク因子 / 遺伝多型 / オピオイド性鎮痛薬 / がん疼痛緩 / 遺伝子多型 |
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| Outline of Research at the Start |
初年度は，ヒストリカルコホート研究により，がん性疼痛患者のオピオイド抵抗性に関するリスク因子を調査する．次年度は，前向きのコホート研究により，がん性疼痛と診断された患者の遺伝的要因，環境要因，社会的要因を調査し，オピオイド抵抗性への寄与を明らかにする．
さらに，2つのコホート研究で抽出したリスク因子のパス図を作成し，因子間の相互関連性を明らかにする．因子間の相互関連性から，オピオイド抵抗性に関する予測式を作成し，オピオイドの導入前に患者個別の反応性を検証することで，がん性疼痛治療の個別化の推進を目指す．
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| Outline of Final Research Achievements |
In opioid therapy for cancer pain, there are individual differences in responsiveness, and the effects of various patient-specific factors and genetic polymorphisms have been reported.We attempted to evaluate the combined effects of these factors and developed a predictive model to identify responsiveness at the time of opioid initiation.The effects of various factors were examined, and it was suggested that age, neuropathic pain, and alkaline phosphatase independently affected opioid resistance, and a prediction model was constructed based on these factors.The effects of various factors were evaluated, and age, neuropathic pain, and alkaline phosphatase were indicated to be factors that independently contribute to opioid resistance, and a predictive model was made from these factors.The negative predictive value for opioid response in the low-risk group was 91.6%, suggesting that opioid responsiveness can be predicted with high accuracy before opioid administration.
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| Academic Significance and Societal Importance of the Research Achievements |
がん性疼痛に対するオピオイド治療の反応性については，各種の因子の影響の検証が試みられているが，因子個々の影響の評価にとどまり，実際に投与前に患者を判別するための臨床応用までには至っていない．本研究では，それらの因子を統合的に検証し，臨床で実用可能なリスクモデルの構築に至った．本モデルは臨床で簡便に測定可能な因子から構築されたモデルであり，高い予測精度が期待されることから，投与前に本モデルを用いて反応性を予測することで，患者個々の除痛効果の改善および，オピオイドの適正使用の一助とし得ると思われる．
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