Encyclopedia
Prescription opioids are used for some chronic pain conditions. However, generally, long-term therapy has unwanted side effects which may trigger addiction, overdose, and eventually cause deaths. Opioid addiction and chronic pain conditions have both been associated with evidence of genetic and epigenetic alterations. Despite intense research interest, many questions about the contribution of epigenetic changes to this typology of addiction vulnerability and development remain unanswered. The aim of this review was to summarize the epigenetic modifications detected in specific tissues or brain areas and associated with opioid prescription and misuse in patients who have initiated prescribed opioid management for chronic non-cancer pain. The review considers the effects of opioid exposure on the epigenome in central and peripheral tissues in animal models and human subjects and highlights the mechanisms in which opioid epigenetics may be involved. This will improve our current understanding, provide the basis for targeted, personalized pain management, and thus balance opioid risks and benefits in managing chronic pain.
- epigenetics
- prescription opioids
- pain
- Prescription opioids are used for some chronic pain conditions. However, generally, long-term therapy has unwanted side effects which may trigger addiction, overdose, and eventually cause deaths. Opioid addiction and chronic pain conditions have both been associated with evidence of genetic and epigenetic alterations.
- The present review summarizes the epigenetic factors that are associated with prescription opioids used for pain (Tables 1, 2, 3 and Figures 1 and 2 at [1]).
- Among the potential biomarkers/therapeutic targets identified, of special interest is the histone methyltransferase G9a, the role of which should be explored in detail.
- The studies conducted in humans are insufficient for the purpose of biomarker identification and the underlying epigenetics remains poorly understood. From these studies, the first evidence of the causal relationship between therapeutic opioid administration and epigenetic changes was revealed and research should further explore the temporal dynamics of these modifications in response to both prescription opioids administration and pain.
- Exploring these pathways could reveal the molecular mechanisms and potential therapeutic targets for preventing chronic pain and addiction.
This entry is adapted from the peer-reviewed paper 10.3390/genes12081226
References
- Gerra MC, Dallabona C, Arendt-Nielsen L. Epigenetic Alterations in Prescription Opioid Misuse: New Strategies for Precision Pain Management. Genes (Basel). 2021 Aug 10;12(8):1226. doi: 10.3390/genes12081226. PMID: 34440400; PMCID: PMC8392465.
