From Individualized Treatment of Sickle Cell Pain to Precision Medicine: A 40-Year Journey

Samir K. Ballas

Abstract


In the 1970s, sickle cell pain was treated with trial and error approach by increasing or decreasing the dose of an opioid or switching from one analgesic to another. This approach was controversial with criticism and doubt about its usefulness. Since then, advances in determining the structure of opioid receptors and the role of the CYP450 enzymes in metabolizing opioids revealed that these anatomic and metabolic findings are not the same in all persons, thus explaining the variability in response to opioids among patients. Thus, thetrial and error approach has a scientific basis after all.




J Clin Med Res. 2016;8(5):357-360
doi: http://dx.doi.org/10.14740/jocmr2508w


Keywords


Sickle cell disease; Pain; Individualized treatment; Personalized medicine; Precision medicine

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