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AMBULATORY ANESTHESIOLOGY

Do Variations in the 5-HT_3A and 5-HT_3B Serotonin Receptor Genes (HTR3A and HTR3B) Influence the Occurrence of Postoperative Vomiting?

From the Department of Anesthesiology and Intensive Care Medicine, Medical Faculty, University of Leipzig, Leipzig, Germany.

Address correspondence and reprint requests to Dr. Henrik Rueffert, Department of Anesthesiology and Intensive Care Medicine, University Hospital of Leipzig, Liebigstr. 20, D-04103 Leipzig, Germany. Address e-mail to henrik.rueffert{at}medizin.uni-leipzig.de.

Abstract

BACKGROUND: Postoperative nausea and vomiting are unpleasant side effects of general anesthesia. Besides known risk factors (female gender, nonsmoker, history, and opioids), a genetic influence of the serotonin receptor system on the development of nausea and vomiting has repeatedly been proposed. In this pilot study, we therefore investigated the genes of the serotonin receptor subunits A and B (HTR3A and HTR3B) for genetic variants.

METHODS: We included 95 patients who had suffered from postoperative vomiting (POV) after general anesthesia and 94 control patients. After DNA isolation, the entire HTR3A and HTR3B coding regions, the 5' flanking regions, and exon/intron boundaries were screened for genetic variants. Correlation of identified genetic variants with POV was determined by logistic regression.

RESULTS: We identified 16 different variants in the HTR3A gene and 19 in the HTR3B gene. By using a multivariate logistic regression model that also included classical risk factors, the HTR3A variant c1377A>G was associated with a significantly higher risk (odds ratio [OR] 2.972; 95% confidence interval [CI] 1.466–6.021; P = 0.003) and the HTR3B variants c5+201_+202delCA (OR 0.421; 95% CI 0.257–0.69; P = 0.001) and c6-137C>T (OR 0.034; 95% CI 0.003–0.332; P = 0.004) were associated with a lower risk for POV. However, all significant genetic variants were located in noncoding regions of their gene.

CONCLUSIONS: Genetic variations in the HTR3A and HTR3B gene seem to be associated with the individual risk of developing POV. How strong their influence is within the multifactorial genesis of POV needs to be investigated in additional studies with an appropriate sample size.

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