The Science Of Testing
When you gently brush the inside of your cheek with the GnomeDX cotton swab, you gather some of your cheek cells. Inside of each cell are your chromosomes, one from each of your parents. Chromosomes are made up of DNA. Segments of DNA are called genes. Genes act as instructions for proteins and are required for your cells, tissues and organs to function.
Not everyone’s genes are exactly the same. The building blocks of those genes (called nucleotides) can be switched, added, or deleted. These variations make up your unique sequence which can affect how you respond to medicine. Your unique sequence is what we determine in your GnomeDX results.
Based on your sequence, your proteins can function differently, therefore processing (metabolizing) medications differently. For example some people are normal metabolizers, meaning the drugs they take work like they are supposed to. However, many people are either intermediate, poor or rapid metabolizers which can increase risk of negative side effects or show no improvement for your health, depending on the type of drug.
It's important for your doctor to know what type of metabolizer you are for a specific set of drugs so they can avoid medications that could harm you, or not work at all.
About this test
The most prescribed opioid analgesic for pain relief is codeine. Codeine is prodrug that is metabolized into morphine by the gene CYP2D6. This gene is also responsible for metabolizing oxycodone, hydrocodone, tramodol and other pain relief medications.
Patients who have a genetic mutation of the gene CYP2D6 will either metabolize codeine faster (ultrarapid metabolizer) or slower (poor metabolizer) than commonly expected. Ultrarapid metabolizers show increased enzyme activity, which results in increased morphine production in the body, leading to respiratory depression while taking a standard dose of codeine. Patients who fall in the poor metabolizer category many not get any relief from a standard dose of codeine because their bodies have less enzyme activity, meaning little or no morphine is produced.
Knowing a patient’s genetic sequence for CYP2D6 is critical for pain management. For example, patients who are poor metabolizers will remain in pain until a medication is switched or dosage is changed. On the flip side, ultrarapid metabolizers are at risk of overdose when given a standard dose of codeine after a routine operation.
The PainDX test covers 7 genes