THE INFLUENCE OF SINGLE-NUCLEOTIDE POLYMORPHISMS OF CATECHOL-O-METHYLTRANSFERASE GENE ON THE FORMATION OF PAIN SYNDROME AND EFFECTIVENESS OF ANALGESIA IN ONCOLOGICAL PATIENTS

The objective is to study the effect of single-nucleotide polymorphisms (SNPs) of COMT gene on the formation and characteristics of chronic pain, level of anxiety and depression, effectiveness of analgesia in oncological patients. Material and Methods. The study includes 196 patients with oncological pathology. The formation of chronic pain syndrome was estimated in all patients one year after surgery using the assessment of pain intensity by numeric rating scale, pain questionnaire of McGill, PainDetect. Basing on the patients genotyping data the genotypes and haplotypes frequency distribution on SNPs of rs4680, rs740603, rs2097603=rs2070577, rs4633 of COMT gene was estimated. The relationship between different genotypes, haplotypes and chronic pain intensity, severity of ranking index of pain for sensor and affective characteristics on McGill scale, presence of neuropathic component of pain and anxiety was studied in all patients sample. The same analysis was carried out in order to clarify difference in morphine consumption (mg/24h) and severity of adverse side effects such as drowsiness, confusion and hallucinations. Results. It is found that after one year the pain syndrome was developed in 134 patients. It was showed that there is direct relationship between chronic pain intensity, anxiety level and presence of mutant allele on polymorphisms of rs4680 in exon and rs740603 in intron of COMT gene. There was also revealed inverse relationship between morphine requirement and presence of pointed polymorphisms in comparison with the patients who have GG genotype of these markers. Conclusion. The determination of pointed SNPs may be useful for choosing the optimal tactics of analgesia in patients with chronic oncological pain syndrome.

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Relationship between catechol-o-methyltransferase gene polymorphism and pain syndrome in breast cancer patients

Regional Anesthesia and Acute Pain Management ◽

10.17816/1993-6508-2020-14-2-72-85 ◽

2020 ◽

Vol 14 (2) ◽

pp. 72-85

Author(s):

Arina P. Spasova ◽

I. V. Kurbatova ◽

O. Y. Barysheva ◽

G. P. Tikhova

Keyword(s):

Breast Cancer ◽

Chronic Pain ◽

Postoperative Period ◽

Mutant Allele ◽

Pain Syndrome ◽

Comt Gene ◽

Nucleotide Polymorphisms ◽

Chronic Pain Syndrome ◽

Narcotic Analgesics ◽

Single Nucleotide

The goal of the study was to explore the influence of single-nucleotide polymorphisms of the COMT gene on the formation and features of pain syndrome, the level of anxiety, and the need for narcotic analgesics in patients with breast cancer. Materials and methods. The intensity of pain and opioid consumption in the postoperative period were evaluated in 58 patients who met the inclusion criteria of the study and were operated for breast cancer. The frequency of chronic pain syndrome after mastectomy was studied in the same group of patients after a year by using short pain questionnaires, McGill Pain Questionnaire and PainDetect. The anxiety level was assessed by using the HADS questionnaire. Genotyping was performed for single-nucleotide polymorphisms, rs4680, rs740603, rs2097603 = rs2070577, rs4633, of the COMT gene localized in the 22q11.21 region in the studied group of patients. The relationship between the carrier of different genotypes and the intensity of acute and chronic pain, the severity of the pain rating index for sensory and affective characteristics, the presence of a neuropathic component of pain, and the severity of anxiety were studied in the entire sample. The use of narcotic analgesics was evaluated in the postoperative period (IU/day and IU/course) and for the relief of chronic pain. Results. It is shown that the intensity of postoperative pain and the severity of anxiety do not depend on the presence of a mutant allele for the studied polymorphisms of the COMT gene, while the postoperative consumption of opioids in patients with the rs4680 missense mutation in the exon of this gene is significantly less. The dependence of the intensity of chronic pain syndrome and the severity of anxiety on the presence of a mutant allele for the polymorphic locus rs4680 localized in the exon of the COMT gene was established. No significant relationship was observed between the mutant alleles and the use of opioids for chronic pain relief after mastectomy. Conclusion. Genotyping for the COMT gene polymorphisms can be useful for choosing the optimal tactics of pain management in patients with breast cancer.

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Genotypic Analysis of SCN9A for Prediction of Postoperative Pain in Female Patients Undergoing Gynecological Laparoscopic Surgery

January 2018 - Pain Physician ◽

10.36076/ppj/2016.19.e151 ◽

2016 ◽

Vol 1;19 (1;1) ◽

pp. E151-E162

Author(s):

Xianwei Zhang

Keyword(s):

Laparoscopic Surgery ◽

Postoperative Pain ◽

Single Nucleotide Polymorphisms ◽

Pain Intensity ◽

Rating Scale ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Female Patients ◽

Genotypic Analysis ◽

Severe Postoperative Pain

Background: The SCN9A gene product is a critical component in human pain perception. Recent studies found that single-nucleotide polymorphisms (SNPs) in this gene contributed to the risk and severity of common pain phenotypes. Objectives: In this study, we aimed to assess the use of SCN9A SNP screening for predicting postoperative pain. Study Design: A retrospective assessment of patients who underwent gynecological laparoscopic surgery. Setting: Department of anesthesiology, a teaching hospital, in a medical college, major metropolitan city, China. Methods: Twenty-nine candidate and tag SCN9A SNPs were analyzed in this study. Four hundred twenty-one patients who underwent gynecological laparoscopic surgery and refused postoperative patient controlled analgesia (PCA) were recruited and completed the study protocol. An additional 578 patients who voluntarily received PCA treatment were included for verification. Postoperative pain intensity was evaluated in all patients using numerical rating scale (NRS), and for patients receiving PCA analgesic requirements were also recorded. Outcomes Assessment: The outcome was assessment of postoperative pain NRS and PCA analgesic requirements. Results: Ten different SCN9A SNPs exhibited significant associations with postoperative pain intensity, the incidence of severe postoperative pain, and postoperative PCA requirement. Of the candidate SCN9A SNPs, there was a statistically significant correlation between SNP rs6746030 and higher maximum NRS scores during the postoperative follow-up of non-PCA patients (P < 0.05). Furthermore, there was a significant association between the tag SNP rs4286289 and both increased postoperative maximum NRS scores (P < 0.05) and higher incidences of severe postoperative pain (P < 0.05) in non-PCA patients. Meanwhile, in PCA patients, rs4286289 exhibited the strongest association (P = 0.001) with increased requirements for postoperative analgesics, which indirectly strengthened the significant association between this SNP and higher postoperative pain. Limitations: The limitations of this study include that it is an assessment of only Chinese women scheduled for gynecological laparoscopic surgery. Conclusion: The current study provides evidence that postoperative pain was affected by SCN9A variability in gynecological patients. Notably, our results provide the first indication that SCN9A SNP rs4286289 can be used as a predictor for hypersensitivity to postoperative pain. Key words: SCN9A, single-nucleotide polymorphisms, genotypic analysis, postoperative pain, female patients, gynecological laparoscopic surgery, genetic markers for pain, predictors of postoperative pain

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