Association of genetic polymorphism of guanosintriphosphate of cyclohydrolases and catechol-O-methyltransferase with the frequency of the appearance of chronic pain after surgery
https://doi.org/10.21292/2078-5658-2019-16-5-5-11
Abstract
The objective of our clinical study was to identify the relationship between the incidence of persistent pain in the late postoperative period and polymorphisms (SNP) in the COMT and GCH1 genes.
Subjects and methods. Following the provision of written informed consent, 102 patients (57 women and 45 men) with ASA physical condition I/II underwent transabdominal radical prostatectomy (n = 45) or hysterectomy (n = 57) for cancer-related pathology. The frequency and intensity of postoperative residual pain in the pelvic and scar areas were assessed by a nurse in all patients using a telephone survey three months after discharge from the clinic. Genotyping was performed in the region Chr14q22.1 and 22q11.21 containing the genes GCH1 and COMT, respectively. We identified five SNP GCH1s that, as shown, had a significant association with pain reactions in a previous study by Tegeder and co-authors: rs752688, rs4411417, rs8007201, rs3783641 and rs8007267, and one SNP COMT-rs4680 G1947A.
Results and discussion. In the first three months after discharge from the hospital, 35 patients (34.3%) were diagnosed with moderate and severe pain of varying duration. In this group, 6 (17.1%) patients manifested signs of chronic neuropathic pain. Statistical analysis of 102 patients undergoing surgery on the lower floor of the abdominal cavity showed a statistically significant relationship only between GCH1 rs752688 and the more frequent occurrence of chronic postoperative pain. This relationship was mainly found in the male patient group, which indicated a gender-dependent effect. SNP GCH1rs752688 can be used as a clinical "marker" of chronic pain.
About the Authors
B. E. Gаbovich
Medicum; Tallinn University of Technology
Estonia
Estonia
Boris E. Gabovich - Anesthesiologist, Algologist.
Punane 61, 13619 Tallinn; Ehitajate tee 5, Tallinn.
Phone: +372 53445431.
A. Veske
Tallinn University of Technology
Estonia
Estonia
Andres Veske - Head of Genetic Technologies Laboratory, Associate Professor, PhD.
Ehitajate tee 5, Tallinn.
Phone: +372 5161186.
F. Dаi
Yale Center for Analytical Sciences, Yale University
United States
United States
Dai Feng - Researcher, PhD, Biostatistician.
New Heaven, Connecticut, 06511.
Phone: + 1 203.737.5248.
Yu. A. Kolesnikov
Medicum
Estonia
Estonia
Yury A. Kolesnikov - Candidate of Medical Sciences, Anesthesiologist and Emergency Physician, Alcohologist.
Punane 61, 13619 Tallinn.
Phone: +372 53663264.
References
1. Ovechkin А.M. Chronic post-operative pain syndrome – a hidden rock of modern surgery. were. Anestesia i Lecheniye Ostroy Boli, 2016, vol. 10, no. 1, pp. 5‒18.(In Russ.)
2. Yakhno N.N., Kukushkin M.L. Chronic pain: medical, biological and socio-economic aspects. Vestnik RAMN, 2012, no. 9, pp. 54-58. (In Russ.)
3. Belfer I., Dai F., Kehlet H., Finelli P. et al. Association of functional variations in COMT and GCH1 genes with postherniotomy pain and related impairment. Pain, 2015, vol. 156, no. 2, pp. 273‒279.
4. Belfer I., Segall S. COMT genetic variants and pain. Drugs Today (Barc), 2011, no. 47, pp. 457-467.
5. Brandsborg B., Nikolajsen L., Hansen C.T. et al. Risk factors for chronic pain after hysterectomy: a nationwide questionnaire and database study. Anesthesiology, 2007, vol. 106, no. 5, pp. 1003-1012.
6. Campbell C.M., Edwards R.R., Carmona C. et al. Polymorphisms in the GTP cyclohydrolase gene (GCH1) are associated with ratings of capsaicin pain. Pain, 2009, vol. 141, no. 6, pp. 114‒118.
7. Clarke H., Katz J., Flor H. et al. Genetics of chronic post-surgical pain: a crucial step toward personal pain medicine. Can. J. Anaesth., 2015, no. 62, pp. 294‒303.
8. Dai F., Belfer I., Schwartz C.E. et al. Association of catechol-O-methyltransferase genetic variants with outcome in patients undergoing surgical treatment for lumbar degenerative disc disease. Spine J., 2010, vol. 10, no. 11, pp. 949-957.
9. Diatchenko L., Slade G.D., Nackley A.G. et al. Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Hum. Mol. Genet., 2005, no. 14, pp. 135-143.
10. Flatters S.J. Effect of analgesic standards on persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR). Neurosci. Lett., 2010, no. 14, pp. 43-47.
11. Kim H., Dionne R.A. Lack of influence of GTP cyclohydrolase gene (GCH1) variations on pain sensitivity in humans. Mol. Pain, 2007, no. 4, pp. 3‒6.
12. Kolesnikov Y., Gabovits B., Levin A. et al. Combined catechol-O-methyltransferase and mu-opioid receptor gene polymorphisms affect morphine postoperative analgesia and central side effects. Anesth. Analg., 2011, vol. 112, no. 2, pp. 448-453.
13. Kolesnikov Y., Gabovits B., Levin A. et al. Chronic pain after lower abdominal surgery: do catechol-O-methyl transferase/opioid receptor μ-1 polymorphisms contribute? Mol. Pain, 2013, no. 9, pp. 19‒24.
14. Kolesnikov Y., Chereshnev I., Criesta M. et al. Opposing actions of neuronal nitric oxide synthase isoforms in formalin-induced pain in mice. Brain. Res., 2009, vol. 1289, pp. 14‒21.
15. Lötsch J., Geisslinger G., Tegeder I. Genetic modulation of the pharmacological treatment of pain. Pharmacol. Ther., 2009, vol. 124, pp. 168‒184.
16. Lotsch J., Belfer I., Kirchhof A. et al. Reliable screening for a pain-protective haplotype in the GTP cyclohydrolase 1 gene (GCH1) through the use of 3 or fewer single nucleotide polymorphisms. Clin. Chem., 2007, no. 53, pp. 1010‒1015.
17. Macrae W.A. Chronic pain after surgery. Br. J. Anaesth., 2001, no. 87, pp. 88-98.
18. Nasser A., Møller L.B. GCH1 variants, tetrahydrobiopterin and their effects on pain sensitivity. Scand. J. Pain, 2014, no. 5, pp. 121‒128.
19. Perkins F.M., Kehlet H. Chronic pain as an outcome of surgery: review of predictive factors. Anesthesiology, 2000, vol. 93, pp. 1123-1133.
20. Tegeder I., Costigan M., Griffin R.S. et аl. GTP cyclohydrolase and tetrahydrobiopterin regulate pain sensitivity and persistence. Nat. Med., 2006, no. 12, pp. 1269-1277.
21. Voscopoulos C., Lema M. When does acute pain become chronic? Br. J. Anaesth., 2010, vol. 105, pp. 69-85.
22. Visser E.J. Chronic post-surgical pain: Epidemiology and clinical implications for acute pain management. Acute Pain., 2006, no. 8, pp. 73‒81.
23. Wylde V., Hewlett S., Learmonth I.D., Dieppe P. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain, 2011, vol. 152, no. 3, pp. 566‒572.
Review
For citations:
Gаbovich B.E., Veske A., Dаi F., Kolesnikov Yu.A. Association of genetic polymorphism of guanosintriphosphate of cyclohydrolases and catechol-O-methyltransferase with the frequency of the appearance of chronic pain after surgery. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2019;16(5):5-11. (In Russ.) https://doi.org/10.21292/2078-5658-2019-16-5-5-11
Email this article 