Genetic variant rs3750625 in the 3 ' UTR of ADRA2A affects stress-dependent acute pain severity after trauma and alters a microRNA-34a regulatory site
PAIN
Authors: Linnstaedt, Sarah D.; Walker, Margaret G.; Riker, Kyle D.; Nyland, Jennifer E.; Hu, JunMei; Rossi, Catherine; Swor, Robert A.; Jones, Jeffrey S.; Diatchenko, Luda; Bortsov, Andrey V.; Peak, David A.; McLean, Samuel A.
Abstract
alpha 2A adrenergic receptor (alpha 2A-AR) activation has been shown in animal models to play an important role in regulating the balance of acute pain inhibition vs facilitation after both physical and psychological stress. To our knowledge, the influence of genetic variants in the gene encoding alpha 2A-AR, ADRA2A, on acute pain outcomes in humans experiencing traumatic stress has not been assessed. In this study, we tested whether a genetic variant in the 3 ' UTR of ADRA2A, rs3750625, is associated with acute musculoskeletal pain (MSP) severity following motor vehicle collision (MVC, n = 948) and sexual assault (n 5 84), and whether this influence was affected by stress severity. We evaluated rs3750625 because it is located in the seed binding region of miR-34a, a microRNA (miRNA) known to regulate pain and stress responses. In both cohorts, the minor allele at rs3750625 was associated with increased musculoskeletal pain in distressed individuals (stress rs3750625 P = 0.043 for MVC cohort and P = 0.007 for sexual assault cohort). We further found that (1) miR-34a binds the 3 ' UTR of ADRA2A, (2) the amount of repression is greater when the minor (risk) allele is present, (3) miR-34a in the IMR-32 adrenergic neuroblastoma cell line affects ADRA2A expression, (4) miR-34a and ADRA2A are expressed in tissues known to play a role in pain and stress, (5) following forced swim stress exposure, rat peripheral nerve tissue expression changes are consistent with miR-34a regulation of ADRA2A. Together, these results suggest that ADRA2A rs3750625 contributes to poststress musculoskeletal pain severity by modulating miR-34a regulation.
Influence from genetic variability on opioid use for cancer pain: A European genetic association study of 2294 cancer pain patients
PAIN
Authors: Klepstad, P.; Fladvad, T.; Skorpen, F.; Bjordal, K.; Caraceni, A.; Dale, O.; Davies, A.; Kloke, M.; Lundstrom, S.; Maltoni, M.; Radbruch, L.; Sabatowski, R.; Sigurdardottir, V.; Strasser, F.; Fayers, P. M.; Kaasa, S.
Abstract
Cancer pain patients need variable opioid doses. Preclinical and clinical studies suggest that opioid efficacy is related to genetic variability. However, the studies have small samples, findings are not replicated, and several candidate genes have not been studied. Therefore, a study of genetic variability with opioid doses in a large population using a confirmatory validation population was warranted. We recruited 2294 adult European patients using a World Health Organization (WHO) step III opioid and analyzed single nucleotide polymorphisms (SNPs) in genes with a putative influence on opioid mechanisms. The patients' mean age was 62.5 years, and the average pain intensity was 3.5. The patients' primary opioids were morphine (n = 830), oxycodone (n = 446), fentanyl (n = 699), or other opioids (n = 234). Pain intensity, time on opioids, age, gender, performance status, and bone or CNS metastases predicted opioid dose and were included as covariates. The patients were randomly divided into 1 development sample and 1 validation sample. None of 112 SNPs in the 25 candidate genes OPRM1, OPRD1, OPRK1, ARRB2, GNAZ, HINT1, Stat6, ABCB1, COMT, HRH1, ADRA2A, MC1R, TACR1, GCH1, DRD2, DRD3, HTR3A, HTR3B, HTR2A, HTR3C, HTR3D, HTR3E, HTR1, or CNR1 showed significant associations with opioid dose in both the development and the validation analyzes. These findings do not support the use of pharmacogenetic analyses for the assessed SNPs to guide opioid treatment. The study also demonstrates the importance of validating findings obtained in genetic association studies to avoid reporting spurious associations as valid findings. To elicit knowledge about new genes that influence pain and the need for opioids, strategies other than the candidate gene approach is needed. (C) 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.