Genetics May Help Decide Pain Tolerance
A new study may have identified key genes that help determine why some people have a higher pain tolerance than others.
Study authors say the study findings are significant in that finding genes that play a role in pain perception could provide a new target for developing therapies, and help physicians better understand how their patients perceive pain.
“A primary care physician, like any doctor, must rely on the patients’ own perception of pain, usually using a numerical scale of 1 to 10,” says Tobore Onojjighofia, MD, MPH, lead study author and clinical affairs manager with Proove Biosciences Inc., which supported the study conducted by Onojjighofia and colleagues.
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“However, a doctor struggles to objectively measure that patient’s perception. To do this, genetics can provide an objective guidepost to interpret a numerical rating scale.”
In the study, researchers evaluated 2,721 individuals with chronic pain for certain genes. Participants were taking prescription opioid pain medications. The genes involved were COMT, DRD2, DRD1, and OPRK1.
The participants also rated their perception of pain on a scale from 0 to 10, with those rating their pain as 0 excluded from the study. Low pain perception was defined as a score of 1, 2, or 3; moderate pain perception was a score of 4, 5, or 6; and high pain perception was a score of 7, 8, 9, or 10. Nine percent of the participants had low pain perception, 46 percent had moderate pain perception, and 45 percent had high pain perception.
The researchers found the DRD1 gene variant was 33 percent more prevalent in the low-pain group than in the high-pain group. Among patients with a moderate pain perception, the COMT and OPRK variants were 25 percent and 19 percent more often found than in those with a high perception of pain. The DRD2 variant was 25 percent more common among those with a high pain perception compared to people with moderate pain.
“Pain management is difficult for primary care practitioners, but it isn’t always practical to refer a patient to a pain specialist—which may involve months of wait time to get an appointment,” says Onojjighofia.
“Thus, a primary care physician may oftentimes have to treat many co-morbidities where pain is involved, including mental health, cardiovascular, and diabetes. With so much to evaluate, they need objective evidence to improve their decision-making. Genetics tests like this one can help improve treatment decisions for pain management, as [physicians] decide whether to prescribe a certain class of medication, how to dose, or whether to explore non-pharmacologic analgesic treatments.”
The study findings are scheduled to be presented at the American Academy of Neurology’s 66th Annual Meeting, to be held in Philadelphia from April 26 to May 3.
—Mark McGraw