Universidad de Salamanca
Estudio de variantes alélicas en genes asociados al dolor en pacientes con SDRC
Abstract
[ES] Introduction The Complex Regional Pain Syndrome (CRPS) is a painful disorder with varied clinical manifestations, characterized by a common pathophysiological mechanism. Although the pathogenic mechanisms known in its entirety, is known to share an abnormal neuronal activity, initially affects the entire central nervous system and is maintained by peripheral devices. The prevalence of chronic pain is very high worldwide, ranging between 15 and 20% of the adult population, encompassing a wide range of severity and intensity in which is involved not only the intensity of the nociceptive stimulus but also the response affective to the individual's emotional stimulus, which in turn results in a marked interindividual variability in the intensity levels of pain in patients with apparently similar boxes. It is postulated that variations SNPs may be directly related to a higher or lower susceptibility to pain in patients with similar characteristics. Far SNPs were identified in more than 20 genes encoding proteins involved in the mechanisms related to pain sensitivity. Among these genes are renowned for being the object of our work: - OPRD - OPRK - OPRM - CNR1 - TRPV1 - BDNF - GABRA1 - GABRA 6 - NOS3 - EDN1 - DRD2 - HTR2A Objectives In this work we investigated the possible association of variations in genes encoding proteins involved in the transmission and integration of painful information both central and peripheral levels in CRPS patients diagnosed with pain levels reported by the same . To assess pain have used two different tools: - VAS (Visual Analog Scale) - QST (Quantitative Sensory Testing), recently implemented in the evaluation of neuropathic pain. Patients and methods We studied 101 patients with CRPS (93 assessed by the VAS and 32 of them also by QST) and 45 control healthy individuals assessed by QST. Studied polymorphisms were amplified by PCR with Taqman probes or PCR and subsequent restriction enzyme digestion. The results were corroborated by sequencing techniques and analizaos statistically using SPSS. Results - We found statistically significant differences when comparing patients with CRPS OPRD1 genes controls, CNR1 and GABRA6 in general, and also in the BDNF gene in men also. - Comparing patient subgroups based referred pain levels in the EVA, we have observed differences in the distribution of allelic variants in the gene EDN1 only in males. - When comparing polymorphisms with QST parameters found differences in many genes, depending on the parameter studied. Conclusions 1. Our work confirms the hypothesis that polymorphisms in genes encoding proteins involved in the transmission and control of pain sensation can alter susceptibility to developing Complex Regional Pain Syndrome. Thus, polymorphisms in genes OPRD1, and GABRA6 CNR1 are associated with a higher risk in the general population, and BDNF with increased risk in men. 2. The observation that gene polymorphism and GABRA1 EDN1 associated with higher levels of pain in determining measured by VAS, suggests that the intensity of pain perception is also modulated at the genetic level. 3. Quantifying the sensory test to differentiate between QST CRPS patients and controls, which can be considered a useful tool in the diagnosis of this disease. 4. The QST sensory quantification test shows a high interindividual variability in patients with CRPS, so it should not be used to define the type of injury prevalent in this clinical 5. The observation that gene polymorphisms OPRK, CNR1 OPRM and are associated with different responses in the test parameters measured by quantification sensory QST reinforces our hypothesis that genetic variability is involved in the modulation of pain perception
Author and committee
dc:creator, dc:contributor.*- Author
-
- López Bartolomé, Mónica
Subjects
dc:subject × 12Identifiers
dc:identifier.*- Identifier
- hdl:10366/121379
- OAI identifier oai:identifier
- oai:gredos.usal.es:10366/121379