Genetic susceptibility to postherniotomy pain. The influence of polymorphisms in the Mu opioid receptor, TNF-alpha, GRIK3, GCH1, BDNF and CACNA2D2 genes

• Background and aims: Despite improvements in surgical technique, 5%-8% of patients undergoing herniorrhaphy still suffer from clinically relevant persistent postherniotomy pain. This is a problem at both individual and society levels. The aim of this study was to determine whether or not a single nucleotide polymorphism in a specific gene contributes to the development of persistent pain after surgery. Methods: One hundred individuals with persistent postherniotomy pain, along with 100 without pain matched for age, gender and type of surgery were identified in a previous cohort study on patients operated for groin hernia. All patients underwent a thorough sensory examination and blood samples were collected. DNA was extracted and analysed for single nucleotide polymorphism in the Mu opioid receptor, TNF-alpha, GRIK3, GCH1, BDNF and CACNA2D2 genes. Results: Patients with neuropathic pain were found to have a homozygous single nucleotide polymorph in the TNF-alpha gene significantly more often than pain-free patients (P = 0.036, one-tailed test). Conclusions: SNP in the TNF-alpha gene has a significant impact on the risk for developing PPSP. Implications: The result suggests the involvement of genetic variance in the development of pain and this requires further investigation.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Persistent postsurgical pain

Single nucleotide polymorphism

Genetic variance

TNF-alpha

Groin hernia

Publikations- och innehållstyp

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