source: The Journal of Pain

year: 2016

authors: K. Roach, E. Jhun, Y. He, M. Suarez, Y. Yao, R. Molokie, Z. Wang, D. Wilkie

Patients suffering from sickle cell disease (SCD) commonly have varying degrees of chronic debilitating pain and episodic acute pain. The variability is broad even between individuals with the same genotype. In this study, the AVPR1A polymorphism was explored to investigate the contribution of gene polymorphisms to variations in pain for individuals with SCD. The sample of 115 individuals (mean age 34.1 +/- 12.3 [range 15-70 years], 68% female) was 97% African American with SCD (81% SS, 10% SC, 9% other). From electronic health record review and bi-weekly telephone calls with subjects, we determined each patient’s utilization of emergency and acute care services (mean 4.4, SD 5.4 [range from 0 to 38 visits]) as an indicator for acute SCD pain. At a routine clinic visit, patients completed PAINReportIt to obtain the Composite Pain Index (CPI) as an indicator of chronic pain (mean 40.7, SD 13.6, [ranged 14.8 to 86.5]) and we obtained blood samples. We performed genotyping on SNP rs10877969 and found that there were 35 with CC genotype, 45 with CT genotype, and 34 with TT genotype (1 subject’s genotype was unknown). Negative binomial regression of patient utilization found that, controlling for age, sex, and SCD type, subjects with either CC or CT genotype had significantly higher utilization than those with TT genotype (p=0.026). This SNP was not a significant predictor for CPI in this study. In previous studies of SNPs related to AVPR1a, analgesia effects were found to be dependent on both stress and sex. This is the first study to show that this SNP (rs10877969) is significantly related to acute SCD pain, a pain condition also associated with stress and inconsistent findings related to sex. Additional research is needed to further examine the influence of the SNP rs10877969 on pain outcomes.

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