Catechol-O-methyltransferase genotype predicts pain severity in hospitalized burn patients.
Increasing evidence suggests that stress system activation after burn injury may contribute to burn-related pain. If this is the case, then genetic variations influencing the function of important stress system components, such as the enzyme catechol-O-methyltransferase (COMT), may predict pain severity after thermal burn injury. The authors evaluated the association between COMT genotype and pain intensity in 57 individuals hospitalized after thermal burn injury. Consenting participants at four burn centers were genotyped and completed daily 0 to 10 numeric rating scale pain assessments on 2 consecutive days including evaluation of waking, least, and worst pain. The association between COMT genotype and individual pain outcomes was calculated using a linear mixed model adjusting for sociodemographic and burn injury characteristics. Overall pain (combination of least, worst, and waking pain scores) was significantly higher in patients with a COMT pain vulnerable genotype (6.3 [0.4] vs 5.4 [0.4], P = .037). Individuals with a COMT pain vulnerable genotype also had significantly higher "least pain" scores (3.8 [0.5] vs 2.6 [0.4], P = .017) and significantly higher pain on awakening (6.8 [0.5] vs 5.3 [0.4], P = .004). Differences in worst pain according to genotype group were not significant. COMT pain vulnerable genotype was a stronger predictor of overall pain severity than burn size, burn depth, or time from admission to pain interview assessment. These findings suggest that genetic factors influencing stress system function may have an important influence on pain severity after burn injury. Further studies of genetic predictors of pain after burn injury are needed.
Department of Anesthesiology and TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC 27599-7455, USA.
Danielle C
DC
Orrey
Andrey V
AV
Bortsov
Janelle M
JM
Hoskins
Jeffrey W
JW
Shupp
Samuel W
SW
Jones
Bryan J
BJ
Cicuto
James
J
Hwang
Marion H
MH
Jordan
James H
JH
Holmes
Linwood R
LR
Haith
Brandon M
BM
Roane
Luda
L
Diatchenko
Bruce A
BA
Cairns
Samuel A
SA
McLean
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D002053:Burn Units; D002056:Burns / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D002394:Catechol O-Methyltransferase / Q000235:genetics*; D015331:Cohort Studies; D018450:Disease Progression; D004198:Disease Susceptibility; D005260:Female; D005838:Genotype; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000235:genetics*; D010147:Pain Measurement; D017288:Pain Threshold; D011110:Polymorphism, Genetic; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013315:Stress, Psychological / Q000235:genetics*; D055815:Young Adult
D000700:Analgesics; D002394:Catechol O-Methyltransferase