Catechol-O-methyltransferase genotype predicts pain severity in hospitalized burn patients.

MedStar author(s):
Citation: Journal of Burn Care & Research. 33(4):518-23, 2012 Jul.PMID: 22210062Institution: MedStar Washington Hospital CenterDepartment: Surgery/Burn ServicesForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Research Support, N.I.H., Extramural | Research Support, Non-U.S. Gov'tSubject headings: *Burns/co [Complications] | *Catechol O-Methyltransferase/ge [Genetics] | *Pain Measurement | *Pain/ge [Genetics] | *Stress, Psychological/ge [Genetics] | Adult | Analgesics/tu [Therapeutic Use] | Burn Units | Burns/di [Diagnosis] | Burns/ge [Genetics] | Cohort Studies | Disease Progression | Disease Susceptibility | Female | Genotype | Hospitalization/sn [Statistics & Numerical Data] | Humans | Injury Severity Score | Linear Models | Male | Pain Threshold | Pain/dt [Drug Therapy] | Pain/et [Etiology] | Polymorphism, Genetic | Predictive Value of Tests | Prognosis | Retrospective Studies | Risk Assessment | Young AdultYear: 2012Local holdings: Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - presentISSN:
  • 1559-047X
Name of journal: Journal of burn care & research : official publication of the American Burn AssociationAbstract: 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.All authors: Bortsov AV, Cairns BA, Cicuto BJ, Diatchenko L, Haith LR, Holmes JH, Hoskins JM, Hwang J, Jones SW, Jordan MH, McLean SA, Orrey DC, Roane BM, Shupp JWFiscal year: FY2013Digital Object Identifier: Date added to catalog: 2013-09-17
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 22210062 Available 22210062

Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present

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.

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