Genetic and Trait Influences on Pain Heterogeneity

遗传和性状对疼痛异质性的影响

• 批准号: 8109196
• 负责人: Laura A Frey Law
• 金额: $ 11.76万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-08 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8109196
• 关键词: ADRB2 gene; ASIC channel; Acute Pain; Adrenergic Agents; Affect; Animals; Anxiety; Biological; Candidate Disease Gene; Caring; Carpal Tunnel Syndrome; Catecholamines; Clinical; Clinical Research; Complex; Cutaneous Muscle; Decision Making; Degenerative polyarthritis; Diagnosis; Diagnostic; Dissociation; Emotional; Environment; Enzymes; Evidence based practice; Exposure to; Female; Fibromyalgia; Fright; Gender; Gender Role; Genes; Genetic; Genetic Drift; Genotype; Goals; Healthcare; Heterogeneity; Hospitals; Human; Hyperalgesia; Individual; Individual Differences; Inflammation; Infusion procedures; Injury; Intramuscular; Investigation; Ischemia; Joint Commission on Accreditation of Healthcare Organizations; Lead; Link; Low Back Pain; Measurable; Measures; Mechanics; Mediating; Medical; Metabolic; Methyltransferase; Methyltransferase Gene; Modeling; Muscle; Musculoskeletal Pain; Myalgia; Neurotic Disorders; Nociception; Nociceptive Stimulus; Nociceptors; Opioid; Osteoporosis; Outcome; Pain; Pain-Free; Pathology; Pathway interactions; Patient Care; Patients; Perception; Peripheral; Personality; Personality Traits; Phosphate Buffer; Play; Population; Postoperative Pain; Predictive Value; Process; Psychological Factors; Quality of life; Replacement Arthroplasty; Reporting; Research; Research Training; Role; Sensory; Severities; Sex Characteristics; Single Nucleotide Polymorphism; Societies; Source; Stimulus; Syndrome; TRPV1 gene; Testing; Tissues; Training; Treatment outcome; Variant; adrenergic; base; biopsychosocial; chronic pain; clinical care; clinical decision-making; clinically relevant; disability; emotional experience; expectation; experience; human subject; improved; insight; male; medical attention; multidisciplinary; novel; patient population; psychologic; response; sex; social; somatosensory; trait; translational study; treatment planning; treatment strategy; vanilloid receptor subtype 1; willingness

DESCRIPTION (provided by applicant): Pain, an unpleasant sensory and emotional experience, is a significant often under-recognized medical problem spanning numerous patient populations. One of the leading causes for individuals to seek medical attention is musculoskeletal pain. Indeed, pain is now considered the 5th vital sign. Unfortunately, pain is highly variable between individuals. In both acute and chronic pain conditions, there is often a dissociation of pain perception and the underlying pathology in a variety of conditions such as low back pain, osteoporosis or osteoarthritis. Significant pain that is disproportionate to the physical findings is challenging to treat and can result in decreased quality of life and greater disability. Thus, pain heterogeneity associated with common clinical conditions Interferes with diagnosis and adequate treatment, ultimately compromising healthcare. The biopsychosocial model of pain suggests pain perception is a complex process that involves a myriad of physical, social, and emotional components. While no one factor can explain pain heterogeneity, individual differences in gender, genotype, and psychological traits may play a significant role. Unfortunately, it is difficult to find individuals with adequate multidisciplinary training to investigate pain from a multi-factorial perspective. Thus, the goal of the proposed research and training is to gain the expertise to determine the degree to which measurable Individual differences, e.g. sex, genotype and personality traits, predict high and low pain responses. This translational study approach utilizes a controlled, deep-tissue, algesic stimulus in human subjects to critically examine factors that contribute to pain heterogeneity. The Intramuscular infusion of an acidic phosphate buffer provides a clinically-relevant nociceptive stimulus of deep-tissue pain. This novel model provides a unique opportunity to study the Influence of baseline individual differences without the confounding factors associated with clinical pain syndromes. RELEVANCE: Musculoskeletal pain is a prevalent problem in our society and pain heterogeneity between individuals may result from multiple factors. This research plan will assess the role of normal personality traits, sex, and genotype on muscle pain sensitivity. This information may improve diagnosis and treatment strategies for musculoskeletal pain, advancing healthcare through increasingly individualized patient care approaches.

描述（由申请人提供）：疼痛是一种令人不快的感觉和情感体验，是一种重要的医学问题，通常未被广泛认识，涉及众多患者人群。肌肉骨骼疼痛是导致个人就医的主要原因之一。事实上，疼痛现在被认为是第五个生命体征。不幸的是，疼痛在个体之间是高度可变的。在急性和慢性疼痛病症中，通常存在疼痛感知与各种病症（例如腰痛、骨质疏松症或骨关节炎）中的潜在病理学的分离。与身体检查结果不成比例的严重疼痛具有治疗挑战性，可能导致生活质量下降和更严重的残疾。因此，与常见临床病症相关的疼痛异质性干扰诊断和充分治疗，最终损害医疗保健。疼痛的生物心理社会模型表明疼痛感知是一个复杂的过程，涉及无数的身体，社会和情感成分。虽然没有一个因素可以解释疼痛异质性，但性别，基因型和心理特征的个体差异可能起着重要作用。不幸的是，很难找到具有足够多学科培训的个人从多因素的角度来研究疼痛。因此，拟议的研究和培训的目标是获得专业知识，以确定可测量的个体差异（例如性别、基因型和人格特质）预测高和低疼痛反应的程度。这种转化研究方法利用人类受试者的受控、深层组织、疼痛刺激来严格检查导致疼痛异质性的因素。肌内输注酸性磷酸盐缓冲液提供了临床相关的深部组织疼痛伤害性刺激。这种新的模型提供了一个独特的机会来研究基线个体差异的影响，而没有与临床疼痛综合征相关的混杂因素。相关性：肌肉骨骼疼痛是我们社会中普遍存在的问题，个体之间的疼痛异质性可能由多种因素引起。这项研究计划将评估正常人格特质，性别和基因型对肌肉疼痛敏感性的作用。这些信息可以改善肌肉骨骼疼痛的诊断和治疗策略，通过日益个性化的患者护理方法推进医疗保健。