Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
Department of Dental Anesthesiology, Tokyo Dental College,Tokyo, Japan.
Mol Pain. 2023 Jan-Dec;19:17448069231193383. doi: 10.1177/17448069231193383.
Phantom tooth pain (PTP) is a rare and specific neuropathic pain that occurs after pulpectomy and tooth extraction, but its cause is not understood. We hypothesized that there is a genetic contribution to PTP. The present study focused on the gene, which encodes the α1C subunit of the Ca1.2 L-type Ca channel (LTCC) that has been reported to be associated with neuropathic pain in previous studies. We investigated genetic polymorphisms that contribute to PTP. We statistically examined the association between genetic polymorphisms and PTP vulnerability in 33 patients with PTP and 118 patients without PTP but with pain or dysesthesia in the orofacial region. From within and around the gene, 155 polymorphisms were selected and analyzed for associations with clinical data. We found that the rs216009 single-nucleotide polymorphism (SNP) of the gene in the recessive model was significantly associated with the vulnerability to PTP. Homozygote carriers of the minor C allele of rs216009 had a higher rate of PTP. Nociceptive transmission in neuropathic pain has been reported to involve Ca influx from LTCCs, and the rs216009 polymorphism may be involved in expression, which regulates intracellular Ca levels, leading to the vulnerability to PTP. Furthermore, psychological factors may lead to the development of PTP by modulating the descending pain inhibitory system. Altogether, homozygous C-allele carriers of the rs216009 SNP were more likely to be vulnerable to PTP, possibly through the regulation of intracellular Ca levels and affective pain systems, such as those that mediate fear memory recall.
幻牙痛(PTP)是一种罕见的、特定的神经性疼痛,发生在牙髓切除和拔牙后,但病因尚不清楚。我们假设 PTP 与遗传有关。本研究集中在基因上,该基因编码钙通道的α1C 亚基,先前的研究表明该亚基与神经性疼痛有关。我们研究了导致 PTP 的遗传多态性。我们对 33 名 PTP 患者和 118 名无 PTP 但面部区域有疼痛或感觉异常的患者的遗传多态性与 PTP 易感性之间的关系进行了统计学检验。在基因内和周围,选择了 155 个多态性,并分析了它们与临床数据的关系。我们发现,基因的 rs216009 单核苷酸多态性(SNP)在隐性模型中与 PTP 的易感性显著相关。rs216009 次要 C 等位基因的纯合子携带者 PTP 发生率更高。神经性疼痛中的伤害性传递已被报道涉及 LTCC 中的 Ca 内流,而 rs216009 多态性可能参与调节细胞内 Ca 水平的表达,从而导致 PTP 的易感性。此外,心理因素可能通过调节下行疼痛抑制系统导致 PTP 的发展。总之,rs216009 SNP 的纯合 C 等位基因携带者更容易发生 PTP,可能通过调节细胞内 Ca 水平和情感疼痛系统,如介导恐惧记忆回忆的系统。