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疼痛相关单核苷酸多态性:与腰椎管狭窄症患者体验及非手术治疗结果的关联

Pain-related single nucleotide polymorphisms: association with lumbar spinal stenosis patient experience and non-surgical treatment outcomes.

作者信息

Ernst Sara, Huang Wan, Conley Yvette, Vo Nam, Schneider Michael, Sowa Gwendolyn

机构信息

Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Ferguson Laboratory for Orthopedic and Spine Research, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Eur Spine J. 2024 Jun;33(6):2213-2221. doi: 10.1007/s00586-024-08182-0. Epub 2024 Apr 6.

Abstract

PURPOSE

Lumbar spinal stenosis (LSS) is common in our aging population resulting in pain and functional impairment. Recent advances in pain research have identified several single nucleotide polymorphisms (SNP) associated with inter-individual symptom and treatment response. The goal of the current study was to investigate the association of SNPs in Neuropeptide Y (NPY) and Catechol-O-methyltransferase (COMT) with pain, function, and treatment outcomes in Lumbar spinal stenosis (LSS) patients receiving non-surgical treatments.

METHODS

An exploratory observational biomarker study was performed ancillary to a previously published clinical trial evaluating three different non-surgical treatments for LSS. Saliva samples were obtained for single nucleotide polymorphism genotyping and blood samples were collected for NPY protein. Data on pain and function collected as part of the clinical trial at baseline, 2 and 6 months were examined for association with known polymorphisms in NPY and COMT.

RESULTS

Subjects with the NPY rs16147 TT genotype exhibited higher baseline symptom severity but also a higher likelihood of responding to non-surgical treatments. Subjects with the COMT rs4680 GG genotype also exhibited higher baseline symptom severity but did not demonstrate greater response to treatment.

CONCLUSIONS

NPY rs16147 and COMT rs4680 are important potential biomarkers associated with pain and function. NPY genotype may be useful in predicting response to non-surgical treatments in older adults with LSS.

摘要

目的

腰椎管狭窄症(LSS)在老年人群中很常见,会导致疼痛和功能障碍。疼痛研究的最新进展已确定了几种与个体症状和治疗反应相关的单核苷酸多态性(SNP)。本研究的目的是调查接受非手术治疗的腰椎管狭窄症(LSS)患者中神经肽Y(NPY)和儿茶酚-O-甲基转移酶(COMT)基因单核苷酸多态性与疼痛、功能及治疗结果之间的关联。

方法

一项探索性观察性生物标志物研究作为先前发表的一项评估三种不同LSS非手术治疗方法的临床试验的辅助研究进行。采集唾液样本进行单核苷酸多态性基因分型,并采集血样检测NPY蛋白。检查作为临床试验一部分在基线、2个月和6个月时收集的疼痛和功能数据,以确定其与NPY和COMT中已知多态性的关联。

结果

携带NPY rs16147 TT基因型的受试者基线症状严重程度较高,但对非手术治疗有反应的可能性也较高。携带COMT rs4680 GG基因型的受试者基线症状严重程度也较高,但对治疗没有更明显的反应。

结论

NPY rs16147和COMT rs4680是与疼痛和功能相关的重要潜在生物标志物。NPY基因型可能有助于预测老年LSS患者对非手术治疗的反应。

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