Li Song, Toneman Masja K, Diatchenko Luda, Parisien Marc, Vissers Kris C P, Ten Broek Richard P G, van Boekel Regina L M, Coenen Marieke J H
Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Br J Anaesth. 2025 Mar;134(3):783-792. doi: 10.1016/j.bja.2024.12.008. Epub 2025 Jan 25.
Chronic postsurgical pain (CPSP) persists beyond the expected healing period after surgery, imposing a substantial burden on overall patient well-being. Unfortunately, CPSP often remains underdiagnosed and undertreated. To better understand the mechanism of CPSP development, we aimed to identify genetic variants associated with CPSP.
A genome-wide association study was conducted in a cohort of 95,931 individuals from the UK Biobank who had undergone different surgical procedures. Three analyses were performed: (1) case-control analysis (2923 cases with CPSP and 93,008 controls), (2) ordinal analysis in three groups based on time of analgesics use (n=95,931), and (3) a meta-analysis combining our dataset with a recent publication (n=97,281).
In the case-control analysis, one genetic locus within GLRA3 displayed a genome-wide significant (P<2.5×10) association with CPSP, and nine loci displayed suggestively significant associations (P<1×10). The ordinal analysis aligned with the case-control analysis, with an additional locus (rs140330443) reaching genome-wide significance. In the meta-analysis with the recently published dataset, the single nucleotide polymorphism (SNP) rs17298280 in the GLRA3 gene remained significant (P=2.19×10).
This study contributes new insights into the genetic factors associated with CPSP. The top hit GLRA3 is known for involvement in prostaglandin E2-induced pain processing pathways. Our study provides a foundation for future investigations into the function of these risk variants and the mechanisms underlying CPSP by offering summary statistics. However, further validation in other cohorts is required to confirm these findings.
慢性术后疼痛(CPSP)在手术预期愈合期后仍持续存在,给患者的整体健康带来沉重负担。不幸的是,CPSP常常未得到充分诊断和治疗。为了更好地理解CPSP发生发展的机制,我们旨在识别与CPSP相关的基因变异。
在英国生物银行中选取了95931名接受过不同手术的个体进行全基因组关联研究。进行了三项分析:(1)病例对照分析(2923例CPSP患者和93008例对照),(2)根据镇痛药使用时间分为三组的有序分析(n = 95931),以及(3)将我们的数据集与最近发表的一篇文章进行荟萃分析(n = 97281)。
在病例对照分析中,GLRA3基因内的一个基因位点与CPSP呈现全基因组显著关联(P < 2.5×10),九个位点呈现提示性显著关联(P < 1×10)。有序分析与病例对照分析结果一致,另外一个位点(rs140330443)达到全基因组显著性。在与最近发表的数据集进行的荟萃分析中,GLRA3基因中的单核苷酸多态性(SNP)rs17298280仍然显著(P = 2.19×10)。
本研究为与CPSP相关的遗传因素提供了新的见解。最显著的GLRA3基因已知参与前列腺素E2诱导的疼痛处理途径。我们的研究通过提供汇总统计数据,为未来研究这些风险变异的功能以及CPSP的潜在机制奠定了基础。然而,需要在其他队列中进行进一步验证以证实这些发现。