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. 2019 Sep;20(9):1100-1111.
doi: 10.1016/j.jpain.2019.03.008. Epub 2019 Mar 21.

Associations Between Catecholaminergic and Serotonergic Genes and Persistent Arm Pain Severity Following Breast Cancer Surgery

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Associations Between Catecholaminergic and Serotonergic Genes and Persistent Arm Pain Severity Following Breast Cancer Surgery

Mitchell R Knisely et al. J Pain. 2019 Sep.

Abstract

Persistent arm pain is a common problem after breast cancer surgery. Little is known about genetic factors that contribute to this type of postsurgical pain. Study purpose was to explore associations between persistent arm pain phenotypes and genetic polymorphisms among 15 genes involved in catecholaminergic and serotonergic neurotransmission. Women (n = 398) rated the presence and intensity of arm pain monthly for 6 months after breast cancer surgery. Three distinct latent classes of patients were identified (ie, no arm pain [41.6%], mild arm pain (23.6%), and moderate arm pain (34.8%). Logistic regression analyses were used to evaluate for differences between genotype or haplotype frequencies and the persistent arm pain classes. Compared with the no arm pain class, 3 single nucleotide polymorphisms and 1 haplotype, in 4 genes, were associated with membership in the mild arm pain class: COMT rs4633, HTR2A haplotype B02 (composed of rs1923886 and rs7330636), HTR3A rs1985242, and TH rs2070762. Compared with the no arm pain class, 4 single nucleotide polymorphisms in 3 genes were associated with membership in the moderate arm pain class: COMT rs165656, HTR2A rs2770298 and rs9534511, and HTR3A rs1985242. Findings suggest that variations in catecholaminergic and serotonergic genes play a role in the development of persistent arm pain. PERSPECTIVE: Limited information is available on genetic factors that contribute to persistent arm pain after breast cancer surgery. Genetic polymorphisms in genes involved in catecholaminergic and serotonergic neurotransmission were associated with 2 persistent arm pain phenotypes. Findings may be used to identify patients are higher risk for this common pain condition.

Keywords: Arm pain; breast cancer; catecholaminergic genes; persistent pain; polymorphisms; postsurgical pain; serotonergic genes.

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Figures

Figure 1
Figure 1
a through d – Differences between No Arm Pain and Mild Arm Pain classes in the percentage of patients who were homozygous for the common allele or heterozygous or homozygous for the rare allele for each significant polymorphism or number of doses of haplotypes identified. Values are plotted as unadjusted proportions with corresponding p-value.
Figure 2
Figure 2
a through d – Differences between No Arm Pain and Moderate Arm Pain classes in the percentage of patients who were homozygous for the common allele or heterozygous or homozygous for the rare allele for each significant polymorphism or number of doses of haplotypes identified. Values are plotted as unadjusted proportions with corresponding p-value.

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