The questions as to why people in similar states of health experience intense pain very differently and why one pain reliever works extremely well in some people and hardly has any effect in others has been answered by Prof. Dr. Jorn Lotsch (Frankfurt, Germany) at the EFIC Congress.
According to Lotsch, one of the reasons can be found in the range of human genome variation, an area that so far received almost no attention in research and development of pain therapies. Lotsch said:
“The fact that we understand these mechanisms better now opens the intriguing prospect of being able to develop tailored therapies and prevention programs for the different genotypes that occur among people.”
Genetic research offers new perspective for understanding pain perception
Pain is formed and perceived through many influences working together. This can be related to previous pain experience to the social environment and to one’s own attitude towards pain. Although pain therapy research has considered quite a few of these factors in their studies, such as investigations to verify the effectiveness of analgesic medications, significant individual differences continue to be apparent in the effectiveness of analgesics.
So far, science has been unable to explain this but now recent genetic research findings presented at the EFIC Congress offer a plausible explanation. Prof. Lötsch explains:
“Certain properties of genetic material can ensure that genes, that are responsible for the production of pain-enhancing or pain-inhibiting neurotransmitters or for the metabolism and absorption of drugs, are either more frequently or less frequently turned on. There are people who, due to hereditary imprinting, are generally more sensitive to pain than others. And there are people who develop a different response and different metabolic properties than others in reaction to certain drugs; for example, when a drug is unable to ‘dock’ owing to changes in receptors in the brain or in the spinal cord.”
Are Epigenetics responsible for the ineffectiveness of therapies?
Researchers discovered that influencing factors for pain perception and response to medications are not only found in genetic differences, i.e. the sequence of base pairs in DNA, but also in so-called epigenetics. Science defines epigenetics as cell properties that can be likewise imprinted and inherited, partly by the spatial arrangement of DNA in the chromosomes and partly also by behavior and lifestyle. According to experts, these factors have at least the same influence regarding pain perception as the interaction between drugs for example. This explains why so many patients suffering pain do not benefit from therapies that are generally effective. It also leads to the conclusion that many pain therapy study-results are not entirely correct because these important factors were not considered until now.
More precise forecasts, tailored drugs
The fact that genetic factors play a role in pain research opens the doors to extraordinary new possibilities; for example, certain genetic factors could turn out to be risk factors for long-lasting or chronic pain, which could lead to better preventive measures.
Prof. Lötsch clarifies:
“The inclusion of genetic differences in pharmacological studies could make their results more meaningful. Instead of just figuring out how many people respond to the drug, it could be shown for which genetic types of patients the remedy is appropriate and for which types it is not.”
In turn, these findings could enable researchers to develop specific and appropriate medication and therapies for each genotype. Prof. Lötsch concluded:
“The inclusion of genetic and epigenetic factors in drug research will significantly enhance the development of analgesics. Individualized pain therapies and preventive measures are also a moving good bit closer through this.”
Written by Petra Rattue