Journal
JOURNAL OF PAIN
Volume 24, Issue 9, Pages 1721-1730Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.jpain.2023.05.005
Keywords
COMT Val158Met; chronic pain; acupuncture; cancer survivors; treatment response
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The COMT Val158Met genetic polymorphism influences the analgesic response to electroacupuncture, but has less impact on the response to auricular acupuncture and usual care. This finding provides new insights into personalized nonpharmacologic pain management tailored to individual genetic backgrounds.
Catechol-O-methyltransferase (COMT) is the major enzyme involved in the catabolism of dopamine, a neurotransmitter in the brain's reward system. The common COMT polymorphism Val158Met (rs4680 G > A) modulates pain response to opioids through a reward-motivated me-chanism; however, its role in nonpharmacological pain medicine has not been clinically characterized. We genotyped 325 participants from a randomized controlled trial of cancer survivors with chronic musculoskeletal pain. We found that carrying methionine at position 158 (158Met) of COMT, encoded by the A allele, significantly increased the analgesic response to electroacupuncture (74% vs 50%; odds ratio [OR]: 2.79; 95% confidence interval [CI]: 1.31, 6.05; P < .01), but not to auricular acupuncture (68% vs 60%; OR: 1.43; 95% CI: .65, 3.12; P = .37) or usual care (24% vs 18%; OR: 1.46; 95% CI: .38, 7.24; P = .61) compared to Val/Val. These findings raise the possibility that COMT Val158Met might be an important predictor of analgesic response to electroacupuncture, providing novel in-sights into precision nonpharmacologic pain management tailored to individual genetic back-grounds.
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