A pilot study conducted on DNA samples from 55 Portuguese Caucasian adult pregnant women undergoing scheduled cesarean section, followed at the maternity hospital of Centro Hospitalar e Universitário de Coimbra (CHUC), showed a positive association between genetic variants of the CYP2D6 enzyme and pain.
Carried out over two years by a multidisciplinary team of scientists and doctors coordinated by Manuela Grazina, professor at the Faculty of Medicine of the University of Coimbra (FMUC), the study revealed that «the genetic variants that result in the absence or reduction of function CYP2D6 enzymes are associated with more pain. This effect is possibly related to a decrease in dopamine synthesis by the activity of the CYP2D6 enzyme in the brain.”
“This is a pioneering study that brings new perspectives on the personalized medical approach in the treatment of post-cesarean pain”, emphasizes Manuela Grazina.
The CYP2D6 enzyme, in addition to metabolizing a high number of drugs in the liver, «has activity in the brain and, under normal physiological conditions, constitutes an alternative pathway for the synthesis of about 12% of dopamine, an essential neurotransmitter for well-being, including the body's analgesic response to pain. The presence of genetic variants that translate into reduced or no enzymatic activity will lead to lower brain production of dopamine and, therefore, a higher pain score», clarifies the UC scientist.
Considering that «acute postpartum pain affects a considerable number of women and 10-15% develop chronic persistent pain after caesarean section, a study that allows personalized medical treatment, according to individual genetic characteristics, will bring great benefits, allowing to adjust analgesic doses for a more effective treatment», stresses the also responsible for the Genetic Biochemistry Laboratory of the Center for Neuroscience and Cell Biology (CNC).
The results of this investigation, published in the scientific journal Pain Medicine, are, therefore, an important contribution «to a better understanding of how the genetic variability of CYP2D6 affects the pain outcome. Genetic analysis of the CYP2D6 gene is a promising, fast, accessible and credible tool, with a very significant contribution to the estimation of analgesic needs in the treatment of post-cesarean pain», concludes Manuela Grazina.
Pain is considered a dynamic and complex process that involves actions at multiple locations, including the genome of cells in the central nervous system. According to the International Association for the Study of Pain, “pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or so perceived as damage” and “remains one of the greatest concerns of Humanity”.
Author: Cristina Pinto (Press Office – University of Coimbra)
Science in the Regional Press – Ciência Viva
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