Related Experiment Video
Updated: May 16, 2026
A Preterm Rat Model for Pain Studies
Published on: February 9, 2024
First evidence of a polygenic susceptibility to pain in a pediatric cohort
Chantal Mamie1, Michela C Rebsamen, Michael A Morris
1Unit of Pediatric Anesthesiology, Division of Anesthesiology, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland. chantal.mamie@hcuge.ch
Insights
Genetic variations in ABCB1 and OPRM influence significant postoperative pain differences in children. This study explores genetic links to pediatric pain variability, offering insights for future research.
Area of Science:
- Pharmacogenetics
- Pediatric Pain Management
- Genetics of Pain
Background:
- Limited understanding of genetic factors contributing to pain variability in children post-surgery.
- Postoperative pain management in children is crucial for recovery and well-being.
Purpose of the Study:
- To investigate the association between candidate gene polymorphisms and postoperative pain variability in children.
- To identify genetic markers that may predict pain intensity and experience after surgery.
Main Methods:
- Prospective cohort study of 168 children undergoing surgery with patient-controlled analgesia (morphine).
- Genotyping for 6 candidate-gene polymorphisms (ABCB1, COMT, NTRK1, OPRM1, POMC, CYP2D6) in children and parents.
- Pain assessment using the Faces Pain Scale (FPS) at rest and during mobilization over 24 hours.
Main Results:
- ABCB1 (C3435T) and OPRM1 (A118G) genotypes were significantly associated with higher pain peaks and scores.
- NTRK1 (C45T) variations correlated with pain during mobilization, while COMT (Val158Met) influenced pain reduction.
- These findings highlight specific gene variants linked to clinically meaningful and subclinical pain variations.
Conclusions:
- ABCB1 and OPRM genotypes are key determinants of significant pain variability in pediatric postoperative patients.
- NTRK1 and COMT gene variations show associations with subclinical pain effects.
- This study provides foundational genetic insights into pediatric pain, warranting further investigation.
Background:
There is currently no evidence about the genetic bases of postoperative pain variability in children.
Methods:
We prospectively followed a cohort of 168 children after orthopedic or abdominal surgery, who were under morphine patient-controlled analgesia. The children and their parents were genotyped for 6 candidate-gene polymorphisms (single-nucleotide polymorphisms [SNPs]) implicated in nociception and opiate metabolism: ABCB1C3435T, COMTVal158Met, NTRK1His40Tyr, OPRMA118G, POMCArg236Gln, and a haplotype of CYP2D6. Postoperative pain was assessed using the Faces Pain Scale (FPS), at rest and during mobilization, 11 times during the first 24 postoperative hours.
Results:
At rest, and to a lesser extent, at mobilization, having at least 4 pain peaks of FPS score >6 in 24 hours was more frequent in children with ABCB1_CC than in children with ABCB1_CT and ABCB1_TT (adjusted risk ratio = 4.5; 95% confidence interval [CI],1.5-13.4; corrected CI for multiple comparisons, 0.98-20.55) and was more frequent in children with OPRM_GA than those with OPRM_AA (adjusted risk ratio = 3.5; 95% CI, 1.1-11.2; corrected CI, 0.70-17.30). After adjusting for parental mating type and correcting for multiple comparisons, mean FPS scores across the 24 postoperative hours were higher for OPRM_GA than for OPRM_AA at rest (P < 0.0002), higher for NTRK1_ CT or NTRK1_ TT than NTRK1_ CC during mobilization (P = 0.002), and lower for COMT_GG than COMT_AA and COMT_GA, during mobilization (P = 0.005).
Conclusions:
ABCB1 and OPRM genotypes are associated with clinically meaningful pain variability, whereas NTRK1 and COMT are linked to subclinical effects. This first but small cohort study provides clues to further explore the genetic foundations of pediatric pain.
