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CRHBP polymorphisms predict chronic pain development following motor vehicle collision
Sarah D Linnstaedt1, Andrey V Bortsov, April C Soward
1TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC, USA Anesthesiology, University of North Carolina, Chapel Hill, NC, USA Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA Emergency Medicine, Spectrum Health System, Grand Rapids, MI, USA Emergency Medicine, Baystate Medical Center, Springfield, MA, USA Emergency Medicine, North Shore University Hospital, Manhasset, NY, USA Emergency Medicine, Saint Joseph Mercy Health System, Ypsilanti, MI, USA Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL, USA Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA.
Genetic variants in stress-related genes, including corticotropin-releasing hormone-binding protein (CRHBP), predict chronic musculoskeletal pain (MSP) after motor vehicle collisions (MVC). These genes interact, influencing long-term pain severity following trauma.
Area of Science:
- Neuroscience
- Genetics
- Psychotraumatology
Background:
- Musculoskeletal pain (MSP) is a common outcome after traumatic stress, such as motor vehicle collisions (MVCs).
- While tissue injury is a traditional focus, neuro/stress/immune system activation is increasingly implicated in chronic MSP.
- Previous research linked FKBP5 gene variants to MSP vulnerability post-MVC.
Purpose of the Study:
- To investigate the influence of genetic variants in other hypothalamic-pituitary-adrenal (HPA) axis genes on chronic MSP risk after MVC.
- Specifically examining NR3C1, CRHR1, and CRHBP genes.
Main Methods:
- Cohort study of 855 individuals following MVC.
- Genotyping for HPA axis-related genes.
- Regression models controlling for multiple comparisons to assess associations with pain severity over one year post-MVC.
Main Results:
- A significant association was found between the CRHBP gene polymorphism rs7718461 and overall pain severity post-MVC (P = 0.0012).
- A significant interaction between the CRHBP locus and time post-trauma was observed, indicating an increasing effect over time.
- A significant interaction between CRHBP and FKBP5 genetic variants revealed substantially increased MSP in individuals with risk alleles in both genes.
Conclusions:
- Genetic variants in HPA axis genes, specifically CRHBP and FKBP5, predict chronic MSP severity after MVC.
- These findings support the HPA axis's role in the pathogenesis of chronic post-MVC MSP.
- Genetic predisposition may influence long-term pain outcomes following traumatic events.
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