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Relationship of Genetic Variants With Procedural Pain, Anxiety, and Distress in Children
Anne L Ersig1, Debra L Schutte2, Jennifer Standley3
11 College of Nursing, The University of Iowa, Iowa City, IA, USA.
Insights
Genetic variations influence children's pain and anxiety during medical procedures. A study identified a specific gene (IL1B) linked to distress, aiding in identifying at-risk children.
Area of Science:
- Genetics
- Pediatrics
- Psychology
Background:
- Procedural pain, anxiety, and distress are significant concerns in pediatric healthcare.
- Understanding the genetic underpinnings of these responses can improve patient care.
- Candidate gene approaches allow focused investigation of specific genetic variants.
Purpose of the Study:
- To investigate genomic variations associated with pain, anxiety, and distress in children undergoing medical procedures.
- To identify specific genes and single-nucleotide polymorphisms (SNPs) linked to these phenotypes.
- To explore the utility of genomic screening for identifying at-risk children.
Main Methods:
- A candidate gene approach was employed in a study of children aged 4-10 undergoing IV catheter insertion.
- Genomic DNA was collected from 828 children and 376 family trios.
- Analyses included child-only association and family-based transmission disequilibrium tests (TDT) for genotyped variants.
Main Results:
- One SNP (rs1143629 in IL1B) was significantly associated with observed child distress (p = .00013) in family-based analyses.
- SNPs in NGFB (rs6330) and BDNF (rs6265) approached significance for association with state and trait anxiety, respectively.
- Child-only analyses revealed nominal associations for multiple SNPs, with BDNF (rs6265) and CCKBR (rs2941026) showing potential links to trait anxiety.
Conclusions:
- Genomic variation exploration enhances understanding of pain, anxiety, and distress in children.
- Genomic screening can identify children at higher risk for procedural distress.
- Findings may guide tailored interventions and identify genes for future genotype-phenotype research.
Objective:
This study used a candidate gene approach to examine genomic variation associated with pain, anxiety, and distress in children undergoing a medical procedure.
Study Design:
Children aged 4-10 years having an IV catheter insertion were recruited from three Midwestern children's hospitals. Self-report measures of pain, anxiety, and distress were obtained as well as an observed measure of distress. Samples were collected from children and biological parents for analysis of genomic variation. Genotyped variants had known or suspected association with phenotypes of interest. Analyses included child-only association and family-based transmission disequilibrium tests.
Results:
Genotype and phenotype data were available from 828 children and 376 family trios. Children were 50% male, had a mean age of 7.2 years, and were 84% White/non-Hispanic. In family-based analysis, one single-nucleotide polymorphism (SNP; rs1143629, interleukin ( IL1B) 1β) was associated with observed child distress at Bonferroni-corrected levels of significance ( p = .00013), while two approached significance for association with high state anxiety (rs6330 Nerve Growth Factor, Beta Subunit, [ NGFB]) and high trait anxiety (rs6265 brain-derived neurotrophic factor [ BDNF]). In the child-only analysis, multiple SNPs showed nominal evidence of relationships with phenotypes of interest. rs6265 BDNF and rs2941026 cholecystokinin B receptor had possible relationships with trait anxiety in child-only and family-based analyses.
Conclusions:
Exploring genomic variation furthers our understanding of pain, anxiety, and distress and facilitates genomic screening to identify children at high risk of procedural pain, anxiety, and distress. Combined with clinical observations and knowledge, such explorations could help guide tailoring of interventions to limit procedure-related distress and identify genes and pathways of interest for future genotype-phenotype studies.