Could epigenetics help explain racial disparities in chronic pain?

Area of Science:

• Health Disparities
• Epigenetics
• Chronic Pain Research

Background:

• African Americans experience disproportionately severe chronic pain compared to non-Hispanic Whites.
• Psychosocial factors like adverse childhood experiences, discrimination, low socioeconomic status, and depression contribute to chronic pain.
• Race, as a social construct, influences early life conditions, potentially leading to epigenetic changes that sustain racial differences in chronic pain.

Purpose of the Study:

• To review the literature on epigenetics as a mechanism explaining racial differences in chronic pain.
• To explore how environmental factors impact gene expression related to chronic pain without altering genetic sequences.

Main Methods:

• Narrative literature review focusing on epigenetic mechanisms in chronic pain.
• Examination of studies investigating DNA methylation in relation to chronic pain and racial disparities.

Main Results:

• Epigenetic modifications, particularly DNA methylation, are implicated in chronic pain.
• Alterations in DNA methylation of the glucocorticoid receptor gene (NR3C1) are linked to depression, stress, socioeconomic status, and chronic pain.
• DNA methylation patterns in immune cytokine genes are associated with chronic stress.

Conclusions:

• Epigenetic changes, especially DNA methylation, play a crucial role in the development and severity of chronic pain across different races.
• Higher incidence of epigenetic alterations in African Americans may contribute to more severe and disabling chronic pain.
• Environmental factors interacting with genetic predispositions through epigenetic mechanisms offer a potential explanation for racial disparities in chronic pain.