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Back Mechanical Sensitivity Assessment in the Rat for Mechanistic Investigation of Chronic Back Pain

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Evidence for a Causal Association Between Human Cytomegalovirus Infection and Chronic Back Pain: A One-Sample

Maryam Kazemi Naeini¹, Maxim B Freidin¹, Isabelle Granville Smith¹

¹Department of Twin Research and Genetic Epidemiology, School of Life Course and Population Sciences King's College London London UK.

|April 9, 2025

Summary

Cytomegalovirus (CMV) infection is causally linked to chronic back pain (CBP). This study used Mendelian randomization to investigate the association between CMV and CBP, finding a significant link.

Keywords:

Epstein–Barr virus causal association chronic Back pain cytomegalovirus

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Last Updated: May 17, 2025

Back Mechanical Sensitivity Assessment in the Rat for Mechanistic Investigation of Chronic Back Pain

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Area of Science:

Genetics
Epidemiology
Infectious Disease

Background:

Chronic back pain (CBP) is a leading global cause of disability.
The multifactorial etiology of CBP includes potential genetic and environmental factors.
Paraspinal muscle fat accumulation is associated with CBP, and cytomegalovirus (CMV) is known to be trophic for fat.

Purpose of the Study:

To test the hypothesis that previous cytomegalovirus (CMV) infection is linked to chronic back pain (CBP).
To investigate a potential causal relationship between CMV infection and CBP using a one-sample Mendelian randomization (MR) approach.

Main Methods:

A one-sample Mendelian randomization (MR) study was conducted using data from 5140 UK Biobank participants.
Genetic variants predicting CMV positivity were identified via genome-wide association studies.
A CMV polygenic risk score (PRS) was used for validation, with Epstein-Barr virus (EBV) used as a negative control.

Main Results:

Genetically predicted CMV infection risk was significantly associated with CBP (OR=1.150, p=0.043).
Using a CMV polygenic risk score (PRS) yielded stronger significant results (OR=1.290, p=1.2E-4).
No significant association was observed between Epstein-Barr virus (EBV) and CBP, supporting the specificity of the CMV finding.

Conclusions:

The study provides evidence for a causal relationship between cytomegalovirus (CMV) infection and chronic back pain (CBP).
Further research is needed to elucidate the specific mechanisms by which CMV may contribute to CBP pathogenesis.