SAN FRANCISCO — Researchers now are able to predict which wounded servicemembers are likely to develop persistent, chronic pain after amputation based on variants in their individual DNA sequence.
The presentation noted that, from 2000 to 2011, 6,144 amputations occurred among 5,694 injured servicemembers, with more than one-third having major amputations, defined as the loss of a hand, foot or more. As many as 80% of all amputees experience pain in their residual limb, or a “phantom pain,” according to the report.
“Traumatic amputations of limbs profoundly change the lives of affected military servicemembers,” said Andrew D. Shaw, MD, associate professor of anesthesiology and critical-care medicine at Duke. “Persistent pain after amputation is a serious problem with no effective treatments. By identifying these ‘pain genes,’ we may be able to discover the reasons why pain occurs and predict which patients are more likely to have it. In the future, we hope to discover the biology of persistent pain and develop ways to combat it.”
For the study, blood was collected for DNA, RNA and plasma extraction from 49 servicemembers with amputations and persistent pain. Blood samples then were mapped using Exome Sequencing technology to identify any variations the patients have in common.
“The researchers were able to identify hundreds of previously unknown DNA sequence variations as pathways of biological importance and as the possible source of chronic, persistent pain.
“This is one of the first studies where ‘pain genes’ have been identified in humans using next-generation sequencing,” Shaw explained. “We have known about some of them in lab studies. Now that we have identified these gene variations, we need to study them and then create new medicines to prevent and relieve the chronic pain for these patients.”
Shaw, AD, Vandeven T, Kieber A, Hsia J, Grisson N, Buchheit T, Macleod, D, McDuffie M, Buckenmaier C. Whole Exome Sequencing Identifies Novel Genetic Variants in Amputees With Persistent Residual Limb Pain.(October 2013) Presented at ANESTHESIOLOGY 2013. Meeting. San Francisco, CA.
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