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Contribution of Endocannabinoid Gene Expression and Genotype on Low Back Pain Susceptibility and Chronicity

Ramesh, Divya PhD*; D’Agata, Amy PhD, RN*; Starkweather, Angela R. PhD, RN, ACNP-BC, CNRN, FAAN*,†; Young, Erin E. PhD*,†,‡

The Clinical Journal of Pain: January 2018 - Volume 34 - Issue 1 - p 8–14
doi: 10.1097/AJP.0000000000000508
Original Articles

Background: A major research emphasis has been focused on defining the molecular changes that occur from acute to chronic pain to identify potential therapeutic targets for chronic pain. As the endocannabinoid system is dynamically involved in pain signaling, a plausible mechanism that may contribute to chronic pain vulnerability involves alterations in the amount of circulating endocannabinoids. Therefore, this study sought to examine cannabinoid type 1 (CNR1), type 2 (CNR2) receptors, fatty acid amide hydrolase (FAAH), and the vanilloid receptor (transient receptor potential cation channel subfamily V member 1 [TRPV1]) gene expression profiles among individuals with acute and chronic low back pain (cLBP) at their baseline visit. We also assessed associations among selected single nucleotide polymorphisms (SNPs) of FAAH and CNR2 and measures of somatosensory function and self-report pain measures.

Using a previously established quantitative sensory testing protocol, we comprehensively assessed somatosensory parameters among 42 acute LBP, 42 cLBP, and 20 pain-free participants. Samples of whole blood were drawn to examine mRNA expression and isolate genomic DNA for genotyping.

CNR2 mRNA was significantly upregulated in all LBP patients compared with controls. However, FAAH mRNA and TRPV1 mRNA were significantly upregulated in cLBP compared with controls. A significant association was observed between FAAH SNP genotype and self-report pain measures, mechanical and cold pain sensitivity among LBP participants. cLBP participants showed increased FAAH and TRPV1 mRNA expression compared with acute LBP patients and controls.

Further research to characterize pain-associated somatosensory changes in the context of altered mRNA expression levels and SNP associations may provide insight on the molecular underpinnings of maladaptive chronic pain.

*UCONN School of Nursing, Storrs, CT

Department of Genetics and Genome Sciences, UCONN School of Medicine Farmington, CT

Institute for Systems Genomics, University of Connecticut, Storrs, CT

The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research (NINR) or the National Institutes of Health (NIH).

Supported by the National Institute of Nursing Research (A.S., PI; R01 NR013932). The remaining authors declare no conflict of interest.

Reprints: Divya Ramesh, PhD, University of Connecticut School of Nursing, 231 Glenbrook Rd, Storrs, CT-06269-4026 (e-mail:

Received January 23, 2017

Received in revised form April 13, 2017

Accepted April 23, 2017

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