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The opioid receptor mu 1 (OPRM1) rs1799971 and catechol-O-methyltransferase (COMT) rs4680 as genetic markers for placebo analgesia

Aslaksen, Per M.a,b,*; Forsberg, June T.a; Gjerstad, Johannesc

doi: 10.1097/j.pain.0000000000001370
Research Paper
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The placebo effect is considered the core example of mind–body interactions. However, individual differences produce large placebo response variability in both healthy volunteers and patients. The placebo response in pain, placebo analgesia, may be dependent on both the opioid system and the dopaminergic system. Previous studies suggest that genetic variability affects the function of these 2 systems. The aim of this study was therefore to address the interaction between the single nucleotide polymorphisms opioid receptor mu 1 (OPRM1) rs1799971 and catechol-O-methyltransferase (COMT) rs4680 on placebo analgesia. Two hundred ninety-six healthy volunteers participated in a repeated-measures experimental design where thermal heat pain stimuli were used as pain stimuli. Participants were randomized either to a placebo group receiving placebo cream together with information that the cream would reduce pain, or to a natural history group receiving the same pain stimuli as the placebo group without any application of cream or manipulation of expectation of pain levels. The results showed that the interaction between OPRM1 rs1799971 and COMT rs4680 was significantly associated with the placebo analgesic response. Participants with OPRM1 Asn/Asn combined with COMT Met/Met and Val/Met reported significant pain relief after placebo administration, whereas those with other combinations of the OPRM1 and COMT genotypes displayed no significant placebo effect. Neither OPRM1 nor COMT had any significant influence on affective changes after placebo administration. As shown in this study, genotyping with regard to OPRM1 and COMT may predict who will respond favorably to placebo analgesic treatment.

Interaction of the opioid receptor mu 1 (OPRM1) rs1799971 and catechol-O-methyltransferase (COMT) rs4680 single nucleotide polymorphisms was significantly associated with placebo analgesia in healthy volunteers.

aDepartment of Psychology, University of Tromsø, Tromsø, Norway

bDepartment of Child and Adolescent Psychiatry, Division of Child and Adolescent Health, University Hospital of North Norway, Tromsø, Norway

cNational Institute of Occupational Health (STAMI), Oslo, Norway

Corresponding author. Address: Department of Psychology, University of Tromsø, Tromsø 9037, Norway. Tel.: + 47 776 49234. E-mail address: per.aslaksen@uit.no (P.M. Aslaksen).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

P.M. Aslaksen and J. Gjerstad contributed equally to this work.

Received January 10, 2018

Accepted August 06, 2018

© 2018 International Association for the Study of Pain
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