ASSOCIATION BETWEEN THE CATECHOL-O-METHYLTRANSFERASE Val158Met POLYMORPHISM WITH SUSCEPTIBILITY AND SEVERITY OF CARPAL TUNNEL SYNDROME
Erkol İnal E1,*, Eroğlu P2, Görükmez O3, Özemri Sağ Ş4, Yakut T4
*Corresponding Author: Dr. Esra Erkol İnal, Department of Physical Medicine and Rehabilitation, Süleyman Demirel University, Faculty of Medicine, Afyon yolu, Çünür, Isparta, Turkey. Tel: +90-246-211-9280. GSM: +90-507-563-6511. Fax: +90-246-211-2830. E-mail: esraerkol@hotmail.com
page: 43

DISCUSSION

Lower COMT gene activity that is linked to Met/ Met genotype, results in elevated levels of catecholamines, which stimulate β2 adrenergic receptors in the peripheral and central nervous system [13,14]. The clinical status in CTS is generally thought be a result of the entrapment of the median nerve, nevertheless, current results revealed the association of the Met/Met genotype with higher pain sensitivity and disability in a number of chronic musculoskeletal disorders such as fibromyalgia [15], temporomandibular pain [16] and CTS [9]. However, our data suggested that there was no relationship between pain severity and disability and the COMT gene Val158Met SNP in the patients with CTS, similar to some previous studies investigating chronic musculoskeletal disorders [17] and neuropathic [18] and widespread pain [19]. These discrepancies may be due to the fact that a patientís SNP in a potential candidate gene does not act alone, but in interaction with environmental and ethnic factors to reveal personal manifestation in the disease course. The COMT gene Val158Met SNP Met/Met genotype was found to be related with higher anxiety, depression and disability in fibromyalgia [20,21]. The COMT gene SNPs related to pain sensitivity such as Val158Met was found to be related with severity of fibromyalgia in Spanish patients, whereas there was no relation in Mexican patients [22]. The patients with the Met/Met genotype had worse clinical features in long-lasting low-back pain, sciatica and lumbar disc herniation [23,24]. Nevertheless, the exact role of the COMT gene Val158Met SNP remains controversial. Supporting all these results: gender, ethnicity and psychological state were accepted to interact with the genes in pain responses to painful conditions [5]. Similar to a recent study, we did not find any relationships between the COMT gene Val158Met SNP and development of CTS [9]. The patient population in the latter study also consisted of solely female patients similar to the present study. There are several limitations in the present study. The population in this study includes only female patients and the participants were all from a secondary hospital. These conditions may limit the results to the general population. Moreover, only one SNP of the COMT gene was investigated in this study; therefore, we could not exclude the other genetic influences. In conclusion, we found no relationships between the Val158Met SNP, CTS and clinical outcomes. Genetic researches can help to offer special care to the patients; however, the results of the reports investigating the relationships between the COMT gene Val158Met SNP and pain perception in painful conditions are conflicting. New studies with a greater number of candidate genes to CTS and pain, in a larger population including both male and female patients from several hospitals and geographic regions, should be designed to establish precise relations. Declaration of Interest. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.



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