THE GENE FOR PAIN DISCOVERED

- by Dr. Robert C. Martin

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If you have been sitting home patiently waiting for the amazing medical breakthrough known as gene therapy to do you some good I have something that might get you off the couch.

Just about everything that happens in the body is directed by a genetic code that can be found on our DNA, otherwise known as our genes. Genes determine relatively simple things like whether we are male or female, have blue or brown eyes and the color of our hair. Genes also control some very complicated body functions such as our response to pain.

Researchers at the University of Toronto, The Hospital for Sick Children and the Amgen Institute have discovered a genetic mechanism involved in pain modulation that could lead to an entirely new approach to pain control.

The researchers genetically engineered mice lacking a gene called DREAM – which stands for downstream regulatory element antagonist modulator. These mice showed a dramatic loss of pain sensitivity compared to mice who had the DREAM gene. The researchers consider this a breakthrough finding because it provides such a different approach to the control of pain than traditional methods of pain management.

The DREAM gene facilitates the pain response by directing the production of a protein that suppresses the genetic machinery that reads the DNA code for an important natural pain suppressant called dynorphin. Dynorphin is an endorphin, one of the body's most powerful natural pain relievers similar to morphine.

When the DREAM gene was absent in the mice, the researchers discovered that increased production of dynorphin in the spinal cord region resulted in decreased sensitivity to acute, inflammatory and neuropathic or nerve type pain. In other words blocking the DREAM gene reduced pain. The fact that mice with neuropathic or nerve-type pain experienced reduced pain is particularly exciting because the medical community currently doesn't have any widely effective treatment for this debilitating type of pain.

Current approaches to pain management focus on drugs such as morphine that stimulate endorphin receptors or drugs such as aspirin and ibuprofen that block prostaglandins. Both of these approaches have drawbacks.

The DREAM gene, however, works in an entirely different way by binding directly to DNA suppressing the body’s natural opioid system. New drugs can be developed that block the DREAM gene and limit the body's pain response.

Even though pain is a very complicated biochemical response of the body to a stimulus we do not like, explaining the sensation of pain is generally unnecessary. Almost everyone has experienced pain in some form, whether it was as relatively minor as a headache, sprained ankle or an abrasion, or as severe as nerve pain or malignant cancer pain - one hundred twenty million Americans experience pain of some sort each year. The fact is the management of pain is one of the most significant factors in healthcare today particularly in orthopedics. Pain is a huge silent health problem that is only beginning to be addressed by researchers.

Evidence of the severity of this problem can be found in the fact that the U.S. government has declared 2001-2010 the Decade of Pain Research and Management. This declaration highlights a growing awareness of the vast problem of untreated or undertreated pain, this research should go a long way to confront this challenge.