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The translocator protein gene is associated with symptom severity and cerebral pain processing in fibromyalgia
Karolinska University Hospital, Sweden; Lowenstromska Hospital, Sweden.
Karolinska University Hospital, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
University of Gothenburg, Sweden.
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2016 (English)In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 58, 218-227 p.Article in journal (Refereed) Published
Abstract [en]

The translocator protein (TSPO) is upregulated during glia activation in chronic pain patients. TSPO constitutes the rate-limiting step in neurosteroid synthesis, thus modulating synaptic transmission. Related serotonergic mechanisms influence if pro- or anti-nociceptive neurosteroids are produced. This study investigated the effects of a functional genetic polymorphism regulating the binding affinity to the TSPO, thus affecting symptom severity and cerebral pain processing in fibromyalgia patients. Gene-to-gene interactions with a functional polymorphism of the serotonin transporter gene were assessed. Fibromyalgia patients (n = 126) were genotyped regarding the polymorphisms of the TSPO (rs6971) and the serotonin transporter (5-HTTLPR/rs25531). Functional magnetic resonance imaging (n = 24) was used to study brain activation during individually calibrated pressure pain. Compared to mixed/low TSPO affinity binders, the high TSPO affinity binders rated more severe pain (p = 0.016) and fibromyalgia symptoms (p = 0.02). A significant interaction was found between the TSPO and the serotonin transporter polymorphisms regarding pain severity (p amp;lt; 0.0001). Functional connectivity analyses revealed that the TSPO high affinity binding group had more pronounced pain-evoked functional connectivity in the right frontoparietal network, between the dorsolateral prefrontal area and the parietal cortex. In conclusion, fibromyalgia patients with the TSPO high affinity binding genotype reported a higher pain intensity and more severe fibromyalgia symptoms compared to mixed/low affinity binders, and this was modulated by interaction with the serotonin transporter gene. To our knowledge this is the first evidence of functional genetic polymorphisms affecting pain severity in FM and our findings are in line with proposed glia-related mechanisms. Furthermore, the functional magnetic resonance findings indicated an effect of translocator protein on the affective-motivational components of pain perception. (C) 2016 The Authors. Published by Elsevier Inc.

Place, publisher, year, edition, pages
Keyword [en]
Fibromyalgia; Translocator protein; Serotonin; Genetic polymorfisms; Functional magnetic resonance imaging; Serotonin transporter; SCL6A4; rs6971; 5-HTTLPR; Gene-to-gene interactions
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URN: urn:nbn:se:liu:diva-132509DOI: 10.1016/j.bbi.2016.07.150ISI: 000385905600026PubMedID: 27448744OAI: diva2:1046505

Funding Agencies|Swedish Rheumatism Association; Stockholm County Council; Swedish Foundation for Strategic Research [2012-0179]; Swedish Research Council [K2013-52X-22199-01-3, K2015-99x-21874-05-4, 2011-4807, K2009-52P-20943-03-2]; AFA insurance; Karolinska Institutet Foundation; Karolinska Institutet; European Union [602919]

Available from: 2016-11-14 Created: 2016-11-13 Last updated: 2016-12-05

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Gerdle, Björn
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