Tell-tale gene affects success of drug used to treat chronic pain

In a study carried out by researchers at the Centre for Reproductive Health within IRR, women with chronic pelvic pain who had a naturally occurring variation of a gene, known as Neuregulin 3, in their DNA were more likely to experience relief after taking the painkilling drug gabapentin.

Targeting gabapentin use to those with this genetic marker would avoid ineffective treatment and unwanted side-effects in those who are unlikely to respond, experts say.

The findings could improve use of gabapentin in treating chronic pelvic pain – a persistent, disabling pain which affects one in four women worldwide.

Gabapentin, often prescribed for chronic pain, targets the central nervous system – which carries messages between the brain and nerves throughout the body – to reduce heightened pain sensitivity that affects people with long-standing conditions.

The findings, from the University of Edinburgh, follow a previous study from the same team which suggested that gabapentin treatment was beneficial for certain women, with moderate improvements in the worst or average pelvic pain for 40 per cent of participants.

The latest study, in collaboration with the University of Oxford, studied the genetic make-up of 71 women with chronic pelvic pain who received gabapentin – 29 responded to the medication and 42 saw no improvement.

They found a naturally occurring variation of the gene Neuregulin 3, which determined who would respond to gabapentin. The gene gives rise to a protein of the same name, found in the brain and spinal cord, which is involved in pain sensation and transmission.

The findings offer fresh insight into the underlying mechanisms behind chronic pain, and may have implications for other conditions besides pelvic pain, experts say.

The team say more research is needed to confirm the findings in a larger population of women. Their work is being supported by Edinburgh Innovations (EI), the University’s commercialisation service, which has patented the discovery and is seeking a commercial partner to further the research.

The study, entitled 'Genome-wide association reveals a locus in neuregulin 3 associated with gabapentin efficacy in women with chronic pelvic pain' is published in the journal iScience.