Genome Sequencing in Pain Management

Genomic strategies of treating illnesses are set to revolutionize the way physicians practice medicine, according to Dr. Clifford Woolf, keynote speaker at the American Pain Society’s 29^th Annual Scientific Conference Meeting May 6.

“Technology is advancing so rapidly, that it is literally around the corner that each of us and our patients can have their genomes sequenced.”

This could mean that at a moment’s notice physicians and healthcare professionals could most likely not only have access to a patient’s medical history, but also a report and in-depth analysis of their basic cellular composition identifying possible risk factors for a variety of hereditary diseases, patterns associated with common treatment outcomes, and more.

For the field of pain management, the genomic strategies are on their way to determining which genes, or mutations are responsible for how the body reacts to pain and can aid pharmacists in developing the right drugs for the right person in a more adequate and efficient manner, Woolf said.

Woolf, professor of neurology and neurobiology at Harvard Medical School and Children’s Hospital Boston, identified three main strategies that have emerged through genetic research to isolate genes and examine their function: uncovering candidate genes, genomic-wide association studies, and whole genome sequences.

Researchers have identified certain candidate genes associated with pain, which have been shown to either reduce the risk of developing pain, or increase the risk, which is key in understanding why the variation in pain manifestation seems to exist in patients, he said. Woolf discussed a study on Drosophila flies that focused on examining the genes that affect it’s capacity to detect and avoid noxious heat, as just one example of where the future of medicine and pain-management studies may lead in humans.

“We now are at a point where we can interrogate the entire genome,” he said.

We are in a position where we will identify those genes which are important in determining why one individual has more pain then another, why an individual is at risk of developing pain, and why one analgesic may be successful fo one patient and not the other, he said.

While studies have proven to be successful in animal models, Woolf stressed the need for more wide-spread testing on human cohorts for the advancement of the science.

Although currently, the price of performing genome sequencing on an individual can costs about $5000, Woolf said he sees the practice becoming standard within 10 years.

“Pandora’s box is open,” he said. “We have this technology and there’s no question about it it’s going to muscle into the way we practice medicine.”