Pain Clinical Trial
Official title:
Heritability of Opioid Effects: A Twin Study
Proposed twin study will test to what degree inter-individual differences in pain sensitivity and amount of pain relief in response to opioid therapy are inherited or alternatively, are due to environmental factors. This knowledge is important to guide future studies trying to explain such inter-individual differences. For example, finding that differences are largely due to environmental factors would discourage genomic studies and emphasize epidemiological studies.
The principal hypothesis to be evaluated is that the degree of analgesia provided by opioids
in humans displays substantial familial aggregation, and is, in fact, heritable. These
studies will use a classical twin paradigm to determine the role of genetics and the
environment in influencing analgesia and a range of other opioid effects.
Specific Aims: (1) Determine the degree to which opioid analgesic responses show familial
aggregation and make preliminary estimates of heritability using both a heat and cold
pressor pain model, and (2) determine the degree to which non-analgesic opioid responses
show familial aggregation and make preliminary estimates of heritability. Side effects such
as sedation, nausea, respiratory depression, and pruritus, as well as the positive affective
response, a measure of abuse potential, will be monitored. Monozygotic (MZ) and dizygotic
(DZ) twin pairs (125 total pairs) will be tested under controlled pain laboratory conditions
for their responses to opioid infusion using the complementary pain models while monitoring
side effects and additional psychometric indices of mood, sleep, and abuse potential. The
selected models provide unique mechanistic information because they involve different
peripheral and/or central pain pathways. DNA samples will be collected for zygosity testing
and banked for future studies.
;
Allocation: Randomized, Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator)
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