Abstract Title

DETERMINATION OF GENETIC FACTORS ASSOCIATED WITH RESPONSE TO OSTEOPATHIC MANIPULATIVE TREATMENT IN INDIVIDUALS WITH CHRONIC LOWER BACK PAIN

Presenter Name

Kayla Richardson

Abstract

OMT (Osteopathic Manipulative Treatment) is an often overlooked, low risk treatment option for management of (Chronic Lower Back Pain) CLBP. My overarching hypothesis is that genetics contributes to OMT response. The study used 216 samples consisting of 111 individuals who received OMT, and a placebo group of 105 individuals who received a sham treatment. Genetic differences between subjects who benefited from OMT (responders) and those who did not benefit from OMT (non-responders) were compared. We found an association between 3 genes (IL-8, GCH1, and LARGE) and response to OMT in individuals who suffer from CLBP.

Presentation Type

Poster

Purpose (a):

OMT (Osteopathic Manipulative Treatment) is an often overlooked, low risk treatment option for management of (Chronic Lower Back Pain) CLBP. Underutilization of OMT is partially due to an undefined mechanism of action for the therapy. Our overarching hypothesis is through analysis of genotypic attributes; it is possible to determine which individuals are more likely to respond to OMT leading to insights into mechanisms of action. The current study investigated potential polymorphisms associated with OMT and pain reduction using data previously collected from a CLBP clinical study, which was part of The OSTEOPATHIC Trials.

Methods (b):

We performed a candidate gene study using single nucleotide polymorphisms (SNPs) within genes previously associated with pain: Catechol-o-methyltransferase (COMT), beta 2 adrenergic receptor (ADRB2), GTP cyclohydrolase GCH1, Interleukin 1 alpha (IL1A), interleukin 1 beta (IL1B), interleukin 1 receptor antagonist (IL1RN), Interleukin 8 (IL8), and like- glycosyltransferase (LARGE). Genotypes from subjects who benefited from OMT (responders) were compared to subjects who did not benefit from OMT (non-responders) using a chi-square analysis to test for associations. For SNPs that showed significance (α=0.05) an odds ratio (O.R.) was calculated. The study utilized 216 samples consisting of 111 individuals who received OMT, and a placebo group of 105 individuals who received a sham treatment.

Results (c):

SNPs in IL-8, GCH1, and LARGE showed significance (α=0.05) in the OMT group only: IL-8 SNP rs2227543 (O.R. 2.2824 CT, confidence interval (C.I.) 1.0053-5.1818), LARGE SNP rs240070 (O.R. 2.8546 TA, 1.0508-7.7548), and GCH1 SNP rs998259 (O.R. 0.4016 GA, C.I. 0.1600-1.0080). A SNP by SNP interaction was detected within GCH1 between rs998259 and rs3783641. When the rs998259 genotype is GG, rs3783641 is associated with response to OMT (α=0.05, O.R. 2.9630 TA, C.I. 1.1269-7.7907).

Conclusions (d):

There is an association between genetics and response to OMT in individuals who suffer from CLBP. Individuals with genotype CT in rs2227543 or TA in rs240070 are more likely to respond to OMT whereas individuals with genotype GA in rs998259 are less likely to respond to OMT. Furthermore, if an individual has genotype GG in rs998259 and TA in rs3783641 they are more likely to respond to OMT. Genes in neuronal, immunological, and muscular pathways affect OMT response.

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DETERMINATION OF GENETIC FACTORS ASSOCIATED WITH RESPONSE TO OSTEOPATHIC MANIPULATIVE TREATMENT IN INDIVIDUALS WITH CHRONIC LOWER BACK PAIN

OMT (Osteopathic Manipulative Treatment) is an often overlooked, low risk treatment option for management of (Chronic Lower Back Pain) CLBP. My overarching hypothesis is that genetics contributes to OMT response. The study used 216 samples consisting of 111 individuals who received OMT, and a placebo group of 105 individuals who received a sham treatment. Genetic differences between subjects who benefited from OMT (responders) and those who did not benefit from OMT (non-responders) were compared. We found an association between 3 genes (IL-8, GCH1, and LARGE) and response to OMT in individuals who suffer from CLBP.