Assoziation eines Polymorphismus im NK1-Rezeptorgen mit Rezidivraten der Endometrioseerkrankung

Background: Dysmenorrhoea is the major symptom in women with endometriosis. Recently, pain modulation through Neurokinin-1-receptor (NK1R) pathways have been investigated in neuropathic pain patients. Aim of this study was therefore, to examine the effect of a single nucleotide polymorphism (SNP) of the NK1R gene on the susceptibility for endometriosis and the disease free survival (DFS) after surgery for endometriosis. Material and Methods: A case-control study of 163 cases and 115 controls was conducted and germline DNA was isolated. The patients of the case-group had a treatment because of endometriosis in the years between 2000 and 2005 in the Gynecology and Obstetric Department of the University Erlangen. Endometriosis was histological proved with laparoscopic surgery. The patients of the control-group had no endometriosis neither in their own nor in the familial medical history. They also had no abdominal surgery in their life until 40 years ( except appendectomy ). Patients were followed up for a recurrence of the disease up to 4 years. Case-control analyses were performed for parameters of the medical history and the genotype of the NK1R-SNP rs881. Furthermore, DFS probabilities were calculated. Results: Concerning the DFS preoperative pain levels and the NK1R genotype were independent predictors for a recurrence with hazard ratios of 2.55 (95% CI: 1.32–4.95) for patients with a high preoperative pain level and 0.44 for patients with a heterozygous or homozygous variant genotype in rs881 (95% CI: 0.21–0.88). Conclusion: The polymorphism rs811 seems to be associated with a lower recurrence risk in endometriosis patients. Thus, there might be a clinical relevant role of the NK1 pathway in the pain perception of endometriosis patients.