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Background  The P2X 7  receptor is a member of the P2X family of adenosine 5′-triphosphate-gated cation channels. Several recent studies have demonstrated that this receptor is involved in mechanisms related to pain and inflammation. However, unknown is whether polymorphisms of the  P2RX7  gene that encodes the human P2X 7  receptor influence pain sensitivity and analgesic effects of opioids. The  P2RX7  gene is known to be highly polymorphic. Thus, the present study examined associations between fentanyl sensitivity and polymorphisms in the  P2RX7  gene in 355 Japanese patients who underwent painful orofacial cosmetic surgery.    Results  We first conducted linkage disequilibrium (LD) analyses for 55 reported single-nucleotide polymorphisms (SNPs) in the region within and around the  P2RX7  gene using genomic samples from 100 patients. In our samples, 42 SNPs were polymorphic, and a total of five LD blocks with six Tag SNPs (rs2708092, rs1180012, rs1718125, rs208293, rs1718136, and rs7132846) were observed. Thus, we further analyzed associations between genotypes/haplotypes of these Tag SNPs and clinical data using a total of 355 samples. In the genotype-based association study, only the rs1718125 G > A SNP tended to be associated with higher pain scores on a visual analog scale 24 h after surgery (VAS24). The haplotype-based association study showed that subjects with homozygous haplotype No.3 (GTAAAC; estimated frequency: 15.0%) exhibited significantly higher cold pain sensitivity and lower analgesic effects of fentanyl for acute cold pain in the cold pressor test. Conversely, subjects who carried haplotype No.1 (ACGGAC; estimated frequency: 24.5%) tended to exhibit lower cold pain sensitivity and higher analgesic effects of fentanyl. Furthermore, subjects with homozygous haplotype No.2 (GCGGAC; estimated frequency: 22.9%) exhibited significantly lower VAS24 scores.    Conclusions  Cold pain sensitivity and analgesic effects of fentanyl were related to the SNP and haplotypes of the  P2RX7  gene. The patients with the rs1718125 G>A SNP tended to show higher VAS24 scores. Moreover, the combination of polymorphisms from the 5′-flanking region to exon 5 recessively affected cold pain sensitivity and analgesic effects of opioids for acute cold pain. The present findings shed light on the involvement of  P2RX7  gene polymorphisms in naive cold pain sensitivity and analgesic effects of fentanyl.    Electronic supplementary material  The online version of this article (doi:10.1186/1744-8069-10-75) contains supplementary material, which is available to authorized users.

Haplotypes of P2RX7 Gene Polymorphisms are Associated with both Cold Pain Sensitivity and Analgesic Effect of Fentanyl