SCN9A and SCN10A Polymorphism and Therapeutic Effectiveness of Lidocaine Local Anesthetic Injection in Subjects with Diabetic Neuropathy Pain

Abstract

Background: Diabetic neuropathy pain (DNP) is one of the complications experienced by more than half of the diabetic population. Treatment using lidocaine injection is one of the effective ways to manage pain in patients with DNP. Pain therapy using lidocaine locally targets the SCN9A and SCN10A genes, which encode the sodium receptors Nav1.7 and Nav1.8. The effect of lidocaine inhibits these sodium channels to reduce pain transmission. Purpose: This study aims to analyze the effect of polymorphism of genes encoding Nav1.7 and Nav1.8 on the effectiveness of lidocaine local injection therapy in patients with DNP. Methods: This study was an analytic observational study with a cross-sectional approach. A total of 63 people with DNP were genotyped for the SCN9A rs 6746030 gene and the SCN10A rs12632942 gene using Real-Time PCR/qPCR and DNA sequencing. Result: The results showed that 91.2% and 70.6% of the population who experienced decreased pain had the GA mutant allele in the SCN9A rs6746030 gene and the AG mutant allele in the SCN10A rs12632942 gene. The results showed a significant association of Nav1.7 and Nav1.8 gene polymorphisms with the effectiveness of lidocaine local anesthetic injection therapy in diabetic neuropathy pain patients (p < 0.05). Conclusion: This study shows that there was an association between Nav1.7 and Nav1.8 gene polymorphisms and the effectiveness of lidocaine local anesthetic injection therapy in patients with DNP. Lidocaine injection therapy that targets the Nav1.7 and Nav1.8 sodium channels involving the SCN9A and SCN10A genes can be a therapeutic alternative for patients with DNP.