Towards prevention of chronic PAIN following surgery: Does surgery-induced hypergLycaemia trigger cEntral nervous system SenSitisation (PAINLESS)?
Description: Chronic pain is the most prevalent disease worldwide, leading to enormous societal costs. PAINLESS aims at unravelling the aetiology, identifying new biomarkers and examining an innovative preventive strategy for chronic pain following knee replacement surgery. Surgery is a stressful event accompanied by hyperglycaemia orchestrated by adrenaline. In patients with chronic pain, we recently found higher DNA methylation in genes encoding for catecholamine-degrading enzymes, resulting in increased catecholamine levels and consequently higher glycaemia and central sensitisation. Therefore, it is hypothesized that knee replacement surgery results in hyperglycaemia, central sensitisation and chronic pain that can be explained by DNA methylation in genes encoding for catecholamine-degrading enzymes. PAINLESS includes a multicentre, quadruple blinded randomized controlled trial to examine whether patients receiving metformin for controlling perioperative glucose levels, compared to placebo, will have less chronic pain and central sensitisation at 3 months following surgery. Second, PAINLESS will examine whether DNA methylation in genes encoding for catecholamine-degrading enzymes, and related longer availability of catecholamines, contribute to surgery-induced hyperglycaemia, central sensitisation and chronic pain. PAINLESS can deliver a new theory with new (preventive) treatment directions that can become a breakthrough potentially in all medical disciplines using surgery.
Funder: Fonds Wetenschappelijk Onderzoek
Funding type: grant
Funder scheme: FWO research project (including WEAVE projects)
Start date: 2026-01-01
End date: 2029-12-31
Investigator: Annick TIMMERMANS
Institution: UHasselt
Funded outputs count: 0
Funder award ID: G059626N
OpenAlex ID: G3725901675