ArticleJournal of pain research2026
An Erythroid Gene Expression Signature in Preoperative Whole-Blood RNA-Seq Associated with Rebound Pain After Brachial Plexus Block: A Prospective Observational Study.
Article in Journal of pain research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Preoperative whole-blood transcriptomic profiles may reflect systemic biological variation before surgery, but their association with rebound pain after brachial plexus block remains unclear. This study investigated whether preoperative whole-blood transcriptomic profiles are associated with pain escalation after brachial plexus block resolution. Methods: This single center prospective study enrolled patients who underwent upper extremity surgery with ultrasound guided brachial plexus block. Preoperative whole blood RNA sequencing was used to compare the transcriptomic profiles between patients with and without rebound pain. Differential expression, functional enrichment, protein-protein interaction analysis, LASSO regression, and random forest analysis were performed. The selected hub gene was further validated by qRT-PCR in an independent cohort using the same matching strategy. Results: Among the 47 analyzed patients, 28 experienced rebound pain. The RNA-seq discovery cohort included 24 matched patients, with 12 patients in each group. RNA-seq analysis identified 110 differentially expressed genes, most of which were upregulated in the rebound pain group. Enrichment analyses highlighted erythrocyte differentiation, hemoglobin metabolism, porphyrin biosynthesis, and oxygen-carbon dioxide exchange. Protein-protein interaction analysis identified a 13-gene cluster, from which Conclusion: Preoperative whole-blood erythrocyte-related transcriptional signals, including Trial Registration: This study was registered with the Chinese Clinical Trial Registry. No. ChiCTR2400081153. Registered 23 February 2024.
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