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By Malika Ramani ‘21 Edited by Jess Sevetson  Imagine putting your hand down on a hot stovetop and not even realizing you are burning. A life without pain – without analgesics, without anxiety – sounds liberating. It is, however, also dangerous – to need someone to inform you of injuries, to be unaware of the fact that you may be hurting your body without even realizing it. For Jo Cameron, this is her reality: the now 71-year-old woman has spent her entire life without feeling pain. It has only recently come to light that her lack of sensation is due to two unusual genetic mutations, and this discovery could lead to innovative treatments for pain and anxiety in the years to come. Jo Cameron, 2019 (Image by Mary Turner for The New York Times) (1) Cameron lived without any pain for more than sixtyyears before she learned of her genetic abnormalities (1).The discovery came at the age of 65, after she refused painkillers following a double hand surgery to ameliorate her osteoarthritis, a procedure which is typically accompanied by excruciating pain (2). Even prior to this surgery, what made Cameron unique is that she never felt emotional orphysical pain, whether during childbirth (she described it as merely a “tickle”) or after eating extremely hot chili peppers (she felt only a “pleasant glow”) (3). She spent decades relying heavily on her husband with regards to physical pain, needing him to warn her when she was bleeding or injured. Furthermore, Cameron herself claims that she cannot remember any event in her life during which she felt distraught. She scored a zero out of 21 points on an anxiety and depression questionnaire (1). Cameron’s lack of post-surgical pain led her physicians to realize that something was different about her, incentivizing them to investigate (4). Upon analyzing her DNA, a team at University College London’s Molecular Nociception Group found two notable mutations.The combination of these changes to her genes had suppressed Cameron’s abilities to feel pain and anxiety and instead boosted her happiness levels and healing abilities (3). The first of the two mutation calms the activity of the FAAH gene. FAAH produces an enzyme in the body that breaks down anandamide, which contributes to sensations of pain, memory, and mood. The more anandamide in an individual’s body, the greater its pain-relieving, “analgesic” effect, but the first of Cameron’s two mutations calms the activity of the FAAH gene, leading her to have twicethe normal amount of anandamide (3). Interestingly, this mutation is not actually that uncommon in the general population. Cameron’s second mutation, however, proved to be far more notable and rare: she is missing a part of a DNA gene that not yet been identified, and she is one of only two people in the world to have the mutation (4). Ironically, scientists originally believed that this was a “junk” gene with no significant function (2). They have since dubbed it the “FAAH-OUT” gene, surmising that it functions as a controller for the regular FAAH gene (3). Cameron’s physicians speculate that both mutations increase signaling at cannabinoid receptors, which aid the body in responding to stressful situations, thus causing reductions in anxiety. Given that the regions of the brain that control physical and emotional pain overlap, it makes sense that these same cannabinoid receptors are also involved in the process of experiencing physical pain (1). Cameron is not the first patient to be studied for a lack of ability to experience physical pain. She is, however, among the first to simultaneously lack an ability to experience feelings of anxiety. According to a pain and anesthesia consultant at King’s College Hospital in London, patients with higher anxiety levels also tend to perceive pain more intensely (1). The discovery of her genetic mutations invokes countless questions regarding how individuals process physical and psychological pain, which had previously been conceived as primarily separate sensations (1). There are endless potential implications for drug innovation following this discovery. Given that 330 million patients undergo surgery around the world each year, Cameron’s mutations could lead to the creation of a painkiller that provides post-surgical pain relief while accelerating wound healing (4). Given the widespread severity of America’s current opioid crisis, this could potentially also lead to a less addictive method of treating both acute and chronic pain. Additionally, since chronic pain patients often face anxiety regarding a lack of control over their body, new treatments may be able to doubly benefit these patients by reducing both their physical pain and its associated anxiety (1). Indeed, it will take time for the results of this discovery to be translated into viable therapeutic treatments, but Cameron’s genetic analysis promises to pave the way for new anxiety and pain therapies in the coming years. Works Cited: [1] Murphy H. How Pain Tolerance and Anxiety Seem to Be Connected [Internet]. The New York Times. The New York Times; 2019 [cited 2019 Apr 13]. Available from: https://www.nytimes.com/2019/03/30/health/pain-anxiety-jo-cameron.html
[2] Times RVT. Genetic Mutation Causes Former Teacher Jo Cameron To Feel No Pain Or Anxiety [Internet]. Tech Times. TechScienceHealthCulture Features Buzz; 2019 [cited 2019 Apr 13]. Available from: https://www.techtimes.com/articles/240523/20190330/genetic-mutation-causes-former-teacher-jo-cameron-to-feel-no-pain-or-anxiety.htm [3] Ishak N. Meet The Woman Who Is Incapable Of Feeling Physical And Emotional Pain [Internet]. All That's Interesting. All That's Interesting; 2019 [cited 2019 Apr 13]. Available from: https://allthatsinteresting.com/jo-cameron [4] Diamond C. The woman who doesn't feel pain [Internet]. BBC News. BBC; 2019 [cited 2019 Apr 13]. Available from: https://www.bbc.com/news/uk-scotland-highlands-islands-47719718
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