En ny blodprøve for smerte er utviklet som kan bidra til å gi objektive behandlinger basert på smertens alvorlighetsgrad
En lege vurderer en pasients smerte sensation subjectively since it is generally determined by patient’s self-reporting or clinical examination. The main cause of opioid epidemic in several countries is the over-prescription of pain-relieving drugs leading to addiction of these medications. The over subscription happens because of unavailability of methods to objectively measure pain. Effective communication of ‘level of pain’ is hardly ever achieved in a clinical setting especially for children and elderly. The smerte medications were continuously subscribed for all levels of smerte og dette har skapt et stort problem. Ubehandlet smerte kan påvirke livskvaliteten, og derfor er det nødvendig å få skreddersydd smertebehandling.
Identifisering av biomarkører for smerte
I en banebrytende studie publisert i Natur journal Molekylær psykiatri, en første prototype noensinne blod test has been developed by Indiana University School of Medicine, USA which can objectively if not completely quantitively measure severity of a patient’s pain with better accuracy. Researchers enrolled hundreds of participants who were psychiatric patients – a high risk group for pain disorders with increased sensation and perception of pain. Researchers identified gene expression biomarkers in the blod (like a signature or fingerprint which is unique) which could objectively determine severity of one’s pain. These biomarkers were molecules that can reflect severity of a disease, for example glucose in blod is a biomarker for diabetes. Some of the biomarkers like MFAP3 had no previous evidence of being involved in pain while many others were targets of existing drugs.
Forutsi naturlige stoffer
Forskere brukte bioinformatikk-medikamentreformålsanalyse for å matche smertebiomarkører med eksisterende ikke-vanedannende medisiner, medisiner og naturlige forbindelser-profiler i en reseptdatabase. Analyse antydet mulige blyforbindelser som ville normalisere smertesignaturen. Disse forbindelsene inkluderte både antidepressiva så vel som naturlige forbindelser som vitamin B6 og vitamin B12. De shortlistede forbindelsene var for det meste ikke-opioide legemidler eller forbindelser. Smertebiomarkørene kan også forutsi når en pasient neste gang vil føle smerte og sannsynligvis vil besøke klinikken. Noen biomarkører ble sett på som universelle og noen var spesifikke for et kjønn.
This information from a simple blod test is helpful to evaluate if a patient is suffering from chronic long-term pain. Treatment can be provided objectively and quantifiably especially for headache, fibromyalgia etc. For any therapeutic treatment the goal is to find the right drug which has minimal side effects. This study is a first step towards precision medicine for pain i.e. a personalized tailored treatment and it could change the way pain is treated by medical care.
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{Du kan lese den originale forskningsoppgaven ved å klikke på DOI-lenken nedenfor i listen over siterte kilder}
Source (s)
Niculescu AB et al 2019. Mot presisjonsmedisin for smerte: diagnostiske biomarkører og gjenbrukte legemidler. Molecular Psychiatry. https://doi.org/10.1038/s41380-018-0345-5
