Rationale for and Development of the Pancreatic Quantitative Sensory Testing Consortium to Study Pain in Chronic Pancreatitis
Rationale for and Development of the Pancreatic Quantitative Sensory Testing Consortium to Study Pain in Chronic Pancreatitis
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DOI：
10.1097/mpa.0000000000001912
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发表时间：
2021-10-01
期刊：
影响因子：
2.9
通讯作者：
Drewes, Asbjorn Mohr
中科院分区：
文献类型：
--
作者：
Phillips, Anna Evans;Faghih, Mahya;Drewes, Asbjorn Mohr
目的腹痛是慢性胰腺炎(CP)的主要症状，但疼痛难以评估，缺乏客观的疼痛评估方法。疼痛的感觉成分作为伤害性感觉的替代物的特征可以通过使用标准化刺激的感觉测试来实现。在这里，我们描述了一个国际联盟的理论基础和发展，以更好地了解和描述CP疼痛。方法奥尔堡大学、约翰霍普金斯大学和匹兹堡大学最初建立了一个合作项目。该小组改进了胰腺定量感觉测试(P-QST)的方案，然后扩大了合作，计划将P-QST纳入前瞻性研究。结果成功研制出P-QST诺模图。经P-QST确诊的具有广泛性痛觉过敏的慢性胰腺炎患者的疼痛强度评分更高，持续疼痛的患病率更高，生活质量下降。精神合并症与疼痛表型无关。多项研究正在进行中，以验证这些发现并评估其在临床试验中的有效性。结论P-QST联盟的发展将促进合作努力，将P-QST用作CP患者疼痛的评估和表征手段，并优化指导个性化疼痛管理方法的方法。
Objectives Abdominal pain is the primary symptom of chronic pancreatitis (CP), but pain is difficult to assess, and objective methods for pain assessment are lacking. The characterization of the sensory component of pain as a surrogate for nociception can be achieved by sensory testing using standardized stimuli. Herein, we describe the rationale for and development of an international consortium to better understand and characterize CP pain. Methods A collaboration was initially formed between the University of Aalborg, Johns Hopkins University, and the University of Pittsburgh. This group refined the protocol for pancreatic quantitative sensory testing (P-QST) and then expanded the collaboration with plans for incorporating P-QST into prospective studies. Results The collaboration has successfully developed a P-QST nomogram. Chronic pancreatitis patients identified with P-QST as having widespread hyperalgesia had higher pain intensity scores, higher prevalence of constant pain, and decreased quality of life. Psychiatric comorbidities were independent of pain phenotypes. Multiple studies are underway to validate these findings and evaluate their utility in clinical trials. Conclusions Development of the P-QST Consortium will facilitate collaborative efforts to use P-QST as a means for evaluation and characterization of pain in CP patients, and optimize methods to guide individualized pain management approaches.