Predicting chronic postsurgical pain: current evidence and a novel program to develop predictive biomarker signatures.
Predicting chronic postsurgical pain: current evidence and a novel program to develop predictive biomarker signatures.
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DOI：
10.1097/j.pain.0000000000002938
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发表时间：
2023-09-01
期刊：
影响因子：
7.4
通讯作者：
中科院分区：
文献类型：
--
作者：
慢性疼痛影响着5000多万美国人。治疗仍然不足，在很大程度上，因为慢性疼痛的发展背后的病理生理机制仍然知之甚少。疼痛生物标志物可以潜在地识别和测量由疼痛改变的生物学途径和表型表达，提供对生物治疗靶点的洞察，并帮助识别可能从早期干预中受益的高危患者。生物标志物被用于诊断，跟踪和治疗其他疾病，但还没有经过验证的临床生物标志物用于慢性疼痛。为了解决这个问题，美国国立卫生研究院共同基金启动了急性至慢性疼痛特征（A2CPS）计划，以评估候选生物标志物，将其开发为生物特征，并发现用于手术后疼痛慢性化的新型生物标志物。本文讨论了由A2CPS鉴定的用于评估的候选生物标志物，包括基因组学、蛋白质组学、代谢组学、脂质组学、神经影像学、心理物理学、心理学和行为学测量。急性至慢性疼痛特征将提供迄今为止进行的向慢性术后疼痛转变的生物标志物的最全面调查。A2CPS产生的数据和分析资源将与科学界分享，希望其他研究人员能够从A2CPS的初步发现中提取有价值的见解。本文将回顾已确定的生物标志物和纳入它们的理由，从急性到慢性疼痛过渡的生物标志物的科学现状，文献中的差距，以及A2CPS将如何解决这些差距。
Chronic pain affects more than 50 million Americans. Treatments remain inadequate, in large part, because the pathophysiological mechanisms underlying the development of chronic pain remain poorly understood. Pain biomarkers could potentially identify and measure biological pathways and phenotypical expressions that are altered by pain, provide insight into biological treatment targets, and help identify at-risk patients who might benefit from early intervention. Biomarkers are used to diagnose, track, and treat other diseases, but no validated clinical biomarkers exist yet for chronic pain. To address this problem, the National Institutes of Health Common Fund launched the Acute to Chronic Pain Signatures (A2CPS) program to evaluate candidate biomarkers, develop them into biosignatures, and discover novel biomarkers for chronification of pain after surgery. This article discusses candidate biomarkers identified by A2CPS for evaluation, including genomic, proteomic, metabolomic, lipidomic, neuroimaging, psychophysical, psychological, and behavioral measures. Acute to Chronic Pain Signatures will provide the most comprehensive investigation of biomarkers for the transition to chronic postsurgical pain undertaken to date. Data and analytic resources generatedby A2CPS will be shared with the scientific community in hopes that other investigators will extract valuable insights beyond A2CPS's initial findings. This article will review the identified biomarkers and rationale for including them, the current state of the science on biomarkers of the transition from acute to chronic pain, gaps in the literature, and how A2CPS will address these gaps.
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