Mechanism-based Approach to Pain in Chronic Pancreatitis (MAP-CP Study)

基于机制的慢性胰腺炎疼痛治疗方法（MAP-CP 研究）

• 批准号: 9976126
• 负责人: Jami Lynn Saloman
• 金额: $ 24.97万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-14 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9976126
• 关键词: Abdominal Pain; Affect; Analgesics; Ancillary Study; Antibodies; Automobile Driving; Biological; Biological Assay; Biological Markers; Characteristics; Chronic; Clinic; Clinical; Clinical Trials; Cross-Sectional Studies; Data; Diabetes Mellitus; Diagnostic; Endoscopy; Evaluation; Evolution; Frequencies; Functional disorder; Future; Guidelines; Human; Individual; Intervention; Letters; Literature; Longitudinal Studies; Low Back Pain; Malignant neoplasm of pancreas; Measures; Naproxen; Natural History; Nerve Growth Factors; Nerve Regeneration; Neuronal Plasticity; Neuropathy; Neuropeptides; Nociception; Operative Surgical Procedures; Opioid; Pain; Pain Measurement; Pain intensity; Pain management; Pancreatic Diseases; Patients; Pattern; Peptides; Pharmacology; Phenotype; Physicians; Procedures; Proteins; Quality of life; Questionnaires; Reporting; Research Design; Sampling; Serum; Severities; Specimen; Symptoms; Testing; Therapeutic; Therapeutic Intervention; Time; United States; Visit; base; biomarker identification; chemokine; chronic pain patient; chronic pancreatitis; clinical pain; cohort; cytokine; design; disorder control; epidemiology study; experience; follow-up; gastrointestinal; improved; nerve injury; new therapeutic target; opioid use; pain patient; pain relief; pain signal; pain symptom; painful neuropathy; patient subsets; phenotypic biomarker; phenotypic data; potential biomarker; prescription opioid; prospective; side effect; standard of care; symptom treatment; targeted treatment; tool; translational study

Project Summary Chronic pancreatitis (CP) is often accompanied by profoundly debilitating pain that is quite difficult to treat. There are a large number of analgesics that can be prescribed, but their efficacy often depends on having a mechanistic assessment of the cause and type of pain. Since there are no tools available in clinics to properly characterize the sub-type of pain a patient is experiencing, it is difficult to choose a therapy most likely to provide sufficient pain relief. The identification of biomarker profiles associated with specific sub-types of pain could inform guidelines for pain management that improve patients' quality of life by reducing the time and expense required to administer the efficacious therapies, reduce the number of patients prescribed opioids, and identify novel therapeutic targets. This study is designed to test the hypothesis that patient-derived information can be used to identify pain phenotypes (biomarker profiles) that inform management of CP-related pain. Aim 1 will be cross-sectional analyses to examine the expression pattern of circulating proteins that are known to be important for pain signaling. We will compare these in relation to pain characteristics that have been previously studied including pain intensity, frequency, and interference with quality of life. We will then determine if putative biomarker profiles and pain characteristics can be differentiated based on the underlying pain mechanism (nociceptive versus neuropathic). Aim 2 will involve longitudinal evaluation of whether temporal changes in biomarker profile are associated with changes in clinical symptoms and treatment, such as opioids. This longitudinal study will allow us to describe the natural history of pain within the same patients. Overall, the results from this study will provide in depth data regarding the evolution of pain in CP and guide future studies aimed at predicting therapeutic responsiveness and developing efficacious interventions.

项目摘要 慢性胰腺炎（CP）通常伴随着令人衰弱的疼痛，这很难治疗。有一个 可以开处方的大量镇痛药，但它们的功效通常取决于对 疼痛的原因和类型。由于诊所没有可用的工具来正确地表征疼痛的亚型 患者正在经历，很难选择最有可能提供足够疼痛的疗法。识别 与特定疼痛子类型相关的生物标志物概况可以为疼痛管理指南提供改善的指南 通过减少管理有效疗法所需的时间和费用，减少患者的生活质量 处方阿片类药物的患者数量，并确定新的治疗靶标。这项研究旨在检验假设 该患者衍生的信息可用于识别告知疼痛表型（生物标志物轮廓） 与CP相关疼痛的管理。 AIM 1将是检查循环的表达模式的横截面分析 已知对于疼痛信号传导很重要的蛋白质。我们将将这些与疼痛特征有关 先前已经研究了包括疼痛强度，频率和对生活质量的干扰。然后我们会 确定假定的生物标志物轮廓和疼痛特征是否可以根据潜在的疼痛来区分 机理（伤害性与神经性疗法）。 AIM 2将涉及纵向评估时间的变化 生物标志物谱与临床症状和治疗的变化有关，例如阿片类药物。这项纵向研究 将使我们能够描述同一患者中疼痛的自然史。总体而言，这项研究的结果将 提供有关CP疼痛演变的深入数据，并指导旨在预测治疗的未来研究 响应能力并发展有效的干​​预措施。