P-QST Project: Pancreatic Quantitative Sensory Testing (P-QST) to Predict Treatment Response for Pain in Chronic Pancreatitis
P-QST 项目:胰腺定量感觉测试 (P-QST) 预测慢性胰腺炎疼痛的治疗反应
基本信息
- 批准号:10438888
- 负责人:
- 金额:$ 56.89万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-07-01 至 2026-06-30
- 项目状态:未结题
- 来源:
- 关键词:Abdominal PainAdoptedAffectAlgorithmsAnalgesicsAutomobile DrivingBiochemicalBiological MarkersClinicalClinical TrialsDataDenmarkDevelopmentDiseaseDrainage procedureDuct (organ) structureEnrollmentEnzyme-Linked Immunosorbent AssayEtiologyFibrosisFoundationsGoalsHealthHealth Care CostsHealth ExpendituresHyperalgesiaIndividualInflammatoryInvestigative TechniquesLassoLeadLinear RegressionsMachine LearningMeasuresMedicalModelingMorbidity - disease rateMulticenter StudiesNerveNeuronal PlasticityNeuronsNeuropathyNociceptionNomogramsNumeric Rating ScaleObstructionOperative Surgical ProceduresOutcomePainPain MeasurementPain managementPancreasPancreatic DiseasesPancreatic ductPatient Outcomes AssessmentsPatientsPeripheral Nervous System DiseasesPersistent painPersonsPhenotypePrediction of Response to TherapyPrevalenceProbabilityProceduresProteinsProtocols documentationQuality of lifeReportingRiskRoleSamplingSensorySerumSeveritiesSpinalStandardizationStimulusSuggestionTechniquesTestingTreatment outcomeUniversitiesUp-RegulationUrineVisceralWagescentral paincentral sensitizationchemokinechronic pancreatitiscostdemographicsdermatomedisabilityexperiencefollow-uphealth care service utilizationhigh riskimpressionimprovedindividual patientinflammatory markerneuroinflammationneurosensoryneurotransmissionnociceptive responsenovelopioid therapyopioid usepain processingpain reductionpain reliefpain scorepatient responsepatient subsetspersonalized approachpersonalized predictionspost interventionpredicting responsepredictive modelingpredictive testprimary outcomeproductivity losspsychiatric comorbidityresponsesecondary outcomeside effectsuccesssymptom managementtooltreatment strategy
项目摘要
ABSTRACT: Abdominal pain is the primary driver of morbidity in chronic pancreatitis (CP) and affects
approximately 90% of patients over the course of their disease with devastating effects on quality of life.
Etiology of pain in CP is multi-factorial. Patients with evidence of pancreatic duct obstruction due to stones
and/or strictures are offered invasive treatments such as endotherapy or surgical drainage to relieve pain.
However, response to invasive treatments is unpredictable, and currently no clinical tool is available to identify
patients who will respond to technically successful treatment. The lack of pain response is at least partially due
to supraspinal central sensitization (SCS), a phenomenon of neuropathic and neuroplastic remodeling resulting
from persistent pain stimuli. Quantitative Sensory Testing (QST), an investigative technique of standardized
stimulations to test nociception (the neural signaling that encodes noxious stimuli and the downstream
experience of pain), is used in other pain conditions to differentiate between patient subgroups to guide
treatment. QST has the potential to change the management algorithm of patients with painful CP. Our
preliminary data show that pancreatic QST (P-QST) can phenotype patients with CP into three groups: normal
pain processing, segmental (T10 dermatome at the pancreas) sensitization, and widespread hyperalgesia
(consistent with SCS). In this proposal, we will evaluate the ability of P-QST to predict response to invasive
treatment for painful CP, and to develop a predictive model for individualized prediction of treatment
response. Our specific aims are: Aim 1. Test the predictive capability of pre-treatment P-QST phenotype for
pain improvement following invasive treatment for painful CP. Using pre-procedure P-QST, we will phenotype
150 patients undergoing clinically-indicated invasive treatment for painful CP at UPMC and Johns Hopkins
University. Our primary outcome will be average pain score measured by Numeric Rating Scale at 6 months
post-intervention. Aim 2. Incorporate P-QST with known and suspected patient, disease, and treatment-
related factors to create a model for individualized prediction of response to invasive treatment. Using machine
learning tools, we will develop a model that optimizes the prediction of probability of response to invasive
treatment in individual patients. This will also determine the relative strength of P-QST as an overall predictor
of treatment response. Aim 3. Augment the predictive model (Aim 2) with biochemical inflammatory markers
to assess the potential to increase predictive capability for pain improvement following invasive treatment for
painful CP. The predictive model developed in aim 2 will be further strengthened by incorporating serum
neuroinflammatory markers at baseline. Our findings will be a major step toward development of
individualized prediction of treatment response following invasive treatment for painful CP. They will lay the
foundation for multicenter studies to fully define the role of P-QST in locally invasive and other treatments for
pain management for painful CP.
摘要:腹痛是慢性胰腺炎(CP)发病率的主要驱动因素,其影响
大约90%的患者在他们的病程中对生活质量产生了毁灭性的影响。
脑性瘫痪疼痛的病因是多因素的。有证据表明胰管结石造成梗阻的患者
和/或狭窄被提供侵入性治疗,如内治疗或外科引流,以减轻疼痛。
然而,对侵入性治疗的反应是不可预测的,目前还没有可用的临床工具来确定
对技术上成功的治疗有反应的患者。疼痛反应的缺乏至少部分是由于
到脊髓上中枢敏化(SCS),一种神经病理性和神经可塑性重塑的现象
来自持续的疼痛刺激。定量感觉测试(QST),一种标准化的研究技术
测试伤害性感觉的刺激(编码伤害性刺激及其下游的神经信号
疼痛体验),用于其他疼痛情况,以区分患者亚组以指导
治疗。QST有可能改变疼痛CP患者的管理算法。我们的
初步数据显示,胰腺QST(P-QST)可将CP患者分为三组:正常组
疼痛处理、节段性(胰腺的T10皮肤刀)敏感化和广泛性痛觉过敏
(与SCS一致)。在这项建议中,我们将评估P-QST预测侵袭性反应的能力
治疗疼痛的CP,并开发个体化预测治疗的预测模型
回应。我们的具体目标是:目的1.检验治疗前P-QST表型对脑出血的预测能力
疼痛CP的侵入性治疗后疼痛改善。使用术前P-QST,我们将进行表型
在UPMC和Johns Hopkins接受临床指征的侵入性治疗疼痛CP的150例患者
大学。我们的主要结果将是6个月后用数字评级表测量的平均疼痛评分
干预后。目标2.将P-QST与已知和可疑的患者、疾病和治疗-
相关因素建立个体化预测侵入性治疗反应的模型。使用机器
学习工具,我们将开发一个模型,优化对入侵反应概率的预测
针对个别患者的治疗。这也将决定P-QST作为总体预测指标的相对强度
治疗反应。目标3.使用生化炎症标志物增强预测模型(目标2
评估在侵入性治疗后提高疼痛改善预测能力的潜力
疼痛的CP。在Aim 2中开发的预测模型将通过纳入血清而得到进一步加强
基线时的神经炎性标志物。我们的发现将是朝着发展
侵入性治疗痛性脑瘫后治疗反应的个体化预测。他们将铺设
为充分确定P-QST在局部侵入性和其他治疗中的作用的多中心研究奠定基础
痛性脑瘫的疼痛管理。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Anna Evans Phillips其他文献
Natural history of spontaneous pancreatic portal vein fistulae: A systematic review of the literature
自发胰腺静脉瘘的自然历史:文献的系统评价
- DOI:
10.1016/j.pan.2024.07.016 - 发表时间:
2024-09-01 - 期刊:
- 影响因子:2.700
- 作者:
Natalie E. Griffin;Morgan Ferrell;Robert Feldman;Anil K. Dasyam;Adam Slivka;Asif Khalid;Harkirat Singh;Charles Gabbert;Rohit Das;Sultan Mahmood;Mordechai Rabinovitz;Jennifer Chennat;Stephanie Romutis;Mary Lou Klem;Dhiraj Yadav;Anna Evans Phillips - 通讯作者:
Anna Evans Phillips
Proton-Pump Inhibitors and Fat Absorption in Cystic Fibrosis and Pancreatic Insufficiency: A Randomized Crossover Pilot Trial
- DOI:
10.1007/s10620-024-08728-8 - 发表时间:
2024-11-13 - 期刊:
- 影响因子:2.500
- 作者:
Anna Evans Phillips;Jefferson N. Brownell;Alyssa Tindall;Bridget Dowd Kiernan;Dhiren Patel;Daniel Gelfond;Virginia A. Stallings - 通讯作者:
Virginia A. Stallings
Prevalence of exocrine pancreatic insufficiency at 12 months after acute pancreatitis: a prospective, multicentre, longitudinal cohort study
急性胰腺炎后 12 个月外分泌胰腺功能不全的患病率:一项前瞻性、多中心、纵向队列研究
- DOI:
10.1016/j.eclinm.2024.102774 - 发表时间:
2024-09-01 - 期刊:
- 影响因子:10.000
- 作者:
Anna Evans Phillips;Joseph Bejjani;Stacey Culp;Jennifer Chennat;Peter J. Lee;Jorge D. Machicado;Vikesh K. Singh;Elham Afghani;Mitchell L. Ramsey;Pedram Paragomi;Kimberly Stello;Melica Nikahd;Phil A. Hart;Georgios I. Papachristou - 通讯作者:
Georgios I. Papachristou
Pancreatitis pain quality changes at year 1 follow-up, but GP130 remains a biomarker for pain
- DOI:
10.1016/j.pan.2024.09.016 - 发表时间:
2024-11-01 - 期刊:
- 影响因子:
- 作者:
Jami L Saloman;Kristofer Jennings;Kimberly Stello;Shuang Li;Anna Evans Phillips;Kristen Hall;Evan L. Fogel;Santhi Swaroop Vege;Dana K. Andersen;William E. Fisher;Christopher E. Forsmark;Phil A. Hart;Stephen J. Pandol;Walter G. Park;Mark D. Topazian;Stephen K. Van Den Eeden;Jose Serrano;Darwin L. Conwell;Liang Li;Dhiraj Yadav - 通讯作者:
Dhiraj Yadav
Anna Evans Phillips的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Anna Evans Phillips', 18)}}的其他基金
P-QST Project: Pancreatic Quantitative Sensory Testing (P-QST) to Predict Treatment Response for Pain in Chronic Pancreatitis
P-QST 项目:胰腺定量感觉测试 (P-QST) 预测慢性胰腺炎疼痛的治疗反应
- 批准号:
10297329 - 财政年份:2021
- 资助金额:
$ 56.89万 - 项目类别:
P-QST Project: Pancreatic Quantitative Sensory Testing (P-QST) to Predict Treatment Response for Pain in Chronic Pancreatitis
P-QST 项目:胰腺定量感觉测试 (P-QST) 预测慢性胰腺炎疼痛的治疗反应
- 批准号:
10641766 - 财政年份:2021
- 资助金额:
$ 56.89万 - 项目类别:
相似海外基金
How novices write code: discovering best practices and how they can be adopted
新手如何编写代码:发现最佳实践以及如何采用它们
- 批准号:
2315783 - 财政年份:2023
- 资助金额:
$ 56.89万 - 项目类别:
Standard Grant
One or Several Mothers: The Adopted Child as Critical and Clinical Subject
一位或多位母亲:收养的孩子作为关键和临床对象
- 批准号:
2719534 - 财政年份:2022
- 资助金额:
$ 56.89万 - 项目类别:
Studentship
A material investigation of the ceramic shards excavated from the Omuro Ninsei kiln site: Production techniques adopted by Nonomura Ninsei.
对大室仁清窑遗址出土的陶瓷碎片进行材质调查:野野村仁清采用的生产技术。
- 批准号:
20K01113 - 财政年份:2020
- 资助金额:
$ 56.89万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
A comparative study of disabled children and their adopted maternal figures in French and English Romantic Literature
英法浪漫主义文学中残疾儿童及其收养母亲形象的比较研究
- 批准号:
2633211 - 财政年份:2020
- 资助金额:
$ 56.89万 - 项目类别:
Studentship
A comparative study of disabled children and their adopted maternal figures in French and English Romantic Literature
英法浪漫主义文学中残疾儿童及其收养母亲形象的比较研究
- 批准号:
2436895 - 财政年份:2020
- 资助金额:
$ 56.89万 - 项目类别:
Studentship
A comparative study of disabled children and their adopted maternal figures in French and English Romantic Literature
英法浪漫主义文学中残疾儿童及其收养母亲形象的比较研究
- 批准号:
2633207 - 财政年份:2020
- 资助金额:
$ 56.89万 - 项目类别:
Studentship
A Study on Mutual Funds Adopted for Individual Defined Contribution Pension Plans
个人设定缴存养老金计划采用共同基金的研究
- 批准号:
19K01745 - 财政年份:2019
- 资助金额:
$ 56.89万 - 项目类别:
Grant-in-Aid for Scientific Research (C)
The limits of development: State structural policy, comparing systems adopted in two European mountain regions (1945-1989)
发展的限制:国家结构政策,比较欧洲两个山区采用的制度(1945-1989)
- 批准号:
426559561 - 财政年份:2019
- 资助金额:
$ 56.89万 - 项目类别:
Research Grants
Securing a Sense of Safety for Adopted Children in Middle Childhood
确保被收养儿童的中期安全感
- 批准号:
2236701 - 财政年份:2019
- 资助金额:
$ 56.89万 - 项目类别:
Studentship
Structural and functional analyses of a bacterial protein translocation domain that has adopted diverse pathogenic effector functions within host cells
对宿主细胞内采用多种致病效应功能的细菌蛋白易位结构域进行结构和功能分析
- 批准号:
415543446 - 财政年份:2019
- 资助金额:
$ 56.89万 - 项目类别:
Research Fellowships