Omics Associated with Self-management Interventions for Symptoms (OASIS) Center

OASIS中心简介 超过一半的美国人患有慢性疾病，每年70%的死亡可归因于 慢性病其中最常见和衰弱的是疼痛，这可能是一种慢性疾病的症状。 疾病或作为主要问题。根据医学研究所（IOM）关于减轻疼痛的报告， 在美国，慢性疼痛是一种公共卫生流行病，影响超过1.16亿美国人， 每年超过6000亿美元的医疗费用和工作效率的损失。尽管传统的 药理学治疗是由我们目前对基本生物学机制的理解所告知的。 慢性疼痛，大多数人没有获得足够的疼痛缓解。一个重要的重点是确定 自我管理干预是否能改善疼痛各种类型的自我管理干预措施 已经过测试，包括认知行为疗法（CBT），非药物治疗（例如，热，冷， 针灸等），运动/体力活动，其他。然而，就像药物基因组学对 个体对药物治疗的反应，自我管理干预试验表明， 一些，但不是全部，研究参与者回应或参与。这可能是由于许多因素，包括 参与活动的弹性、动机和/或能力。在某些情况下，尚不清楚剂量和 自我管理干预的强度提供了益处。此外，分子机制 在个人层面上自我管理干预的相对成功或失败的基础是， 替补演员马里兰州，巴尔的摩（UMB）与自我相关的组学的目的， 症状管理干预（OASIS）中心，由改编版的国家 美国卫生研究院症状科学模型（NIHSSM），是将联合收割机严格的临床前表型分型 模型和患者在慢性疼痛与先进的组学方法，以促进我们的理解， 个体差异影响一个人的弹性，动机和从事体育活动的能力， 锻炼来控制慢性疼痛。我们假设个体的基因组，转录组， 表观基因组学和蛋白质组学（下文称为“组学”）谱预测它们的恢复力， 参与自我管理行为的动机和能力以及他们对治疗的反应。 潜在的调解人和主持人（例如，社会心理因素、性别差异、环境）可能 也会影响对自我管理干预的反应或慢性疼痛的水平。我们 我们的目标不是测试实验组和对照组中体力活动对减轻慢性疼痛的疗效 条件;我们知道这些策略可以工作;而是要了解组学相关性，这将开始 向我们介绍支持复原力、积极性和参与能力的机制， 个人对身体活动的反应。我们承认，其他因素，如心理社会因素， 地位、环境和性别差异可以调节或介导组学效应。我们断言， 跨学科团队为基础的绿洲中心和翻译，机制为基础的方法将加速 自我管理的科学，以产生高影响力的结果，将推动该领域的发展。

OVERALL OASIS CENTER ABSTRACT More than half of all Americans suffer from a chronic condition and 70% of deaths annually can be attributed to chronic conditions. One of the most frequent and debilitating is pain, which can occur as a symptom of chronic illness or as a primary problem. According to the Institute of Medicine (IOM) report on Relieving Pain in America, chronic pain is a public health epidemic affecting more than 116 million Americans and costing more than $600 billion per year in healthcare expenses and lost work productivity. Despite advances in conventional pharmacological treatments that are informed by our current understanding of basic biological mechanisms of chronic pain, most people do not obtain adequate pain relief. An important focus has been to determine whether self-management interventions improve pain. Various types of self-management interventions have been tested, including cognitive behavioral therapy (CBT), non-pharmacologic treatments (e.g., heat, cold, acupuncture, etc.), exercise/physical activity, others. However, much like pharmacogenomic influences on individual response to drug treatment, self-management intervention trials have demonstrated mixed results in that some, but not all, study participants respond or participate. This is could be due to many factors, including resilience, motivation and/or capability to engage in the activity. In some cases it is unclear what dose and intensity of the self-management intervention provide a benefit. Moreover, the molecular mechanisms underlying the relative success or failure of self-management interventions on an individual level have been understudied. The purpose of the University of Maryland, Baltimore (UMB) Omics Associated with Self- management Interventions for Symptoms (OASIS) Center, guided by an adapted version of the National Institutes of Health Symptom Science Model (NIHSSM), is to combine rigorous phenotyping of pre-clinical models and patients in chronic pain with cutting edge omics methods to advance our understanding of how individual differences influence one's resilience, motivation and capability to engage in physical activity and exercise to manage chronic pain. We hypothesize that an individual's genomic, transcriptomic, epigenomic and proteomic (hereafter referred to as “omics”) profile predicts their resilience, motivation and capability to engage in self-management behaviors and their response to treatment. Potential mediators and moderators (e.g., psychosocial factors, sex differences, the environment) may also influence either the response to self-management interventions or the level of chronic pain. Our goal is not to test the efficacy of physical activity on chronic pain reduction in experimental versus control conditions; we know these strategies can work; but rather, to understand the omics correlates that will begin to inform us about mechanisms that underlie the resilience, motivation and capability to engage, and the response of the individuals to physical activity. We acknowledge that other factors, such as psychosocial status, the environment, and sex differences can moderate or mediate omics effects. We assert that our interdisciplinary team-based OASIS Center and translational, mechanism-based approach will accelerate the science of self-management to produce high impact results that will move the field forward.