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Pain in the Blood? Envisioning Mechanism-Based Diagnoses and Biomarkers in Clinical Pain Medicine

Overview
Specialty Radiology
Date 2016 Feb 9
PMID 26854144
Citations 13
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Abstract

Chronic pain is highly prevalent, and pain medicine lacks objective biomarkers to guide diagnosis and choice of treatment. The current U.S. "opioid epidemic" is a reminder of the paucity of effective and safe treatment options. Traditional pain diagnoses according to the International Classification of Diseases are often unspecific, and analgesics are often prescribed on a trial-and-error basis. In contrast to this current state of affairs, the vision of future mechanism-based diagnoses of chronic pain conditions is presented in this non-technical paper, focusing on the need for biomarkers and the theoretical complexity of the task. Pain is and will remain a subjective experience, and as such is not objectively measurable. Therefore, the concept of "noci-marker" is presented as an alternative to "pain biomarker", the goal being to find objective, measurable correlates of the pathophysiological processes involved in different chronic pain conditions. This vision entails a call for more translational pain research in order to bridge the gap between clinical pain medicine and preclinical science.

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References
1.
Melzack R . From the gate to the neuromatrix. Pain. 1999; Suppl 6:S121-S126. DOI: 10.1016/S0304-3959(99)00145-1. View

2.
. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001; 69(3):89-95. DOI: 10.1067/mcp.2001.113989. View

3.
Brisby H, Olmarker K, Larsson K, Nutu M, Rydevik B . Proinflammatory cytokines in cerebrospinal fluid and serum in patients with disc herniation and sciatica. Eur Spine J. 2002; 11(1):62-6. PMC: 3610490. DOI: 10.1007/s005860100306. View

4.
Mannes A, Martin B, Yang H, Keller J, Lewin S, Gaiser R . Cystatin C as a cerebrospinal fluid biomarker for pain in humans. Pain. 2003; 102(3):251-256. DOI: 10.1016/S0304-3959(02)00403-7. View

5.
Craig A . A new view of pain as a homeostatic emotion. Trends Neurosci. 2003; 26(6):303-7. DOI: 10.1016/s0166-2236(03)00123-1. View