Many people face chronic pain that can last for months or even years. How to best treat chronic pain? First, the pain must be classified in order to formulate the correct treatment plan. However, it is very challenging for patients to use questionnaires to define their pain, intensity and even location. In order to overcome this difficulty, scientists at the University of Geneva (UNIGE) and the Clinique romande de réadaptation (CRR) research department in Sion have conducted a complete epigenome analysis of patients, making it possible to find epigenetic features specific to Every pain category. Therefore, a simple blood test can determine the pain suffered by the patient, and formulate a corresponding treatment plan in the future, and observe whether the biomarkers changed due to pain return to normal.These results can be found in Pain Magazine.
Chronic pain is divided into two main categories: nociceptive pain-defined by the activation of nerve fiber terminal receptors, seen in osteoarthritis, burns or infection-and neuropathic pain, caused by damage to the nerve structure, such as shingles. Pain. In order to classify the pain suffered by the patients, they filled out several questionnaires and used an evaluation scale to quantify the intensity of pain. However, this is very subjective and time-consuming.
Blind genome analysis
“At CRR, we treat many people with chronic diseases,” explains Bertrand Léger, a CRR researcher and the last author of the study. “We have teamed up with UNIGE scientists to conduct a complete epigenome study and define specific biomarkers for each type of pain, so that various types of pain can be classified quickly and reliably.”
To this end, the Geneva team analyzed the entire genome of 57 patients: 20 had no pain, 18 had nociceptive pain, and 19 had neuropathic pain. Ariane Giacobino, co-author of the study and professor of the Department of Genetic Medicine and Development at the UNIGE School of Medicine, explained: “The goal is to start exploring the entire genome and identify all pain-related biomarkers without any previous assumptions.
Specific and potentially reversible biomarkers
Unexpectedly, not only did the scientists discover very significant pain epigenetic features, but there was no overlap between nociceptive pain and neuropathic pain. “The complete lack of similarity between the two types of pain is very surprising, because intuitively, we might think that the difficulty in defining a person’s pain comes from the similarity of epigenetic characteristics. We can prove that this is definitely not the case. Situation,” pointed out Ariana Giacobino.
In fact, biomarkers specific to nociceptive pain are expressed by genes in the opioid system—involving mood, reward, and pain—and inflammatory genes that are specific to stimuli. In contrast, the biomarkers of neuropathic pain are only related to the genes of the GABA system, the neurotransmitters of the central nervous system.
Bertrand Léger said: “Now that these epigenetic features have been clearly defined, a simple blood test can determine the type of pain the patient is suffering and prescribe an appropriate treatment plan.” Therefore, treatment will no longer focus on symptoms, but on The root of the problem. Finally, since the characteristic of epigenetics is that the expression of a gene is permanently altered, the correct treatment may restore it to normal. “We can imagine monitoring the reversal of pain by observing whether the biomarker returns to normal from an epigenetic point of view and adjusting the treatment accordingly,” Ariane Giacobino concluded.
Materials provided University of Geneva. Note: The content can be edited according to style and length.