Left untreated, pain can have major negative effects on sufferers’ quality of life. However, quantifying pain is complicated because it is a subjective feeling that can reflect both actual and perceived biological damage. Dr. Alexander Niculescu, a NIH New Innovator Awardee, is working on an approach to objectively evaluate pain perception using a simple blood draw. He and his team set out to determine if biological indicators of pain exist—pain biomarkers. More specifically, he was interested in those detectable in the blood. The researchers focused their efforts on a cohort of psychiatric patients; as a group, psychiatric patients are at higher risk for pain disorders and often have an increased perception of pain.

During each of approximately six visits, Dr. Niculescu and his team asked participants to rate their pain as high or low. They also drew the participants’ blood and measured the activity levels of different genes. By associating differences in gene activity levels with high-pain or low-pain over time, the researchers identified 65 potential pain biomarkers. After prioritizing and validating potential biomarkers, the team analyzed their ability to predict a high pain state in a second cohort of psychiatric patients. They found (when separated by gender and diagnosis) individual biomarkers were better predictors than the full 65 biomarker panel. The researchers suggest that for the approach to be most useful, biomarkers may need to be personalized for each individual to accurately determine their pain level..

While this study exclusively focused on participants with psychiatric disorders, the researchers hope that its findings could be generalizable to other populations. Although we are still a long way from being able to accurately quantify pain, this approach demonstrates the potential of precision medicine for its diagnosis and treatment.

Reference

• Towards precision medicine for pain: diagnostic biomarkers and repurposed drugs. Niculescu AB, Le-Niculescu H, Levey DF, Roseberry K, Soe KC, Rogers J, Khan F, Jones T, Judd S, McCormick MA, Wessel AR, Williams A, Kurian SM, & White FA. Mol Psychiatry. 2019 Apr;24(4):501-522.