Researchers have created a prototype for a blood test that could measure pain.
They tracked hundreds of participants to identify biomarkers in the blood that can help objectively determine how severe a patient’s pain is. The blood test, the first of its kind, would allow physicians far more accuracy in treating pain—as well as a better long-term look at the patient’s medical future. It could also help stem the opioid crisis.
“Until now we have had to rely on patients self-reporting or the clinical impression the doctor has…”
“We have developed a prototype for a blood test that can objectively tell doctors if the patient is in pain, and how severe that pain is. It’s very important to have an objective measure of pain, as pain is a subjective sensation. Until now we have had to rely on patients self-reporting or the clinical impression the doctor has,” says Alexander Niculescu, a professor of psychiatry at the Indiana University School of Medicine.
“When we started this work it was a farfetched idea. But the idea was to find a way to treat and prescribe things more appropriately to people who are in pain.”
During the study, which appears in the journal Molecular Psychiatry, researchers looked at biomarkers in the blood—in this case molecules that reflect disease severity. Much like as glucose serves as a biomarker to diabetes, these biomarkers allow doctors to assess the severity of the pain the patient is experiencing, and provide treatment in an objective, quantifiable manner. With an opioid epidemic raging throughout the country, Niculescu says there has never been a more important time to administer drugs to patients responsibly.
“The opioid epidemic occurred because addictive medications were overprescribed due to the fact that there was no objective measure whether someone was in pain, or how severe their pain was,” Niculescu says.
“Before, doctors weren’t being taught good alternatives. The thought was that this person says they are in pain, let’s prescribe it. Now people are seeing that this created a huge problem. We need alternatives to opioids, and we need to treat people in a precise fashion. This test we’ve developed allows for that.”
In addition to providing an objective measure of pain, Niculescu’s blood test helps physicians match the biomarkers in the patient’s blood with potential treatment options. Like a scene out of CSI, researchers utilize a prescription database—similar to fingerprint databases employed by the FBI—to match the pain biomarkers with profiles of drugs and natural compounds cataloged in the database.
“Through precision medicine you’re giving the patient treatment that is tailored directly to them and their needs…”
“The biomarker is like a fingerprint, and we match it against this database and see which compound would normalize the signature,” says Niculescu, adding that often the best treatment identified is a non-opioid drug or compound.
“We found some compounds that have been used for decades to treat other things pair the best with the biomarkers. We have been able to match biomarkers with existing medications, or natural compounds, which would reduce or eliminate the need to use the opioids.”
By treating and prescribing medicine more appropriately to the individual person, this prototype may help alleviate the dilemmas that have contributed to the current opioid epidemic.
“In any field, the goal is to match the patient to the right drug, which hopefully does a lot of good and very little harm,” Niculescu says. “But through precision health, by having lots of options geared toward the needs of specific patients, you prevent larger problems, like the opioid epidemic, from occurring.”
Additionally, study experts discovered biomarkers that not only match with non-addictive drugs that can treat pain, but can also help predict when someone might experience pain in the future—helping to determine if a patient is exhibiting chronic, long-term pain which might result in future emergency room visits.
“Through precision medicine you’re giving the patient treatment that is tailored directly to them and their needs,” Niculescu says.
“We wanted first to find some markers for pain that are universal, and we were able to. We know, however, based on our data that there are some markers that work better for men, some that work better for women. It could be that there are some markers that work better for headaches, some markers that work better for fibromyalgia and so on. That is where we hope to go with future larger studies.”
Moving forward, Niculescu’s group hopes to continue and accelerate these studies—with the hopes of personalizing the approach even more and moving toward a clinical application. A self-described longshot at the start, Niculescu says that the work his group has done could have a major impact on how doctors around the world treat pain in the future.
“It’s been a goal of many researchers and a dream to find biomarkers for pain,” Niculescu says. “We have come out of left field with an approach that had worked well in psychiatry for suicide and depression in previous studies. We applied it to pain, and we were successful.”
The National Institutes of Health and VA Merit Award funded the study. The content is solely the responsibility of Indiana University School of Medicine and does not necessarily represent the official views of the National Institutes of Health or the VA.
Source: Indiana University