Relieving pain by mapping its biological signatures
Many people are confronted with chronic pain that can last for months or even years. How to best treat chronic pain? First, pain must be categorized for the right treatment to be prescribed. However, is that it is very challenging for patients to define their pain, its intensity or even its location using questionnaires. To overcome this difficulty, scientists from the University of Geneva (UNIGE) have joined forces with the research department of the Clinique romande de réadaptation (CRR) in Sion to carry out a complete epigenomic analysis of patients, making it possible to find the epigenetic signatures specific to each pain category. Thus, a simple blood test would make it possible to define which pain the person suffers from and, in the future, to prescribe treatment accordingly and to observe whether the biomarkers modified by the pain return to normal. These results can be read in the Journal of Pain.
Chronic pain is classified into two main categories: nociceptive pain – defined by the activation of receptors at the end of nerve fibres and found in osteoarthritis, burns or infections – and neuropathic pain, which is caused by damage to nerve structures, such as pain caused by shingles. In order to classify which pain the patient suffers from, they fill in several questionnaires and quantify pain intensity of using assessment scales. However, this is very subjective and time-consuming.
Blind genome analysis
“At the CRR, we treat many people suffering from chronic diseases”, explains Bertrand Léger, a researcher at the CRR and last author of the study. “We joined forces with UNIGE scientists to carry out a complete epigenomic study and define specific biomarkers for each type of pain, in order to be able to categorise the various types of pain quickly and reliably.”
To do this, the Geneva team carried out an analysis of the entire genomes of 57 patients: 20 with no pain, 18 with nociceptive pain and 19 with neuropathic pain. “The aim was to start without any prior hypothesis to probe the genome as a whole and identify all the biomarkers involved in pain”, explains Ariane Giacobino, the study’s coauthor and a professor in the Department of Genetic Medicine and Development at UNIGE Faculty of Medicine.
Specific and potentially reversible biomarkers
Unexpectedly, not only did the scientists identify very striking epigenetic signatures of pain, but there was no overlap between nociceptive and neuropathic pain. “This total absence of similarities between the two categories of pain is very surprising, because intuitively, we might think that the difficulty in defining one’s pain comes from a similarity in the epigenetic signature. We could prove that itis absolutely not the case”, notes Ariane Giacobino.
Indeed, the biomarkers specific to nociceptive pain are expressed by the genes of the opioid system – involved in emotion, reward and pain – as well as by the genes of inflammation, specific to irritation. Conversely, the biomarkers for neuropathic pain are linked only to genes of the GABA system, the neurotransmitters of the central nervous system.
“Now that these epigenetic signatures are clearly defined, a simple blood test will make it possible to define the type of pain the person is suffering from and prescribe the appropriate treatment”, says Bertrand Léger. The treatment will thus no longer target the symptoms, but the very root of the problem. And finally, since epigenetics is characterised by the fact that the expression of a gene is durably modified, the right treatment may return it to normal. “We could imagine monitoring the reversion of pain by observing, from an epigenetic point of view, whether the biomarkers return to normal, and adapt the treatment accordingly”, concludes Ariane Giacobino.
“My hunger I keep wrapped in lilacs / and in the memory of lilacs
at times / I have thought I would die of it.”
Conversations at All Hours, Nancy Mairs as seen in With Wings: An Anthology of Literature by and about Women with Disabilities’ Edited by Marsha Saxton & Florence Howe
[image description: a two page comic drawn traditionally. The first panel is a skull with green stems growing out of its eyes, nose, and mouth. Black all caps text reads: “they say that ‘pain is only temporary’”. The second is a skeleton arm with green vines wrapping around the bones. Text reads: “but pain spreads like a weed; it grows roots”. The third is a skeletal hip with a flowering dandelion growing on one side. The roots curl around and through the spaces in the bone. Text reads: “strong, stubborn roots”. End description.]
ARG. My joints hurt SO BAD today, and I don’t know why. I’ve been eating low histamine. I have gotten lots of sleep. I haven’t been overly active. My work stress is way down.
The only two things I can figure are that I’m on my period and there’s a low pressure weather system coming in. Neither of which I can stop. But I really hope the pain goes away soon… it’s been so nice to feel relatively able-bodied!
I had a much better pain day today! I think it was the low pressure system.
My right ankle is still bad, but I’m pretty sure I have Achilles tendonitis in that ankle so… yeah. Bracing it during the day and R.I.C.E. at night
I actually found some research the other day stating that the time around periods is when the estrogen in your body is lowest and due to estrogen being a hormone that among other things increases pain tolerance, your pain sensitivity is heightened. As a result, in patients with arthritis, fibromyalgia and other chronic pain conditions who have periods it has been noted that during their period is often when the pain is worst.
Or it was the low pressure system. Hope you’re feeling a bit better!
As much as i realize it is unreasonable to think that tests wont show anything if my symptoms arent showing, it’s very frustrating that my hands are numb TODAY and not YESTERDAY when i had the EMG.
I genuinely enjoy going to a new dentist and seeing the horrified and dismayed look on their faces when they discover im missing 5 teeth cause GENETICS.
Me, yelling at the robot vacuum: god damn it! who made you, why are you so freakishly strong? What the fuck!
Oppy, turning the corner having ripped the fucking wall vent off the wall in the dining room and merrily trundling on her way:
A criminal.
whaaaaaat? oppy is shredded! Our Dop wouldn’t be able to do that afaik and he’s same brand
I maintain there is something wrong with her because it genuinely seems too powerful for something designed to vacuum a floor. Nothing it safe, the other day she pushed the armchair out of the corner and in front of the TV. It’s like living with a mechanical poltergeist.
My WallE (same type as Oppy) constantly just knocks things out of the way. Benches? Check. Boxes? Check. Dogs? Check.
Will Riker understands struggling with chronic pain. It can be difficult to deal with pain on a recurring basis, and it can be difficult to wake up and be in pain, knowing it might be a difficult day to get through. Remember to take care of yourself and to be forgiving with yourself; chronic pain can make life more difficult, and it’s okay to acknowledge that. He believes in you!
This is a simple yet beautiful depiction of thousands of people’s daily lives. Everyone who does not understand the Spoon Theory or chronic illness (physical or mental) needs to see this kind of thing.
Some days I start my day in that half-drained yellow stage. Some days I start my day even lower.
There is only one appropriate time to ask someone what their disability is. This being, if you are a medical professional who is currently treating them. There is litterally no other time when this is ok, if someone wants you to know. They. Will. Tell. You. Otherwise it is none of your business. This includes mental health problems.
I’m going to start this off by saying, mobility aids shouldn’t be used as a fashion accessory, however, if you need one. You have every right to make it look nice.
1. Stickers, this is probably the easiest and can be used on most mobility aids. You can get stickers online (amazon, red bubble etc.) Or if you find any in stores, that works to (obviously). They can also be low energy to apply.
2. Painting, this might take alot of energy for some people, but if you can, painting is a great way to make it look nice. For wheelchairs you can paint the back or if you have solid wheels you can paint those too. Crutches, walking sticks and walking frames can all be painted on the bar part (I’m sorry I dont know what its called)
3. Duck tape, a great alternative to painting.
4. Grips, these can be expensive but you can get grips for the wheels on wheelchairs and the handle on crutches, I’m not sure about walking frames.
I hope you find this helpful, I’m sorry if I got anything wrong, feel free to correct me if i did. I hope you have a good day :)
“Why should I go out of my way to make things accessible for disabled people, i never see them anyway.” There are way more disabled people than you think. Do you know why you dont see them very often? Because alot of disabilities are invisible, and the ones that aren’t. The people who use mobility aids, you dont see them very often because you aren’t making things accessible.
How hard is it to add a ramp? How hard is it to have a few tables at your restaurant that are made for wheelchairs to fit under? I’ve literally seen charities that raise awareness for accessibility that aren’t accessible. Build ramps, add items onto menus that accommodate allergies, make sure (if its needed) there is a lift that is working.
