How chronic pain arises

How chronic pain arises

EU project on chronic pain

A new EU project will help to understand how chronic pain arises and what role RNA molecules play in it. The project is scheduled to run for four years.

20 percent of all Europeans suffer from chronic pain A new EU project led by Innsbruck should help to find out what role RNA molecules play in the development of chronic pain. The expected results could be important for many people, as 20 percent of all Europeans suffer from chronic pain, according to the Europe-wide Pain Proposal Consensus Report. In addition to the immense personal consequences, such as fear of social isolation or job loss, there would be huge economic consequences: the cost of chronic pain is estimated at 1.5 to three percent of European economic output (GDP).

It can take years for a diagnosis. What is particularly striking in the report is that a quarter of the patients have to wait longer than a year for a correct diagnosis. And every tenth person doesn't even have one after five years. An accurate diagnosis would be the basis for effective treatment. However, almost 40 percent of chronic pain patients reported that they were not being adequately treated.

Different types of pain It is essential to distinguish between the types of pain. On the one hand there is the nociceptive pain that arises when pain receptors are stimulated mechanically, chemically or thermally. This is an important early warning system for the body. On the other hand, there is the neuropathic pain caused by nerve damage. In addition, pain is often a companion to other diseases. But practically all types of pain have in common that the nervous and immune systems work closely together.

Research well advanced Research is well advanced in some areas. For example, it is known that the patterns (the relative frequencies) of signal molecules are changed. With neuropathic pain, for example, there are more anti-inflammatory cytokines and fewer anti-inflammatory ones. "If you block a cytokine with medication, it has an effect, but the other cytokines are not affected," explains Michaela Kress, professor at the Med-Uni Innsbruck. From this knowledge, the question arose of what if one could influence the common cause of the changed cytokine levels?

Discovery a few years ago This idea received further nourishment through advances in genetic research: microRNA (miRNA) plays an important role in the regulation of many processes in the body. In contrast to the better known DNA, these small molecules, which consist of around 20 bases, are single-stranded and come from a very early phase of evolution. According to popular belief, there were no proteins at the time. It was only a few years ago that it was discovered that the miRNA is crucial for regulating gene expression, i.e. when the genes (DNA) are copied into the messenger RNA (mRNA) and the subsequent structure of proteins according to this blueprint.

Researchers from seven countries According to Kress, the influence of miRNA is well known for some diseases, such as cancer or cardiovascular diseases. Since this is not yet the case with pain, the EU project ncRNAPAIN will be started with a kick-off meeting next weekend in order to progress in this area. Researchers from seven countries are working under the direction of Kress on the four-year project. The budget is just under six million euros. "We want to understand the mechanisms of how chronic pain arises and what role miRNA plays," says Kress.

Examinations based on two types of pain This should be examined using two types of pain: First, polyneuropathies, which 40 percent of all diabetics suffer ten years after the onset of the disease, and Sudeck's disease (CRPS), a chronic pain that partly arises after injuries. Among other things, the project will use bioinformatics methods to predict which miRNAs act on which genes. "For some we know a connection, for many we suspect one," explained Kress.

Rapid, effective pain therapy for patients as a goal In this clinic, miRNA patterns should then be identified with this basic knowledge, which could then serve as biomarkers, i.e. to predict how great the individual risk is, for example after a broken bone or the outbreak of diabetes from chronic Suffering from pain. The biomarkers could also show which drugs patients respond to. "Our long-term goal is to provide the optimally effective pain therapy for each patient as quickly as possible," said Kress. However, it remains open whether the research results could also justify new therapeutic approaches for neuropathic pain. (ad)

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