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Medicina de precisión de nueva generación para el dolor

R Bhagar1, H Le-Niculescu1, S C Corey2

  • 1Department of Psychiatry, University of Arizona College of Medicine, Phoenix, AZ, USA.

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|August 25, 2025
PubMed
Resumen

Los nuevos biomarcadores sanguíneos pueden evaluar objetivamente la gravedad del dolor crónico en pacientes psiquiátricos. Los principales marcadores CD55 y ANXA1, relacionados con la inflamación y el dolor, sugieren tratamientos personalizados como el litio y la ketamina.

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Área de la Ciencia:

  • Neurociencia y Genética
  • Descubrimiento de biomarcadores
  • Investigaciones psiquiátricas

Sus antecedentes:

  • El dolor crónico afecta significativamente a las poblaciones de salud general y mental, con vínculos bidireccionales.
  • No existen herramientas objetivas para evaluar el dolor, lo que dificulta el tratamiento y la prevención eficaces.
  • Los biomarcadores sanguíneos ofrecen una ventana potencial a la biología del dolor, ayudando a la evaluación y el tratamiento.

Objetivo del estudio:

  • Para identificar, priorizar y validar los biomarcadores de expresión génica de la sangre para el dolor.
  • Para investigar estos biomarcadores trans-diagnóstico en pacientes psiquiátricos.
  • Establecer biomarcadores reproducibles utilizando múltiples cohortes y plataformas independientes.

Principales métodos:

  • Se llevaron a cabo dos estudios independientes utilizando microarrays y secuenciación de ARN.
  • Empleado un diseño de cohortes múltiples independientes para la reproducibilidad biológica y técnica.
  • Centrado en biomarcadores convergentes y reproducibles entre los dos estudios.

Principales resultados:

  • Identificaron biomarcadores nuevos y conocidos que predicen estados de dolor intenso y futuras visitas al departamento de emergencias.
  • El biomarcador con mayor disminución de expresión (supresor del dolor) fue CD55; el biomarcador con mayor aumento (algógeno) fue ANXA1.
  • Las vías clave involucraron la respuesta celular al TNF y la neuroinflamación, con el TNF como el regulador superior.

Conclusiones:

  • CD55 y ANXA1 validados como biomarcadores sanguíneos clave para la evaluación del dolor crónico en pacientes psiquiátricos.
  • Se identificaron posibles combinaciones terapéuticas que incluyen litio, ketamina, ácidos grasos omega-3 y magnesio.
  • Desarrolló un marco para informes personalizados de pacientes para ayudar a la evaluación objetiva y la combinación de tratamientos individualizados.