Scientist Testing Possible Biomarkers to Measure Pain

Scientist Testing Possible Biomarkers to Measure Pain

By Staff

A researcher from Saint Louis University has discovered a pain pathway, and is now determining if either of two key molecules can be used as biomarkers for pain associated with chemotherapy-induced peripheral neuropathy (CIPN), endometriosis, interstitial cystitis and vulvodynia.

SLU scientist and principal investigator Daniela Salvemini, Ph.D., received a $363,000 grant from The Mayday Fund to advance her work to understand pain in order to develop new painkillers.

“It is exciting to reach the moment when you can take your research from the laboratory to the clinic,” said Salvemini, who is professor of pharmacology and physiology at SLU.

In previous work, Salvemini discovered pain pathways – the molecular series of events that lead to pain – that helped researchers understand how pain occurs. The pain pathways are dependent on two molecules: S1PR1 and A3AR (sphingosine 1-phosphate receptor subtype 1 and A3 adenosine receptor subtype). By modulating these molecules, scientists were able to block and reverse pain. This finding is particularly encouraging because a drug that modulates S1PR1 is already on the market and one that modulates A3AR is in advanced clinical trials.

Salvemini’s next goal is to see if S1PR1 and A3AR can serve as biomarkers in the clinic.

Based on her previous work, Salvemini believes that higher levels of S1PR1 and/or A3AR correlate with chronic pain incidence and intensity and predict the development of chronic pain syndromes, suggesting these receptors may be good targets for new drugs that target these pathways to treat or prevent chronic pain syndromes.

“Our goal is to take this exciting basic science work a step further and study to see if these molecules can serve as biomarkers in people, helping us to identify patients who would and who would not benefit from drugs that target this pathway and providing a more personalized approach to pain treatment,” Salvemini said. “This study focuses on high impact, high potential chronic pain-associated conditions.”

In the newly funded study, Salvemini and her team will partner with Saint Louis University clinicians in the SLUCare practice to study patients with four different conditions that cause pain: chemotherapy-induced neuropathic pain (CIPN), with Jack Lionberger, M.D., Ph.D., assistant professor of hematology and medical oncology; endometriosis with Patrick Yeung Jr., M.D., associate professor of obstetrics, gynecology and women’s health; interstitial cystitis with E. Cristian Campian, M.D., Ph.D., assistant professor of obstetrics, gynecology and women’s health; and vulvodynia with Cherie LeFevre, M.D., associate professor of obstetrics, gynecology and women’s health.

“The direct and indirect economic costs of endometriosis, which is mostly from pain and lost productivity, is estimated to be upwards of $20 billion annually in the US alone. Having a better way to treat endometriosis-related pain that does not just treat symptoms and without the negative side effects of high-dose anti-inflammatories or narcotics, is long overdue. We must do better do better for women, and this research collaboration has great potential,” said Patrick Yeung Jr., M.D., associate professor of obstetrics, gynecology and women’s health, who is partnering with Salvemini on the endometriosis study.

“The problem of chemotherapy-induced pain is a critical unmet need that severely impacts our patients struggling with cancer and their ability to receive potentially lifesaving treatment. While SLU has had an enduring commitment to managing chronic pain, Dr. Salvemini’s work represents an important, innovative approach that will directly benefit the population that our Cancer Center serves. This ‘bench to bedside’ project is central to the clinical research mission of our hematology and oncology division, and I am excited to be a part of this work,” said Jack Lionberger, M.D., Ph.D., assistant professor of hematology and medical oncology, who is working on the chemotherapy-induced pain study.

If one or both of these two molecules does prove to be a useful biomarker, researchers will have laid the groundwork for a proof-of-concept trial to test a drug that interferes with the molecular pathways engaged by these molecules and could serve as a new non-narcotic painkiller.

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Authored by: Staff

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Jean Price

I have heard it said several time that cancer itself is NOT a disease usually characterized by high level of pain…unless maybe it is cancer of the pancreas or of the bowel with a resulting obstruction. Cancer patients develop pain from the effects of treatments…the surgeries and also, as in this study, from the effects of chemotherapy! So isn’t that a lot like most of us…failed surgieries creating more pain and more inability to fully function, and RSD, CRPS often the result of invasive procedures! So then…why are we ostracized in the treatment of pain…being denied or so drastically reduced in the dosages of opioid medications allowed that we don’t even achieve a therapeutic level to quiet the pain!? This is something I’ll never understand! EVER, i had a doctor some seventeen years ago tell me if I had terminal cancer, he would gladly treat my pain. So if I’m dying and have a limited time to be in pain, I guess I would receive appropriate pain care…and spend what time I have left at least medicated to a level of comfort. HOWEVER, if I’m going to live for an indeterminate length of years and years…then I don’t! I just hurt…spending what life I do have left in pain! And because of lack of pain medications…it will be in such a reduced capacity that it can’t really even be called living!! What kind of skewed mindset is this, anyway?! And how did we arrive at punishing those with non-cancer pain?! This is, once again, a senseless parody of what health care was meant to be…causing endless hours of tortured existence due to unnecessary pain.

Like Connie says, it is a bit suspect. It’s a very nice idea/concept: being able to measure pain, but since people are so varied, as is their experience of pain, there would probably end up being a component of the population that register as little to none, when it is severe for them. it’s like when I had a small fibroid, my symptoms were way worse than they should have been given the size of it, according to the medical “experts”, yet I had to have surgery to alleviate the suffering. It was excruciating. So I’ll remain skeptical of this study as well.

Kathy C

It seems like any “Research” would be a positive thing. This makes it sound as if they are working on it. The amount of the Grant, doesn’t seem to be enough, though they already have these Patients. It sounds as if they won’t be treating their current pain, that might interfere with the Study. We have been hearing this for years, the search for “Bio Makers” or other tangible or quantifiable indicators of Pain. It sounds good, a nice PR bump for that University. Unfortunately the Hysteria about treating pain, and Bias is not very Scientific. These subjects are already told that Opiods will ruin their lives, so even if they are in pain, they will under report. They will very likely be given a bunch of random and ineffective Drugs, like Anti depressants, and Lyrica.
This will only ad to the stress of chemo therapy. It seems to me that a lot of these types of Studies fail, and they never get the results reported. Since they are already biased, what comes out of the Study is useless and unscientific. In this Climate though, they could publish anything, even the Stress Markers. The only way this “Study” would yield any valid Scientific information would be to have a Control Group with treated pain. That would be a group that has their pain treated with opiates, since there is nothing else as effective. Of Course that won’t happen, so there is already a Bias. They would not want to reinforce the use of opiates for Pain, that would mean no more funding, since they are unpopular. This is the kind of Science we are dealing with, a “Science” undermined by Bias, funding Issues, and pre-conceived notions. It is not Science anymore. This is probably why all of the other “Studies” in this area have failed. I have followed this subject for over 20 Years. Every so often there is another “Study” like this, then no more. They don’t even publish the Studies, since those might show how not to do a Study. This kind of information is important for real Science. It is “Groundhog Day” again!

Ben Aiken Longfellow

The ability to “measure” pain would be a definite tool in the arsenal in the fight against pain. The physicians that I have experienced in the last 25 years after two “failed surgery syndrome” surgeries do not fully realize the nightmare of living in continuous severe pain. They do not comprehend how much effort and sheer will power that a severe chronic pain patient has to expend every day, to just survive. I am sure that chronic pain affects people from slightly, to absolute overpowering. It is the people that have been diagnosed with a disease that cripples AND causes uncontrollable pain, an accident that instantly changes a persons life to survival “mode” or failed surgery that I am currently extremely concerned about. Future medical applications are great but, it is not an immediate remedy for non cancer chronic pain. I can speak personally of the effort, the time and the money that I and my family expended in the attempt to gain some normalcy in life. I was hopeful that surgery would help, not disable me. I still can work but, with the CDC RULING, I will be applying for SS disability in the next two months. I know what is coming and I should have already applied. I am an optimist at heart. I have worked since the age of 16. I realized at an early age that no one will help you if you don’t first help yourself. Life becomes very real, very quick. Once again, at age 58, life is becoming very real, surreal. With the help of moderate opioid medication I have remained employed for almost 25 years after my orthopedic surgeon made the remark “you will be going on disability” BEFORE I had my second lower back surgery. I was already counted out by the doctor before surgery. I guess I am just stubborn or selfish. I wanted the American dream for my children. I was blessed with two children and our intention was to give these children a better life than I or my wife of 40 years could ever have imagined.Call it selfish if you wish. I also understood that if I “layed down” after surgery, I would NEVER be better. I understand that some situations are not possible to recover from. However with the aid of medication, I found that I could actually keep making my own “living”. It makes me happy to be self sufficient. I don’t have to like a dependency on anything but, I, like100’s of thousands of others use medication just like a carpenter uses their tools.. Now my tools are being stolen from me. I have been a happier person for 25 years and I have taken opioid medication. I do not like being “grouped” into the spectrum of ALL opioid users, illicit or prescribed. I as an individually, lawfully prescribed, responsible chronic pain patient have NOT helped create an opioid epidemic as the CDC states is in America at this time. The medication has literally… Read more »

What about worldwide RSD CRPS??? The pain from this horrible disease can get as bad if not Worse!!! Than Cancer!! Pain can be like a woman in bad horrible hard labor delivering a baby!!! The fight for RSD CRPS to be recognized is Worldwide!!! Anyone can get it at any time any injury or intrusion. If your test is painful or an intrusion on one’s body… Then you will be further abusing patients. Those who have RSD suffer greatly every day. Horror stories these patients can tell you from Doctor abuse… Hospital abuse and no proper care. Some people who have not been given pain relief have actually amputated the injured area thinking it would be gone. But pain still there. Put this disease on the top of your list for pain!!!!! Do not ignore it! Too many people have it and not recognized. Any age you are… You can get it just by normal activities you do every day. Worldwide groups are active in bringing RSD knowledge to everyone. Too many millions and millions have it. Not recognizing it will cost healthcare with or without insurance billions of wasted costs. If recognized and treated for pain one can live a somewhat normal life. But there are limits. Loss of volunteers… Loss of loved ones… A simple old fashioned pain medicines prevent the horror stories and saves lives young and old.. Any age… Any person rich or poor. !!!! We insist on this Disease RSD be recognized and put on the top of the list with Cancer.. Fibromialgia and others. God Bless ALL of the sick people. It’s possible these diseases like Cancer also develop RSD CRPS with it for some people due to the pain and surgeries they may have had causes RSD. Any kind of injury OR intrusion causes it!!! So research quickly cause people are Mad this is ignored. You could get it easily. Athletes??? It may not happen or it easily can at any time for Athletes for example??? One never knows?? It’s a weird disease. Research!!!!


Perhaps I am the eternal pessimist but something that I can’t put my finger on bothers me about this study. It does bear watching.