Tracing The Evolution Of Neuropathic Pain Markers: A Journey From Past Discoveries To Emerging Innovations And Future Directions
Abstract
Pain research has significantly advanced over the past fifty years, yet identifying definitive biomarkers for chronic pain remains a challenge. The gap between basic and applied research persists due to the lack of rigorous standards for selecting candidate biomarkers and the subjective nature of validation processes. For biomarkers to develop effectively, especially for chronic pain, it is crucial to understand the molecular and genetic similarities between psychological disorders and chronic pain. This understanding may shift therapeutic interventions from peripheral to central nervous system targets, emphasizing broader neural network changes over specific genotypes. A comprehensive grasp of the complex interactions leading to chronic pain is essential for personalized and effective treatments. This involves not only identifying and validating biomarkers but also understanding their interactions with biological and environmental factors. Technological advancements like artificial intelligence and machine learning can help identify patterns in large datasets, leading to new biomarker discoveries. By integrating data from genomics, proteomics, metabolomics, and neuroimaging, researchers can gain a deeper understanding of chronic pain mechanisms and identify new intervention targets. Despite these advancements, the development and validation of biomarkers is a complex process requiring collaboration across multiple disciplines. This multidisciplinary effort is necessary to bridge the gap between basic science and clinical practice, ultimately improving chronic pain management. The focus of biomarker research is shifting from disease-specific studies to identifying common pain mechanisms. Advances in understanding nociceptive transmission, inflammation, and neuropathic pain have opened new strategies for discovering and validating biomarkers and identifying drug targets. Systems biology and bioinformatics, which integrate large-scale molecular data and personal information through quantitative models, are proving effective in understanding nervous system development and function. In silico modeling can predict clinical phenomena, enhancing early clinical study design, safety, and biomarker studies. Emphasizing advanced systems and longitudinal, multi-omics single-cell analysis from preclinical to clinical stages is crucial for future success.
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