The spinal fluid of patients with chronic pain will be examined by a team of Australian researchers as part of a novel pilot study in the hope it could lead to new, more effective treatments.
It is estimated one in five Australians aged under 65 live with chronic pain however it remains “quite a mystery” to many experts, says Professor Paul Rolan, Director of Innovation at the University of Adelaide.
“Currently many treatments for chronic pain only work in a proportion such as 25 to 50 per cent of patients, necessitating multiple trials of drug therapy which may be ineffective yet expose patients to unwanted effects. A suitable test has the potential to select therapy more effectively,” said the clinical pharmacologist.
In the face of an opioid epidemic and few effective chronic pain treatments, Professor Rolan with Professor Rainer Haberberger, convenor of the Centre for Neuroscience at Flinders University, will lead a two-year study of 30 chronic pain patients whose pain is so severe they require catheters for pain relief medication.
Researchers will examine the tiny “bubbles” called exsomes which are shed from brain cells and present in spinal fluid.
“It’s hard to see into the brain, we’ve got lots of scans and images that tell us what the structure of the brain is doing, but its quite hard to work out what are the chemical processes going on in the brain,” said Professor Rolan.
“We’re … looking at these chemicals in the spinal fluid so we can help better diagnose and develop new treatments,” he told AAP.
Exosomes contain markers known as microRNAs, messenger chemicals that will provide information on brain activity.
Professor Rolan says these microRNAs will give them a “snapshot” into the brain processes happening in people with chronic brain.
This hasn’t been done before, but it is hoped the analysis of spinal fluid will reveal specific patterns of pain and possibly provide clues as to how to treat it.
“Blood tests could then be developed and this could help in the diagnosis and management of patients with chronic pain,” explained Professor Rolan.
The project is being funded by the Australian and New Zealand College of Anaesthetists (ANZCA) Research Foundation.