Abstract
The diagnosis of pain nature is a troublesome task and a wrong attribution often leads to an increase of costs and to avoidable pharmaceutical adverse reactions. An objective and specific approach to achieve this diagnosis is highly desirable. The aim of this work was to investigate urine samples collected from patients suffering from pain of different nature by a metabolomics approach based on 1H NMR spectroscopy and multivariate statistical analysis. We performed a prospective study on 74 subjects: 37 suffering from pain (12 with nociceptive and 25 with neuropathic pain), and 37 controls not suffering from any kind of chronic pain. The application of discriminant analysis on the urine spectral profiles allowed us to classify these two types of pain with high sensibility and specificity. Although the classification relies on the global urine metabolic profile, the individual contribution in discriminating neuropathic pain patients of metabolites such as choline and phosphocholine, taurine and alanine, suggests potential lesions to the nervous system. To the best of our knowledge, this is the first time that a urine metabolomics profile is used to classify these two kinds of pain. This methodology, although based on a limited sample, may constitute the basis for a new helpful tool in the clinical diagnosis.
Highlights
The diagnosis of chronic pain is still challenging for physicians in the everyday clinical setting
Urine samples were collected from patients diagnosed as suffering from nociceptive pain (NC, n = 12) and neuropathic pain (NP, n = 25) and from controls (C, n = 37)
We analyzed the variable loadings values along the predictive component of the OPLS-DA “NP vs. NC” model and we found that urine of patients classified as affected by neuropathic pain are characterized by higher levels of choline and phosphocholine, citrate, alanine and taurine, when compared with those of patients with nociceptive pain
Summary
The diagnosis of chronic pain is still challenging for physicians in the everyday clinical setting. This difficulty is due to the absence of a universal agreement about the description and classification of the different typologies of pain [1]. The International Association for the Study of Pain (IASP) defines pain as an individual, sensorial and subjective experience, characterized by both mental and physical factors, combined with a variety of other symptoms [2]. It may be PLOS ONE | DOI:10.1371/journal.pone.0150476. If the diagnostic process leads to a wrong result, the treatment will be unsatisfactory and treating the patient with an inappropriate therapy will increase the direct and indirect costs of the illness and side effects will be unjustified
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call