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外周神经性疼痛患者与健康对照者脑脊液的多变量蛋白质组学分析——一项产生假设的初步研究。

Multivariate proteomic analysis of the cerebrospinal fluid of patients with peripheral neuropathic pain and healthy controls - a hypothesis-generating pilot study.

作者信息

Bäckryd Emmanuel, Ghafouri Bijar, Carlsson Anders K, Olausson Patrik, Gerdle Björn

机构信息

Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden ; Pain and Rehabilitation Centre, Anaesthetics, Operations and Specialty Surgery Centre, Region Östergötland, Linköping, Sweden.

出版信息

J Pain Res. 2015 Jul 1;8:321-33. doi: 10.2147/JPR.S82970. eCollection 2015.

Abstract

Pain medicine lacks objective biomarkers to guide diagnosis and treatment. Combining two-dimensional gel proteomics with multivariate data analysis by projection, we exploratively analyzed the cerebrospinal fluid of eleven patients with severe peripheral neuropathic pain due to trauma and/or surgery refractory to conventional treatment and eleven healthy controls. Using orthogonal partial least squares discriminant analysis, we identified a panel of 36 proteins highly discriminating between the two groups. Due to a possible confounding effect of age, a new model with age as outcome variable was computed for patients (n=11), and four out of 36 protein spots were excluded due to a probable influence of age. Of the 32 remaining proteins, the following seven had the highest discriminatory power between the two groups: an isoform of angiotensinogen (upregulated in patients), two isoforms of alpha-1-antitrypsin (downregulated in patients), three isoforms of haptoglobin (upregulated in patients), and one isoform of pigment epithelium-derived factor (downregulated in patients). It has recently been hypothesized that the renin-angiotensin system may play a role in the pathophysiology of neuropathic pain, and a clinical trial of an angiotensin II receptor antagonist was recently published. It is noteworthy that when searching for neuropathic pain biomarkers with a purely explorative methodology, it was indeed a renin-angiotensin system protein that had the highest discriminatory power between patients and controls in the present study. The results from this hypothesis-generating pilot study have to be confirmed in larger, hypothesis-driven studies with age-matched controls, but the present study illustrates the fruitfulness of combining proteomics with multivariate data analysis in hypothesis-generating pain biomarker studies in humans.

摘要

疼痛医学缺乏用于指导诊断和治疗的客观生物标志物。我们将二维凝胶蛋白质组学与投影多元数据分析相结合,对11例因创伤和/或手术导致严重周围神经性疼痛且对传统治疗无效的患者以及11名健康对照者的脑脊液进行了探索性分析。使用正交偏最小二乘判别分析,我们鉴定出一组36种蛋白质,可高度区分两组。由于年龄可能存在混杂效应,我们为患者(n = 11)计算了一个以年龄为结果变量的新模型,36个蛋白质斑点中有4个因年龄的可能影响而被排除。在剩下的32种蛋白质中,以下7种在两组之间具有最高的判别力:血管紧张素原的一种同工型(在患者中上调)、α-1抗胰蛋白酶的两种同工型(在患者中下调)、触珠蛋白的三种同工型(在患者中上调)以及色素上皮衍生因子的一种同工型(在患者中下调)。最近有人提出,肾素-血管紧张素系统可能在神经性疼痛的病理生理学中起作用,并发表了一项血管紧张素II受体拮抗剂的临床试验。值得注意的是,在使用纯探索性方法寻找神经性疼痛生物标志物时,本研究中确实是一种肾素-血管紧张素系统蛋白在患者和对照之间具有最高的判别力。这项产生假设的初步研究结果必须在更大规模、以年龄匹配对照为驱动的假设性研究中得到证实,但本研究说明了在人类产生假设的疼痛生物标志物研究中,将蛋白质组学与多元数据分析相结合的成效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/282c/4492642/f6b7a1ce7f51/jpr-8-321Fig1.jpg

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