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Objective clinical pain analysis using serum cyclooxygenase-2 and inducible nitric oxide synthase in American patients     
Yazarlar
Omowunmi Sadik
Doç. Dr. İdris YAZGAN
Kastamonu Üniversitesi, Türkiye
Orhan Eroglu
Peng Liu
Sarah T Olsen
Alecia M Moser
Philip G Sander
Courage Tsiagbe
Kei Harada
Bajwa Saeed
Christian D Tvetenstrand
Lijun Yin
Peter Gerhardstein
Özet
Background: Pain is a multidimensional condition of multiple origins. Determining both intensity and underlying cause are critical for effective management. Utilization of painkillers does not follow any guidelines relying on biomarkers, which effectively eliminates objective treatment. The aim of this study was to evaluate the use of serum cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) as pain biomarkers. This work could significantly advance the diagnosis and treatment of pain. Methods: We assessed the potential utility of serum COX-2 and iNOS as objective measures of pain in a sample of American patients. Pain was scaled between level 0–5 in accordance with the level reported by the patients. Blood samples were collected from 102 patients in the emergency room. Sandwich ELISA was used to determine the COX-2 and iNOS levels in the blood serum while statistical analysis was performed using Pearson product-moment correlation coefficients, Regression and Receiver Operating Characteristics (ROC) analyses. The biomarker results were also compared with self-reports of pain by the patients using conventional pain ratings and patients were asked to report the cause of the pain. Pain levels were clustered into four groups as 0 [self-reported 0], 1 [self-reported as 1], 2 [self-reported as 2 and 3] and 3 [self-reported as 4 and 5]. Co-expression of COX-2 and iNOS could significantly alter pain development and its sensitization. Therefore, iNOS dependent COX-2 levels were employed as categorized level. Results: Self-reported pain levels did not show a correlation with the serum level of COX-2 and iNOS. The lack of correlation is attributed to multiple reasons including patients’ intake of painkillers prior to participation, painkiller intake habit, chronic diseases, and subjectivity of self-reported pain. Increased serum COX-2 levels were reported in relation to the subtypes of these health issues. Further, 83% of the patients who reported pain also showed the presence of COX-2 in serum, while only 53% of the patients showed the presence of iNOS in serum. Moderate relation was found between the clustered pain level and categorized COX-2 and iNOS- levels. Conclusions: The findings support the requirement of further studies to use COX-2 and iNOS as prognostic biomarkers for objective quantification of pain at the clinical level.
Anahtar Kelimeler
Biomarker | Cyclooxygenase-2 | Inducible nitric oxide synthase | Objective pain level classification
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı Clinica Chimica Acta
Dergi ISSN 0009-8981
Dergi Tarandığı Indeksler SCI
Makale Dili İngilizce
Basım Tarihi 09-2018
Cilt No 484
Sayfalar 278 / 283
Doi Numarası 10.1016/j.cca.2018.06.005
Makale Linki https://linkinghub.elsevier.com/retrieve/pii/S0009898118302912