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Purpose:
To evaluate the evolution of a set of proposed pain biomarkers in the saliva of subjects following Advanced Surface Ablation (ASA), in order to determine their validity as objective pain measures.
Methods:
A multicenter, prospective, and descriptive study was carried out to assess the variations between biomarkers and perceived pain. Th...
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Introduction
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Citations
... This may indicate that sIgA may play a protective role during orthodontic treatment, reducing the pain experienced by patients [24]. Additionally, studies by Sobas et al. found that sIgA concentrations were significantly higher after surgery at each visit compared to the baseline values (p = 0.053, p < 0.001, respectively) [43]. Another study by Sobas et al., including 34 subjects, found that sIgA showed acceptable levels of reproducibility and could be used as a potential salivary biomarker in pain diagnostics [39]. ...
... According to Sobas et al.'s research, sTNFαRII has the potential to serve as a diagnostic marker for pain in healthy individuals [39]. Furthermore, in another study by the same author, sTNFαRII levels post-surgery were significantly higher at each follow-up visit compared to the baseline values (p = 0.053, p < 0.001, respectively) [43]. However, cortisol awakening response (CAR) and sTNFαRII showed no association with acute pain [34]. ...
... Therefore, various studies have investigated the use of different blood and saliva biomarkers for objective pain evaluation. In our review, we observed that the majority of the studies were performed on an adult population [34][35][36][37][38][39][40][41][42][43][45][46][47][48][49][50]. In addition, it is easy to explain that biomarkers, e.g., cortisol, are already measured in the blood with pre-defined reference values. ...
Pain is one of the most common complaints leading to a pediatric emergency department visit and is associated with various painful procedures, leading to increased anxiety and stress. Assessing and treating pain in children can be challenging, so it is crucial to investigate new methods for pain diagnosis. The review aims to summarize the literature on non-invasive salivary biomarkers, such as proteins and hormones, for pain assessment in urgent pediatric care settings. Eligible studies were those that included novel protein and hormone biomarkers in acute pain diagnostics and were not older than 10 years. Chronic pain studies were excluded. Further, articles were divided into two groups: studies in adults and studies in children (<18 years). The following characteristics were extracted and summarized: study author, enrollment date, study location, patient age, study type, number of cases and groups, as well as tested biomarkers. Salivary biomarkers, such as cortisol, salivary α-amylase, and immunoglobulins, among others, could be appropriate for children as saliva collection is painless. However, hormonal levels can differ among children in different developmental stages and with various health conditions, with no predetermined levels of saliva. Thus, further exploration of biomarkers in pain diagnostics is still necessary.
... Current assessment approaches rely on clinical impression and behavioral rating scales completed by proxy report. Furthermore, Sobas et al. (2020) have recently described its possible use in pain perception after advanced corneal surface ablation surgery. ...
We are currently witnessing the aging of the world’s population due to increased life expectancy and declining fertility rates, and this aging population carries high health costs. The elderly population is associated with the presence of comorbidities, and those are at the same time associated with pain, as well as pathologies where age is a risk factor such as neurodegenerative pathologies, specifically Alzheimer’s disease. The presence of both factors in the elderly normally leads to poor pain management, leading to under or overtreatment. The incorrect usage of analgesia is mainly due to lack of knowledge of the influence of dementia on the perception of pain, the inability of patients to communicate or describe it, as well as the absence of objective tools that allow caregivers and/or health professionals to assess pain and consequently correctly manage the prescription of analgesia.
In this context, it would be interesting to carry out studies that address the biology and/or perception of pain, as well as the factors associated with it, in people with neurodegenerative diseases such as Alzheimer’s disease, and with easy, inexpensive, and noninvasive tools that allow the correct management of pain, and subsequently, of analgesia.
... Possible methods to measure and assess pain objectively have been proposed in the literature. In a recent study [10], different pain biomarkers in the saliva of subjects were explored, with concentrations of secretory immunoglobulin A and tumor necrosis factor-alpha presenting acceptable levels of reproducibility in healthy subjects. However, pain-related information is not the only contributing factor of salivarybased biomarker discrepancies [12]. ...
... Specifically, some biomarkers of pain, such as salivary cortisol, salivary amylase, testosterone, secretory IgA (sIgA), or tumor necrosis factor receptor type II (sTNF-RII), have been determined in previous studies [21][22][23][24][25]. However, among these, sIgA and sTNF-RII have been shown to be the most reproducible in healthy people [26], also being used to determine pain in surgical patients [27]. ...
The pain assessment in advanced dementia (PAINAD) appears to be a clinically useful tool. However, the salivary determination of tumor necrosis factor receptor type II (sTNF-RII) and secretory IgA (sIgA) as pain biomarkers is still incipient. The aim was to correlate the PAINAD score with sTNF-RII and sIgA biomarker levels in the saliva of patients with advanced dementia. In this regard, a cross-sectional study was conducted. The sample consisted of 75 elderly patients with a clinical diagnosis of dementia and a global deterioration scale (GDS) score of 5 to 7. The PAINAD scale was determined by a previously trained professional and the collection of salivary samples was performed using the passive secretion method. Human sTNF-RII and sIgA using ELISA kits. The results showed a correlation between the PAINAD scale (numeric, binary, and recoded) and sTNF-RII and sIgA (p < 0.001). No association between the sociodemographic and clinical variables and the PAINAD scale was found (p > 0.05). Between 97.3% and 96.2% of patients with pain on the PAINAD scale also showed pain based on the sTNF-RII levels; in all of them, sIgA levels did not fit the logistic models. Therefore, the correlation highlights the usefulness of this scale and confirms the usefulness of sTNF-RII and sIgA as biomarkers of pain.
... Possible methods to measure and assess pain objectively have been proposed in the literature. In a recent study [12], different pain biomarkers in the saliva of subjects were explored, with concentrations of secretory immunoglobulin A and tumor necrosis factor-alpha presenting acceptable levels of reproducibility in healthy subjects; however, salivarybased biomarker variations are not only due to pain-related information [12]. Another example is the use of cerebrospinal fluid which has been reported to identify pain in patients with neuropathic pain and movement disorders in patients with complex regional pain syndrome [4]. ...
... Possible methods to measure and assess pain objectively have been proposed in the literature. In a recent study [12], different pain biomarkers in the saliva of subjects were explored, with concentrations of secretory immunoglobulin A and tumor necrosis factor-alpha presenting acceptable levels of reproducibility in healthy subjects; however, salivarybased biomarker variations are not only due to pain-related information [12]. Another example is the use of cerebrospinal fluid which has been reported to identify pain in patients with neuropathic pain and movement disorders in patients with complex regional pain syndrome [4]. ...
Assessing pain in patients unable to speak (also called non-verbal patients) is extremely complicated and often is done by clinical judgement. However, this method is not reliable since patients vital signs can fluctuate significantly due to other underlying medical conditions. No objective diagnosis test exists to date that can assist medical practitioners in the diagnosis of pain. In this study we propose the use of functional near-infrared spectroscopy (fNIRS) and deep learning for the assessment of human pain. The aim of this study is to explore the use deep learning to automatically learn features from fNIRS raw data to reduce the level of subjectivity and domain knowledge required in the design of hand-crafted features. Four deep learning models were evaluated, multilayer perceptron (MLP), forward and backward long short-term memory net-works (LSTM), and bidirectional LSTM. The results showed that the Bi-LSTM model achieved the highest accuracy (90.6%)and faster than the other three models. These results advance knowledge in pain assessment using neuroimaging as a method of diagnosis and represent a step closer to developing a physiologically based diagnosis of human pain that will benefit vulnerable populations who cannot self-report pain.
Nociception related salivary biomolecules can be useful patients who are not able to self-report pain. We present the existing evidence on this topic using the PRISMA-ScR guidelines and a more focused analysis of cortisol change after cold pain induction using the direction of effect analysis combined with risk of bias analysis using ROBINS-I. Five data bases were searched systematically for articles on adults with acute pain secondary to disease, injury or experimentally induced pain. 43 articles met the inclusion criteria for the general review and 11 of these were included in the cortisol-cold pain analysis. Salivary melatonin, kallikreins, pro-inflammatory cytokines, soluable TNFαreceptor II, secretory IgA, testosterone, salivary α-amylase and, most commonly, cortisol have been studied in relation to acute pain. There is greatest information about cortisol and sAA which both rise after cold pain when compared with other modalities. Where participants have been subjected to both pain and stress, stress is consistently a more reliable predictor of salivary biomarker change than pain. In conclusion, there remain considerable challenges in identifying biomarkers that can be used in clinical practice to guide the measurement of nociception and treatment of pain. Standardization of methodology and researchers’ greater awareness of the factors that affect salivary biomolecule concentrations are needed to improve our understanding of this field towards creating a clinically relevant body of evidence.
