Pain characteristics and biomarkers in treatment approaches for osteoarthritis pain

Abstract

Osteoarthritis (OA) is a progressive disease and OA pain intensity is related to ongoing pathophysiological changes. However, OA pain is complex and multimodal; its characteristics, including severity, localization and the stimuli that elicit it, can change as the disease progresses and differ greatly among patients. Understanding mechanisms underlying specific pain characteristics may help guide clinicians in choosing appropriate treatments, targeting treatments to those patients most likely to benefit. Associations have been demonstrated between biomarkers and some characteristics of OA pain, and to processes linked to the shift in pain characteristics over the course of OA. This article examines how understanding OA pain characteristics and their relation to the disease process could inform treatment choice when applying well-established treatment guidelines.

Diagnostic Biomarkers for Upper Extremity Chronic Pain Conditions

“…12 Levels of C-reactive protein metabolite increased significantly with the degree of central sensitization, and brainderived neurotrophic factor has been reported as a reliable indicator of central sensitization. 12 With regard to metabolites, the synovial fluid of patients with chronic symptomatic OA have elevated levels of fructose and citrate and decreased levels of O-acetylcarnitine, N-phenylacetylglycine, methionine, ethanol, creatine, malate, ethanolamine, 3hydroxybutyrate, and hexanoylcarnitine. 10 Significantly depleted serum arginine levels were found in a separate cohort of patients with knee OA.…”

“…11 Patients with osteoarthritis (OA) have pain with joint movement that may occur at any stage of disease progression. 12 Initial OA pain is derived from a nociceptive response to joint damage, whereas later changes in the severity and location of pain result from peripheral sensitization that occurs when proinflammatory cytokines at the joint increase the reactivity of nociceptors. 12 Central sensitization may also occur over time.…”

“…12 Matrix metalloproteinases (MMPs) including MMP-3 and MMP-13, markers of cartilage/bone turnover including tissue inhibitor of metalloproteinase-1, C-terminal cross-linked telopeptide of type II collagen, and cartilage oligomeric matrix protein, as well as additional growth factors and adhesion molecules have been positively correlated to pain severity. 12 Levels of C-reactive protein metabolite increased significantly with the degree of central sensitization, and brainderived neurotrophic factor has been reported as a reliable indicator of central sensitization. 12 With regard to metabolites, the synovial fluid of patients with chronic symptomatic OA have elevated levels of fructose and citrate and decreased levels of O-acetylcarnitine, N-phenylacetylglycine, methionine, ethanol, creatine, malate, ethanolamine, 3hydroxybutyrate, and hexanoylcarnitine.…”

Welcome to the 11th Volume of Pain Management

“…Osteoarthritis is a chronic condition, with patients suffering from pain that often increases in severity over time. In their review article, Fayet and Hagen examine how understanding osteoarthritis pain characteristics and their relation to the disease process could inform treatment choice when applying well-established treatment guidelines [3].…”

Emerging role of chondroitin sulfate based nanocarriers in improving the therapeutic outcome of NSAIDs in the treatment of osteoarthritis through the TDDDS

“…Therapeutic objective of osteoarthritis treatment is to slow down the progression of inflammation and reduce pain. Current therapeutic regimen for the treatment of osteoarthritis comprised of NSAIDs, 23 Disease modifying anti-rheumatic drugs (DMARDs), glucocorticoids and biologics as key therapeutic agents. 24,25 Vivid progress in the development of innovative therapeutic agents that can effectively decrease the disease progression and slow down tissue damage thus improving quality of life of patient of this disabling disease.…”