title: Can Urine Metabolomics Be Helpful in Differentiating Neuropathic and Nociceptive Pain? A Proof-of-Concept Study.
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 (1)H 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.
authors.affiliation: Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Finco
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Locci
authors.affiliation: Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Mura
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Massa
authors.affiliation: Department of Surgery, University of Cagliari, Cagliari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Noto
authors.affiliation: Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Musu
authors.affiliation: Department of Anesthesia and Intensive Care, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: d'Aloja
authors.affiliation: Public Health Institute, Catholic University of Rome, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: De-Giorgio
authors.affiliation: Department of Chemical and Geological Sciences, University of Cagliari, Cagliari, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Scano
authors.affiliation: Department of Emergency, Catholic University of Rome, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Evangelista
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009437:Neuralgia / Q000175:diagnosis* / Q000652:urine*; D059226:Nociceptive Pain / Q000175:diagnosis* / Q000652:urine*; D011446:Prospective Studies