A Systematic Review of the Association Between Urinary Biomarkers and Pain
There are many clinical situations where it is not possible to be certain if a patient is experiencing pain. A urinary biomarker of pain would expedite diagnosis and treatment. The collection of urine is non-invasive, which makes it an ideal choice in sit
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Abstract
There are many clinical situations where it is not possible to be certain if a patient is experiencing pain. A urinary biomarker of pain would expedite diagnosis and treatment. The collection of urine is non-invasive, which makes it an ideal choice in situations where patients are stressed and already suffering pain. This systematic review aims to determine if there is a urinary biomarker that has consistently been associated with changing levels of pain, and may reflect underlying biological mechanisms associated with the production of pain. Materials and Methods A literature search was conducted of Embase, Medline, PubMed, Web of Science, and Scopus using the search keywords urine, biomarker and pain. There were no limitations on publication dates. The search was limited to English language and human studies. Results 1251 articles were screened. 833 were eliminated by title or abstract as not fulfilling the search criteria. After elimination of duplicates, 277 studies were identified as uniquely fulfilling the search characteristics composed of 22 randomized controlled trials (RCTs), 44 controlled observational studies, and 211 case studies or series. In order to fulfill the selection criteria, the 22 RCTs had to include both pain and urinary measurements as outcomes in the abstract of the article. The RCTS involved 2177 patients with varied pain conditions and urinary biomarkers. Discussion The research involving urinary biomarkers in painful conditions of bone turnover have found statistically significant correlations between disease progression and pain. The biomarkers chosen may reflect the mechanism of the disorder rather than pain. Conclusion High quality long duration RCTs using interventions with proven efficacy are required to investigate the association between urinary biomarkers and pain.
Keywords
Urinary
Biomarker
K. McCloy N. Doan (&) School of Dentistry, The University of Queensland, Sir Fred Schonell Drive, Brisbane, QLD, Australia e-mail: [email protected] U. Abeyratne Department of Info Tech and Electrical Engineering, The University of Queensland, Brisbane, QLD, Australia
Pain
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Introduction
A biomarker is an objective and measureable indicator of normal or pathologic biological processes or of responses to therapeutic interventions [1]. If it exists, the ideal biomarker for pain would be found in all pain conditions irrespective of gender, age or ethnicity. It would be accessible via multiple
© Springer Nature Singapore Pte Ltd. 2018 T. Vo Van et al. (eds.), 6th International Conference on the Development of Biomedical Engineering in Vietnam (BME6), IFMBE Proceedings 63, https://doi.org/10.1007/978-981-10-4361-1_75
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bodily fluids such as urine, serum, and saliva using simple and reliable, economically feasible tests. Changes in its detectable levels would reflect alterations in both subjective and objective measurements of pain [1]. The difficulty with the search for a biomarker of pain is that pain is a subjective experience that can have di
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