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Exploring biomarkers in trigeminal neuralgia patients operated with microvascular decompression: A comparison with multiple sclerosis patients and non-neurological controls
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Functional Pharmacology and Neuroscience.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Functional Pharmacology and Neuroscience.ORCID iD: 0009-0008-8549-1350
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurology.ORCID iD: 0000-0001-9567-470x
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurosurgery.
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2024 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 28, no 6, p. 929-942Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Trigeminal neuralgia (TN) is a severe facial pain condition often associated with a neurovascular conflict. However, neuroinflammation has also been implicated in TN, as it frequently co-occurs with multiple sclerosis (MS).

METHODS: We analysed protein expression levels of TN patients compared to MS patients and controls. Proximity Extension Assay technology was used to analyse the levels of 92 proteins with the Multiplex Neuro-Exploratory panel provided by SciLifeLab, Uppsala, Sweden. Serum and CSF samples were collected from TN patients before (n = 33 and n = 27, respectively) and after (n = 28 and n = 8, respectively) microvascular decompression surgery. Additionally, we included samples from MS patients (n = 20) and controls (n = 20) for comparison.

RESULTS: In both serum and CSF, several proteins were found increased in TN patients compared to either MS patients, controls, or both, including EIF4B, PTPN1, EREG, TBCB, PMVK, FKBP5, CD63, CRADD, BST2, CD302, CRIP2, CCL27, PPP3R1, WWP2, KLB, PLA2G10, TDGF1, SMOC1, RBKS, LTBP3, CLSTN1, NXPH1, SFRP1, HMOX2, and GGT5. The overall expression of the 92 proteins in postoperative TN samples seems to shift towards the levels of MS patients and controls in both serum and CSF, as compared to preoperative samples. Interestingly, there was no difference in protein levels between MS patients and controls.

CONCLUSIONS: We conclude that TN patients showed increased serum and CSF levels of specific proteins and that successful surgery normalizes these protein levels, highlighting its potential as an effective treatment. However, the similarity between MS and controls challenges the idea of shared pathophysiology with TN, suggesting distinct underlying mechanisms in these conditions.

SIGNIFICANCE: This study advances our understanding of trigeminal neuralgia (TN) and its association with multiple sclerosis (MS). By analysing 92 protein biomarkers, we identified distinctive molecular profiles in TN patients, shedding light on potential pathophysiological mechanisms. The observation that successful surgery normalizes many protein levels suggests a promising avenue for TN treatment. Furthermore, the contrasting protein patterns between TN and MS challenge prevailing assumptions of similarity between the two conditions and point to distinct pathophysiological mechanisms.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024. Vol. 28, no 6, p. 929-942
National Category
Neurology
Identifiers
URN: urn:nbn:se:uu:diva-519432DOI: 10.1002/ejp.2231ISI: 001133731000001PubMedID: 38158702OAI: oai:DiVA.org:uu-519432DiVA, id: diva2:1824702
Available from: 2024-01-08 Created: 2024-01-08 Last updated: 2025-01-25Bibliographically approved
In thesis
1. Identification of candidate biomarkers in neurological and psychiatric health
Open this publication in new window or tab >>Identification of candidate biomarkers in neurological and psychiatric health
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Psychiatric and neurological diseases present substantial challenges in healthcare, affecting millions of individuals worldwide. Conditions such as depression, trigeminal neuralgia (TN), and narcolepsy have a profound impact on the quality of life for both patients and their families. The complex nature of these conditions necessitates the development of innovative diagnostic and treatment strategies. In recent years, the importance of biomarkers in understanding, diagnosing, and managing psychiatric and neurological diseases has emerged as a promising field of research. In the current thesis, five studies were conducted to identify candidate biomarkers in depression, TN, and narcolepsy. Study I validated depression-associated genetic variants in the UK Biobank (UKB) cohort, with transcriptome and DNA methylation analyses in independent datasets. Eight single nucleotide polymorphisms corresponding to six protein-coding genes (TNXB, NCAM1, LTBP3, BTN3A2, DAG1, FHIT) were strongly linked to depression. Study II analyzed 92 proteins in cerebrospinal fluid and serum from TN patients, compared with multiple sclerosis patients and controls. Several proteins, including SFRP1, FKBP5, and TBCB, were elevated in TN, suggesting their relevance in disease mechanisms. Study III examined protein levels in adolescents assessed for depression in the domestic Psychiatric Health in Adolescent Study (PSY cohort) in Sweden, with transcriptome validation in independent cohorts. Key findings highlighted protein and transcriptomic differences, particularly in PPP3R1, implicating the calcineurin pathway and prefrontal cortex in depression. Study IV explored genetic evidence in the UKB to validate the role of 17 proteins from previous studies in TN. Novel associations were identified with C8B (complement system) and MFGE8 (neuroinflammation regulation), highlighting their roles in TN pathology. Finally, Study V assessed protein biomarkers in narcolepsy using Swedish and Finnish cohorts, with transcriptome validation in an independent dataset. The identified candidate proteins were indicative of neural development involving survival, growth, and differentiation (UNC5C, VWC2, GFR-alpha-1, ADAM23), oxidative stress (HAGH), immune response (CLEC10A), and cell cycle regulation (ILKAP). Collectively, these studies identify potential biomarkers across these conditions, offering insights into their underlying mechanisms. The findings expand our understanding of psychiatric and neurological health and may inform future research and therapeutic strategies.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2025. p. 64
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 2119
Keywords
Biomarkers, genomics, transcriptomics, proteomics, depression, trigeminal neuralgia, narcolepsy
National Category
Neurosciences Neurology Psychiatry
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-548490 (URN)978-91-513-2364-0 (ISBN)
Public defence
2025-03-21, H:son Holmdahlsalen, Akademiska sjukhuset, Ingång 100/101, Dag Hammarskjölds Väg 8, Uppsala, 09:00 (English)
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Supervisors
Available from: 2025-02-26 Created: 2025-01-25 Last updated: 2025-03-17

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Lafta, Muataz SSokolov, Aleksandr V.Landtblom, Anne-MarieEricson, HansSchiöth, HelgiAbu Hamdeh, Sami

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