Omics Associated with Self-management Interventions for Symptoms (OASIS) Center

与症状自我管理干预相关的组学 (OASIS) 中心

基本信息

批准号：
9483786
负责人：
SUSAN G DORSEY
金额：
$ 54.07万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-09 至 2021-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9483786
关键词：
Acupuncture Therapy Adverse effects Affect American Americas Area Baltimore Behavior Behavioral Biological Cessation of life Chronic Chronic Disease Clinical Cognitive Therapy Collaborations Dentistry Diabetes Mellitus Dose Environment Epidemic Exercise Extramural Activities Failure Foundations Funding Gender Genomics Goals Healthcare Heart Diseases Individual Individual Differences Institute of Medicine (U.S.)Intervention Intervention Trial Leadership Length Link Malignant Neoplasms Maryland Mediating Mediation Mediator of activation protein Medicine Methods Modeling Molecular Motivation Pain Participant Patients Pharmaceutical Preparations Pharmacogenomics Pharmacological Treatment Pharmacotherapy Pharmacy facility Phenotype Physical Exercise Physical activity Pilot Projects Pre-Clinical Model Productivity Proteomics Psychosocial Factor Public Health Reporting Research Activity Research Infrastructure Resources School Nursing Science Self Management Senior Scientist Sex Characteristics Symptoms Testing Time United States National Institutes of Health Universities Work addiction base chronic pain cost design efficacy testing epigenomics improved individual response mortality pain reduction pain relief persistent symptom pre-clinical psychosocial ranpirnase resilience response success symptom management symptom science symptom self management transcriptomics treatment response

项目摘要

OVERALL OASIS CENTER ABSTRACT More than half of all Americans suffer from a chronic condition and 70% of deaths annually can be attributed to chronic conditions. One of the most frequent and debilitating is pain, which can occur as a symptom of chronic illness or as a primary problem. According to the Institute of Medicine (IOM) report on Relieving Pain in America, chronic pain is a public health epidemic affecting more than 116 million Americans and costing more than $600 billion per year in healthcare expenses and lost work productivity. Despite advances in conventional pharmacological treatments that are informed by our current understanding of basic biological mechanisms of chronic pain, most people do not obtain adequate pain relief. An important focus has been to determine whether self-management interventions improve pain. Various types of self-management interventions have been tested, including cognitive behavioral therapy (CBT), non-pharmacologic treatments (e.g., heat, cold, acupuncture, etc.), exercise/physical activity, others. However, much like pharmacogenomic influences on individual response to drug treatment, self-management intervention trials have demonstrated mixed results in that some, but not all, study participants respond or participate. This is could be due to many factors, including resilience, motivation and/or capability to engage in the activity. In some cases it is unclear what dose and intensity of the self-management intervention provide a benefit. Moreover, the molecular mechanisms underlying the relative success or failure of self-management interventions on an individual level have been understudied. The purpose of the University of Maryland, Baltimore (UMB) Omics Associated with Self- management Interventions for Symptoms (OASIS) Center, guided by an adapted version of the National Institutes of Health Symptom Science Model (NIHSSM), is to combine rigorous phenotyping of pre-clinical models and patients in chronic pain with cutting edge omics methods to advance our understanding of how individual differences influence one's resilience, motivation and capability to engage in physical activity and exercise to manage chronic pain. We hypothesize that an individual's genomic, transcriptomic, epigenomic and proteomic (hereafter referred to as “omics”) profile predicts their resilience, motivation and capability to engage in self-management behaviors and their response to treatment. Potential mediators and moderators (e.g., psychosocial factors, sex differences, the environment) may also influence either the response to self-management interventions or the level of chronic pain. Our goal is not to test the efficacy of physical activity on chronic pain reduction in experimental versus control conditions; we know these strategies can work; but rather, to understand the omics correlates that will begin to inform us about mechanisms that underlie the resilience, motivation and capability to engage, and the response of the individuals to physical activity. We acknowledge that other factors, such as psychosocial status, the environment, and sex differences can moderate or mediate omics effects. We assert that our interdisciplinary team-based OASIS Center and translational, mechanism-based approach will accelerate the science of self-management to produce high impact results that will move the field forward.

绿洲中心整体摘要超过一半的美国人患有慢性病，每年 70% 的死亡可归因于慢性病最常见且令人衰弱的慢性疾病之一是疼痛，它可能是慢性疾病的症状。根据医学研究所 (IOM) 关于缓解疼痛的报告，在美国，慢性疼痛是一种公共卫生流行病，影响超过 1.16 亿美国人，造成更多损失尽管传统技术取得了进步，但每年仍会造成超过 6000 亿美元的医疗费用和工作效率损失。基于我们目前对基本生物学机制的理解而提供的药物治疗慢性疼痛，大多数人没有获得足够的疼痛缓解，一个重要的焦点是确定。自我管理干预措施是否可以改善疼痛。已经过测试，包括认知行为疗法（CBT）、非药物治疗（例如热、冷、然而，这与药物基因组学的影响非常相似。个体对药物治疗的反应，自我管理干预试验表明结果好坏参半一些（但不是全部）研究参与者做出反应或参与这可能是由于多种因素造成的，包括在某些情况下，尚不清楚参与活动的弹性、动机和/或能力。此外，自我管理干预的强度也有好处。个人层面自我管理干预相对成功或失败的根本原因是马里兰大学巴尔的摩分校 (UMB) 与自我相关的组学的目的管理干预症状（OASIS）中心，以国家标准的改编版本为指导健康症状科学模型（NIHSSM），是结合严格的临床前表型分析使用尖端组学方法研究慢性疼痛模型和患者，以加深我们对慢性疼痛的理解个体差异会影响一个人参与体育活动的弹性、动力和能力，我们勇敢地面对一个人的基因组、转录组、表观基因组和蛋白质组（以下简称“组学”）概况可预测其恢复能力，进行自我管理行为的动机和能力及其对治疗的反应。潜在的中介因素和调节因素（例如，心理社会因素、性别差异、环境）可能也会影响对自我管理干预的反应或慢性疼痛的程度。目标不是测试实验与对照中体力活动对减轻慢性疼痛的功效条件；我们知道这些策略可以发挥作用；但是，要了解将开始发挥作用的组学相关性。告诉我们构成复原力、动机和参与能力的机制，以及我们承认其他因素，例如心理社会。我们断言，地位、环境和性别差异可以调节或调节组学效应。基于跨学科团队的 OASIS 中心和基于机制的转化方法将加速自我管理科学产生高影响力的成果，推动该领域向前发展。