Can Gut Bacteria Help Diagnose CRPS?
/By Pat Anson
In what’s being called a breakthrough discovery, an international team of researchers has identified patterns in gut bacteria that appear to be associated with Chronic Regional Pain Syndrome (CRPS), a disabling nerve disease that causes severe pain. The discovery could lead to easier diagnosis of CRPS and potential new treatments.
Researchers at McGill University in Canada, working with colleagues in Israel and Ireland, used artificial intelligence (AI) to identify significant differences in the gut bacteria of CRPS patients and those of pain-free individuals. The findings were based on an analysis of stool and plasma samples from 53 CRPS patients and 52 healthy volunteers, which confirmed differences in fecal and plasma short-chain fatty acid levels.
The study is published in the journal Anesthesiology.
“What’s remarkable about this study is that we trained our machine learning algorithms on high quality microbiome data from patients in Israel and successfully predicted CRPS in Canadian patients with over 90-per-cent accuracy,” said lead author Emmanuel Gonzalez, PhD, from the McGill Centre for Microbiome Research and Canadian Centre for Computational Genomics.
“This is extraordinary because factors like geography, climate, diet and natural variation between people typically create large microbiome differences. Yet, our AI approach seems to have identified a common ‘microbiome signature’ of CRPS, suggesting microbiome-based diagnostics could work across populations in different countries.”
CRPS is a nerve disorder that often starts with an injury to an arm or leg, with the skin in the affected area becoming warm, red and painful to touch. Most cases are mild and people recover, but in rare cases it gets worse, resulting in chronic nerve pain that spreads throughout the body.
Also known as Reflex Sympathetic Dystrophy (RSD), CRPS affects between 400,000 and 2.1 million people worldwide. The disease is poorly understood, making it difficult to diagnose and treat.
“CRPS remains challenging to treat, with patients often experiencing prolonged suffering before receiving appropriate care,” said senior author Amir Minerbi, MD, Director of the Institute for Pain Medicine at Rambam Health Campus in Haifa, Israel.
With no known cure and few ways to manage symptoms, some CRPS patients become so desperate they resort to amputation. Researchers found that three male patients whose symptoms disappeared after limb amputation still had the same gut bacteria pattern that was linked to CRPS.
“This persistent signature suggests the gut microbiome might make some people more prone to developing CRPS, with an injury or other event triggering the condition,” said Yoram Shir, MD, a Professor of Anesthesia and Director at McGill’s Alan Edwards Pain Management Unit.
The research adds to a growing body of evidence that gut microbiome — the population of microorganisms that live in the gastrointestinal tract — play a role in some chronic pain syndromes. Recent studies have linked gut bacteria to rheumatoid arthritis and irritable bowel syndrome (IBS).
A healthy balance of bacteria helps the body fight disease and regulates inflammatory reactions. Changes in the gut microbiome can disrupt the immune system and lead to inflammaging, when low levels of inflammation become chronic and spread throughout the body.
