Deep Phenotyping to Improve our Understanding of Chronic Pelvic Pain

Chronic pelvic pain is common, affecting almost one quarter of women worldwide, with a significant impact on quality of life and high associated financial cost. The diagnosis of underlying pathology is difficult and frequently requires multiple surgical procedures often under different specialists. It is perhaps unsurprising therefore that the focus of biomarker research in this field has been non-invasive diagnostic tests. The TRiPP subproject of IMI-PainCare is taking a different approach, aiming to use biomarkers to identify underlying pain pathways rather than the presence of disease. This multi-site study integrates detailed phenotypic data with genomics and plasma proteomics and metabolomics in a cohort of almost 800 woman (556 with pelvic pain and 230 pain-free controls) and expands this data-set with additional questionnaires and psychophysical assessments in a subset. Additionally, our design allows us to specifically explore associations of endometriosis and of bladder symptoms. We will present results from integrative analyses of this rich dataset, determining key pathways underlying pain in women with pelvic pain and identifying clinically meaningful subgroups and associated biomarkers. Ultimately we hope this strategy will identify novel therapeutic targets, inform a more personalised approach to treatment and allow refinement of preclinical models to optimise drug discovery.