RNA Biomarker Framework for Neuropathic Pain Outlined in Clinical Review Article

RNA biomarkers could help characterize neuropathic pain, a condition still assessed largely through patient-reported symptoms and clinical examination, according to a clinical review article published in Frontiers in Pain Research.

In the article, investigators from The Ohio Pain Clinic, Lilac Biosciences, and Brown University, propose a translational framework for using RNA-based biomarkers in diagnosis, patient stratification, drug development, and treatment monitoring. The authors outline several RNA classes, including mRNA signatures, circulating miRNAs, lncRNAs, ADAR-mediated RNA editing, and epitranscriptomic modifications such as N6-methyladenosine.

Review Highlights

• The article proposes a “pain biology score” built from multilayer RNA markers, including mRNA, miRNA, and RNA editing events.
• Candidate markers discussed include TCL1A and ERAP2 in immune-related pain biology, DRG-associated genes such as EFNB2, GABBR1, NCAM1, and SCN11A, and ADAR2-related RNA editing.
• RNA biomarkers may have potential use as pharmacodynamic readouts in analgesic and neuromodulation trials, including spinal cord stimulation studies.
• The authors note that no FDA-approved RNA-based biomarkers for pain currently exist, and the proposed pain biology score has not been clinically validated.

The review emphasizes that RNA biomarkers should complement, not replace, clinical assessment. Further work is needed to standardize assays, validate findings across diverse neuropathic pain populations, and determine whether RNA-based tools can improve treatment selection or monitoring.

Source

Soin A, Khaira M, Soin A, Soin D, Shah S, Tolppi S and Tripathi A. New insight into RNA biomarkers in neuropathic pain: a clinician–neuroscientist roadmap to translational testing and treatment monitoring a clinical review. Front Pain Res. 2026;7:1874336. doi: 10.3389/fpain.2026.1874336