{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:41:52Z","timestamp":1768405312159,"version":"3.49.0"},"reference-count":63,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ACIMAGO","award":["03\/21"],"award-info":[{"award-number":["03\/21"]}]},{"DOI":"10.13039\/501100001871","name":"oundation for Science and Technology (FCT), Portugal, through the Strategic Project","doi-asserted-by":"publisher","award":["UID\/04539\/2025"],"award-info":[{"award-number":["UID\/04539\/2025"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Funds through FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","award":["UIDB\/4255\/2020"],"award-info":[{"award-number":["UIDB\/4255\/2020"]}]},{"name":"project RISE, Associated Laboratory","award":["LA\/P\/0053\/2020"],"award-info":[{"award-number":["LA\/P\/0053\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomedicines"],"abstract":"<jats:p>Background\/Objectives: Patients in need of specialized palliative care are clinically highly complex, with pain being the most prevalent problem. Furthermore, in these patients, a self-report for characterization of pain could be difficult to obtain. This cross-sectional, exploratory study investigates the use of clinical parameters and peripheral blood biomarkers for potentially identifying and characterizing pain (assessed using Pain Assessment in Advanced Dementia (PAINAD) and Numeric Scale (NS)) in patients under palliative care, including a population with dementia where pain is often underdiagnosed. Methods: Fifty-three patients with non-oncological diseases were analyzed in a cross-sectional study using medical and nursing records. Among previous biomarkers related to monocytes and platelets assessed by flow cytometry, we selected the most significative ones for pain characterization in a logistic regression analysis (multivariate analysis), alongside patient-specific characteristics such as renal function, nutritional status, and age. Results: Our exploratory findings suggest strong relationships between chronic pain and advanced age, reduced glomerular filtration rate (GFR), and malnutrition within this cohort. Furthermore, the percentage of lymphocytes, total and classical monocytes, the relative expression in monocytes of CD206, CD163, the CD163\/CD206 ratio, and the relative expression in platelets of CD59 emerged as potential predictors of pain. Statistical analyses highlighted the challenges of multicollinearity among variables such as age, GFR, and nutritional status. A classification model further suggested that all patients over 65 years in our specific sample reported pain. Conclusions: This pilot study provides preliminary support for prior evidence linking chronic pain to aging, nutritional deficits, and renal impairment, and highlights potential novel peripheral blood biomarkers for pain assessment. This work emphasizes the promise of clinical and molecular biomarkers to improve pain detection and management, contributing to personalized and effective palliative care strategies.<\/jats:p>","DOI":"10.3390\/biomedicines14010176","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:03:10Z","timestamp":1768381390000},"page":"176","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Peripheral Blood Cells and Clinical Profiles as Biomarkers for Pain Detection in Palliative Care Patients"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6623-7420","authenticated-orcid":false,"given":"Hugo","family":"Ribeiro","sequence":"first","affiliation":[{"name":"Community Palliative Care Support Team Gaia, Health Local Unit Gaia and Espinho, 4434-502 Vila Nova de Gaia, Portugal"},{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Group of Environment, Genetics and Oncobiology (CIMAGO)\u2014FMUC, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal"},{"name":"Departamento de Medicina da Comunidade, Informa\u00e7\u00e3o e Decis\u00e3o em Sa\u00fade, Faculty of Medicine, University of Porto, 4200-393 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2599-6433","authenticated-orcid":false,"given":"Raquel","family":"Alves","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Group of Environment, Genetics and Oncobiology (CIMAGO)\u2014FMUC, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal"},{"name":"Centro Acad\u00e9mico Cl\u00ednico, 3004-504 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0755-8077","authenticated-orcid":false,"given":"Joana","family":"Jorge","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Group of Environment, Genetics and Oncobiology (CIMAGO)\u2014FMUC, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal"},{"name":"Centro Acad\u00e9mico Cl\u00ednico, 3004-504 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7836-8161","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Oliveiros","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Group of Environment, Genetics and Oncobiology (CIMAGO)\u2014FMUC, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2597-6849","authenticated-orcid":false,"given":"T\u00e2nia","family":"Gaspar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Group of Environment, Genetics and Oncobiology (CIMAGO)\u2014FMUC, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0335-0156","authenticated-orcid":false,"given":"In\u00eas","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Community Palliative Care Support Team Gaia, Health Local Unit Gaia and Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Jo\u00e3o Rocha","family":"Neves","sequence":"additional","affiliation":[{"name":"Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-393 Porto, Portugal"},{"name":"RISE-Health, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7538-0158","authenticated-orcid":false,"given":"Joana Brand\u00e3o","family":"Silva","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"School of Medicine and Biomedical Sciences, University of Porto, 4200-393 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0209-7670","authenticated-orcid":false,"given":"Ant\u00f3nio Pereira","family":"Neves","sequence":"additional","affiliation":[{"name":"Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-393 Porto, Portugal"},{"name":"Vascular Service, Local Health Unit S. Jo\u00e3o, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4142-4841","authenticated-orcid":false,"given":"Ana Bela","family":"Sarmento-Ribeiro","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Group of Environment, Genetics and Oncobiology (CIMAGO)\u2014FMUC, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal"},{"name":"Centro Acad\u00e9mico Cl\u00ednico, 3004-504 Coimbra, Portugal"},{"name":"Clinical Hematology Department, Local Health Unit of Coimbra, 3004-561 Coimbra, Portugal"}]},{"given":"Mar\u00edlia","family":"Dourado","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Group of Environment, Genetics and Oncobiology (CIMAGO)\u2014FMUC, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1470-4802","authenticated-orcid":false,"given":"Ana Cristina","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Faculty of Medicine (FMUC), University of Coimbra, 3004-504 Coimbra, Portugal"},{"name":"Group of Environment, Genetics and Oncobiology (CIMAGO)\u2014FMUC, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal"},{"name":"Centro Acad\u00e9mico Cl\u00ednico, 3004-504 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2585-200X","authenticated-orcid":false,"given":"Jos\u00e9 Paulo","family":"Andrade","sequence":"additional","affiliation":[{"name":"Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-393 Porto, Portugal"},{"name":"RISE-Health, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"791","DOI":"10.21037\/apm-22-894","article-title":"Complexity of patient care needs in palliative care: A scoping review","volume":"12","author":"Cerullo","year":"2023","journal-title":"Ann. 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