Articles: neuralgia.
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Inflammopharmacology · Dec 2020
Paeoniflorin attenuates chronic constriction injury-induced neuropathic pain by suppressing spinal NLRP3 inflammasome activation.
Neuropathic pain remains one of the most common pain conditions worldwide. Accumulating evidence shows that activation of the NOD-like receptor protein 3 (NLRP3) inflammasome contributes to the pathogenesis of neuropathic pain, although the role of the NLRP3 inflammasome in neuropathic pain has not yet been fully elucidated. In animal models of neuropathic pain, paeoniflorin (PF) was shown to have analgesic, anti-inflammatory, and antidepressant effects. ⋯ We found that activation of the NLRP3 inflammasome mediated the development of neuropathic pain following chronic constriction injury of the sciatic nerve and that PF attenuated neuropathic pain by inhibiting NLRP3 inflammasome activation. Moreover, PF enhanced the translocation of the transcription factor nuclear factor erythroid 2-related factor 2 into the nucleus and suppressed nuclear factor-kappa B activity in the spinal cord. These results suggest that PF may be a potential therapeutic agent for neuropathic pain.
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J Pain Palliat Care Pharmacother · Dec 2020
Evaluation of a Pharmacist Managed Telephone Pain Clinic for Neuropathy Treatment.
Pain is prevalent in our society, affecting more than a quarter-million U. S. adults and leading to poor patient outcomes. At the Veteran's Affairs San Diego Healthcare System (VASDHS), a Telephone Pain Clinic (TPC) was developed to improve these outcomes. ⋯ At discharge, pain medications that were increased were use of serotonin and norepinephrine reuptake inhibitors (SNRIs), pregabalin, and capsaicin. Management by the TPC showed promise and trends toward reducing pain experienced by patients with diabetic neuropathy, fibromyalgia, or postherpetic neuralgia. The TPC also may be more effective in maximizing evidenced-based pharmacotherapy for neuropathic pain, suggesting expertise by pharmacist clinical specialists.
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Randomized Controlled Trial
Factors with impact on magnitude of the placebo response in randomized, controlled, cross-over trials in peripheral neuropathic pain.
The presence and magnitude of placebo responses is important for the outcome in clinical trials of analgesics. This explorative study aimed at identifying patients and trial-specific factors with impact on this response in randomized, controlled, cross-over trials in peripheral neuropathic pain. Data were derived from 7 trials and included observations on pinprick hyperalgesia, allodynia, and pain on repetitive stimulation. ⋯ The findings were similar in patients having placebo in the first treatment period. There was no marked difference between patients with (n = 43) and without (n = 275) a clinically meaningful placebo response with respect to the patient-specific factors including frequency of sensory signs and symptoms. In conclusion, this study on cross-over trials in peripheral neuropathic pain found no robust impact of trial and patient-specific factors on the placebo response.
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The chronification of pain can be attributed to changes in membrane receptors and channels underlying neuronal plasticity and signal transduction largely within nociceptive neurons that initiate and maintain pathological pain states. These proteins are subject to dynamic modification by posttranslational modifications, creating a code that controls protein function in time and space. Phosphorylation is an important posttranslational modification that affects ∼30% of proteins in vivo. ⋯ This narrative review discusses the molecular mechanisms of Cdk5-mediated regulation of target proteins involved in neuropathic pain. We focus on Cdk5 substrates that have been linked to nociceptive pathways, including channels (eg, transient receptor potential cation channel and voltage-gated calcium channel), proteins involved in neurotransmitter release (eg, synaptophysin and collapsin response mediator protein 2), and receptors (eg, glutamate, purinergic, and opioid). By altering the phosphoregulatory "set point" of proteins involved in pain signaling, Cdk5 thus appears to be an attractive target for treating neuropathic pain conditions.
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Observational Study
Somatosensory dysfunction related neuropathic pain component affects disease activity, functional status and quality of life in ankylosing spondylitis.
To investigate the neuropathic pain (NP) component in ankylosing spondylitis (AS) and to assess the relations between NP and disease characteristics. ⋯ Our results revealed that the presence of NP component in patients with AS is associated with various disease-related variables, including pain, high disease activity, reduced mobility of the axial skeleton, depression and poor quality of life.