Expert consensus of Chinese Association for the Study of Pain on the application of ozone therapy in pain medicine.

This consensus was compiled by first-line clinical experts in the field of pain medicine and was organized by the Chinese Association for the Study of Pain. To reach this consensus, we consulted a wide range of opinions and conducted in-depth discussions on the mechanism, indications, contraindications, operational specifications and adverse reactions of ozone iatrotechnique in the treatment of pain disorders. We also referred to related previous preclinical and clinical studies published in recent years worldwide. The purpose of this consensus is to standardize the rational application of ozone iatrotechnique in pain treatment, to improve its efficacy and safety and to reduce and prevent adverse reactions and complications in this process.

Selective phosphodiesterase-2A inhibitor alleviates radicular inflammation and mechanical allodynia in non-compressive lumbar disc herniation rats.

PURPOSE: Phosphodiesterase inhibitors possess anti-inflammatory properties. In addition, some studies report that phosphodiesterase 2A (PDE2A) are highly expressed in the dorsal horn of the spinal cord. The present study aimed to investigate whether intrathecal administration of Bay 60-7550, a specific PDE2A inhibitor, could alleviate mechanical allodynia in non-compressive lumbar disc herniation (NCLDH) rats. METHODS: Rat NCLDH models by autologous nucleus pulposus implantation to dorsal root ganglion were established. Vehicle or Bay 60-7550 (0.1, 1.0 mg/kg) was injected by intrathecal catheter at day 1 post-operation. The ipsilateral mechanical withdrawal thresholds were analyzed from the day before surgery to day 7 after surgery. At day 7 post-operation, the ipsilateral lumbar (L4-L6) segments of the spinal dorsal horns were removed, and tumor necrosis factor α (TNF-α), interleukin-1ß (IL-1ß), interleukin-6 (IL-6), cyclic adenosine monophosphate (cAMP), and cyclic guanosine monophosphate (cGMP) expressions were measured by ELISA. Furthermore, PDE2A mRNA and protein expressions in spinal cord were measured by Real-Time PCR and Western blot. RESULTS: Intrathecal administration of the PDE2A inhibitor Bay 60-7550, significantly attenuated mechanical allodynia, down-regulated spinal TNF-α, IL-1ß and IL-6 over-expressions, increased the expression of spinal cAMP, as well as cGMP in a more remarkable manner, and decreased the spinal PDE2A expression in NCLDH rats in a dose-dependent manner. CONCLUSIONS: Bay 60-7550 alleviated mechanical allodynia and inflammation in NCLDH rats, which might be associated with increased cAMP and especially cGMP increase. Thus, spinal PDE2A inhibition might represent a potential analgesic strategy for radiculopathy treatment in non-compressive lumbar disc herniation.

[Effect of electroacupuncture on the expression of spinal glial fibrillary acidic protein, tumor necrosis factor-alpha and interleukin-1beta in chronic neuropathic pain rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the expression of spinal glial fibrillary acidic protein (GFAP), tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) in chronic constriction injury (CCI) rats. METHODS: Seventy-two SD rats were randomized into sham operation (sham), CCI (model) and EA groups (n = 24/group). The mechanical and thermal pain thresholds were measured by using Von Frey filaments and radiant-heat irridiation separately. The immunoactivity of GFAP of spinal dorsal horn (L4-L5) was assessed by immunohistochemistry, and the expression of spinal TNF-alpha mRNA and IL-1beta mRNA was detected by real time-PCR. RESULTS: Compared with pre-CCI and sham group, both mechanical and thermal pain thresholds decreased considerably in rats with CCI (P < 0.05), and in comparison with model group, those of EA group increased markedly (P < 0.05). Compared with sham group, GFAP immunoactivity (mainly in the lamina I-II of the spinal dorsal horn), TNF-alpha mRNA and IL-1beta mRNA expression in the ipsilateral spinal cord on the CCI side in model group increased considerably (P < 0.05), while compared with model group, the expression of GFAP, TNF-alpha mRNA and IL-1beta mRNA in EA group was down-regulated remarkably (P < 0.05). CONCLUSION: EA can effectively suppress CCI-induced up-regulation of expression of spinal GFAP, TNF-alpha mRNA and IL-1beta mRNA, which may contribute to its effect in reducing mechanical allodynia and thermal hyperalgesia in neuropathic pain rats.