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1.
Top Spinal Cord Inj Rehabil ; 27(1): 75-83, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33814885

RESUMEN

The prevalence of obesity and of neuropathic pain are both estimated at above 50% in the population of people with chronic spinal cord injury (SCI). These secondary consequences of SCI have significant negative impact on physical functioning, activities of daily living, and quality of life. Investigations of relationships between weight or body composition and chronic neuropathic pain in people with SCI are lacking, but investigations in non-SCI cohorts suggest an association between obesity and the presence and severity of neuropathic pain conditions. In the present article, we present a review of the literature linking obesity and neuropathic pain and summarize findings suggesting that metabolic syndrome and chronic, systemic inflammation due to excess adiposity increase the risk for neuropathic pain after an SCI.


Asunto(s)
Neuralgia/etiología , Obesidad/complicaciones , Traumatismos de la Médula Espinal/complicaciones , Humanos , Síndrome Metabólico/etiología , Neuralgia/metabolismo , Factores de Riesgo
2.
Int J Mol Sci ; 22(5)2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33808020

RESUMEN

Neuropathic pain is difficult to cure and is often accompanied by emotional and psychological changes. Exploring the mechanisms underlying neuropathic pain will help to identify a better treatment for this condition. The insular cortex is an important information integration center. Numerous imaging studies have documented increased activity of the insular cortex in the presence of neuropathic pain; however, the specific role of this region remains controversial. Early studies suggested that the insular lobe is mainly involved in the processing of the emotional motivation dimension of pain. However, increasing evidence suggests that the role of the insular cortex is more complex and may even be related to the neural plasticity, cognitive evaluation, and psychosocial aspects of neuropathic pain. These effects contribute not only to the development of neuropathic pain, but also to its comorbidity with neuropsychiatric diseases. In this review, we summarize the changes that occur in the insular cortex in the presence of neuropathic pain and analgesia, as well as the molecular mechanisms that may underlie these conditions. We also discuss potential sex-based differences in these processes. Further exploration of the involvement of the insular lobe will contribute to the development of new pharmacotherapy and psychotherapy treatments for neuropathic pain.


Asunto(s)
Corteza Cerebral , Neuralgia , Plasticidad Neuronal , Corteza Cerebral/metabolismo , Corteza Cerebral/patología , Corteza Cerebral/fisiopatología , Humanos , Neuralgia/metabolismo , Neuralgia/patología , Neuralgia/fisiopatología
3.
Zhen Ci Yan Jiu ; 46(3): 209-14, 2021 Mar 25.
Artículo en Chino | MEDLINE | ID: mdl-33798293

RESUMEN

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the behavior, histomorphology and the expression of angiopoietin-1 (Angpt-1) in rats with spinal nerve injury, so as to explore its mechanism on neuropathic pain. METHODS: Forty-five male SD rats were randomly divided into sham, model and EA groups (n=15 rats in each group). Spinal nerve ligation (SNL) of the L5 lumbar vertebra was performed to establish a rat model of neuropathic pain. The rats in the EA group were given EA at "Zusanli" (ST36) and "Kunlun" (BL60) of the operation side with continuous wave at a frequency of 2 Hz and an intensity of 1.5 mA once a day, 30 minutes each time for 7 days. The sham group only exposed L5 spinal nerves without ligation. Mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were observed and recorded before modeling and on days 3,5,7,10,12 and 14 after modeling. L4-L6 segments of spinal cord were taken and the morphological changes of spinal dorsal horn were observed by HE staining. The changes of spinal dorsal horn nerve fiber structure were observed by silver plating staining. Angpt-1 expression was detected by Western blot and immunohistochemistry. RESULTS: Compared with the sham group, the model group had significant reductions in MWT and TWL at each time point (P<0.01); compared with the model group, the EA group had significant increases in MWT and TWL on days 10,12 and 14 after intervention (P<0.05, P<0.01). HE staining showed that in the model group, the spinal dorsal horn showed degeneration and necrosis of neurons, nuclear fixation and shrinkage, and loose surrounding tissues. The degree of tissue damage of the EA group was milder than that of the model group. The silver staining results showed the model group had obvious neuronal fibrillary tangles, while there were fewer neuronal fibrillary tangles in the EA group. Compared with the sham group, the Angpt-1 expression in the model group was significantly decreased (P<0.01), and compared with the model group, the EA group had a significant increase in the expression of Angpt-1 (P<0.01). CONCLUSION: EA can promote the recovery of nerve function in SNL rats by up-regulating Angpt-1 expression.


Asunto(s)
Electroacupuntura , Neuralgia , Angiopoyetina 1/genética , Animales , Masculino , Neuralgia/genética , Neuralgia/terapia , Ratas , Ratas Sprague-Dawley , Médula Espinal , Asta Dorsal de la Médula Espinal
4.
Int J Mol Sci ; 22(5)2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33804568

RESUMEN

The limited effect of current medications on neuropathic pain (NP) has initiated large efforts to develop effective treatments. Animal studies showed that glycine transporter (GlyT) inhibitors are promising analgesics in NP, though concerns regarding adverse effects were raised. We aimed to study NFPS and Org-25543, GlyT-1 and GlyT-2 inhibitors, respectively and their combination in rat mononeuropathic pain evoked by partial sciatic nerve ligation. Cerebrospinal fluid (CSF) glycine content was also determined by capillary electrophoresis. Subcutaneous (s.c.) 4 mg/kg NFPS or Org-25543 showed analgesia following acute administration (30-60 min). Small doses of each compound failed to produce antiallodynia up to 180 min after the acute administration. However, NFPS (1 mg/kg) produced antiallodynia after four days of treatment. Co-treatment with subanalgesic doses of NFPS (1 mg/kg) and Org-25543 (2 mg/kg) produced analgesia at 60 min and thereafter meanwhile increased significantly the CSF glycine content. This combination alleviated NP without affecting motor function. Test compounds failed to activate G-proteins in spinal cord. To the best of our knowledge for the first time we demonstrated augmented analgesia by combining GlyT-1 and 2 inhibitors. Increased CSF glycine content supports involvement of glycinergic system. Combining selective GlyT inhibitors or developing non-selective GlyT inhibitors might have therapeutic value in NP.


Asunto(s)
Proteínas de Transporte de Glicina en la Membrana Plasmática/antagonistas & inhibidores , Glicina/líquido cefalorraquídeo , Hiperalgesia/prevención & control , Neuralgia/tratamiento farmacológico , Sarcosina/análogos & derivados , Animales , Hiperalgesia/metabolismo , Hiperalgesia/patología , Masculino , Actividad Motora , Neuralgia/metabolismo , Neuralgia/patología , Ratas , Ratas Wistar , Sarcosina/farmacología , Médula Espinal/efectos de los fármacos , Médula Espinal/metabolismo , Médula Espinal/patología
5.
J Headache Pain ; 22(1): 31, 2021 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-33902429

RESUMEN

BACKGROUND: Trigeminal neuralgia is a characteristic disease that manifests as orofacial phasic or continuous severe pain triggered by innocuous orofacial stimulation; its mechanisms are not fully understood. In this study, we established a new animal model of trigeminal neuralgia and investigated the role of P2X3 receptor (P2X3R) alteration in the trigeminal ganglion (TG) via tumor necrosis factor alpha (TNFα) signaling in persistent orofacial pain. METHODS: Trigeminal nerve root compression (TNC) was performed in male Sprague-Dawley rats. Changes in the mechanical sensitivity of whisker pad skin, amount of TNFα in the TG, and number of P2X3R and TNF receptor-2 (TNFR2)-positive TG neurons were assessed following TNC. The effects of TNFR2 antagonism in TG and subcutaneous P2X3R antagonism on mechanical hypersensitivity following TNC were examined. RESULTS: TNC induced unilateral continuous orofacial mechanical allodynia, which was depressed by carbamazepine. The accumulation of macrophages showing amoeboid-like morphological changes and expression of TNFα in the TG was remarkably increased following TNC treatment. The number of P2X3R- and TNFR2-positive TG neurons innervating the orofacial skin was significantly increased following TNC. TNFα was released from activated macrophages that occurred in the TG following TNC, and TNFR2 antagonism in the TG significantly diminished the TNC-induced increase in P2X3R-immunoreactive TG neurons. Moreover, subcutaneous P2X3R antagonism in the whisker pad skin significantly depressed TNC-induced mechanical allodynia. CONCLUSIONS: Therefore, it can be concluded that the signaling of TNFα released from activated macrophages in the TG induces the upregulation of P2X3R expression in TG neurons innervating the orofacial region, resulting in orofacial mechanical allodynia following TNC.


Asunto(s)
Neuralgia , Neuralgia del Trigémino , Animales , Dolor Facial , Hiperalgesia , Macrófagos , Masculino , Neuronas , Ratas , Ratas Sprague-Dawley , Ganglio del Trigémino , Factor de Necrosis Tumoral alfa , Regulación hacia Arriba
6.
Sheng Li Xue Bao ; 73(2): 223-232, 2021 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-33903884

RESUMEN

The present study was aimed to investigate the role of GluN2B-BDNF pathway in the cerebrospinal fluid-contacting nucleus (CSF-CN) in neuropathic pain. Intra-lateral ventricle injection of cholera toxin subunit B conjugated with horseradish peroxidase (CBHRP) was used to label the CSF-CN. Double-labeled immunofluorescent staining and Western blot were used to observe the expression of GluN2B and BDNF in the CSF-CN. Chronic constriction injury of sciatic nerve (CCI) rat model was used to duplicate the neuropathic pain. Pain behavior was scored to determine the analgesic effects of GluN2B antagonist Ro 25-6981 and BDNF neutralizing antibody on CCI rats. GluN2B and BDNF were expressed in the CSF-CN and their expression was up-regulated in CCI rats. Intra-lateral ventricle injection of GluN2B antagonist Ro 25-6981 or BDNF neutralizing antibody notably alleviated thermal hyperalgesia and mechanical allodynia in CCI rats. Moreover, the increased expression of BDNF protein in CCI rats was reversed by intra-lateral ventricle injection of Ro 25-6981. These results suggest that GluN2B and BDNF are expressed in the CSF-CN and alteration of GluN2B-BDNF pathway in the CSF-CN is involved in the modulation of the peripheral neuropathic pain.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo , Neuralgia , Animales , Hiperalgesia , Ratas , Ratas Sprague-Dawley , Nervio Ciático
7.
Int J Mol Sci ; 22(5)2021 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-33800907

RESUMEN

BACKGROUND: In the present study, we examined superoxide-mediated excitatory nociceptive transmission on at-level neuropathic pain following spinal thoracic 10 contusion injury (SCI) in male Sprague Dawley rats. METHODS: Mechanical sensitivity at body trunk, neuronal firing activity, and expression of superoxide marker/ionotropic glutamate receptors (iGluRs)/CamKII were measured in the T7/8 dorsal horn, respectively. RESULTS: Topical treatment of superoxide donor t-BOOH (0.4 mg/kg) increased neuronal firing rates and pCamKII expression in the naïve group, whereas superoxide scavenger Tempol (1 mg/kg) and non-specific ROS scavenger PBN (3 mg/kg) decreased firing rates in the SCI group (* p < 0.05). SCI showed increases of iGluRs-mediated neuronal firing rates and pCamKII expression (* p < 0.05); however, t-BOOH treatment did not show significant changes in the naïve group. The mechanical sensitivity at the body trunk in the SCI group (6.2 ± 0.5) was attenuated by CamKII inhibitor KN-93 (50 µg, 3.9 ± 0.4) or Tempol (1 mg, 4 ± 0.4) treatment (* p < 0.05). In addition, the level of superoxide marker Dhet showed significant increase in SCI rats compared to the sham group (11.7 ± 1.7 vs. 6.6 ± 1.5, * p < 0.05). CONCLUSIONS: Superoxide and the pCamKII pathway contribute to chronic at-level neuropathic pain without involvement of iGluRs following SCI.


Asunto(s)
Proteína Quinasa Tipo 2 Dependiente de Calcio Calmodulina/fisiología , Hiperalgesia/tratamiento farmacológico , Proteínas del Tejido Nervioso/fisiología , Neuralgia/tratamiento farmacológico , Nocicepción/efectos de los fármacos , Traumatismos de la Médula Espinal/tratamiento farmacológico , Superóxidos/metabolismo , Animales , Bencilaminas/farmacología , Proteína Quinasa Tipo 2 Dependiente de Calcio Calmodulina/biosíntesis , Proteína Quinasa Tipo 2 Dependiente de Calcio Calmodulina/genética , Contusiones/fisiopatología , Óxidos N-Cíclicos/farmacología , Depuradores de Radicales Libres/uso terapéutico , Hiperalgesia/etiología , Masculino , Modelos Animales , Proteínas del Tejido Nervioso/biosíntesis , Proteínas del Tejido Nervioso/genética , Neuralgia/etiología , Umbral del Dolor/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Especies Reactivas de Oxígeno/metabolismo , Receptores Ionotrópicos de Glutamato/efectos de los fármacos , Marcadores de Spin , Asta Dorsal de la Médula Espinal/efectos de los fármacos , Traumatismos de la Médula Espinal/fisiopatología , Sulfonamidas/farmacología , Transmisión Sináptica
8.
Life Sci ; 276: 119441, 2021 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794257

RESUMEN

AIM: Ligature tightness of chronic constriction injury (CCI) model remains inconsistent and controversial, presenting barriers for researchers. METHODS: We summarized the different ligation criteria in literature and attempted to clarify their effects. To assess constriction under different criteria, we calculated the radial strain (εR) of ligated nerves from digital photographs. The mechanical withdrawal thresholds (MWT), thermal withdrawal latency (TWL) and sciatic functional index (SFI) were observed in rats of different groups to assess the state of model. Changes of myelin sheath were detected by pathological staining and immunohistochemistry. RESULTS: The median εR values in the Loose, Medium and Tight groups were 13.6%, 15.2% and 21.7%, respectively. Ligated groups had lower MWT than Sham group and the TWL of rats in the Loose approached to rats with sham operation, while that of the Tight group was higher than Medium group 14 days after surgery. Medium and Tight groups showed more abnormal in SFI, compared with the other two groups 14 days. Pathological staining revealed demyelination in three CCI groups, especially in the sciatic nerves. Myelin protein zero levels decreased in the sciatic nerves as the degree of constriction increased, but myelin basic protein of the Medium group was lowest abundant in the spinal cords of all rats. CONCLUSIONS: Our study demonstrated that the surrounding muscles briefly twitched when the diameter of the sciatic nerves was constricted by approximately 14-15%, which may provide a reference for other researchers for establishing CCI models.


Asunto(s)
Lesiones por Aplastamiento/complicaciones , Neuralgia/patología , Nervio Ciático/lesiones , Traumatismos de la Médula Espinal/complicaciones , Animales , Constricción , Lesiones por Aplastamiento/cirugía , Ligadura , Masculino , Neuralgia/etiología , Ratas , Ratas Sprague-Dawley , Nervio Ciático/cirugía , Traumatismos de la Médula Espinal/cirugía
9.
Dtsch Arztebl Int ; 118(6): 81-87, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33827748

RESUMEN

BACKGROUND: Idiopathic facial pain syndromes are relatively rare. A uniform classification system for facial pain became available only recently, and many physicians and dentists are still unfamiliar with these conditions. As a result, patients frequently do not receive appropriate treatment. METHODS: This article is based on pertinent publications retrieved by a selective search in PubMed, focusing on current international guidelines and the International Classification of Orofacial Pain (ICOP). RESULTS: The ICOP subdivides orofacial pain syndromes into six major groups, the first three of which consist of diseases of the teeth, the periodontium, and the temporomandibular joint. The remaining three groups (non-dental facial pain) are discussed in the present review. Attack-like facial pain syndromes most closely resemble the well-known primary headache syndromes, such as migraine, but with pain located below the orbitomeatal line. These syndromes are treated in accordance with the guidelines for the corresponding types of headache. Persistent idiopathic facial pain (PIFP) is a chronic pain disorder with persistent, undulating pain in the face and/or teeth, without any structural correlate. Since this type of pain tends to become chronified after invasive procedures, no dental procedures should be performed to treat it if the teeth are healthy; rather, the treatmentis similar to that of neuropathic pain, e.g., with antidepressant and anticonvulsive drugs. Neuropathic facial pain is also undulating and persistent. It is often described as a burning sensation, and neuralgiform attacks may additionally be present. Trigeminal neuralgia is a distinct condition involving short-lasting, lancinating pain of high intensity with a maximum duration of two minutes. The first line of treatment is with medications; invasive treatment options should be considered only if pharmacotherapy is ineffective or poorly tolerated. CONCLUSION: With the aid of this pragmatic classification system, the clinician can distinguish persistent and attack-like primary facial pain syndromes rather easily and treat each syndrome appropriately.


Asunto(s)
Neuralgia Facial , Neuralgia , Neuralgia del Trigémino , Neuralgia Facial/diagnóstico , Neuralgia Facial/terapia , Dolor Facial/diagnóstico , Dolor Facial/terapia , Cefalea , Humanos
10.
Undersea Hyperb Med ; 48(1): 13-23, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33648029

RESUMEN

Neuropathic pain (NPP) refers to the pain caused by primary or secondary injury or dysfunction of the peripheral or central nervous system, and usually requires multidisciplinary treatment. However, most pharmacological and non-pharmacological interventions can only temporarily and/or moderately improve pain-related symptoms, and they often produce unbearable adverse reactions or cause drug resistance. Hyperbaric oxygen (HBO2) therapy has been widely used in the clinical treatment of some diseases due to its advantages of safety, few side effects, no resistance, and non-invasiveness. In recent years, increasing numbers of basic and clinical studies have been conducted to investigate the efficacy and mechanism of HBO2 in the treatment of NPP, and great progress has been made in this field. In this paper, we briefly introduce the pathogenesis of NPP and therapeutic effects of HBO2 and summarize the mechanisms underlying the effects of HBO2 in treating NPP, which may provide reference for the clinical treatment of pain with HBO2.


Asunto(s)
Oxigenación Hiperbárica/tendencias , Neuralgia/terapia , Animales , Apoptosis/fisiología , Presión Atmosférica , Modelos Animales de Enfermedad , Neuronas GABAérgicas/fisiología , Humanos , Oxigenación Hiperbárica/métodos , Ratones , Trastornos Migrañosos/terapia , Neuralgia/etiología , Neuritis/complicaciones , Óxido Nítrico/fisiología , Estrés Oxidativo/fisiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Ratas , Receptores Opioides/fisiología
11.
Artículo en Ruso | MEDLINE | ID: mdl-33728847

RESUMEN

OBJECTIVE: To analyze the effect of Alflutop on neuroinflammation in patients with chronic lower back pain (CBP). MATERIAL AND METHODS: Forty-one patients with a verified CBP diagnosis were enrolled in the study. Alflutop was used for treating CBP, 1 ml once/day, for 20 days. Treatment efficacy was monitored using the Visual Analogue Scale (VAS), DN4 test; the Roland-Morris questionnaire; the index of pain activity in the lumbar spine; and the level of tumor necrosis factor-α (TNF-α) in blood plasma. There were three visits in total: screening (visit 0), treatment start (visit 1, 0-3 days after screening) and visit 2 (3 months later (±7 days) from the start of treatment). RESULTS: Before the start of therapy, in some patients (group 1, n=14 (34.1%) the TNF-α concentration in the blood plasma was below the detectable level (less than 4.0 pg/ml), while in group 2 (n=27 (659%)), the expression of TNF-α in peripheral blood was observed at the level of 6.3 [4.9; 7.4] pg/ml. Patients in group 2 significantly (p<0.05) differed from patients in group 1 by the greater number of CBP exacerbations over the last year as well as by the results of testing on DN4 (higher values) and SBI (greater discomfort). In group 2, a significant relationship was found between the TNF-α level in blood plasma and the number of exacerbations as well as between the TNF-α level and the number of DN4 points. At visit 2, patients in group 2 had a significant (p<0.05) decrease in pain intensity according to VAS, an improvement in the quality of life according to the Roland-Morris questionnaire, a decrease in the severity of the neuropathic component of pain according to DN4 test as well as subjective condition improvement associated with the activity of pain in the lumbar spine. A significant relationship was found between the level of TNF-α and the number of DN4 points after treatment and the period of active observation. CONCLUSIONS: In the majority of CBP patients, the high relapse rate and neuropathic nature of pain may be associated with persistent neuroinflammation due to TNF-α synthesis. Alflutop inhibits the TNF-α expression substantially, which significantly correlates with a decrease in the neuropathic pain syndrome component according to the DN4 questionnaire. The use of Alflutop can be considered as an effective method of treating patients with CBP, which has an impact on the process of neuroinflammation as one of the leading causes of changes in the pain nature and its chronicity.


Asunto(s)
Dolor de la Región Lumbar , Neuralgia , Humanos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/tratamiento farmacológico , Dimensión del Dolor , Calidad de Vida , Encuestas y Cuestionarios
12.
J Oral Facial Pain Headache ; 35(1): 35-40, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33730125

RESUMEN

AIMS: To evaluate the diagnostic value of non-nerve-selective MRI sequences in posttraumatic trigeminal neuropathic pain (PTNP). METHODS: This study retrospectively analyzed all MRI protocols performed between February 2, 2012 and June 20, 2018 commissioned by the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven. Demographic, clinical, and radiologic data were extracted from the records of patients with an MRI in the context of PTNP. A contingency table was constructed based on the opinions of the treating physician and the radiologist who initially evaluated the MRI. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS: The sample consisted of 27 women (65.9%) and 14 men (34.1%). The sensitivity and negative predictive value of MRI in PTNP were 0.18 and 0.77, respectively. Artifacts interfered with visualization of a possible cause of the trigeminal pain in 24.4% of MRIs. Almost all artifacts (90%) were caused by metal debris originating from the causal procedure or posttraumatic surgeries. MRI resulted in changed management for PTNP patients only once. CONCLUSION: The diagnostic value of non-nerve-selective MRI sequences for PTNP is low and has little impact on clinical management. Therefore, there is a need for dedicated sequences with high resolution and low artifact susceptibility for visualizing the posttraumatic injuries of the trigeminal branches.


Asunto(s)
Neuralgia , Neuralgia del Trigémino , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Neuralgia/diagnóstico por imagen , Neuralgia/etiología , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Neuralgia del Trigémino/diagnóstico por imagen , Neuralgia del Trigémino/etiología
13.
AAPS PharmSciTech ; 22(3): 95, 2021 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-33686480

RESUMEN

Vulvodynia is a chronic clinical condition associated with vulvar pain that can impair the sexual, social, and psychological life of women. There is a need for more research to develop novel strategies and therapies for the treatment of vulvodynia. Vulvodynia in experimental animal models induced via infections, allergens, and diabetes are tedious and with lessor induction rate. The objective of the study was to explore the possibility of inducing vulvodynia using a chemotherapeutic agent in a rodent model. Paclitaxel is commonly used in treating breast and ovarian cancer, whose dose-limiting side effect is peripheral neuropathy. Studies have shown that peripheral neuropathy is one of the etiologies for vulvodynia. Following paclitaxel administration (2 mg/kg i.p.), the intensity of vulvar hypersensitivity was assessed using a series of von Frey filaments (0.008 to 1 g) to ensure the induction of vulvodynia. Vulvodynia was induced from day 2 and was well sustained for 11 days. Furthermore, the induced vulvodynia was validated by investigating the potentiation of a flinch response threshold, upon topical application and systemic administration of gabapentin, a commonly used medication for treating neuropathic pain. The results demonstrate that vulvodynia was induced due to administration of paclitaxel. The fact that chemotherapeutic agent-induced vulvodynia was responsive to topical and parenterally administered gabapentin provides validity to the model. The study establishes a new, relatively simple and reliable animal model for screening drug molecules for vulvar hypersensitivity.


Asunto(s)
Antineoplásicos/efectos adversos , Vulvodinia/inducido químicamente , Analgésicos/uso terapéutico , Animales , Antineoplásicos Fitogénicos/efectos adversos , Modelos Animales de Enfermedad , Femenino , Gabapentina/uso terapéutico , Neuralgia/inducido químicamente , Neuralgia/psicología , Paclitaxel/efectos adversos , Dimensión del Dolor/efectos de los fármacos , Ratas , Ratas Sprague-Dawley
15.
Medicine (Baltimore) ; 100(10): e25140, 2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33725916

RESUMEN

BACKGROUND: Human immunodeficiency virus (HIV)-associated distal symmetric peripheral neuropathy (DSPN) is one of the most frequent neurological complications of HIV infection, and causes pain and dysaesthesias in millions globally. Many individuals with this infection report using acupuncture to manage their symptoms, but evidence supporting the use of acupuncture is limited. This systematic review will assess the effectiveness and safety of acupuncture for patients with HIV-associated DSPN. METHODS: Databases including MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Scopus, Web of science, AMED (Allied and Complementary Medicine), the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Database, VIP Database and clinical trials registers (the WHO International Clinical Trials Registry Platform portal and www.ClinicalTrials.gov) will be electronically searched from inception to December 1, 2020. All randomized controlled trials in English or Chinese without restriction on publication status will be included. Selection of studies, extraction of data, and assessment of studies quality will be independently performed by 2 reviewers. The primary outcome measure will be the change in pain intensity assessed by validated scales. Secondary outcomes include change in neurologic summary scores, quality of life, physical function evaluated by admitted tools, and adverse events related to acupuncture reported in the included trials. If possible, a meta-analysis will be conducted to provide an estimate of the pooled treatment effect using Review Manager 5.3 statistical software. Otherwise, qualitative descriptive analysis will be given. The results will be presented as the risk ratio for binary data and the mean difference (MD) or standardized MD for continuous data. RESULTS: The results of the systematic review will be disseminated via publication in a peer-reviewed journal and presented at a relevant conference. CONCLUSION: This review will be the first review entirely focused on assessing the effectiveness and safety of acupuncture for HIV-associated DSPN. PROSPERO REGISTRATION NUMBER: CRD42020210994.


Asunto(s)
Terapia por Acupuntura/efectos adversos , Infecciones por VIH/complicaciones , Neuralgia/terapia , Parestesia/terapia , Polineuropatías/terapia , Infecciones por VIH/inmunología , Infecciones por VIH/virología , Humanos , Metaanálisis como Asunto , Neuralgia/diagnóstico , Neuralgia/inmunología , Neuralgia/virología , Dimensión del Dolor , Parestesia/diagnóstico , Parestesia/inmunología , Parestesia/virología , Polineuropatías/diagnóstico , Polineuropatías/inmunología , Polineuropatías/virología , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Índice de Severidad de la Enfermedad , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
16.
Medicine (Baltimore) ; 100(9): e25012, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655971

RESUMEN

ABSTRACT: Epidural steroid injections (ESI) are commonly performed for the treatment of chronic cervical disc herniation (CDH). Although they are considered to be effective for both nociceptive and neuropathic types of pain, there is a lack of data regarding the impact of neuropathic pain (NP) and nociceptive pain components on treatment outcomes. The aim of this study is to compare the effectiveness of interlaminar epidural steroid injection (ILESI) between patients with predominantly NP and nociceptive pain due to CDH.Sixty five participants were initially included in the study and assessed by numeric rating scale (NRS), neck pain and disability scale (NPDS), short form-12 (SF-12), and self-reported Leeds assessment of neuropathic symptoms and signs (S-LANSS) pain scale at baseline and 1 month, 3 months, 6 months after ILESI.All patients were evaluated at 1st month and 3rd month follow-up periods while 54 of patients achieved to complete 6th month follow-up. There were significant improvements in all outcome measures for all time periods when compared with the pre-intervention scores. At baseline 24 (36.9%) of patients had predominantly NP in accordance with S-LANSS pain scale. The ratio of NP predominant patients reduced to 7.6% at 1st month, 12.3% at 3rd month, and 12.9% at 6th month with a significant difference for each follow-up period when compared with the baseline. Although all NRS and NPDS scores at baseline were significantly higher in patients with NP, improvement was significant at all follow-up periods in both groups. Minimal clinically important change in NRS was observed in >75% of patients at 1st, 3rd, and 6th month in both groups.The results of this study showed that NP is present in one-third of the patients suffering from neck and radiating arm pain due to CDH and cervical ILESI is an effective treatment approach for both neuropathic and nociceptive components of pain.Clinical Trials Registration Number: NCT04235478.


Asunto(s)
Glucocorticoides/administración & dosificación , Desplazamiento del Disco Intervertebral/tratamiento farmacológico , Dolor de Cuello/etiología , Neuralgia/etiología , Adolescente , Adulto , Anciano , Vértebras Cervicales , Enfermedad Crónica , Femenino , Humanos , Inyecciones Epidurales , Desplazamiento del Disco Intervertebral/complicaciones , Desplazamiento del Disco Intervertebral/diagnóstico , Masculino , Persona de Mediana Edad , Dolor de Cuello/diagnóstico , Neuralgia/diagnóstico , Dimensión del Dolor , Pronóstico , Estudios Prospectivos , Adulto Joven
17.
Rev Infirm ; 70(269): 45-47, 2021 Mar.
Artículo en Francés | MEDLINE | ID: mdl-33742595

RESUMEN

At the neuro-vascular emergencies unit at the Pitié-Salpêtrière (AP-HP,Paris), a population that is mostly elderly and dependent is cared for daily by caregivers. With an average age of stroke of 74 years, these patients regularly suffer from neuropathic pain in post-stroke situations. Caregivers are very vigilant in preventing pain induced during care, particularly during mobilization, and are developing holistic pain management that includes non-drug approaches.


Asunto(s)
Neuralgia , Accidente Cerebrovascular , Anciano , Cuidadores , Humanos , Neuralgia/etiología , Neuralgia/prevención & control , Manejo del Dolor , Paris , Accidente Cerebrovascular/complicaciones
18.
Medicine (Baltimore) ; 100(12): e25147, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761683

RESUMEN

BACKGROUND: Long non-coding RNAs (LncRNAs) play important roles in the regulation of neuropathic pain (NP) development. LncRNAs dysregulations are related to the development of NP. However, a comprehensive meta-analysis has never been conducted to assess the relationship between LncRNAs and NP. To combine the results of dysregulated LncRNAs in individual NP studies and to identify potential LncRNAs biomarkers. METHODS: LncRNAs profiling studies of NP were extracted from Pubmed, Web of science, Embase, Google Scholar, and Chinese National Knowledge Infrastructure, and the Chinese Biomedical Literature Database if they met the inclusion criteria. The meta-analysis was conducted using a random effects model to identify the effect of each multiple-reported LncRNAs. We also performed subgroup analysis according to LncRNAs detecting methods and sample type. Sensitivity analysis was performed on the sample size. Bioinformatic analysis was performed to identify the potential biomatic functions. All results were represented as log10 odds ratios. RESULTS: This review will be disseminated in print by peer-review. CONCLUSION: The identified LncRNAs may be closely linked with NP and may act as potentially useful biomarkers. ETHICS AND DISSEMINATION: The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not available. The results may be published in a peer- reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/ZRX7C.


Asunto(s)
Predisposición Genética a la Enfermedad/genética , Neuralgia/genética , ARN Largo no Codificante/genética , Estudios de Casos y Controles , Biología Computacional , Marcadores Genéticos/genética , Humanos , Metaanálisis como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
19.
BMJ Case Rep ; 14(3)2021 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-33766961

RESUMEN

COVID-19 affects a wide spectrum of organ systems. We report a 52-year-old man with hypertension and newly diagnosed diabetes mellitus who presented with hypoxic respiratory failure due to COVID-19 and developed severe brachial plexopathy. He was not treated with prone positioning respiratory therapy. Associated with the flaccid, painfully numb left upper extremity was a livedoid, purpuric rash on his left hand and forearm consistent with COVID-19-induced microangiopathy. Neuroimaging and electrophysiological data were consistent with near diffuse left brachial plexitis with selective sparing of axillary, suprascapular and pectoral fascicles. Given his microangiopathic rash, elevated D-dimers and paucifascicular plexopathy, we postulate a patchy microvascular thrombotic plexopathy. Providers should be aware of this significant and potentially under-recognised neurologic complication of COVID-19.


Asunto(s)
Neuropatías del Plexo Braquial/etiología , /complicaciones , Brazo/patología , Neuropatías del Plexo Braquial/diagnóstico , Diabetes Mellitus , Exantema/complicaciones , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Hipertensión/complicaciones , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neuralgia/complicaciones , Posicionamiento del Paciente/efectos adversos , Insuficiencia Respiratoria/etiología , /aislamiento & purificación
20.
Life Sci ; 273: 119308, 2021 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-33667520

RESUMEN

AIMS: Brain-derived neurotrophic factor (BDNF) is vital in the pathogenesis of mechanical allodynia with a paucity of reports available regarding diabetic neuropathy pain (DNP). Herein we identified the involvement of BDNF in driving mechanical allodynia in DNP rats via the activation of transient receptor potential canonical 6 (TRPC6) channel. MATERIALS AND METHODS: The DNP rat model was established via streptozotocin (STZ) injection, and allodynia was assessed by paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL). The expression profiles of BDNF and TRPC6 in dorsal root ganglia (DRG) and spinal cord were illustrated by immunofluorescence and Western blotting. Intrathecal administration of K252a or TrkB-Fc was performed to inhibit BNDF/TrkB expression, and respective injection of GsMTX-4, BTP2 and TRPC6 antisense oligodeoxynucleotides (TRPC6-AS) was likewise conducted to inhibit TRPC6 expression in DNP rats. Calcium influx in DRG was monitored by calcium imaging. KEY FINDINGS: The time-dependent increase of BDNF and TRPC6 expression in DRG and spinal cord was observed since the 7th post-STZ day, correlated with the development of mechanical allodynia in DNP rats. Intrathecal administration of K252a, TrkB-Fc, GsMTX-4 and BTP2 prevented mechanical allodynia in DNP rats. Pre-treatment of TRPC6-AS reversed the BDNF-induced pain-like responses in DNP rats rather than the naïve rats. In addition, the TRPC6-AS reversed BDNF-induced increase of calcium influx in DRG neurons in DNP rats. SIGNIFICANCE: The intrathecal inhibition of TRPC6 alleviated the BDNF-induced mechanical allodynia in DNP rat model. This finding may validate the application of TRPC6 antagonists as interesting strategy for DNP management.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/metabolismo , Diabetes Mellitus Experimental/fisiopatología , Neuropatías Diabéticas/complicaciones , Modelos Animales de Enfermedad , Hiperalgesia/etiología , Neuralgia/complicaciones , Canales Catiónicos TRPC/metabolismo , Animales , Conducta Animal , Factor Neurotrófico Derivado del Encéfalo/administración & dosificación , Hiperalgesia/metabolismo , Hiperalgesia/patología , Masculino , Ratas , Ratas Sprague-Dawley , Canales Catiónicos TRPC/genética
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