Microglia and mast cells: new targets for the treatment of chronic pain

The article is devoted to the problem of effective management of chronic pain. A review of the known mechanisms of development and maintenance of chronic pain and possible methods of influence is given. One of the reasons for the lack of chronic pain treatment effectiveness in some patients is the use of treatment regimens with drugs acting exclusively on the targets located in the nerve structures. Today an important role of microglia and mast cells in the development and maintenance of chronic pain conditions is well acknowledged. A new class of drugs from the group of acylethanolamides is described. One of the representatives of this group is palmitoylethanolamide. This drug may modulate the activity of microglia and mast cells, thus increasing the pain threshold and the effectiveness of therapy. The use of palmitoylethanolamide in patients with chronic pain can increase the effectiveness of therapy.

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Problematic Prescription Opioid Use in a Chronic Pain Treatment Facility: The Role of Emotional Processes

Substance Use & Misuse ◽

10.1080/10826084.2018.1521426 ◽

2018 ◽

Vol 54 (3) ◽

pp. 495-505 ◽

Cited By ~ 1

Author(s):

Lindsay M. S. Oberleitner ◽

Mark A. Lumley ◽

Emily R. Grekin ◽

Kathryn M. Z. Smith ◽

Amy M. Loree ◽

...

Keyword(s):

Chronic Pain ◽

Pain Treatment ◽

Prescription Opioid ◽

Opioid Use ◽

Treatment Facility ◽

Emotional Processes ◽

Chronic Pain Treatment ◽

Prescription Opioid Use

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Optogenetics and photopharmacology in pain research and therapeutics

STEMedicine ◽

10.37175/stemedicine.v1i3.43 ◽

2020 ◽

Vol 1 (3) ◽

pp. e43 ◽

Cited By ~ 2

Author(s):

Federico Iseppon ◽

Manuel Arcangeletti

Keyword(s):

Chronic Pain ◽

Pain Treatment ◽

Molecular Switches ◽

Genetic Profiling ◽

Pain Research ◽

Recent Advances ◽

Cellular Components ◽

The Brain

Pain afflicts billions of people worldwide, who suffer especially from long-term chronic pain. This gruelling condition affects the nervous system at all levels: from the brain to the spinal cord, the Dorsal Root Ganglia (DRG) and the peripheral fibres innervating the skin. The nature of the different molecular and cellular components of the somatosensory modalities, as well as the complexity of the peripheral and central circuitry are yet poorly understood. Light-based techniques such as optogenetics, in concert with the recent advances in single-cell genetic profiling, can help to elucidate the role of diverse neuronal sub-populations in the encoding of different sensory and painful stimuli by switching these neurons on and off via optically active proteins, namely opsins. Recently, photopharmacology has emerged from the efforts made to advance optogenetics. The introduction of azo-benzene-based light-sensitive molecular switches has been applied to a wide variety of molecular targets, from ion channels and receptors to transporters, enzymes and many more, some of which are paramount for pain research and therapy. In this Review, we summarise the recent advances in the fields of optogenetics and photopharmacology and we discuss the use of light-based techniques for the study of acute and chronic pain physiology, as well as their potential for future therapeutic use to improve pain treatment.

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The role of illness perception and emotions on quality of life in fibromyalgia compared with other chronic pain conditions

Reumatismo ◽

10.4081/reumatismo.2012.142 ◽

2012 ◽

Vol 64 (3) ◽

Cited By ~ 1

Author(s):

M. Capraro ◽

M. Della Valle ◽

M. Podswiadek ◽

P. De Sandre ◽

E. Sgnaolin ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Illness Perception ◽

Chronic Pain Conditions

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The missing link: Enhanced functional connectivity between amygdala and visceroceptive cortex in migraine

Cephalalgia ◽

10.1177/0333102413490344 ◽

2013 ◽

Vol 33 (15) ◽

pp. 1264-1268 ◽

Cited By ~ 88

Author(s):

Nouchine Hadjikhani ◽

Noreen Ward ◽

Jasmine Boshyan ◽

Vitaly Napadow ◽

Yumi Maeda ◽

...

Keyword(s):

Chronic Pain ◽

Functional Connectivity ◽

Resting State ◽

Healthy Subjects ◽

Spreading Depression ◽

Migraine Aura ◽

Migraine Pain ◽

Tunnel Syndrome ◽

Chronic Pain Conditions

Background Migraine is a neurovascular disorder in which altered functional connectivity between pain-modulating circuits and the limbic system may play a role. Cortical spreading depression (CSD), which underlies migraine aura (MWA), induces C-fos expression in the amygdala. The role of CSD and amygdala connectivity in migraine without aura (MwoA) is less clear and may differentiate migraine from other chronic pain disorders. Methods Using resting-state functional MRI, we compared functional connectivity between the amygdala and the cortex in MWA and MWoA patients as well as in healthy subjects and in two other chronic pain conditions not associated with CSD: trigeminal neuralgia (TGN) and carpal tunnel syndrome (CTS). Results Amygdala connectivity in both MWA and MWoA was increased to the visceroceptive insula relative to all other groups examined. Conclusion The observed increased connectivity within the limbic/viscerosensory network, present only in migraineurs, adds to the evidence of a neurolimbic pain network dysfunction and may reflect repetitive episodes of CSD leading to the development of migraine pain.

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ROLE OF AGNI VAISHAMYA IN CHRONIC PAIN PATHOLOGIES WITH SPECIAL REFERENCE TO NECK AND BACK PAIN- A CROSS SECTIONAL STUDY.

International Journal of Ayurvedic Medicine ◽

10.47552/ijam.v7i3.836 ◽

2016 ◽

Vol 7 (3) ◽

Author(s):

Mukesh Edavalath

Keyword(s):

Chronic Pain ◽

Back Pain ◽

Cross Sectional Study ◽

Low Back ◽

College Hospital ◽

Cross Sectional ◽

Treatment Regimens ◽

Ayurvedic Treatment ◽

Sectional Analysis

Chronic back and neck pain are common clinical entities in ayurvedic practice. Most of the patients are not rendered pain free with the current ayurvedic treatment regimens. Ayurveda considers agni (digestive power) derangements as the basic cause for all nija rogas (endogenous diseases). The term agnivaishamya is implied for functional derangement of agni. Emerging evidences through modern researches point to the role of GI dysfunctions in pain pathologies.Â A cross sectional analysis of patients with chronic pain in the neck and back was conducted at VPSV Ayurveda college hospital to explore associations between pain and features of agnivaishamya in koshta (GIT). In the twenty eight patients analyzed, significant association has been found between pain in low back and koshta (GIT) features like Arsas (hemorrhoids) and vibandha (Constipation). Strength of association was more between arsas and low back pain with OR Â of 4.2 (P<0.05). In the case of cervical pain , multiple features of Koshta like avipaka (feeling of indigestion), aruchi (anorexia), amlodgara (sour eructations), urodhumayana (chest burn) and muhurbadha muhurdrava pureesha (alternating constipation and loose stools) were found to be associated. Hence it can be concluded that there is significant association of agnivaishamya with chronic pain in neck and back.

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Brain Imaging Biomarkers for Chronic Pain

Frontiers in Neurology ◽

10.3389/fneur.2021.734821 ◽

2022 ◽

Vol 12 ◽

Author(s):

Zhengwu Zhang ◽

Jennifer S. Gewandter ◽

Paul Geha

Keyword(s):

Chronic Pain ◽

Brain Imaging ◽

Substance Misuse ◽

Clinical Applications ◽

Imaging Biomarkers ◽

Costs And Benefits ◽

Brain Circuitry ◽

Chronic Pain Conditions ◽

The Brain

The prevalence of chronic pain has reached epidemic levels. In addition to personal suffering chronic pain is associated with psychiatric and medical co-morbidities, notably substance misuse, and a huge a societal cost amounting to hundreds of billions of dollars annually in medical cost, lost wages, and productivity. Chronic pain does not have a cure or quantitative diagnostic or prognostic tools. In this manuscript we provide evidence that this situation is about to change. We first start by summarizing our current understanding of the role of the brain in the pathogenesis of chronic pain. We particularly focus on the concept of learning in the emergence of chronic pain, and the implication of the limbic brain circuitry and dopaminergic signaling, which underly emotional learning and decision making, in this process. Next, we summarize data from our labs and from other groups on the latest brain imaging findings in different chronic pain conditions focusing on results with significant potential for translation into clinical applications. The gaps in the study of chronic pain and brain imaging are highlighted in throughout the overview. Finally, we conclude by discussing the costs and benefits of using brain biomarkers of chronic pain and compare to other potential markers.

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Chronic Pain Treatment: The Influence of Tricyclic Antidepressants on Serotonin Release and Uptake in Mast Cells

Mediators of Inflammation ◽

10.1155/2013/340473 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Ilonka Ferjan ◽

Metoda Lipnik-Štangelj

Keyword(s):

Chronic Pain ◽

Mast Cells ◽

Tricyclic Antidepressants ◽

Cell Function ◽

Pain Treatment ◽

Serotonin Release ◽

Experimental Conditions ◽

Pain Mechanisms ◽

Chronic Pain Treatment ◽

5 Ht Uptake

The involvement of serotonin (5-HT) in chronic pain mechanisms is established. 5-HT inhibits central painful stimuli, but recent data suggests that 5-HT could also enhance pain stimulus from the periphery, where mast cells play an important role. We aimed in our study to clarify the influence of selected tricyclic antidepressants (TCAs) on mast cell function: secretion, uptake, and reuptake of 5-HT, that could interfere with 5-HT levels and in this way contribute to the generation of pain. As an experimental model, we used isolated rat peritoneal mast cells and incubated them with selected TCAs (clomipramine, amitriptyline, doxepin, and imipramine) under different experimental conditions. 5-HT release, uptake, and reuptake were determined spectrofluorometrically. We showed that TCAs were able to inhibit 5-HT secretion from mast cells, as well as uptake of exogenous 5-HT and reuptake of secreted 5-HT back into mast cells. The effects of TCAs were concentration dependent; higher concentrations of TCAs inhibited the secretion of 5-HT induced by compound 48/80, whereas lower concentrations of TCAs inhibited 5-HT uptake. The most effective TCA was halogenated clomipramine. As TCAs are well introduced in chronic pain treatment, the insight into mechanisms of action is important for an understanding of their effect in various pain conditions.

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