scholarly journals Prospects for the Personalized Multimodal Therapy Approach to Pain Management via Action on NO and NOS

Molecules ◽  
2021 ◽  
Vol 26 (9) ◽  
pp. 2431
Author(s):  
Natalia A. Shnayder ◽  
Marina M. Petrova ◽  
Tatiana E. Popova ◽  
Tatiana K. Davidova ◽  
Olga P. Bobrova ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Molecular Genetic ◽  
Pain Syndrome ◽  
Medical Problem ◽  
Single Nucleotide Variants ◽  
Genetic Studies ◽  
Pain Syndromes ◽  
Nos Inhibitors ◽  
Peripheral Pain

Chronic pain syndromes are an important medical problem generated by various molecular, genetic, and pathophysiologic mechanisms. Back pain, neuropathic pain, and posttraumatic pain are the most important pathological processes associated with chronic pain in adults. Standard approaches to the treatment of them do not solve the problem of pain chronicity. This is the reason for the search for new personalized strategies for the prevention and treatment of chronic pain. The nitric oxide (NO) system can play one of the key roles in the development of peripheral pain and its chronicity. The purpose of the study is to review publications devoted to changes in the NO system in patients with peripheral chronical pain syndromes. We have carried out a search for the articles published in e-Library, PubMed, Oxford Press, Clinical Case, Springer, Elsevier, and Google Scholar databases. The search was carried out using keywords and their combinations. The role of NO and NO synthases (NOS) isoforms in peripheral pain development and chronicity was demonstrated primarily from animal models to humans. The most studied is the neuronal NOS (nNOS). The role of inducible NOS (iNOS) and endothelial NOS (eNOS) is still under investigation. Associative genetic studies have shown that single nucleotide variants (SNVs) of NOS1, NOS2, and NOS3 genes encoding nNOS, iNOS, and eNOS may be associated with acute and chronic peripheral pain. Prospects for the use of NOS inhibitors to modulate the effect of drugs used to treat peripheral pain syndrome are discussed. Associative genetic studies of SNVs NOS1, NOS2, and NOS3 genes are important for understanding genetic predictors of peripheral pain chronicity and development of new personalized pharmacotherapy strategies.

scholarly journals The role of NO system in low back pain chronicity

2021 ◽  
Vol 1 (1) ◽  
pp. 37-45
Author(s):  
V. V. Trefilova ◽  
N. A. Shnayder ◽  
T. E. Popova ◽  
O. V. Balberova ◽  
R. F. Nasyrova
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Russian Language ◽  
Chronic Lower Back Pain ◽  
Low Back ◽  
Single Nucleotide Variants ◽  
Genetic Studies ◽  
Nos Inhibitors ◽  
Nos Isoforms

Low back pain (LBP) is an important interdisciplinary medical problem, in the development of which various molecular genetics, pathomorphological and pathobiomechanical mechanisms play a role. Intervertebral disc degeneration (IVDD), facet joints arthrosis and myofascial syndrome are the most important pathological processes associated with chronic lower back pain in adults. The nitric oxide (NO) system may play one of the key roles in the development of LBP and its chronicity. (1): Background: The review of publications which are devoted to changes in the NO system in patients with LBP. (2): Materials: We have carried out a search for Russian-language and English-language full-text articles published in e-Library, PubMed, Oxford Press, Clinical Case, Springer, Elsevier, Google Scholar databases. The search was carried out using keywords and their combinations. The search depth was 10 years (2011-2021). (3): Results: Role of NO and various NOsynthase (NOS) isoforms in LBP process demonstrated primarily from animal models to humans. The most studied are the neuronal NOS (nNOS). The role of inducible nose (iNOS) and endothelial (eNOS) - continues to be studied. Associative genetic studies have shown that single nucleotide variants (SNV) of genes encoding all three NOS isoforms (nNOS, NOS1 gene; iNOS, NOS2 gene; eNOS, NOS3 gene) may be associated with chronic LBP. Prospects for the use of NOS inhibitors to modulate the effect of drugs used to treat back pain are discussed. (4): Conclusion: Associative genetic studies of SNV NOS1, NOS2, NOS3 genes are important for understanding genetic predictors of LBP chronicity and development of new personalized pharmacotherapy strategies.

Sodium Channels in Human Pain Disorders: Genetics and Pharmacogenomics

2019 ◽  
Vol 42 (1) ◽  
pp. 87-106 ◽  
Author(s):  
Sulayman D. Dib-Hajj ◽  
Stephen G. Waxman
Keyword(s):  
Chronic Pain ◽  
Sodium Channels ◽  
Molecular Genetic ◽  
Channel Blockers ◽  
Peripheral Neurons ◽  
Global Challenge ◽  
Pain Syndromes ◽  
Voltage Gated Sodium Channels ◽  
Peripheral Pain ◽  
Recent Developments

Acute pain is adaptive, but chronic pain is a global challenge. Many chronic pain syndromes are peripheral in origin and reflect hyperactivity of peripheral pain-signaling neurons. Current treatments are ineffective or only partially effective and in some cases can be addictive, underscoring the need for better therapies. Molecular genetic studies have now linked multiple human pain disorders to voltage-gated sodium channels, including disorders characterized by insensitivity or reduced sensitivity to pain and others characterized by exaggerated pain in response to normally innocuous stimuli. Here, we review recent developments that have enhanced our understanding of pathophysiological mechanisms in human pain and advances in targeting sodium channels in peripheral neurons for the treatment of pain using novel and existing sodium channel blockers.

scholarly journals The effects of a multiday (10–14 days) subanesthetic dose IV ketamine infusion in the treatment of refractory chronic pain

2021 ◽  
Author(s):  
Amokrane Chebini ◽  
Sina Marzoughi ◽  
Jason Randhawa ◽  
Daphne Guh ◽  
Stephen Wiseman ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Prospective Trial ◽  
Pain Syndrome ◽  
Chronic Patients ◽  
Chronic Neuropathic Pain ◽  
Chronic Noncancer Pain ◽  
Ketamine Infusion ◽  
Pain Syndromes ◽  
Clinically Significant ◽  
Noncancer Pain

Aim: Ketamine is an anesthetic agent that at lower doses can be a potent analgesic. There has been an interest in the use of low dose ketamine in treatment of chronic pain syndromes. Patients & methods: We report the results of a retrospective observational study for patients diagnosed with a chronic noncancer pain syndrome receiving a 2-week continuous subanesthetic IV ketamine infusion. Results & conclusion: We conclude that a 10–14 days of subanesthetic ketamine infusion in chronic patients results in clinically significant lowering of patients' numerical pain score. Further studies looking at subanesthetic ketamine infusion in a prospective trial of multi-day IV ketamine infusion in chronic refractory chronic neuropathic pain are needed to further assess the efficacy of ketamine.

scholarly journals Analgetic effect of ozone therapy: myths of reality?

2020 ◽  
Author(s):  
Iryna Vladimirovna Baranova ◽  
Yurii A. Bezsmertnyi ◽  
Halyna V. Bezsmertnaya ◽  
Kateryna P. Postovitenko ◽  
Iryna A. Iliuk ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal System ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
Neurological Complications ◽  
Potential Effect ◽  
Intervertebral Disk ◽  
Ozone Therapy ◽  
Pain Syndromes ◽  
Innovative Techniques

Introduction: Administration of an oxygen-ozone mixture is one of the innovative techniques used in single-drug or complex therapeutic schemes for treatment of many degenerative-dystrophic pathologies of the musculoskeletal system and related neurological complications. Aim: The aim was to determine the mechanisms of physiological action of the oxygen-ozone mixture in order to substantiate its efficacy for treatment of chronic pain syndrome with underlying degenerative-dystrophic pathologies of the musculoskeletal system. Material and methods: The article covers biochemical and pathomorphological studies that explain the mechanism of the pain syndrome and the potential effect of the ozone therapy. Results and discussion: The treatment schemes and benefits of different routes of ozone administration (intramuscularly, intravenously, intradiscally and intraarticularly) were analyzed. Diverse research data demonstrated influence on the causes of chronic pain, pathophysiological phases, and possible complications. The prospects of further studies for development of the most effective techniques for treatment of various pain syndromes were assessed. Conclusions: Ozone therapy is one of the alternative rehabilitation methods with a substantial pain relieving effect. As of today, the possibility of using the oxygen-ozone mixture for treatment of chronic back pain related to intervertebral disk hernia and fibromyalgia has been substantially confirmed.

scholarly journals The role of genetic research with family design in the study of affective disorders

2019 ◽  
pp. 106-108
Author(s):  
E. D. Kasyanov ◽  
G. E. Maso ◽  
A. O. Kibitov
Keyword(s):  
Affective Disorders ◽  
Bipolar Affective Disorder ◽  
Molecular Genetic ◽  
Genetic Research ◽  
Important Criterion ◽  
Genetic Studies ◽  
The Family ◽  
Polygenic Diseases ◽  
Potential Biomarkers

Affective disorders (recurrent depressive disorder and bipolar affective disorder) are multifactorial and polygenic diseases, which suggests the involvement of multiple neurobiological mechanisms. The phenotype of affective disorders is a heterogeneous group of clinically similar psychopathological symptoms, which also makes it difficult to detect potential biomarkers and new therapeutic targets. To study families at high risk of developing affective disorders using both clinical and molecular genetic approaches can help to study the neurobiological basis of depressive conditions, as well as to identify endophenotypes of affective disorders. The most important criterion for an endophenotype is its heritability, which can be proved only within the framework of the family design of the study. Comprehensive clinical and molecular genetic studies based on family design have the best prospects.

Chronic pain syndromes

2018 ◽  
pp. 623-642
Author(s):  
Gavin Clunie ◽  
Nick Wilkinson ◽  
Elena Nikiphorou ◽  
Deepak R. Jadon
Keyword(s):  
Chronic Pain ◽  
General Practitioner ◽  
Children And Adolescents ◽  
Complex Regional Pain Syndrome ◽  
Musculoskeletal Pain ◽  
Pain Syndrome ◽  
Pain Syndromes ◽  
Pain Medications ◽  
Cross Reference ◽  
Chronic Pain Syndromes

The Oxford Handbook of Rheumatology 4th edition, has been extensively updated to thoroughly review aspects of musculoskeletal pain. Pain pathophysiology is reviewed. Chronic pain and fibromyalgia in adults and in children and adolescents is dealt with in detail. The reader is advised to cross reference from this chapter to Chapters 1–3 in the Handbook, where regional musculoskeletal pain conditions are listed and reviewed. In localized pain syndromes, the chapter has an overview of complex regional pain syndrome (CRPS), which is not infrequently encountered in rheumatology and musculoskeletal clinics. Included in detail for this edition, is the assessment and management of pain in children, which is a highly specialized clinical area of medicine and will be of use to the adult rheumatologist and general practitioner as well as paediatric specialists. Readers should cross reference to Chapter 23 on medications, for ‘pain medications’ in the Handbook

Metabolic Therapy and Pain

2016 ◽  
Author(s):  
David N. Ruskin
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Poor Quality ◽  
Fatty Acid Supplementation ◽  
Pain Syndromes ◽  
Drug Treatments ◽  
Dietary Treatments ◽  
Dietary Modifications ◽  
Chronic Pain Syndromes

Chronic pain is associated strongly with poor quality of life. Drug treatments for pain can be problematic; with the understanding that chronic pain syndromes often involve derangement of homeostasis, there is an increased interest in applying nonpharmacological metabolic therapies. This chapter surveys clinical and animal research into the effects of fasting, calorie restriction, ketogenic diet, and polyunsaturated fatty acid supplementation on pain. These dietary treatments can significantly ameliorate pain in inflammatory and neuropathic disorders. The choice among these treatments might depend on the specific pain syndrome and the tolerance of the patient for particular dietary modifications. Several possible mechanisms are discussed, some of which might be in common among these treatments, and some treatments might engage multiple mechanisms. Multiple mechanisms acting together could be ideal for restoring the disordered metabolism underlying some pain syndromes.

Multiple Sclerosis and Pain: A Medical Focus

2000 ◽  
Vol 2 (3) ◽  
pp. 40-47 ◽  
Author(s):  
Marilyn Kassirer
Keyword(s):  
Multiple Sclerosis ◽  
Chronic Pain ◽  
Joint Pain ◽  
Pain Syndrome ◽  
Surgical Interventions ◽  
Alternative Interventions ◽  
Pain Syndromes ◽  
Drug Treatments ◽  
Patients Experience ◽  
Iatrogenic Pain

Abstract About 65% of multiple sclerosis (MS) patients experience a broad range of both acute and subacute painful syndromes. Acute conditions (eg, trigeminal neuralgia and Lhermitte's syndrome) cause intense, unrelenting pain that may worsen with age and disease progression. Chronic pain (eg, joint pain) is also a component of MS. Pain syndromes, including optic neuritis, complex regional pain syndrome (CRPS), and other less well-known syndromes, may respond to a variety of pharmacologic, surgical, or alternative interventions. MS patients may also experience iatrogenic pain. Some successful drug treatments for pain that are used in combination or alone include anticonvulsants, tricyclics, methylprednisolone, and narcotics. Surgical interventions, percutaneous compression-balloons, and radiofrequency ablation are other viable options for some pain syndromes.

scholarly journals Pathophysiological substantiation of the complex approach to rehabilitation of patients with myofascial pain syndrome of the neck region

2020 ◽  
Vol 2 (1) ◽  
pp. 66-70
Author(s):  
O. V. Shimarova ◽  
V. V. Malakhovskiy ◽  
V. G. Zilov
Keyword(s):  
Myofascial Pain ◽  
Neck Region ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Trigger Points ◽  
Muscle Stiffness ◽  
Myofascial Pain Syndromes ◽  
Pain Syndromes ◽  
Complex Approach

Myofascial pain syndromes are a widespread pathology, which is a condition that is characterized by local muscle stiffness and the formation of trigger points in them. The pathophysiology of myofascial pain syndromes is not fully understood. Studies indicate the role of dysfunction of the end plate of the muscle, impaired proprioreception and sensomotor control, central sensitization. The review presents a modern view of approaches to the treatment of myofasial pain syndrome of the neck region, based on an understanding of its pathophysiology.

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