Clinical Characteristics, Treatment Effectiveness, and Predictors of Response to Pharmacotherapeutic Interventions Among Patients with Herpetic-Related Neuralgia: A Retrospective Analysis

Zhou, Jiehua; Sun, Wuping; Liu, Yingzhi; Yang, Shaomin; Wu, Songbin; Wang, Sashuang; Xiong, Dehua; Ho, I.H.M; Zhang, Lin; Chan, Matthew T. V.; Wu, William; Liu, Xiaodong; Xiao, Lizu

doi:10.1007/s40122-021-00303-7

Cited by 6 publications

(8 citation statements)

References 30 publications

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“…Notably, ML models also provide a novel identification method for patients with herpetic neuralgia who are at risk of inadequate pain management. Studies have explored the clinical characteristics of herpetic neuralgia patients with medication responsiveness and built an optimal ML model to discriminate medication-resistant pain (MRP) from medication-sensitive pain (MSP) ( Zhou et al, 2021 ). However, this study has some limitations.…”

Section: Discussionmentioning

confidence: 99%

Characterization of plasma metabolites and proteins in patients with herpetic neuralgia and development of machine learning predictive models based on metabolomic profiling

Zhou

Li²,

Zhang³

et al. 2022

Front. Mol. Neurosci.

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Herpes zoster (HZ) is a localized, painful cutaneous eruption that occurs upon reactivation of the herpes virus. Postherpetic neuralgia (PHN) is the most common chronic complication of HZ. In this study, we examined the metabolomic and proteomic signatures of disease progression in patients with HZ and PHN. We identified differentially expressed metabolites (DEMs), differentially expressed proteins (DEPs), and key signaling pathways that transition from healthy volunteers to the acute or/and chronic phases of herpetic neuralgia. Moreover, some specific metabolites correlated with pain scores, disease duration, age, and pain in sex dimorphism. In addition, we developed and validated three optimal predictive models (AUC > 0.9) for classifying HZ and PHN from healthy individuals based on metabolic patterns and machine learning. These findings may reveal the overall metabolomics and proteomics landscapes and proposed the optimal machine learning predictive models, which provide insights into the mechanisms of HZ and PHN.

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Section: Discussionmentioning

confidence: 99%

Characterization of plasma metabolites and proteins in patients with herpetic neuralgia and development of machine learning predictive models based on metabolomic profiling

Zhou

Li²,

Zhang³

et al. 2022

Front. Mol. Neurosci.

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“…Medication-resistant PHN is a further challenge. A Chinese study evaluated potential risk factors and identified subacute HZ (vs. acute HZ; odds ratio (OR): 9.0), severe lesions (vs. mild lesions; OR: 3.8), and depressed mood (OR: 1.1) as risk factors [46].…”

Section: Complications 61 Postherpetic Neuralgiamentioning

confidence: 99%

Herpes zoster: A Review of Clinical Manifestations and Management

Patil

Goldust

Wollina

2022

Viruses

218

123

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The Varicella-zoster virus (VZV) or human herpes virus 3 is a neurotropic human alpha herpes virus responsible for chickenpox/varicella and shingles/herpes zoster (HZ). This review will focus on HZ. Since HZ is secondary to varicella, its incidence increases with age. In children and youngsters, HZ is rare and associated to metabolic and neoplastic disorders. In adults, advanced age, distress, other infections (such as AIDS or COVID-19), and immunosuppression are the most common risk factors. HZ reactivation has recently been observed after COVID-19 vaccination. The disease shows different clinical stages of variable clinical manifestations. Some of the manifestations bear a higher risk of complications. Among the possible complications, postherpetic neuralgia, a chronic pain disease, is one of the most frequent. HZ vasculitis is associated with morbidity and mortality. Renal and gastrointestinal complications have been reported. The cornerstone of treatment is early intervention with acyclovir or brivudine. Second-line treatments are available. Pain management is essential. For (secondary) prophylaxis, currently two HZV vaccines are available for healthy older adults, a live attenuated VZV vaccine and a recombinant adjuvanted VZV glycoprotein E subunit vaccine. The latter allows vaccination also in severely immunosuppressed patients. This review focuses on manifestations of HZ and its management. Although several articles have been published on HZ, the literature continues to evolve, especially in regard to patients with comorbidities and immunocompromised patients. VZV reactivation has also emerged as an important point of discussion during the COVID-19 pandemic, especially after vaccination. The objective of this review is to discuss current updates related to clinical presentations, complications, and management of HZ.

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“…The present analgesic treatments for HN are still limited due to the poor understanding of its pathogenic mechanism. It has been reported that age, immune deficiencies, malignancies, organ transplantations, autoimmune diseases, emotional stress, and immunosuppressive therapies are the major risks for HN 9,10 . Clinical treatment for HN only focuses on symptom control, including the use of topical lidocaine or capsaicin and oral gabapentin, pregabalin, or tricyclic antidepressants, 11,12 as well as the improvement of immunity and antiviral treatments 13,14 …”

Section: Introductionmentioning

confidence: 99%

HSV‐1 infection‐induced herpetic neuralgia involves a CCL5/CCR5‐mediated inflammation mechanism

Yang

et al. 2023

Journal of Medical Virology

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Herpetic-related neuralgia (HN) caused by varicella-zoster virus (VZV) infection is one of the most typical and common neuropathic pain in the clinic. However, the potential mechanisms and therapeutic approaches for the prevention and treatment of HN are still unclear. This study aims to provide a comprehensive understanding of the molecular mechanisms and potential therapeutic targets of HN. We used an HSV-1 infection-induced HN mouse model and screened the differentially expressed genes (DEGs) in the DRG and spinal cord using an RNAseq technique. Moreover, bioinformatics methods were used to figure out the signaling pathways and expression regulation patterns of the DEGs enriched.In addition, quantitative real-time RT-PCR and western blot were carried out to further confirm the expression of DEGs. HSV-1 inoculation in mice resulted in mechanical allodynia, thermal hyperalgesia, and cold allodynia, following the infection of HSV-1 in both DRG and spinal cord. Besides, HSV-1 inoculation induced an up-regulation of ATF3, CGRP, and GAL in DRG and activation of astrocytes and microglia in the spinal cord. Moreover, 639 genes were upregulated, 249 genes were downregulated in DRG, whereas 534 genes were upregulated and 12 genes were downregulated in the spinal cord of mice 7 days after HSV-1 inoculation. GO and KEGG enrichment analysis suggested that immune responses and cytokine-cytokine receptor interaction are involved in DRG and spinal cord neurons in mice after HSV-1 infection. In addition, CCL5 and its receptor CCR5 were significantly upregulated in DRG and spinal cord upon HSV-1 infection in mice. And blockade of CCR5 exhibited a significant analgesic effect and suppressed the upregulation of inflammatory cytokines in DRG and spinal cord induced by HSV-1 infection in mice. HSV-1 infection-induced allodynia and hyperalgesia in mice through dysregulation of immune response and cytokine-cytokine receptor interaction mechanism. Blockade of CCR5 alleviated allodynia and hyperalgesia probably through the suppression of

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Clinical Characteristics, Treatment Effectiveness, and Predictors of Response to Pharmacotherapeutic Interventions Among Patients with Herpetic-Related Neuralgia: A Retrospective Analysis

Cited by 6 publications

References 30 publications

Characterization of plasma metabolites and proteins in patients with herpetic neuralgia and development of machine learning predictive models based on metabolomic profiling

Characterization of plasma metabolites and proteins in patients with herpetic neuralgia and development of machine learning predictive models based on metabolomic profiling

Herpes zoster: A Review of Clinical Manifestations and Management

HSV‐1 infection‐induced herpetic neuralgia involves a CCL5/CCR5‐mediated inflammation mechanism

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