Overcoming clinical challenges of refractory neuropathic pain

Pirvulescu, Iulia; Biskis, Alexandras; Candido, Kenneth D.; Knežević, Nebojša Nick

doi:10.1080/14737175.2022.2105206

Cited by 7 publications

(6 citation statements)

References 95 publications

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“…Most of the available treatments for neuropathic pain do not show satisfactory results [ 3 , 4 ], and it remains a significant unmet medical need. In this context of a lack of effective treatments, suitable new pharmacological strategies are being studied, and among them, interest in the potential suitability of herbal medicine for pain alleviation is growing annually [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…For instance, and particularly for SCI-induced neuropathic pain, it is known that this can be successfully modulated with single polyphenols such as apocynin [ 7 ], Eugenol [ 8 ], or (-)-Epigallocatechin-3-gallate [ 9 , 10 ]. However, based on the current data from refractory neuropathic pain studies, it has been recently suggested that single-drug therapy can be ineffective [ 4 ]. Thus, in applying this knowledge in the field of polyphenolic treatments for pathological pain relief, a suitable strategy would be to use whole natural extracts, containing several polyphenols, which could exert synergistic effects, unlike single compounds.…”

Section: Introductionmentioning

confidence: 99%

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Central Neuropathic Pain Development Modulation Using Coffee Extract Major Polyphenolic Compounds in Spinal-Cord-Injured Female Mice

Soler-Martínez

Deulofeu

Bagó-Mas

et al. 2022

Biology

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It was recently shown that coffee polyphenolic extract exerts preventive effects on central neuropathic pain development, but it is unknown whether its beneficial effects are associated with only one of its major polyphenolic compounds or if the whole extract is needed to exert such effects. The main objective of this study was to determine whether the separate administration of major polyphenols from coffee extract exerts preventive effects on the development of central neuropathic pain in mice compared with the effects of the whole coffee extract. Thus, spinal-cord-injured female ICR-CD1 mice were daily treated with either coffee extract or its major polyphenolic compounds during the first week, and reflexive and nonreflexive pain responses were evaluated within the acute phase of spinal cord injury. In addition, the injury-induced gliosis and dorsal horn sprouting were evaluated with immunohistochemistry. The results showed that the coffee extract prevented spinal cord injury-induced neuropathic pain, whereas its major polyphenolic compounds resulted in reflexive pain response attenuation. Both preventive and attenuation effects were associated with gliosis and afferent fiber sprouting modulation. Overall, the results suggested that coffee extract effects may be associated with potential synergistic mechanisms exerted by its major polyphenolic compounds and not by the sole effect of only one of them.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Central Neuropathic Pain Development Modulation Using Coffee Extract Major Polyphenolic Compounds in Spinal-Cord-Injured Female Mice

Soler-Martínez

Deulofeu

Bagó-Mas

et al. 2022

Biology

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“…PRF therapy for ZAP achieves its analgesic effects through neural regulation. 23 , 24 The mechanism of these effects may be related to generation of the nerve thermal disconnection effect, to changes in synaptic transmission, cell morphology or c-fos gene expression in the superficial layer of the spinal dorsal horn, to weakening of microglial activation, and/or to reverse blocking of abnormal impulse transmission by small unmyelinated nerve fibres. The effects may also be related to an increase in norepinephrine and 5-hydroxytryptamine, neurotransmitters that activate the spinal descending inhibitory system, regulate the level of central pain mediators, and affect the expression of neuronal genes.…”

Section: Discussionmentioning

confidence: 99%

The Effect of CT-Guided Pulsed Radiofrequency Combined with Ozone Injection on Zoster-Associated Pain: A Retrospective Study

Wang¹,

Yu²,

Han³

et al. 2023

JPR

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Purpose Globally, the incidence of herpes zoster (HZ) is increasing, and the resulting zoster-associated pain (ZAP) severely affects the quality of life of patients. Therefore, active treatment of ZAP and prevention of postherpetic neuralgia (PHN) are very important for patients in the early stage of the disease. This retrospective observational study aimed to evaluate the effect of CT-guided pulsed radiofrequency (PRF) combined with ozone injection on zoster-associated pain. Patients and Methods From 2018 to 2020, 84 patients with AHN (n=28), SHN (n=32), or PHN (n=24) underwent PRF combined with ozone injection treatment after pharmacologic and conservative therapies failed. The visual analogue scale (VAS), the Pittsburgh Sleep Quality Index (PSQI), and pregabalin consumption were recorded at baseline, post-PRF, and at 1, 3, 6, and 12 months after treatment. The number of remediations performed and adverse reactions were recorded, and treatment inefficiency was calculated using a VAS score greater than 3 as the criterion. Results The pooled results demonstrated statistically significant decreases in VAS scores, PSQI scores and consumption of pregabalin post-PRF and at 1, 3, 6, and 12 months follow-up (P<0.05). Compared with the PHN group, both the AHN and SHN groups showed clinical and statistical improvement in VAS scores and PSQI scores and in consumption of pregabalin (P< 0.05). At 1 year after the operation, the PHN group had a significantly greater number of remediation events and greater treatment inefficiency than the other two groups. No serious adverse events were observed during the procedure or during the follow-up period. Conclusion CT-guided PRF combined with ozone injection is safe and effective for individuals with ZAP, and its short-term and long-term effects are significant. In a sense, early PRF combined with ozone injection is more effective.

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“…In this context, a growing body of evidence suggests that polyphenols exert neuroinflammation modulatory effects in the nervous system leading to pathological pain responses decrease (Basu et al, 2021;Boadas-Vaello et al, 2017;Guerrero-Solano et al, 2020;Miguel et al, 2021;Szymaszkiewicz et al, 2022), and they would therefore be highlighted candidates for nociplastic pain alleviation. These findings together with recent evidence from refractory pathological pain studies suggest that single drug administration would be not effective enough (Pirvulescu et al, 2022), a suitable strategy may be the administration of a mixture of different polyphenols. In this regard, it has been shown that the administration of decaffeinated coffee polyphenolic extract (CE) in a mice model of spinal cord injury significantly attenuates the development of central neuropathic pain by modulating neuroinflammation processes (Bagó-Mas et al, 2022).…”

Section: Introductionmentioning

confidence: 98%

Natural polyphenolic coffee extract administration relieves chronic nociplastic pain in a reserpine‐induced fibromyalgia‐like female mouse model

Toledano‐Martos,

Bagó‐Mas,

Deulofeu

et al. 2024

Brain and Behavior

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IntroductionNociplastic pain involves reflexive and nonreflexive pain responses and it is a core symptom of fibromyalgia (FM). The increasing prevalence of this health condition and the low rates of patients’ quality of life, combined with the lack of suitable pharmacologic treatments, evidence the demand to research new alternatives. Polyphenols may be potential therapeutic candidates as they have been reported to exert pathological pain modulation in preclinical models. In that context, this work was aimed to study the antinociceptive effects of a polyphenolic extract obtained from decaffeinated ground roasted coffee, in the RIM6 FM‐like mouse model.MethodsTo this end, RIM6 adult ICR‐CD1 female mice were administered daily once a week with either 10 or 15 mg/kg of extract, and reflexive pain responses were evaluated for up to 3 weeks. At the end, the depressive‐like behavior was assessed as a nonreflexive pain response, and spinal cord and serum samples were collected for immunohistochemical and toxicological analyses.ResultsThese findings showed that the repeated administration of the coffee polyphenolic extract (CE) modulated reflexive pain responses, depressive‐like behavior, and spinal cord gliosis in a dose‐dependent manner, without signs of systemic toxicity.ConclusionThus, the CE may be a potential pharmacological treatment suitable to relieve nociplastic pain responses characteristic of FM.

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Overcoming clinical challenges of refractory neuropathic pain

Cited by 7 publications

References 95 publications

Central Neuropathic Pain Development Modulation Using Coffee Extract Major Polyphenolic Compounds in Spinal-Cord-Injured Female Mice

Central Neuropathic Pain Development Modulation Using Coffee Extract Major Polyphenolic Compounds in Spinal-Cord-Injured Female Mice

The Effect of CT-Guided Pulsed Radiofrequency Combined with Ozone Injection on Zoster-Associated Pain: A Retrospective Study

Natural polyphenolic coffee extract administration relieves chronic nociplastic pain in a reserpine‐induced fibromyalgia‐like female mouse model

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