Pain-relieving effects of intravenous ATP in chronic intractable orofacial pain: an open-label study

Fukuda, Ken‐ichi; Hayashida, Masakazu; Fukunaga, A. F.; Kasahara, Masataka; Koukita, Yoshihiko; Ichinohe, Tatsuya; Kaneko, Yuzuru

doi:10.1007/s00540-006-0444-3

Cited by 6 publications

(5 citation statements)

References 31 publications

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“…171 They found that ATP caused a reduction of the VAS scores for spontaneous pain and allodynia by 82%±15% and 74%±9% respectively. These beneficial effects of ATP outlasted the infusion period (for medians of 7 and 12 h respectively).…”

Section: 0 Atp and P2x Ion Channel Receptors Antagonists As Potentimentioning

confidence: 95%

Potential for Developing Purinergic Drugs for Gastrointestinal Diseases

Ochoa-Cortés¹,

Liñán-Rico²,

Jacobson³

et al. 2014

Inflammatory Bowel Diseases

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Treatments for IBD, IBS, FD or motility disorders are not adequate, and purinergic drugs offer exciting new possibilities. GI symptoms that could be targeted for therapy include visceral pain, inflammatory pain, dysmotility, constipation and diarrhea. The focus of this review is on potential for developing purinergic drugs for clinical trials to treat GI symptoms. Purinergic receptors are divided into adenosine P1 (A1,A2A,A2B,A3), ionotropic ATP-gated P2X ion channel (P2X1–7) or metabotropic P2Y1,2,4,6,11–14 receptors. There is good experimental evidence for targeting A2A, A2B, A3, P2X7, P2X3 receptors or increasing endogenous adenosine levels to treat IBD, inflammatory pain, IBS/visceral pain, inflammatory-diarrhea and motility disorders. Purine genes are also potential biomarkers of disease. Advances in medicinal-chemistry have an accelerated pace toward clinical trials: Methotrexate and sulfasalazine, used to treat IBD, act by stimulating CD73-dependent adenosine production. ATP protects against NSAID-induced enteropathy and has pain-relieving properties in humans. A P2X7R antagonist AZD9056 is in clinical trials for CD. A3 AR drugs target inflammatory diseases (e.g. CF101; CF102). Dipyridamole, a nucleoside uptake-inhibitor, is in trials for endotoxemia. Drugs for pain in clinical-trials include P2X3/P2X2/3(AF-219) and P2X7(GSK1482160) antagonists and A1(GW493838) or A2A(BVT.115959) agonists. IberogastR is a phytopharmacon targeting purine-mechanisms with efficacy in IBS and FD. Purinergic drugs have excellent safety/efficacy profile for prospective clinical trials in IBD, IBS, FD and inflammatory-diarrhea. Genetic polymorphisms and caffeine consumption may affect susceptibility to treatment. Further studies in animals can clarify mechanisms and test new-generation drugs. Finally, there is still a huge gap in our knowledge of human pathophysiology of purinergic signaling.

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Section: 0 Atp and P2x Ion Channel Receptors Antagonists As Potentimentioning

confidence: 95%

Potential for Developing Purinergic Drugs for Gastrointestinal Diseases

Ochoa-Cortés¹,

Liñán-Rico²,

Jacobson³

et al. 2014

Inflammatory Bowel Diseases

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“…ATP is immediately decomposed in the blood into adenosine; intravenous administration of drugs causes an analgesic effect that is mediated by A1 receptors. Continuous drip infusion, for 2 hours or longer, at a rate of 5-6 mg/kg/h can provide temporary, dramatic relief of phantom tooth pain [ 1 ]. The effect is slow to begin, but its duration can be anywhere from several days to several weeks.…”

Section: Case Reportmentioning

confidence: 99%

Diagnosis and treatment of abnormal dental pain

Fukuda

2016

J Dent Anesth Pain Med

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Most dental pain is caused by an organic problem such as dental caries, periodontitis, pulpitis, or trauma. Diagnosis and treatment of these symptoms are relatively straightforward. However, patients often also complain of abnormal dental pain that has a non-dental origin, whose diagnosis is challenging. Such abnormal dental pain can be categorized on the basis of its cause as referred pain, neuromodulatory pain, and neuropathic pain. When it is difficult to diagnose a patient's dental pain, these potential alternate causes should be considered. In this clinical review, we have presented a case of referred pain from the digastric muscle (Patient 1), of pulpectomized (Patient 2), and of pulpectomized pain (Patient 3) to illustrate referred, neuromodulatory, and neuropathic pain, respectively. The Patient 1 was advised muscle stretching and gentle massage of the trigger points, as well as pain relief using a nonsteroidal anti-inflammatory and the tricyclic antidepressant amitriptyline. The pain in Patient 2 was relieved completely by the tricyclic antidepressant amitriptyline. In Patient 3, the pain was controlled using either a continuous drip infusion of adenosine triphosphate or intravenous Mg2+ and lidocaine administered every 2 weeks. In each case of abnormal dental pain, the patient's diagnostic chart was used (Fig.2 and 3). Pain was satisfactorily relieved in all cases.

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“…Second, although the direct actions of adenosine and ATP on the vascular smooth muscle are vasodilation via A2A purinoceptors and vasoconstriction via P2X purinoceptors, respectively [24,25], both intravenous adenosine and ATP equally cause dose-dependent vasodilation and hypotension [26]. Third, although the direct actions of adenosine and ATP on the spinal cord are antinociception via A1 purinoceptors [1] and pronociception via P2X purinoceptors [7,8], respectively, both intravenous adenosine and ATP analogously relieve neuropathic pain [12][13][14][15]. Fourth, although adenosine and ATP are known to act as anti-infl ammatory and proinfl ammatory substances, respectively [25], our present data suggest an anti-infl ammatory rather than proinfl ammatory property of intravenous ATP, as described below.…”

Section: Discussionmentioning

confidence: 97%

“…However, intravenous ATP may reduce postoperative pain, analogous to adenosine, because ATP is converted to adenosine within seconds via the action of ectonucleotidases in the bloodstream [10,11]. Actually, we have recently found that intravenous infusion of ATP can alleviate neuropathic pain [12,13], analogous to adenosine [14,15]. To date, however, the effects of intravenous ATP on pain control during and/or after surgery have not been investigated in humans.…”

Section: Introductionmentioning

confidence: 98%