Targeting the endocannabinoid system for management of HIV-associated neuropathic pain: A systematic review

Aly, Esraa; Masocha, Willias

doi:10.1016/j.ibneur.2021.01.004

Cited by 10 publications

(12 citation statements)

References 91 publications

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“…Although HIV-associated neuropathic pain negatively affects the patient’s quality of life, to date there are no approved FDA medications to either prevent it or treat it ( 261 , 262 ). In the case of ATN, substituting the offending drug is the first step in treatment, which may still be challenging in some parts of Africa due to limited access to drugs due to procurement difficulties even though more antiretroviral drug options have become available in recent years.…”

Section: Specific Neurological Disturbances Related To Neuroinflammat...mentioning

confidence: 99%

“…In the case of ATN, substituting the offending drug is the first step in treatment, which may still be challenging in some parts of Africa due to limited access to drugs due to procurement difficulties even though more antiretroviral drug options have become available in recent years. Some drugs used for other types of neuropathic pain such as anticonvulsants, antidepressants, topical agents, as well as non-steroidal anti-inflammatory drugs, and opioids are used and show modest activity ( 261 , 263 ). However, in clinical trials, antidepressants such as amitriptyline ( 264 , 265 ), and anticonvulsants such as pregabalin ( 266 ) were not effective for the management of HIV-DSP.…”

Section: Specific Neurological Disturbances Related To Neuroinflammat...mentioning

confidence: 99%

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The Interplay Between Neuroinfections, the Immune System and Neurological Disorders: A Focus on Africa

et al. 2022

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Neurological disorders related to neuroinfections are highly prevalent in Sub-Saharan Africa (SSA), constituting a major cause of disability and economic burden for patients and society. These include epilepsy, dementia, motor neuron diseases, headache disorders, sleep disorders, and peripheral neuropathy. The highest prevalence of human immunodeficiency virus (HIV) is in SSA. Consequently, there is a high prevalence of neurological disorders associated with HIV infection such as HIV-associated neurocognitive disorders, motor disorders, chronic headaches, and peripheral neuropathy in the region. The pathogenesis of these neurological disorders involves the direct role of the virus, some antiretroviral treatments, and the dysregulated immune system. Furthermore, the high prevalence of epilepsy in SSA (mainly due to perinatal causes) is exacerbated by infections such as toxoplasmosis, neurocysticercosis, onchocerciasis, malaria, bacterial meningitis, tuberculosis, and the immune reactions they elicit. Sleep disorders are another common problem in the region and have been associated with infectious diseases such as human African trypanosomiasis and HIV and involve the activation of the immune system. While most headache disorders are due to benign primary headaches, some secondary headaches are caused by infections (meningitis, encephalitis, brain abscess). HIV and neurosyphilis, both common in SSA, can trigger long-standing immune activation in the central nervous system (CNS) potentially resulting in dementia. Despite the progress achieved in preventing diseases from the poliovirus and retroviruses, these microbes may cause motor neuron diseases in SSA. The immune mechanisms involved in these neurological disorders include increased cytokine levels, immune cells infiltration into the CNS, and autoantibodies. This review focuses on the major neurological disorders relevant to Africa and neuroinfections highly prevalent in SSA, describes the interplay between neuroinfections, immune system, neuroinflammation, and neurological disorders, and how understanding this can be exploited for the development of novel diagnostics and therapeutics for improved patient care.

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Section: Specific Neurological Disturbances Related To Neuroinflammat...mentioning

confidence: 99%

Section: Specific Neurological Disturbances Related To Neuroinflammat...mentioning

confidence: 99%

The Interplay Between Neuroinfections, the Immune System and Neurological Disorders: A Focus on Africa

et al. 2022

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“…Considerable evidence suggests that MAGL inhibition can have significant therapeutic benefit for the treatment of pain, inflammation, and neurodegenerative diseases (reviewed in [Deng & Li, 2020]). Recent studies have demonstrated beneficial effects of MAGL inhibitors in alleviating cancer‐induced bone pain (Thompson et al, 2020), HIV‐associated neuropathic pain (Aly & Masocha, 2021) and migraine‐like pain (Greco, Demartini, Francavilla, et al, 2021). MAGL inhibition shows promise for the treatment of neurodegenerative diseases such as Alzheimer's disease (Hashem et al, 2021), Huntington's disease (Covey et al, 2018), and amyotrophic lateral sclerosis (Pasquarelli et al, 2017).…”

Section: Selected Recent Discoveries Regarding Components Of the Ecs ...mentioning

confidence: 99%

Endocannabinoid signaling in the central nervous system

Ramirez

Ruiz‐Pérez

Stollenwerk

et al. 2022

Glia

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It is hard to overestimate the influence of the endocannabinoid signaling (ECS) system on central nervous system (CNS) function. In the 40 years since cannabinoids were found to trigger specific cell signaling cascades, studies of the ECS system continue to cause amazement, surprise, and confusion! CB1 cannabinoid receptors are expressed widely in the CNS and regulate cell-cell communication via effects on the release of both neurotransmitters and gliotransmitters. CB2 cannabinoid receptors are difficult to detect in the CNS but seem to "punch above their weight" as compounds targeting these receptors have significant effects on inflammatory state and behavior. Positive and negative allosteric modulators for both receptors have been identified and examined in preclinical studies. Concentrations of the endocannabinoid ligands, N-arachidonoylethanolamine and 2-arachidonoylglycerol (2-AG), are regulated by a combination of enzymatic synthesis and degradation and inhibitors of these processes are available and making their way into clinical trials. Importantly, ECS regulates many essential brain functions, including regulation of reward, anxiety, inflammation, motor control, and cellular development. While the field is on the cusp of preclinical discoveries providing impactful clinical and therapeutic insights into many CNS disorders, there is still much to be learned about this remarkable and versatile modulatory system.

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“…Both the stroke and traumatic brain injury literature are hampered by small sample sizes and heterogeneous study designs, making overall definitive conclusions difficult. Two recent reviews were published on neuropathic pain, but neither of these applied a completely systematic approach [ 21 , 22 ]. The findings from these two reviews suggest minocycline may be useful for controlling certain types of pain (e.g., diabetic and leprotic neuropathies) but not others (such as lumbar radicular pain).…”

Section: Introductionmentioning

confidence: 99%

Minocycline as Treatment for Psychiatric and Neurological Conditions: A Systematic Review and Meta-Analysis

Panizzutti

Skvarc

Lin

et al. 2023

IJMS

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Minocycline has anti-inflammatory, antioxidant, and anti-apoptotic properties that explain the renewed interest in its use as an adjunctive treatment for psychiatric and neurological conditions. Following the completion of several new clinical trials using minocycline, we proposed an up-to-date systematic review and meta-analysis of the data available. The PICO (patient/population, intervention, comparison and outcomes) framework was used to search 5 databases aiming to identify randomized controlled trials that used minocycline as an adjunctive treatment for psychiatric and neurological conditions. Search results, data extraction, and risk of bias were performed by two independent authors for each publication. Quantitative meta-analysis was performed using RevMan software. Literature search and review resulted in 32 studies being included in this review: 10 in schizophrenia, 3 studies in depression, and 7 in stroke, with the benefit of minocycline being used in some of the core symptoms evaluated; 2 in bipolar disorder and 2 in substance use, without demonstrating a benefit for using minocycline; 1 in obsessive-compulsive disorder, 2 in brain and spinal injuries, 2 in amyotrophic lateral sclerosis, 1 in Alzheimer’s disease, 1 in multiple systems atrophy, and 1 in pain, with mixes results. For most of the conditions included in this review the data is still limited and difficult to interpret, warranting more well-designed and powered studies. On the other hand, the studies available for schizophrenia seem to suggest an overall benefit favoring the use of minocycline as an adjunctive treatment.

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Targeting the endocannabinoid system for management of HIV-associated neuropathic pain: A systematic review

Cited by 10 publications

References 91 publications

The Interplay Between Neuroinfections, the Immune System and Neurological Disorders: A Focus on Africa

The Interplay Between Neuroinfections, the Immune System and Neurological Disorders: A Focus on Africa

Endocannabinoid signaling in the central nervous system

Minocycline as Treatment for Psychiatric and Neurological Conditions: A Systematic Review and Meta-Analysis

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