Are Opioids Effective in Relieving Neuropathic Pain?

Schembri, Emanuel

doi:10.1007/s42399-018-0009-4

Cited by 25 publications

(15 citation statements)

References 234 publications

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“…Approximately 5-10% of the population worldwide suffers from neuropathic pain. 1,2 This pathological state is caused by a lesion or disease of the somatosensory nervous system, which can result from injury or a medical condition such as cancer, diabetes or autoimmune diseases. 1,3 The treatment of neuropathic pain is still challenging.…”

Section: Introductionmentioning

confidence: 99%

The blockade of CC chemokine receptor type 1 influences the level of nociceptive factors and enhances opioid analgesic potency in a rat model of neuropathic pain

et al. 2020

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Summary A growing body of evidence has indicated that the release of nociceptive factors, such as interleukins and chemokines, by activated immune and glial cells has crucial significance for neuropathic pain generation and maintenance. Moreover, changes in the production of nociceptive immune factors are associated with low opioid efficacy in the treatment of neuropathy. Recently, it has been suggested that CC chemokine receptor type 1 (CCR1) signaling is important for nociception. Our study provides evidence that the development of hypersensitivity in rats following chronic constriction injury (CCI) of the sciatic nerve is associated with significant up‐regulation of endogenous CCR1 ligands, namely, CCL2, CCL3, CCL4, CCL6, CCL7 and CCL9 in the spinal cord and CCL2, CCL6, CCL7 and CCL9 in dorsal root ganglia (DRG). We showed that single and repeated intrathecal administration of J113863 (an antagonist of CCR1) attenuated mechanical and thermal hypersensitivity. Moreover, repeated administration of a CCR1 antagonist enhanced the analgesic properties of morphine and buprenorphine after CCI. Simultaneously, repeated administration of J113863 reduced the protein levels of IBA‐1 in the spinal cord and MPO and CD4 in the DRG and, as a consequence, the level of pronociceptive factors, such as interleukin‐1β (IL‐1β), IL‐6 and IL‐18. The data obtained provide evidence that CCR1 blockade reduces hypersensitivity and increases opioid‐induced analgesia through the modulation of neuroimmune interactions.

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Section: Introductionmentioning

confidence: 99%

The blockade of CC chemokine receptor type 1 influences the level of nociceptive factors and enhances opioid analgesic potency in a rat model of neuropathic pain

et al. 2020

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“…It is worth underlining that, before the diagnosis, patients had been formally prescribed or were taking symptomatic drugs according to a self-medication regimen, with little or no benefit, especially from the NSAID class and opioids for acute attacks. There is indeed evidence for a limited effect of opioids in neuropathic pain in general [25]. Only a minority of patients had been prescribed anti-epileptic drugs, of the class of gabapentinoids, before the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Pitfals in recognition and management of trigeminal neuralgia

et al. 2020

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Background: Trigeminal neuralgia (TN) is a severe, disabling form of painful cranial neuropathy. Even though TN has a typical clinical picture, diagnosis it is often missed or delayed in clinical practice. In order to investigate the occurrence of diagnostic and therapeutic errors in TN, we studied 102 patients suffering from TN recruited through a multicentric survey. Methods: We performed a Pubmed database search on errors and pittfalls in TN diagnosis and management. Then, patients with TN were consecutively enrolled in the period from February 2017 to October 2019, by several European Headache Centers participating in the study, following a call of the Headache and Pain Scientific Panels of the European Academy of Neurology (EAN). Diagnosis of Classical Trigeminal Neuralgia (CTN) was made according to the International Headache Society (IHS) criteria (Tölle et al., Pain Pract 6:153-160, 2006). All the patients were evaluated using telephone/frontal interviews conducted by headache/pain specialists using an ad hoc questionnaire. Results: A number of 102 patients were recruited, mostly females (F:M ratio 2.64:1). Eighty-six percent of the patients consulted a physician at the time they experienced the first pain attacks. Specialists consulted before TN diagnosis were: primary care physicians (PCP) (43.1%), dentists (in 30.4%), otorhinolaryngologists (3.9%), neurosurgeons (3.9%), neurologists or headache specialists (14.7%), others (8%). The final diagnosis was made mainly by a neurologist or headache specialist (85.3%), and the mean interval between the disease onset and the diagnosis made by a specialist was 10.8 ± 21.2 months. The "diagnostic delay" was 7.2 ± 12.5 months, and misdiagnoses at first consultation were found in 42.1% of cases. Instrumental and laboratory investigations were carried out in 93.1% of the patients before the final diagnosis of TN. Conclusion: While TN has typical features and it is well defined by the available international diagnostic criteria, it is still frequently misdiagnosed and mistreated. There is a need to improve the neurological knowledge in order to promptly recognize the clinical picture of TN and properly adhere to the specific guidelines. This may result in a favorable outcome for patients, whose quality of life is usually severely impaired.

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“…Fortunately, most cancers are very curable diseases when founds early and treated [51]. Specialists need to consider the challenge of managing cancer pain in a patient over a potentially longer duration, as cancer is no longer considered a terminal disease [52,53].…”

Section: Female Malementioning

confidence: 99%

Common Cancers Among Kurdish People in the Northwest of Iran: Current Status and Future Prospects

Hosseini

Fereidunian

Jamshidi

et al. 2018

SN Compr. Clin. Med.

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Northwest of Iran is a high-risk area with the highest annual incidence of cancers. Despite the growing epidemic of incidence of cancers, little information is available about that in the Kurdistan region. This was a cross-sectional epidemiological study during 2010-2015. The crude incidence rates (CRs) and age-standardized incidence rates (ASRs) were calculated per 100,000 people by different categories. Of 9218 patients, 5320 (57.71%) were male. The mean ages were 63.4 (± 21.43) and 55.8 (± 18.50) for male and female, respectively. The most common cancer (cases/100,000, percentage) among male gender was stomach cancer (24.23, 22%) and among female gender was breast cancer (18.38, 24%). Besides skin cancer, other most common cancers were bladder (12.33, 11%), colorectal (11.78, 11%), and esophageal (11.14, 10%) cancers in men. Esophageal (9.57, 13%), colorectal (8.68, 11%), and stomach (8.34, 11%) were the common cancers among women. The overall ASR of cancers was 94.98 and 131.99 per 100,000 among females and males. The standard sex ratio (male to female) was 1.39. Broadly applying effective prevention measures such as vaccination, use of early detection tests, awareness campaign, and lifestyle modifications could be adopted by local health authority for the reduction of such important public health priority.

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Are Opioids Effective in Relieving Neuropathic Pain?

Cited by 25 publications

References 234 publications

The blockade of CC chemokine receptor type 1 influences the level of nociceptive factors and enhances opioid analgesic potency in a rat model of neuropathic pain

The blockade of CC chemokine receptor type 1 influences the level of nociceptive factors and enhances opioid analgesic potency in a rat model of neuropathic pain

Pitfals in recognition and management of trigeminal neuralgia

Common Cancers Among Kurdish People in the Northwest of Iran: Current Status and Future Prospects

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