Clinical application of adenosine and ATP for pain control

Hayashida, Masakazu; Fukuda, Ken‐ichi; Fukunaga, A. F.

doi:10.1007/s00540-005-0310-8

Cited by 64 publications

(58 citation statements)

References 73 publications

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“…Fibroblasts not only produce proteins that make up the extracellular matrix, but also transform into myofibroblasts to repair injury via production of collagen and α smooth muscle actin protein. 36 Findings from research studies on the mechanisms of action underlying the effects of needling not only explain why needling per se is effective for musculoskeletal pain treatment, [29][30][31][32][33][34][35] but also account for the growing use of DN in the musculoskeletal field including sports medicine. Needling may thus improve muscle performance, although large, high quality research studies are needed to determine the optimal parameters of needling, including location and direction of needle insertion, duration of needle retention, the requirement for a local twitch response or de qi sensation, the frequency of treatments, and its potential role as a preventive measure.…”

Section: Needling Effects In the Musculoskeletal System: Therapeutic mentioning

confidence: 99%

Dry Needling versus Acupuncture: The Ongoing Debate

Zhou

Brogan

2015

Acupunct Med

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Although Western medical acupuncture (WMA) is commonly practised in the UK, a particular approach called dry needling (DN) is becoming increasingly popular in other countries. The legitimacy of the use of DN by conventional non-physician healthcare professionals is questioned by acupuncturists. This article describes the ongoing debate over the practice of DN between physical therapists and acupuncturists, with a particular emphasis on the USA. DN and acupuncture share many similarities but may differ in certain aspects. Currently, little information is available from the literature regarding the relationship between the two needling techniques. Through reviewing their origins, theory, and practice, we found that DN and acupuncture overlap in terms of needling technique with solid filiform needles as well as some fundamental theories. Both WMA and DN are based on modern biomedical understandings of the human body, although DN arguably represents only one subcategory of WMA. The increasing volume of research into needling therapy explains its growing popularity in the musculoskeletal field including sports medicine. To resolve the debate over DN practice, we call for the establishment of a regulatory body to accredit DN courses and a formal, comprehensive educational component and training for healthcare professionals who are not physicians or acupuncturists. Because of the close relationship between DN and acupuncture, collaboration rather than dispute between acupuncturists and other healthcare professionals should be encouraged with respect to education, research, and practice for the benefit of patients with musculoskeletal conditions who require needling therapy.

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Section: Needling Effects In the Musculoskeletal System: Therapeutic mentioning

confidence: 99%

Dry Needling versus Acupuncture: The Ongoing Debate

Zhou

Brogan

2015

Acupunct Med

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“…Adenosin und ATP entfalten ihre Wirkung über die Aktivierung purinerger P1-(Adenosin) und P2-(ATP-)Rezeptoren. Adenosinrezeptoren werden in 4 Subtypen unterteilt (G-Protein-gekoppelte A1-, A2a-, A2b-und A3-Rezeptoren; [10,18]). Es werden verschiedene Mechanismen der Adenosinwirkung im Rahmen der Nozizeption diskutiert [18].…”

Section: Adenosinunclassified

“…Elektrophysiologisch konnte gezeigt werden, dass periphere menschliche Nerven über Adenosinrezeptoren verfügen, die hemmende (A1) und auch erregende (A2) Eigenschaften besitzen [13]. Tierexperimentelle Daten belegen, dass eine Aktivierung von A1-Rezeptoren an sensorischen Nervenendigungen eine antinozizeptive Wirkung zur Folge hat, während A2-Rezeptoren pronozizeptive Eigenschaften vermitteln können [10,18]. Einen antinozizeptiven Effekt durch die Aktivierung von A1-Rezeptoren im Rückenmark konnte bei verschiedenen Schmerzarten (nozizeptiv, inflammatorisch und neuropathisch) gezeigt werden [18].…”

Section: Adenosinunclassified

“…So scheint der Applikationsweg von Adenosin noch nicht abschließend geklärt zu sein. Diskutiert wird, ob antiinflammatorische Effekte (via A2a-und/oder A3-Rezeptoren) beim perioperativen Einsatz eine Wirksamkeit besitzen und dadurch die andauernde Stimulation peripherer Nozizeptoren reduzieren [10,17]. Beim akuten experimentellen Ischä-mieschmerz mittels Tourniquet hat Adenosin eine analgetische Wirksamkeit [19].…”

Section: Adenosinunclassified

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Adenosin zur Behandlung von Ischämieschmerzen bei Thrombangiitis obliterans

Lang

Irnich

2007

Schmerz

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Treating ischemic pain is often unsatisfactory. Current findings demonstrate that patients with chronic ischemia may develop sensory neuropathy and signs of central sensitization. This issue makes is reasonable treating with conventional analgesics and drugs against neuropathic pain. Adenosine has also a pain reducing effect in neuropathic pain which makes it a possible therapeutic option in ischemic pain.We report of a patient with thromboangiitis obliterans. We treated his pain with a broad analgesic therapy and administered adenosine intravenously, which resulted in a reduction of pain for several hours. Afterwards the patient received buflomedil to increase adenosine plasma levels. A long term pain reduction could be achieved. Modulation of adenosine demonstrates an experimental approach in the therapy of ischemic pain in thromboangiitis obliterans.

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“…This may be quite important because adenosine attenuates pain (Sawynok and Liu, 2003;Hayashida et al, 2005) and suppresses neuroinflammation (Tsutsui et al, 2004). Potentially, then, damage to myelinated nerves in the PNS could activate a 29,39-cAMP-adenosine pathway that inhibits pain signals and reduces neuroinflammation.…”

Section: Introductionmentioning

confidence: 99%

Schwann Cells Metabolize Extracellular 2′,3′-cAMP to 2′-AMP

Verrier

Kochanek

Jackson

2015

J Pharmacol Exp Ther

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The 39,59-cAMP-adenosine pathway (39,59-cAMP→59-AMP→ adenosine) and the 29,39-cAMP-adenosine pathway (29,39-cAMP→29-AMP/39-AMP→adenosine) are active in the brain. Oligodendrocytes participate in the brain 29,39-cAMP-adenosine pathway via their robust expression of 29,39-cyclic nucleotide 39-phosphodiesterase (CNPase; converts 29,39-cAMP to 29-AMP). Because Schwann cells also express CNPase, it is conceivable that the 29,39-cAMP-adenosine pathway exists in the peripheral nervous system. To test this and to compare the 29,39-cAMP-adenosine pathway to the 39,59-cAMP-adenosine pathway in Schwann cells, we examined the metabolism of 29,39-cAMP, 29-AMP, 39-AMP, 39,59-cAMP, and 59-AMP in primary rat Schwann cells in culture. Addition of 29,39-cAMP (3, 10, and 30 mM) to Schwann cells increased levels of 29-AMP in the medium from 0.006 6 0.002 to 21 6 2, 70 6 3, and 187 6 10 nM/mg protein, respectively; in contrast, Schwann cells had little ability to convert 29,39-cAMP to 39-AMP or 39,59-cAMP to either 39-AMP or 59-AMP. Although Schwann cells slightly converted 29,39-cAMP and 29-AMP to adenosine, they did so at very modest rates (e.g., 5-and 3-fold, respectively, more slowly compared with our previously reported studies in oligodendrocytes). Using transected myelinated rat sciatic nerves in culture medium, we observed a time-related increase in endogenous intracellular 29,39-cAMP and extracellular 29-AMP. These findings indicate that Schwann cells do not have a robust 39,59-cAMP-adenosine pathway but do have a 29,39-cAMP-adenosine pathway; however, because the pathway mostly involves 29-AMP formation rather than 39-AMP, and because the conversion of 29-AMP to adenosine is slow, metabolism of 29,39-cAMP mostly results in the accumulation of 29-AMP. Accumulation of 29-AMP in peripheral nerves postinjury could have pathophysiological consequences.

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Clinical application of adenosine and ATP for pain control

Cited by 64 publications

References 73 publications

Dry Needling versus Acupuncture: The Ongoing Debate

Dry Needling versus Acupuncture: The Ongoing Debate

Adenosin zur Behandlung von Ischämieschmerzen bei Thrombangiitis obliterans

Schwann Cells Metabolize Extracellular 2′,3′-cAMP to 2′-AMP

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