Contribution of central sensitisation to the development of noncardiac chest pain

Sarkar, S; Aziz, Qasim; Woolf, Clifford J.; Hobson, Anthony; Thompson, David G.

doi:10.1016/s0140-6736(00)02758-6

Cited by 312 publications

(290 citation statements)

References 22 publications

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“…'delayed-onset muscle soreness model' mimics clinical pain [35]. In the viscera, central modifications manifested by hyperalgesia/allodynia, can also be induced by application of strong or long lasting noxious stimuli [36].…”

Section: Models Applied In the Skinmentioning

confidence: 99%

Assessing analgesic actions of opioids by experimental pain models in healthy volunteers – an updated review

Staahl

Olesen

Andresen

et al. 2009

Brit J Clinical Pharma

111

131

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AIMExperimental pain models may help to evaluate the mechanisms of action of analgesics and target the clinical indications for their use. This review addresses how the efficacy of opioids can be assessed in human volunteers using experimental pain models. The drawback with the different study designs is also discussed. METHODA literature search was completed for randomized controlled studies which included human experimental pain models, healthy volunteers and opioids. RESULTSOpioids with a strong affinity for the m-opioid receptor decreased the sensation in a variety of experimental pain modalities, but strong tonic pain was attenuated more than short lasting pain and non-painful sensations. The effects of opioids with weaker affinity for the m-opioid receptor were detected by a more narrow range of pain models, and the assessment methods needed to be more sensitive. CONCLUSIONThe way the pain is induced, assessed and summarized is very important for the sensitivity of the pain models. This review gives an overview of how different opioids perform in experimental pain models. Generally experimental pain models need to be designed with careful consideration of pharmacological mechanisms and pharmacokinetics of analgesics. This knowledge can aid the decisions needed to be taken when designing experimental pain studies for compounds entering phase 1 clinical trials.

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Section: Models Applied In the Skinmentioning

confidence: 99%

Assessing analgesic actions of opioids by experimental pain models in healthy volunteers – an updated review

Staahl

Olesen

Andresen

et al. 2009

Brit J Clinical Pharma

111

131

View full text Add to dashboard Cite

show abstract

“…After peripheral nerve injury, damaged and nondamaged electrophysiological changes particular to central sensitization correlate with the development in human experimental subjects after a noxious conditioning input of allodynia (particularly dynamic tactile or brush-evoked allodynia), the temporal summation of repeated low-intensity stimuli from an innocuous sensation to pain, with ‘after-pain’ on cessation of the stimulus, and widespread secondary hyperalgesia [66]. These changes can be elicited in human volunteers by noxious stimulation of the skin as with topical or intradermal capsaicin or repeated heat stimuli [67], and in the gastrointestinal tract by exposure to low pH solutions [68]. Similar clinical features such as an abnormal laryngeal sensation or throat tickle (laryngeal paresthesia), increased cough sensitivity in response to a known tussigen (hypertussia), and cough triggered in response to non-tussive triggers such as cold air or talking on the phone (allotussia) are seen in refractory CC [65].…”

Section: Introductionmentioning

confidence: 99%

An update and systematic review on drug therapies for the treatment of refractory chronic cough

Ryan

Vertigan

Birring

2018

Expert Opinion on Pharmacotherapy

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Introduction: Chronic Cough (CC) is common and often associated with significant comorbidity and decreased quality of life. In up to 50% of cases, the cough is refractory despite extensive investigation and treatment trials. It is likely that the key abnormality in refractory CC is dysfunctional, hypersensitive sensory nerves, similar to conditions such as laryngeal hypersensitivity and neuropathic pain.Areas covered: The aim of this systematic review is to assess drug therapies for refractory CC. The authors review the current management of CC and provide discussion of the similarities between neuropathic pain and refractory CC. They review repurposed and new pharmacological treatments. Several meta-analyses were performed to compare the efficacy of treatments where possible.Expert opinion: Repurposed pain medications such as gabapentin and pregabalin reduce the frequency of cough and improve quality of life. Along with speech pathology, they are important and alternate treatments for refractory CC. However, more treatments are needed and the P2X3 ion channel receptor antagonists show the most promise. With a better understanding of neuronal activation and sensitisation and their signal processing in the brain, improved animal models of cough, and the use of validated cough measurement tools, more effective treatments will develop.

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“…In the present study, we used a previously employed electrical method that directly stimulates afferent nerves rather than receptors, 25,26 to analyze esophageal perception. Prior methods used to evaluate the threshold of esophageal perception have included chemical stimulation, an acid perfusion test, a mechanical stimulation method, and a barostat test.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Corticotropin-releasing Hormone Administration Increases Esophageal Electrical Sensitivity in Healthy Individuals

Yamasaki

Tomita

Takimoto

et al. 2017

J Neurogastroenterol Motil

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Background/AimsWhen a person is experiencing stress, corticotropin-releasing hormone (CRH) can modulate gut physiologies, such as visceral sensation or gastrointestinal motility, and its intravenous administration mimics stress-induced physiological changes. However, the influence of CRH on the esophagus is yet unknown. Accordingly, we investigated whether intravenous CRH administration increases esophageal sensitivity to electrical stimulation in healthy Japanese subjects. MethodsTwenty healthy subjects were recruited. We quantified the initial perception threshold (IPT) every 15 minutes after CRH injection. Venous blood was collected with a cannula, and both plasma adrenocorticotropic hormone (ACTH) and cortisol were measured at pre-stimulation, 0, 30, 60, 90, and 120 minutes. The results from each time point were compared against a baseline IPT obtained before electrical stimulation was initiated. ResultsWhen compared to the baseline IPT value (16.9 ± 4.5), CRH significantly decreased electrical threshold of the esophagus at 30, 45, 60, 75 minutes (14.1 ± 4.2, 13.1 ± 5.0, 12.1 ± 5.7, 14.0 ± 5.8 minutes, P < 0.01, respectively) after CRH injection, suggesting that CRH increased esophageal sensitivity to the electrical stimulus. CRH also significantly increased plasma ACTH levels at 30 minutes (50.3 ± 17.7, P < 0.01), and cortisol levels at 30 minutes (22.0 ± 6.7 minutes, P < 0.01) and 60 minutes (20.3 ± 6.7 minutes, P < 0.01) after CRH injection, when compared to the pre-stimulation ACTH and cortisol values. ConclusionIntravenous CRH administration increased esophageal electrical sensitivity in normal subjects, emphasizing the important role of stress in esophageal sensitivity.

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Contribution of central sensitisation to the development of noncardiac chest pain

Cited by 312 publications

References 22 publications

Assessing analgesic actions of opioids by experimental pain models in healthy volunteers – an updated review

Assessing analgesic actions of opioids by experimental pain models in healthy volunteers – an updated review

An update and systematic review on drug therapies for the treatment of refractory chronic cough

Intravenous Corticotropin-releasing Hormone Administration Increases Esophageal Electrical Sensitivity in Healthy Individuals

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