Neuropathic Pain Component in Axial Spondyloarthritis and the Influence on Disease Burden

Gök, Kevser; Cengiz, Gizem; Erol, Kemal; Özgöçmen, Salih

doi:10.1097/rhu.0000000000000711

Cited by 26 publications

(32 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neuropathic pain is a common clinical chronic disease, and its etiology, pathogenesis, and initiation process are greatly complicated [ 32 , 33 ], which is mainly through peripheral and central nervous system damage or obstacles caused by a series of pathological symptoms [ 34 ]. Presently, neuropathic pain is still a serious health issue [ 32 ], and it is very urgent to search for more effective management of neuropathic pain.…”

Section: Discussionmentioning

confidence: 99%

Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDR Neurons in Spared Nerve Injury Rats

Xue

Sun

Xia

et al. 2020

IJMS

View full text Add to dashboard Cite

Neuropathic pain is more complex and severely affects the quality of patients’ life. However, the therapeutic strategy for neuropathic pain in the clinic is still limited. Previously we have reported that electroacupuncture (EA) has an attenuating effect on neuropathic pain induced by spared nerve injury (SNI), but its potential mechanisms remain to be further elucidated. In this study, we designed to determine whether BDNF/TrκB signaling cascade in the spinal cord is involved in the inhibitory effect of 2 Hz EA on neuropathic pain in SNI rats. The paw withdrawal threshold (PWT) of rats was used to detect SNI-induced mechanical hypersensitivity. The expression of BDNF/TrκB cascade in the spinal cord was evaluated by qRT-PCR and Western blot assay. The C-fiber-evoked discharges of wide dynamic range (WDR) neurons in spinal dorsal horn were applied to indicate the noxious response of WDR neurons. The results showed that 2 Hz EA significantly down-regulated the levels of BDNF and TrκB mRNA and protein expression in the spinal cord of SNI rats, along with ameliorating mechanical hypersensitivity. In addition, intrathecal injection of 100 ng BDNF, not only inhibited the analgesic effect of 2 Hz EA on pain hypersensitivity, but also reversed the decrease of BDNF and TrκB expression induced by 2 Hz EA. Moreover, 2 Hz EA obviously reduced the increase of C-fiber-evoked discharges of dorsal horn WDR neurons by SNI, but exogenous BDNF (100 ng) effectively reversed the inhibitory effect of 2 Hz EA on SNI rats, resulting in a remarkable improvement of excitability of dorsal horn WDR neurons in SNI rats. Taken together, these data suggested that 2 Hz EA alleviates mechanical hypersensitivity by blocking the spinal BDNF/TrκB signaling pathway-mediated central sensitization in SNI rats. Therefore, targeting BDNF/TrκB cascade in the spinal cord may be a potential mechanism of EA against neuropathic pain.

show abstract

Section: Discussionmentioning

confidence: 99%

Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDR Neurons in Spared Nerve Injury Rats

Xue

Sun

Xia

et al. 2020

IJMS

View full text Add to dashboard Cite

show abstract

“…Unfortunately, our cohort lacks assessment of fibromyalgia, but the observation of female axSpA patients presenting with more extreme PROs than males suggests that fibromyalgia could have been a frequent co-morbidity for our axSpA patients, possibly influencing the degree of symptom complaint in females. Indeed, it has been described that about a third of axSpA patients could have a neuropathic pain component [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Are gender-specific approaches needed in diagnosing early axial spondyloarthritis? Data from the SPondyloArthritis Caught Early cohort

et al. 2018

View full text Add to dashboard Cite

BackgroundAlthough gender differences have been observed in the severity of axial spondyloarthritis (axSpA), gender differences in disease presentation of early axSpA have not been thoroughly investigated. In particular, their impact on the diagnostic process is unknown.MethodsBaseline data from the SPondyloArthritis Caught Early cohort, which includes patients with chronic back pain (CBP; duration ≥ 3 months and ≤ 2 years, age of onset < 45 years), were analysed. Patients underwent a full diagnostic work-up, including MRI and radiograph of the sacroiliac joints (MRI-SIJ and X-SIJ), to establish a diagnosis of axSpA. Characteristics of male and female patients with a certain diagnosis of axSpA (confidence level by the physician ≥ 7 on a 0–10 rating scale) were compared. Regression models were built for: the whole CBP cohort stratified by gender, to study which SpA features were associated most with diagnosis in each gender; and for axSpA patients, to test whether gender was associated with imaging positivity (MRI-SIJ+ and/or X-SIJ+).ResultsOf the 719 CBP patients, 275 were male. With 146/275 males and 155/444 females diagnosed as axSpA, males were more likely to be diagnosed with axSpA (OR 2.1, 95% CI 1.5–2.9). Despite similar symptom duration, male axSpA patients were younger at diagnosis (27.4 ± 7.5 vs 29.5 ± 7.8 years; p = 0.02). Presence of SpA features was similar in male and female axSpA patients, except for HLA-B27 and imaging positivity that were more common in male axSpA patients (80% vs 60%; p < 0.01 and 78% vs 64%; p = 0.01). Nevertheless, these SpA features were still more prevalent in female axSpA patients than in no-axSpA patients, both females (HLA-B27+ 23%, positive imaging 7%) and males (HLAB27+ 34%, positive imaging 11%) (all p < 0.01). Moreover, in multivariable models with diagnosis of axSpA as outcome, HLA-B27 and imaging positivity were associated with the diagnosis in both sexes. In models with imaging positivity as outcome, male gender and HLA-B27 were both independently associated with MRI+ and/or X-SI+.ConclusionsWhile our data show clear gender differences in early axSpA, they highlight that HLA-B27 and imaging are still key elements for diagnosis in both genders. Our study does not suggest that separate diagnostic strategies for men and women are required.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1705-x) contains supplementary material, which is available to authorized users.

show abstract

“…In these painful conditions, NP has been ascribed to pathological changes of articular nerves 28. Joint cartilage is poorly innervated in normal conditions but may undergo neurovascular invasion in osteoarthritis; in contrast, the highly innervated synovial membrane presents loss and plastic changes of nerve terminals 27–33. Furthermore, in functional magnetic resonance imaging, CLBP patients with high PDQ scores presented with decreased cortical activation in response to painful stimuli, which suggests that CLBP may be associated to decreased descending inhibitory modulation of pain 28–34,89,90.…”

Section: Tapentadol In Musculoskeletal Conditions With a Neuropathicmentioning

confidence: 99%

“…Alternatively, however, in rheumatological conditions NP has been postulated to be due to somatosensory lesions, such as loss of nerve terminals and/or ectopic innervation, which have been described in articular and periarticular tissues; much alike, in neurodegenerative disorders, changes of the peripheral and central somatosensory system have been pathologically identified and linked to NP 24–28. When a neural lesion can be only hypothesized and not demonstrated, the occurrence of NP symptoms has been variously labeled as “NP component,” “NP mechanisms,” “NP-like phenotype,” “pain with NP features,”, or “NP symptoms.”8,27,33…”

Section: Introductionmentioning

confidence: 99%

“…However, whatever the cause, it is clinically relevant that patients with a high probability of NP present with higher comorbidity and with a poorer quality of life and surgical outcome than their counterparts with a low level of NP symptoms 24,27,28,33–35. Untreated NP may cause trials to fail and, conversely, treating NP symptoms with antineuropathic agents may be beneficial to patients 3,5–21.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Tapentadol for neuropathic pain: a review of clinical studies</p>

Freo¹,

Romualdi²,

Kress³

2019

JPR

View full text Add to dashboard Cite

Neuropathic pain (NP) is an enormous burden for patients, caregivers and society. NP is a pain state that may develop after injury of the peripheral or central nervous system because of a wide range of diseases and traumas. A NP symptom component can be found also in several types of chronic pain. Many NP patients are substantially disabled for years. Due to its chronicity, severity and unpredictability, NP is difficult to treat. Tapentadol is a central-acting oral analgesic with combined opioid and noradrenergic properties, which make it potentially suitable for a wide range of pain conditions, particularly whenever a NP component is present or cannot be excluded. In randomized controlled trials, tapentadol has proved to be effective in relieving NP in diabetic peripheral neuropathy and in chronic low back pain. In observational studies, tapentadol reduced NP in chemotherapy-induced peripheral neuropathies, blood and solid cancers, and the NP component in neck pain and Parkinson’s disease. This narrative review aims to provide clinicians with a broad overview of tapentadol effects on NP.

show abstract

Neuropathic Pain Component in Axial Spondyloarthritis and the Influence on Disease Burden

Abstract: Nearly one third of patients with axSpA may have NeP component regardless of having nr-axSpA or AS. Neuropathic pain component may contribute worsened QoL and poorer patient-reported outcome data and should be kept in mind during patient evaluation.

Cited by 26 publications

References 18 publications

Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDR Neurons in Spared Nerve Injury Rats

Electroacupuncture Modulates Spinal BDNF/TrκB Signaling Pathway and Ameliorates the Sensitization of Dorsal Horn WDR Neurons in Spared Nerve Injury Rats

Are gender-specific approaches needed in diagnosing early axial spondyloarthritis? Data from the SPondyloArthritis Caught Early cohort

<p>Tapentadol for neuropathic pain: a review of clinical studies</p>

Contact Info

Product

Resources

About