Neuropathic pain: Mechanisms and therapeutic strategies

Petroianu, Georg; Aloum, Lujain; Adem, Abdu

doi:10.3389/fcell.2023.1072629

Cited by 17 publications

(9 citation statements)

References 167 publications

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“…Capsaicin is widely used worldwide, but there is ongoing debate about the safety. For example, epidemiological and laboratory data have suggested that capsaicin can act as a carcinogen or anticarcinogen ( 88 – 90 ). Capsaicin appears to interact with xenobiotic-metabolizing enzymes, particularly microsomal cytochrome P450-dependent monooxygenases, which are involved in activation as well as detoxification of various chemical carcinogens and mutagens ( 1 , 91 , 92 ).…”

Section: Pharmacokinetics Of Capsaicinmentioning

confidence: 99%

Pharmacological activity of capsaicin: Mechanisms and controversies (Review)

Zhang,

Fan

et al. 2024

Mol Med Rep

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Capsaicin, which is abundant in chili peppers, exerts antioxidative, antitumor, antiulcer and analgesic effects and it has demonstrated potential as a treatment for cardiovascular, gastrointestinal, oncological and dermatological conditions. Unique among natural irritants, capsaicin initially excites neurons but then ‘calms’ them into long-lasting non-responsiveness. Capsaicin can also promote weight loss, making it potentially useful for treating obesity. Several mechanisms have been proposed to explain the therapeutic effects of capsaicin, including antioxidation, analgesia and promotion of apoptosis. Some of the mechanisms are proposed to be mediated by the capsaicin receptor (transient receptor potential cation channel subfamily V member 1), but some are proposed to be independent of that receptor. The clinical usefulness of capsaicin is limited by its short half-life. The present review provided an overview of what is known about the therapeutic effects of capsaicin and the mechanisms involved and certain studies arguing against its clinical use were mentioned.

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Section: Pharmacokinetics Of Capsaicinmentioning

confidence: 99%

Pharmacological activity of capsaicin: Mechanisms and controversies (Review)

Zhang,

Fan

et al. 2024

Mol Med Rep

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“…Serotonin (5-hydroxytryptamine, 5-HT) receptors, particularly the 5-HT3 and 5-HT1A subtypes, play a role in pain modulation [ 27 , 28 ]. The 5-HT3 receptor is involved in the transmission of pain signals in the spinal cord [ 29 , 30 , 31 ].…”

Section: Drug Targets In Neuropathic Painmentioning

confidence: 99%

Novel Drug Targets and Emerging Pharmacotherapies in Neuropathic Pain

et al. 2023

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Neuropathic pain is a debilitating condition characterized by abnormal signaling within the nervous system, resulting in persistent and often intense sensations of pain. It can arise from various causes, including traumatic nerve injury, neuropathy, and certain diseases. We present an overview of current and emerging pharmacotherapies for neuropathic pain, focusing on novel drug targets and potential therapeutic agents. Current pharmacotherapies, including tricyclic antidepressants, gabapentinoids, and serotonin norepinephrine re-uptake inhibitors, are discussed, as are emerging treatments, such as ambroxol, cannabidiol, and N-acetyl-L-cysteine. Additionally, the article highlights the need for further research in this field to identify new targets and develop more effective and targeted therapies for neuropathic pain management.

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“…In other chronic painful diseases, prognosis, choice of therapy, and treatment response vary according to pain type (nociceptive, neuropathic, and/or nociplastic). 6,54,57,58 Recently published HS pain management algorithms suggest differential treatment according to HS pain type 59 ; however, data supporting the presence of multiple pain types in HS have been based exclusively on survey studies. 7,44,60,61 This study provides additional evidence for the presence of nociplastic and nociceptive pain in HS.…”

Section: Limitations and Clinical Implicationsmentioning

confidence: 99%

Quantitative Sensory Testing to Characterize Sensory Changes in Hidradenitis Suppurativa Skin Lesions

Alsouhibani,

Speck,

Cole

et al. 2023

JAMA Dermatol

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ImportancePain is the most impactful symptom in patients with hidradenitis suppurativa (HS). Characterization of sensory profiles may improve understanding of pain mechanisms in HS and facilitate identification of effective pain management strategies.ObjectiveTo characterize somatosensory profiles in patients with HS at clinically affected and nonaffected sites compared with pain-free reference data.Design, Setting, and ParticipantsThis cross-sectional study was conducted at the Emory University Dermatology Clinic. It was hypothesized (1) that patients with HS would demonstrate hypersensitivity to pain in HS lesions and (2) that some patients would have sensory profiles consistent with complex pain mechanisms. Therefore, adults with dermatologist-diagnosed HS and at least 1 painful HS lesion at the time of testing were enrolled between September 10, 2020, and March 21, 2022. Patients with other diagnoses contributing to pain or neuropathy were excluded. Data analysis was conducted between March and April 2022.ExposureQuantitative sensory testing was performed on HS lesions and control skin according to a standardized protocol.Main Outcomes and MeasuresQuantitative sensory testing outcomes included innocuous thermal and mechanical sensitivity (cold, warmth, and light touch detection thresholds), noxious thermal and mechanical sensitivity (cold, heat, pinprick, and deep pressure pain thresholds and suprathreshold pinprick sensitivity), temporal summation of pinprick, paradoxical thermal sensations, and dynamic mechanical allodynia (pain upon light stroking of the skin). Sensitivity in HS lesions was compared with sensitivity in a control location (the hand) and in pain-free controls using t tests.ResultsThis study included 20 participants with a median age of 35.5 (IQR, 30.0-46.5) years, the majority of whom were women (15 [75%]). In terms of race and ethnicity, 2 participants (10%) self-identified as Asian, 11 (55%) as Black, 6 (30%) as White, and 1 (5%) as more than 1 race or ethnicity. Compared with site-specific reference values from healthy, pain-free control participants, HS lesions were insensitive to innocuous cold and warmth, noxious heat, and light touch (t = −5.69, −10.20, −3.84, and 4.46, respectively; all P &lt; .001). In contrast, HS lesions also demonstrated significant hypersensitivity to deep pressure pain (t = 8.36; P &lt; .001) and cutaneous pinprick (t = 2.07; P = .046). Hypersensitivity to deep pressure pain was also observed in the control site (t = 5.85; P &lt; .001). A subset of patients with HS displayed changes in pain processing that are often seen in neuropathic and nociplastic pain conditions, including hypersensitivity to repetitive pinprick (5 [26%]), paradoxical thermal sensations (3 [15%]), and pain upon light stroking of the skin (10 [50%]).Conclusions and RelevanceThe findings of this cross-sectional study suggest that HS involves local changes in the skin or its free nerve endings, possibly leading to peripheral neuropathy and alterations in the transduction of innocuous and noxious thermal and mechanical stimuli. For some patients, central nervous system changes in somatosensory processing may also occur, but confirmatory evidence is needed. Better understanding of neuropathic and nociplastic mechanisms in HS pain could lead to individually tailored treatments.

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Neuropathic pain: Mechanisms and therapeutic strategies

Cited by 17 publications

References 167 publications

Pharmacological activity of capsaicin: Mechanisms and controversies (Review)

Pharmacological activity of capsaicin: Mechanisms and controversies (Review)

Novel Drug Targets and Emerging Pharmacotherapies in Neuropathic Pain

Quantitative Sensory Testing to Characterize Sensory Changes in Hidradenitis Suppurativa Skin Lesions

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