Mechanisms and Mediators of Neuropathic Pain

Mechanisms and Mediators of Neuropathic Pain
Author: Annika B. Malmberg
Publisher: Springer
Total Pages: 278
Release: 2012-12-06
Genre: Medical
ISBN: 3034881290

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Numerous improvements in our understanding of the mechanisms that underlie neuropathic pain states have come from the development of animal models, most of which involve partial peripheral nerve injury. The animal models have shown that nerve injury initiates a cascade of events resulting in altered neurochemistry and molecular biology of the peripheral neurons, the dorsal root ganglion cell, and changes in neurotransmitter and receptor expression in the dorsal horn of the spinal cord. Moreover, nerve injury produces anatomical changes with functional consequences. This volume summarises the current understanding of the pathophysiological processes in the peripheral and central nervous system that contribute to the neuropathic pain. It provides a timely review of neuropathic pain mechanisms, written by experts in the field.

Identification & Characterization of Potential Mediators & Mechanisms Invloved in Neuropathic Pain

Identification & Characterization of Potential Mediators & Mechanisms Invloved in Neuropathic Pain
Author: Amin Boroujerdi
Publisher:
Total Pages: 109
Release: 2010
Genre:
ISBN: 9781124183602

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Pain is defined as an unpleasant sensation and emotional experience associated with actual or potential tissue injury. Everyone at some point has experienced a painful sensation. Pain can cause unwanted physical, emotional and social anguish throughout one's daily life. According to the American Chronic Pain Association, pain is the number one cause of adult disability in the U.S. costing an estimated $80 billion annually in medical bills and lost productivity. Unfortunately, over the past decades, our understanding of pain mechanisms and efforts to control pain are not adequate. So as a consequence, current medications for pain managements, especially that for chronic pain, are not efficacious, and often associated with intolerable side effects. Therefore, target specific, mechanism based therapeutic medications for effective, and safe pain control is an unmet medical need. In my dissertation I have focused on characterizing the role of two proteins involved in mediating neuropathic pain, a form of chronic pain. I provide evidence showing that the auxiliary subunit of the voltage gated calcium channel alpha 2 delta-1 protein is upregulated in the dorsal spinal cord (DSC) due to peripheral nerve injury. This upregulation can be pervented by blocking ectopic discharges at the site of injury or using intrathecal calcium channel alpha 2 delta-1 antisense oligodeoxynucleotide preemptively. This inhibition of calcium channel alpha 2 delta-1 levels in DSC result in delay in the development of neuropathic pain, suggesting elevated levels of calcium channel alpha 2 delta-1 in the DSC mediates the initiation of peripheral nerve injury induced neuropathic pain. I have also determined that the calcium channel alpha 2 delta-1 protein plays a role in central neuropathic pain. I observed an upregulation of the calcium channel alpha 2 delta-1 protein in the DSC of spinal cord injured (SCI) rats with neuropathic pain states, and both neuropathic pain states and calcium channel alpha 2 delta-1 protein levels could be reversed by intrathecal calcium channel alpha 2 delta-1 antisense oligodeoxynucleotides. Lastly, I contributed to identifying thrombospondin-4 (TSP4) protein, a synapse inducer, as a novel mediator in the development of neuropathic pain. Similar to the calcium channel alpha 2 delta-1 protein, TSP4 protein levels were also upregulated in DSC of peripheral nerve injury induced neuropathic pain models that correlated with pain states, . Various pharmacological agents could alter both the TSP4 levels in DSC and behavioral hypersensitivity supporting the notion that TSP4 plays a novel role in neuropathic pain. I was also able to show using immunohistchemistry that enhanced levels of TSP4 colocalized with calcium channel alpha 2 delta-1 and presynaptic marker synaptic vesicle-2 protein (sv2) in the DSC, suggesting that interaction of these two proteins plays a possible role in spinal synaptogenesis, leading to neuropathic pain transmission. These findings provide a greater understanding in the mechanism of chronic pain, which can ultimately contribute to development of new target specific medications for alleviating this debilitating disease state.

Cytokines and Pain

Cytokines and Pain
Author: L.R. Watkins
Publisher: Springer
Total Pages: 248
Release: 2013-03-08
Genre: Medical
ISBN: 3034887493

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Within the past few years, it has become recognized that the immune system communicates to the brain. Substances released from activated immune cells (cytokines) stimulate peripheral nerves, thereby signaling the brain and spinal cord that infection/inflammation has occurred. Additionally, peripheral infection/inflammation leads to de novo synthesis and release of cytokines within the brain and spinal cord. Thus, cytokines effect neural activation both peripherally and centrally. Through this communication pathway, cytokines such as interleukin-1, interleukin-6 and tumor necrosis factor markedly alter brain function, physiology and behavior. One important but underrecognized aspect of this communication is the dramatic impact that immune activation has on pain modulation. The purpose of this book is to examine, for the first time, immune-to-brain communication from the viewpoint of its effect on pain processing. It is aimed both at the basic scientist and health care providers, in order to clarify the major role that substances released by immune cells play in pain modulation. This book contains chapters contributed by all of the major laboratories focused on understanding how cytokines modulate pain. These chapters provide a unique vantage point from which to examine this question, as the summarized work ranges from evolutionary approaches across diverse species, to the basics of the immune response, to the effect of cytokines on peripheral and central nervous system sites, to therapeutic potential in humans.

Mechanisms of Vascular Disease

Mechanisms of Vascular Disease
Author: Robert Fitridge
Publisher: University of Adelaide Press
Total Pages: 589
Release: 2011
Genre: Medical
ISBN: 1922064009

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New updated edition first published with Cambridge University Press. This new edition includes 29 chapters on topics as diverse as pathophysiology of atherosclerosis, vascular haemodynamics, haemostasis, thrombophilia and post-amputation pain syndromes.

Neuropathic Pain

Neuropathic Pain
Author: Cory Toth
Publisher: Cambridge University Press
Total Pages: 385
Release: 2013-11-07
Genre: Medical
ISBN: 1107470439

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Central or peripheral neuropathic pain can be caused by a wide range of injuries, infections and diseases such as: spinal cord injury, multiple sclerosis, stroke, herpes zoster, diabetes and cancer. Many of these pain syndromes are difficult to treat, representing a challenge for many neurologists not routinely trained in pain management. Written by an international team of experts in the field, Neuropathic Pain: Causes, Management and Understanding gives readers an in-depth understanding of the multitude of conditions causing neuropathic pain. Epidemiology, clinical diagnosis, pathophysiology, outcome measurement and the best evidence-based management of individual and general neuropathic pain conditions are also described in depth. A unique chapter, written from a patient's viewpoint, gives new insight into how chronic neuropathic pain affects the lives of those patients with the condition. This book is essential reading for all pain specialists, neurologists, psychiatrists and anesthesiologists who wish to better understand their patients' neuropathic pain.

Acute Pain Management

Acute Pain Management
Author: Raymond S. Sinatra
Publisher: Cambridge University Press
Total Pages: 729
Release: 2009-04-27
Genre: Medical
ISBN: 0521874912

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This textbook provides an overview of pain management useful to specialists as well as non-specialists, surgeons, and nursing staff.

The Essence of Analgesia and Analgesics

The Essence of Analgesia and Analgesics
Author: Raymond S. Sinatra
Publisher: Cambridge University Press
Total Pages: 551
Release: 2010-10-14
Genre: Medical
ISBN: 1139491989

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The Essence of Analgesia and Analgesics is an invaluable practical resource for clinicians giving pain relief in any clinical setting, describing the pharmacologic principles and clinical use of all available pain medications. As well as detailed overviews of pain processing and analgesic theory, sections are dedicated to oral and panteral opioid analgesics, neuraxial opioids, NSAIDs, local anesthetics, anticonvulsant type analgesics, NMDA antagonists, alpha adrenergic analgesics, antidepressant analgesics, muscle relaxants, adjuvant medications, and new and emerging analgesics. The concise format of the chapters allows for quick and easy reading and assimilation of information. Enhanced by summary tables and figures, each chapter provides an overview of a particular drug, covering chemical structure, mode of activity, indications, contraindications, common doses and uses, advantages and disadvantages, and drug related adverse events. Key references are also provided. Edited by leading experts in pain management, this is essential reading for any clinician involved in pain management.

Analgesia

Analgesia
Author: Christoph Stein
Publisher: Springer Science & Business Media
Total Pages: 429
Release: 2007-01-26
Genre: Medical
ISBN: 3540338233

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This book presents the development and experimental validation of the structural test strategy called Oscillation-Based Test – OBT in short. The results presented here assert, not only from a theoretical point of view, but also based on a wide experimental support, that OBT is an efficient defect-oriented test solution, complementing the existing functional test techniques for mixed-signal circuits.

Neuropathic Pain

Neuropathic Pain
Author: David M. Simpson
Publisher: Oxford University Press, USA
Total Pages: 544
Release: 2012-06-21
Genre: Medical
ISBN: 0195394704

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The incidence of neuropathic pain continues to rise, yet it is an affliction often misdiagnosed or inadequately treated. Although in recent years considerable research has been dedicated to understanding its mechanisms, there have been few advances in treatment. The contributors to this book are internationally renowned leaders in the fields of peripheral neuropathy and neuropathic pain. They discuss clinical approaches to diagnosis and treatment of neuropathic pain, its underlying mechanisms, and strategies for prevention. In addition, chapters cover timely issues, including legal and ethical concerns surrounding pain treatment, the status of clinical trial methods, and educational efforts. Comprehensive yet concise, this book serves as a guide for diagnostic approaches and treatment of neuropathic pain for the student, resident, practicing physician, researcher, and specialist.

Pain Modulation

Pain Modulation
Author: Howard L. Fields
Publisher: Elsevier Publishing Company
Total Pages: 454
Release: 1988-01-01
Genre: Medical
ISBN: 9780444809841

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This volume represents edited material that was presented at a conference on brainstem modulation of spinal nociception held in Beaune, France during July, 1987. Pain Modulation, Volume 77 in the series Progress in Brain Research reviews, analyses and suggests new research strategies on several relevant topics including: the endogenous opioid peptides; sites of action of opiates; the role of biogenic animes and non-opioid peptides in analgesia; dorsal horn circuitry; behavioural factors in the activation of pain modulating networks and clinical studies of nociceptive modulation.