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Diaz MM, Caylor J, Strigo I, Lerman I, Henry B, Lopez E, Wallace MS, Ellis RJ, Simmons AN, Keltner JR. Toward Composite Pain Biomarkers of Neuropathic Pain-Focus on Peripheral Neuropathic Pain. FRONTIERS IN PAIN RESEARCH 2022; 3:869215. [PMID: 35634449 PMCID: PMC9130475 DOI: 10.3389/fpain.2022.869215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/21/2022] [Indexed: 01/09/2023] Open
Abstract
Chronic pain affects ~10-20% of the U.S. population with an estimated annual cost of $600 billion, the most significant economic cost of any disease to-date. Neuropathic pain is a type of chronic pain that is particularly difficult to manage and leads to significant disability and poor quality of life. Pain biomarkers offer the possibility to develop objective pain-related indicators that may help diagnose, treat, and improve the understanding of neuropathic pain pathophysiology. We review neuropathic pain mechanisms related to opiates, inflammation, and endocannabinoids with the objective of identifying composite biomarkers of neuropathic pain. In the literature, pain biomarkers typically are divided into physiological non-imaging pain biomarkers and brain imaging pain biomarkers. We review both types of biomarker types with the goal of identifying composite pain biomarkers that may improve recognition and treatment of neuropathic pain.
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Affiliation(s)
- Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Jacob Caylor
- Department of Anesthesiology, University of California, San Diego, San Diego, CA, United States
| | - Irina Strigo
- Department of Psychiatry, San Francisco Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Imanuel Lerman
- Department of Anesthesiology, University of California, San Diego, San Diego, CA, United States
| | - Brook Henry
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Eduardo Lopez
- Department of Psychiatry, San Francisco Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Mark S. Wallace
- Department of Anesthesiology, University of California, San Diego, San Diego, CA, United States
| | - Ronald J. Ellis
- Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
| | - Alan N. Simmons
- Department of Psychiatry, San Diego & Center of Excellence in Stress and Mental Health, Veteran Affairs Health Care System, University of California, San Diego, San Diego, CA, United States
| | - John R. Keltner
- Department of Psychiatry, San Diego & San Diego VA Medical Center, University of California, San Diego, San Diego, CA, United States
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Stensson N, Grimby-Ekman A. Altered relationship between anandamide and glutamate in circulation after 30 min of arm cycling: A comparison of chronic pain subject with healthy controls. Mol Pain 2020; 15:1744806919898360. [PMID: 31838922 PMCID: PMC6964246 DOI: 10.1177/1744806919898360] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The insufficient knowledge of biochemical mechanisms behind the emergence and
maintenance of chronic musculoskeletal pain conditions constrains the
development of diagnostic and therapeutic tools for clinical use. However,
physical activity and exercise may improve pain severity and physical function
during chronic pain conditions. Nevertheless, the biochemical consequences of
physical activity and exercise in chronic pain need to be elucidated to increase
the precision of this therapeutic tool in chronic pain treatment. The
endocannabinoid system has been suggested to play an important role in
exercise-induced reward and pain inhibition. Moreover, glutamatergic signalling
has been suggested as an important factor for sensation and transmission of
pain. In addition, a link has been established between the endocannabinoid
system and glutamatergic pathways. This study examines the effect of dynamic
load arm cycling (30 min) on levels of lipid mediators related to the
endocannabinoid system and glutamate in plasma of chronic pain subjects and
pain-free controls. Pain assessments and plasma levels of
arachidonoylethanolamide (anandamide), 2-aracidonoylglycerol,
oleoylethanolamide, palmitoylethanolamide, stearoylethanolamide and glutamate
from 21 subjects with chronic neck pain (chronic pain group) and 11 healthy
controls were analysed pre and post intervention of dynamic load arm cycling.
Pain intensity was significantly different between groups pre and post exercise.
Post exercise, anandamide levels were significantly decreased in health controls
but not in the chronic pain group. A strong positive correlation existed between
anandamide and glutamate in the control group post exercise but not in the
chronic pain group. Moreover, the glutamate/anandamide ratio increased
significantly in the control group and differed significantly with the chronic
pain group post exercise. The altered relationship between anandamide and
glutamate after the intervention in the chronic pain group might reflect
alterations in the endocannabinoid-glutamate mechanistic links in the chronic
pain group compared to the pain-free control group.
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Affiliation(s)
- Niclas Stensson
- Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Anna Grimby-Ekman
- Health Metrics, Department of Medicine, School of Public Health and Community Medicine, Gothenburg University, Gothenburg, Sweden
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Grimby-Ekman A, Ahlstrand C, Gerdle B, Larsson B, Sandén H. Pain intensity and pressure pain thresholds after a light dynamic physical load in patients with chronic neck-shoulder pain. BMC Musculoskelet Disord 2020; 21:266. [PMID: 32326925 PMCID: PMC7181519 DOI: 10.1186/s12891-020-03298-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 04/17/2020] [Indexed: 12/31/2022] Open
Abstract
Background To investigate the development of pain intensity and pressure pain thresholds during and 24 h after a light dynamic physical load among patients with chronic neck-shoulder pain. Methods Twenty-six patients with chronic neck-shoulder pain and 12 healthy controls were included. The participants arm-cycled on an ergometer. Effort was rated with the Borg Rating of Perceived Exertion scale (RPE), and pain intensity with an numeric rating scale (NRS). Pressure pain thresholds were measured by an algometer. Participants started a pain diary 1 week before the physical exercise and continued until 1 week after. Pain intensity was assessed before, during and the following two evenings after arm-cycling. Pressure pain thresholds were assessed before, 15 min after, 105 min after and 24 h after. Results The chronic pain group showed increased pain intensity during, and the following two evenings after the arm cycling, and decreased pain thresholds immediately after the arm cycling involving painful regions. In the patient group there were no impact on pain thresholds in the neck the following day. Conclusions Patients with chronic neck-shoulder pain reported increased pain intensity during and in the evenings after a light dynamic load involving painful regions. In addition, they showed decreased pain thresholds close to the exercise, indicating mechanical hyperalgesia.
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Affiliation(s)
- A Grimby-Ekman
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Postal address: Box 414, 405 30, Gothenburg, Sweden
| | - C Ahlstrand
- Occupational and Environmental Medicine at School of Public Health and community medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - B Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - B Larsson
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - H Sandén
- Occupational and Environmental Medicine at School of Public Health and community medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Abdelaleem SA, Hassan OA, Ahmed RF, Zenhom NM, Rifaai RA, El-Tahawy NF. Tramadol Induced Adrenal Insufficiency: Histological, Immunohistochemical, Ultrastructural, and Biochemical Genetic Experimental Study. J Toxicol 2017; 2017:9815853. [PMID: 29279713 PMCID: PMC5723970 DOI: 10.1155/2017/9815853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/31/2017] [Accepted: 11/07/2017] [Indexed: 11/17/2022] Open
Abstract
Tramadol is a synthetic, centrally acting analgesic. It is the most consumed narcotic drug that is prescribed in the world. Tramadol abuse has dramatically increased in Egypt. Long term use of tramadol can induce endocrinopathy. So, the aim of this study was to analyze the adrenal insufficiency induced by long term use of tramadol in experimental animals and also to assess its withdrawal effects through histopathological and biochemical genetic study. Forty male albino rats were used in this study. The rats were divided into 4 groups (control group, tramadol-treated group, and withdrawal groups). Tramadol was given to albino rats at a dose of 80 mg/kg body weight for 3 months and after withdrawal periods (7-15 days) rats were sacrificed. Long term use of tramadol induced severe histopathological changes in adrenal glands. Tramadol decreased the levels of serum cortisol and DHEAS hormones. In addition, it increased the level of adrenal MDA and decreased the genetic expression of glutathione peroxidase and thioredoxin reductase in adrenal gland tissues. All these changes started to return to normal after withdrawal of tramadol. Thus, it was confirmed that long term use of tramadol can induce severe adrenal insufficiency.
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Affiliation(s)
| | - Osama A. Hassan
- Forensic Medicine & Toxicology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Rasha F. Ahmed
- Biochemistry Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Nagwa M. Zenhom
- Biochemistry Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Rehab A. Rifaai
- Histology Department, Faculty of Medicine, Minia University, Minia, Egypt
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