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Kraus SI, Ferreira JB, França AP, Wippel VA, Leal RB, Oppermann R, Alberton MD, da Silva MD. Pharmacological Evidence of Eugenia Brasiliensis Leaves in a Reserpine-Induced Fibromyalgia Model: Antinociceptive, Emotional, Anti-Inflammatory, and Neurotrophic Effects. Mol Neurobiol 2024:10.1007/s12035-024-04167-8. [PMID: 38639862 DOI: 10.1007/s12035-024-04167-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Abstract
Fibromyalgia (FM) is a painful chronic condition that significantly impacts the quality of life, posing challenges for clinical management. Given the difficulty of understanding the pathophysiology and finding new therapeutics, this study explored the effects of a medicinal plant, E. brasiliensis, in an FM model induced by reserpine in Swiss mice. Animals were treated with saline 0.9% (vehicle), duloxetine 10 mg/kg (positive control), or hydroalcoholic extract of E. brasiliensis leaves 300 mg/kg (HEEb). Nociceptive parameters, as well as locomotion, motor coordination, strength, anxiety, and depressive-like behaviors, were evaluated for 10 days. After that, the brain and blood were collected for further analysis of cytokines (interleukin 1? and interleukin 6), brain-derived neurotrophic factor (BDNF), and the immunocontents of total and phosphorylated Tropomyosin receptor kinase B (TrkB). The results demonstrated that the acute and prolonged treatment with HEEb was able to reduce both mechanical and thermal nociception. It was also possible to observe an increase in the strength, without changing locomotion and motor coordination parameters. Interestingly, treatment with HEEb reduces anxious and depressive-like behaviors. Finally, we observed a reduction in inflammatory cytokines in the hippocampus of animals treated with HEEb, while an increase in BDNF was observed in the prefrontal cortex (PFC). However, no alterations related to total and phosphorylated TrkB receptor expression were found. Our study demonstrated the antinociceptive and emotional effects of HEEb in mice, possibly acting on neuroinflammatory and neurotrophic mechanisms. These data provide initial evidence about the E. brasiliensis potential for treating chronic pain.
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Affiliation(s)
- Scheila Iria Kraus
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center for Biological Sciences, Federal University of Santa Catarina, Trindade, Florian?polis, SC, 88040-900, Brazil
- Post-Graduate Program in Neurosciences, Center for Biological Sciences, Federal University of Santa Catarina, University Campus, Trindade, Florian?polis, SC, 88040-900, Brazil
| | - Jeane Bachi Ferreira
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center for Biological Sciences, Federal University of Santa Catarina, Trindade, Florian?polis, SC, 88040-900, Brazil
- Post-Graduate Program in Neurosciences, Center for Biological Sciences, Federal University of Santa Catarina, University Campus, Trindade, Florian?polis, SC, 88040-900, Brazil
| | - Angela Patricia França
- Signal Transduction Laboratory, Department of Biochemistry, Center for Biological Sciences, Federal University of Santa Catarina, Trindade, Florian?polis, SC, 88040-900, Brazil
- Graduate Program in Medical Sciences, Health Sciences Center (CCS), University Hospital (HU), Federal University of Santa Catarina, Trindade, Florian?polis, SC, 88040-970, Brazil
| | - Vinícius Alexandre Wippel
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center for Biological Sciences, Federal University of Santa Catarina, Trindade, Florian?polis, SC, 88040-900, Brazil
- Post-Graduate Program in Neurosciences, Center for Biological Sciences, Federal University of Santa Catarina, University Campus, Trindade, Florian?polis, SC, 88040-900, Brazil
| | - Rodrigo Bainy Leal
- Signal Transduction Laboratory, Department of Biochemistry, Center for Biological Sciences, Federal University of Santa Catarina, Trindade, Florian?polis, SC, 88040-900, Brazil
- Post-Graduate Program in Neurosciences, Center for Biological Sciences, Federal University of Santa Catarina, University Campus, Trindade, Florian?polis, SC, 88040-900, Brazil
| | - Raquel Oppermann
- Department of Pharmaceutical Sciences, Campus III, Regional University of Blumenau- Rua S?o Paulo 2171, Itoupava Seca, 89030-003, Brazil
| | - Michele Debiasi Alberton
- Department of Pharmaceutical Sciences, Campus III, Regional University of Blumenau- Rua S?o Paulo 2171, Itoupava Seca, 89030-003, Brazil
| | - Morgana Duarte da Silva
- Laboratory of Neurobiology of Pain and Inflammation, Department of Physiological Sciences, Center for Biological Sciences, Federal University of Santa Catarina, Trindade, Florian?polis, SC, 88040-900, Brazil.
- Post-Graduate Program in Neurosciences, Center for Biological Sciences, Federal University of Santa Catarina, University Campus, Trindade, Florian?polis, SC, 88040-900, Brazil.
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Perry R, Whitmarsh A, Leach V, Davies P. A comparison of two assessment tools used in overviews of systematic reviews: ROBIS versus AMSTAR-2. Syst Rev 2021; 10:273. [PMID: 34696810 PMCID: PMC8543959 DOI: 10.1186/s13643-021-01819-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/16/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AMSTAR-2 is a 16-item assessment tool to check the quality of a systematic review and establish whether the most important elements are reported. ROBIS is another assessment tool which was designed to evaluate the level of bias present within a systematic review. Our objective was to compare, contrast and establish both inter-rater reliability and usability of both tools as part of two overviews of systematic reviews. Strictly speaking, one tool assesses methodological quality (AMSTAR-2) and the other assesses risk of bias (ROBIS), but there is considerable overlap between the tools in terms of the signalling questions. METHODS Three reviewers independently assessed 31 systematic reviews using both tools. The inter-rater reliability of all sub-sections using each instrument (AMSTAR-2 and ROBIS) was calculated using Gwet's agreement coefficient (AC1 for unweighted analysis and AC2 for weighted analysis). RESULTS Thirty-one systematic reviews were included. For AMSTAR-2, the median agreement for all questions was 0.61. Eight of the 16 AMSTAR-2 questions had substantial agreement or higher (> 0.61). For ROBIS, the median agreement for all questions was also 0.61. Eleven of the 24 ROBIS questions had substantial agreement or higher. CONCLUSION ROBIS is an effective tool for assessing risk of bias in systematic reviews and AMSTAR-2 is an effective tool at assessing quality. The median agreement between raters for both tools was identical (0.61). Reviews that included a meta-analysis were easier to rate with ROBIS; however, further developmental work could improve its use in reviews without a formal synthesis. AMSTAR-2 was more straightforward to use; however, more response options would be beneficial.
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Affiliation(s)
- R. Perry
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - A. Whitmarsh
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - V. Leach
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - P. Davies
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Tan D, Li G, Lv W, Shao X, Li X, Niu H, Xu Y, Zhang J, Qin L, He Y, Jiang M, Cheng L. Distribution, Metabolism, Excretion and Toxicokinetics of Vitexin in Rats and Dogs. CURR PHARM ANAL 2021. [DOI: 10.2174/1573412917666210809154537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Vitexin is the main bioactive compound of hawthorn (Crataegus pinnatifida),
a famous traditional Chinese medicine, and vitexin for injection is currently in phase I clinical
trial in China.
Objective:
This investigation systematically evaluated the metabolism and toxicokinetics of vitexin
in rats and dogs.
Methods:
Rats and beagle dogs were administrated different doses of vitexin, and then the plasma
concentration, tissue distribution, excretion, metabolism, pharmacokinetics and plasma protein
binding were investigated.
Results :
The elimination half-life (t1/2) values in rats after a single intravenous dose of 3, 15 and 75
mg/kg were estimated as 43.53±10.82, 22.86±4.23, and 21.17±8.64 min, and the values of the area
under the plasma concentration-time curve (AUC0→∞) were 329.34±144.07, 974.79±177.27, and
5251.49±786.98 mg•min/L, respectively. The plasma protein binding rate in rats was determined
as about 65% by equilibrium dialysis after 72 hr. After 24 hr of intravenous administration,
16.30%, 3.47% and 9.72% of the given dose were excreted in urine, feces and bile, respectively.
The metabolites of the vitexin were hydrolyzed via deglycosylation. The pharmacokinetics of dogs
after intravenous administration revealed t1/2, AUC0-∞ and mean residence time (MRT0-∞) values of
20.43±6.37 min, 227.96±26.68 mg•min/L and 17.12±4.33 min, respectively. The no-observed-adverse-
effect level (NOAEL) was 50 mg/kg body weight/day. There was no significant accumulation
effect at 8 or 20 mg/kg/day in dogs over 92 days of repeated administration. For the 50 mg/kg/-
day dose group, the exposure (AUC, Cmax) decreased significantly with prolonged administration.
This trend suggests that repeated administration accelerates vitexin metabolism.
Conclusion:
The absorption of vitexin following routine oral administration was very low. To improve
the bioavailability of vitexin, the development of an injectable formulation would be a suitable
alternative choice.
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Affiliation(s)
- Daopeng Tan
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, School of Pharmacy, Zunyi Medical University, Guizhou 563009, China
| | - Geng Li
- China–Japan Friendship Hospital, Beijing 100029, China
| | - Wenying Lv
- Community Health Service Center of Chaoyangmen, Dongcheng, Beijing 100036, China
| | - Xu Shao
- Hefei Qixing Pharmaceutical Medicine and Technology Co., Ltd.; Hefei 230032, China
| | - Xiaoliang Li
- Hefei Qixing Pharmaceutical Medicine and Technology Co., Ltd.; Hefei 230032, China
| | - Haijun Niu
- Hefei Qixing Pharmaceutical Medicine and Technology Co., Ltd.; Hefei 230032, China
| | - Yaoqing Xu
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, School of Pharmacy, Zunyi Medical University, Guizhou 563009, China
| | - Jianyong Zhang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, School of Pharmacy, Zunyi Medical University, Guizhou 563009, China
| | - Lin Qin
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, School of Pharmacy, Zunyi Medical University, Guizhou 563009, China
| | - Yuqi He
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, School of Pharmacy, Zunyi Medical University, Guizhou 563009, China
| | - Min Jiang
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, School of Pharmacy, Zunyi Medical University, Guizhou 563009, China
| | - Long Cheng
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, School of Pharmacy, Zunyi Medical University, Guizhou 563009, China
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Moore RA, Fisher E, Finn DP, Finnerup NB, Gilron I, Haroutounian S, Krane E, Rice ASC, Rowbotham M, Wallace M, Eccleston C. Cannabinoids, cannabis, and cannabis-based medicines for pain management: an overview of systematic reviews. Pain 2021; 162:S67-S79. [PMID: 32804833 DOI: 10.1097/j.pain.0000000000001941] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023]
Abstract
ABSTRACT Cannabinoids, cannabis, and cannabis-based medicines (CBM) are increasingly used to manage pain, with limited understanding of their efficacy and safety. We assessed methodological quality, scope, and results of systematic reviews of randomised controlled trials of these treatments. Several search strategies sought self-declared systematic reviews. Methodological quality was assessed using both AMSTAR-2 and techniques important for bias reduction in pain studies. Of the 106 articles read, 57 were self-declared systematic reviews, most published since 2010. They included any type of cannabinoid, cannabis, or CBM, at any dose, however administered, in a broad range of pain conditions. No review examined the effects of a particular cannabinoid, at a particular dose, using a particular route of administration, for a particular pain condition, reporting a particular analgesic outcome. Confidence in the results in the systematic reviews using AMSTAR-2 definitions was critically low (41), low (8), moderate (6), or high (2). Few used criteria important for bias reduction in pain. Cochrane reviews typically provided higher confidence; all industry-conflicted reviews provided critically low confidence. Meta-analyses typically pooled widely disparate studies, and, where assessable, were subject to potential publication bias. Systematic reviews with positive or negative recommendation for use of cannabinoids, cannabis, or CBM in pain typically rated critically low or low (24/25 [96%] positive; 10/12 [83%] negative). Current reviews are mostly lacking in quality and cannot provide a basis for decision-making. A new high-quality systematic review of randomised controlled trials is needed to critically assess the clinical evidence for cannabinoids, cannabis, or CBM in pain.
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Affiliation(s)
| | - Emma Fisher
- Centre for Pain Research, University of Bath, Bath, United Kingdom
- Cochrane Pain, Palliative, and Supportive Care Review Groups, Oxford University Hospitals, Oxford, United Kingdom
| | - David P Finn
- Pharmacology and Therapeutics, School of Medicine, Galway Neuroscience Centre and Centre for Pain Research, NCBES, National University of Ireland Galway, Galway, Ireland
| | - Nanna B Finnerup
- Department of Clinical Medicine, Danish Pain Research Center, Aarhus University, Aarhus, Denmark
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Ian Gilron
- Department of Anesthesiology and Perioperative Medicine, Kingston General Hospital and Queen's University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
- School of Policy Studies, Queen's University, Kingston, ON, Canada
| | - Simon Haroutounian
- Division of Clinical and Translational Research, Washington University Pain Center, St. Louis, MO, United States
- Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, United States
| | - Elliot Krane
- Department of Anesthesiology, Perioperative and Pain Medicine, and Pediatrics, Stanford University School of Medicine, Stanford, Palo Alto, CA, United States
| | - Andrew S C Rice
- Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, United Kingdom
| | - Michael Rowbotham
- Department of Anesthesia, Pain Management Center, University of California San Francisco, San Francisco, CA, United Kingdom
- Sutter Health, CPMC Research Institute, California Pacific Medical Center Research Institute, San Francisco, CA, United States
| | - Mark Wallace
- Division of Pain Medicine, Department of Anesthesiology, University of California San Diego, San Diego, CA, United States
| | - Christopher Eccleston
- Centre for Pain Research, University of Bath, Bath, United Kingdom
- Cochrane Pain, Palliative, and Supportive Care Review Groups, Oxford University Hospitals, Oxford, United Kingdom
- Department of Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Maffei ME. Fibromyalgia: Recent Advances in Diagnosis, Classification, Pharmacotherapy and Alternative Remedies. Int J Mol Sci 2020; 21:E7877. [PMID: 33114203 PMCID: PMC7660651 DOI: 10.3390/ijms21217877] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
Fibromyalgia (FM) is a syndrome that does not present a well-defined underlying organic disease. FM is a condition which has been associated with diseases such as infections, diabetes, psychiatric or neurological disorders, rheumatic pathologies, and is a disorder that rather than diagnosis of exclusion requires positive diagnosis. A multidimensional approach is required for the management of FM, including pain management, pharmacological therapies, behavioral therapy, patient education, and exercise. The purpose of this review is to summarize the recent advances in classification criteria and diagnostic criteria for FM as well as to explore pharmacotherapy and the use of alternative therapies including the use of plant bioactive molecules.
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Affiliation(s)
- Massimo E Maffei
- Department of Life Sciences and Systems Biology, University of Turin, 10135 Turin, Italy
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Abstract
Fibromyalgia is characterized by chronic, widespread musculoskeletal pain and associated fatigue, sleep disturbances, and other cognitive and somatic symptoms. For many patients, these symptoms persist for years and lead to frequent health care use; for some, fibromyalgia and its symptoms can be debilitating. Although many treatments are available, management remains challenging. This article highlights the clinical features of fibromyalgia, discusses diagnostic criteria and their evolution, and reviews treatment options.
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Affiliation(s)
- Matthew J Bair
- Richard L. Roudebush VA Medical Center, Indianapolis, Indiana (M.J.B.)
| | - Erin E Krebs
- Minneapolis VA Health Care System, Minneapolis, Minnesota (E.E.K.)
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Montero-Oleas N, Arevalo-Rodriguez I, Nuñez-González S, Viteri-García A, Simancas-Racines D. Therapeutic use of cannabis and cannabinoids: an evidence mapping and appraisal of systematic reviews. BMC Complement Med Ther 2020; 20:12. [PMID: 32020875 PMCID: PMC7076827 DOI: 10.1186/s12906-019-2803-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 12/22/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although cannabis and cannabinoids are widely used with therapeutic purposes, their claimed efficacy is highly controversial. For this reason, medical cannabis use is a broad field of research that is rapidly expanding. Our objectives are to identify, characterize, appraise, and organize the current available evidence surrounding therapeutic use of cannabis and cannabinoids, using evidence maps. METHODS We searched PubMed, EMBASE, The Cochrane Library and CINAHL, to identify systematic reviews (SRs) published from their inception up to December 2017. Two authors assessed eligibility and extracted data independently. We assessed methodological quality of the included SRs using the AMSTAR tool. To illustrate the extent of use of medical cannabis, we organized the results according to identified PICO questions using bubble plots corresponding to different clinical scenarios. RESULTS A total of 44 SRs published between 2001 and 2017 were included in this evidence mapping with data from 158 individual studies. We extracted 96 PICO questions in the following medical conditions: multiple sclerosis, movement disorders (e.g. Tourette Syndrome, Parkinson Disease), psychiatry conditions, Alzheimer disease, epilepsy, acute and chronic pain, cancer, neuropathic pain, symptoms related to cancer (e.g. emesis and anorexia related with chemotherapy), rheumatic disorders, HIV-related symptoms, glaucoma, and COPD. The evidence about these conditions is heterogeneous regarding the conclusions and the quality of the individual primary studies. The quality of the SRs was moderate to high according to AMSTAR scores. CONCLUSIONS Evidence on medical uses of cannabis is broad. However, due to methodological limitations, conclusions were weak in most of the assessed comparisons. Evidence mapping methodology is useful to perform an overview of available research, since it is possible to systematically describe the extent and distribution of evidence, and to organize scattered data.
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Affiliation(s)
- Nadia Montero-Oleas
- Centro de investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE, Quito, Ecuador.
| | - Ingrid Arevalo-Rodriguez
- Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS), CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Solange Nuñez-González
- Centro de investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE, Quito, Ecuador
| | - Andrés Viteri-García
- Centro de investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE, Quito, Ecuador
| | - Daniel Simancas-Racines
- Centro de investigación en Salud Pública y Epidemiología Clínica (CISPEC). Facultad de Ciencias de la Salud "Eugenio Espejo", Universidad UTE, Quito, Ecuador
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Evcik D, Ketenci A, Sindel D. The Turkish Society of Physical Medicine and Rehabilitation (TSPMR) guideline recommendations for the management of fibromyalgia syndrome. Turk J Phys Med Rehabil 2019; 65:111-123. [PMID: 31453551 PMCID: PMC6706830 DOI: 10.5606/tftrd.2019.4815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 05/23/2019] [Indexed: 11/21/2022] Open
Abstract
In the present study, we aimed to establish a national guideline including recommendations of the Turkish Society of Physical Medicine and Rehabilitation (TSPMR) for the management of Fibromyalgia (FM) syndrome. This guideline was built mainly in accordance with the 2017 revised European League Against Rheumatism (EULAR) guideline recommendations for the management of FM. A total of 46 physical medicine and rehabilitation specialists were included. A systematic literature search was carried out in PubMed, Scopus, Cochrane, and Turkish Medical Index between 2000 and 2018. Evidence levels of the publications were evaluated, and the levels of recommendation were graded on the basis of relevant levels of evidence, The Assessment of Level of Agreement with opinions by task force members was established using the electronic Delphi technique. Recommendations were assessed by two Delphi rounds and 7 of 10 points were deemed necessary for agreement. The treatment recommendations were classified as non-pharmacological therapies (6 main items), pharmacological treatments (10 items), and complementary therapies (5 items). These were recommended in the light of evidence, depending on the clinical and general condition of each patient. This is the first national TSPMR guideline recommendations for the management of FM in Turkey. We believe our effort would be helpful for the physicians who are interested in the treatment of FM.
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Affiliation(s)
- Deniz Evcik
- Department of Physical Medicine and Rehabilitation, Guven Hospital, Ankara, Turkey
| | - Ayşegül Ketenci
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Dilşad Sindel
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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Contreras T, Bravo-Soto G, Rada G. Do cannabinoids constitute a therapeutic alternative for insomnia? Medwave 2018; 18:e7152. [PMID: 29474349 DOI: 10.5867/medwave.2018.01.7151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 12/31/2017] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION It has been suggested that cannabinoids would constitute a therapeutic alternative for patients with insomnia. METHODS To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified eight systematic reviews including three studies overall, of which two were randomized trials. We concluded it is not clear whether cannabinoids have an effect on insomnia severity or on sleep quality; that they might have no effect on sleep conciliation, sleep awakening or behavior during wakefulness, and are probably associated with frequent adverse effects.
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Affiliation(s)
- Tania Contreras
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile
| | - Gonzalo Bravo-Soto
- Proyecto Epistemonikos, Santiago, Chile; Centro Evidencia UC, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gabriel Rada
- Proyecto Epistemonikos, Santiago, Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Centro Evidencia UC, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; The Cochrane Collaboration; GRADE working group. . Address: Centro Evidencia UC, Pontificia Universidad Católica de Chile, Centro de Innovación UC Anacleto Angelini, Avda. Vicuña Mackenna 4860, Macul, Santiago, Chile
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Shakiba M, Moazen-Zadeh E, Noorbala AA, Jafarinia M, Divsalar P, Kashani L, Shahmansouri N, Tafakhori A, Bayat H, Akhondzadeh S. Saffron ( Crocus sativus) versus duloxetine for treatment of patients with fibromyalgia: A randomized double-blind clinical trial. AVICENNA JOURNAL OF PHYTOMEDICINE 2018; 8:513-523. [PMID: 30456199 PMCID: PMC6235666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Saffron was found efficient and safe in treatment of neuropsychiatric disorders, in particular depression. We compared the efficacy of saffron with duloxetine in treatment of patients with fibromyalgia. MATERIALS AND METHODS In this double-blind parallel-group clinical trial, outpatients with fibromyalgia were randomized to receive either saffron 15 mg or duloxetine 30 mg starting with 1 capsule per day in the first week followed by 2 capsules per day from week 2 until the end of week 8. Participants were men and women aged 18-60 years diagnosed with fibromyalgia based on the American College of Rheumatology 2010 criteria who also had a pain score≥40 based on visual analogue scale. Participants were excluded in case they had rheumatologic diseases, inflammatory/infectious/autoimmune arthritis, comorbid neuropsychiatric disorders except depressive disorders, pain due to traumatic injuries, drug history of duloxetine or saffron use, current use of psychoactive medications, recent use of muscle relaxants, steroids, opioid analgesics, benzodiazepines, anti-epileptics, or injective analgesics. Primary outcomes included differences in mean score changes from baseline to endpoint between the treatment arms for Hamilton Rating Scale for Depression, Fibromyalgia Impact Questionnaire, and Brief Pain Inventory. RESULTS Socio-demographic characteristics and baseline scores were similarly distributed between the two treatment arms (2n=46). No significant difference was detected for any of the scales neither in terms of score changes from baseline to endpoint between the two treatment arms (Mean score changes: -4.26 to 2.37; p-values: 0.182-0.900) nor in terms of timetreatment interactions (p-values: 0.209-0.964). CONCLUSIONS Saffron and duloxetine demonstrated comparable efficacy in treatment of fibromyalgia symptoms.
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Affiliation(s)
- Mansoor Shakiba
- Psychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran ,Equal first author
| | - Ehsan Moazen-Zadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran ,Equal first author
| | - Ahmad Ali Noorbala
- Psychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Jafarinia
- Psychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Divsalar
- Psychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Kashani
- Infertility Ward, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Shahmansouri
- Psychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Neurology Ward, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hannaneh Bayat
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran ,Corresponding Author: Tel: +98 21-88281866, Fax: +98 21-55419113,
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Oliveira MA, Guimarães AG, Araújo AAS, Quintans-Júnior LJ, Quintans JSS. New drugs or alternative therapy to blurring the symptoms of fibromyalgia-a patent review. Expert Opin Ther Pat 2017; 27:1147-1157. [PMID: 28665159 DOI: 10.1080/13543776.2017.1349105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Fibromyalgia (FM) is a musculoskeletal condition characterized by chronic widespread pain, tenderness and often accompanied by other comorbid conditions such as depression, anxiety, chronic fatigue, among others. Now, we aimed to survey the recent patents describing new drugs or alternative therapy for FM. Areas covered: This review covers the therapeutic patents published between 2010 and 2017 from specialized search databases (WIPO, DERWENT, INPI, ESPANET and USPTO) that report the discovery of new drugs or pharmacologic alternative for the treatment of FM. Expert opinion: New therapeutic substances have been proposed in the last seven years. At least as it has been found in our survey, most are still in the pre-clinical phase of the study, and its clinical applicability is unclear. However, other therapeutic approaches were found in patents such as well-established drugs in the market in combination or drug repositioning that combines the 'new analgesic' effects with the old side effects. Hence, it is a safe approach for pharmaceutical market, but poorer to patients who need a radical innovation. So, there is the emerging need for further studies on the safety and efficacy of such therapeutic measures and the search for improvement of side effects, as well as the development of new drugs that are unorthodox for different FM symptoms.
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Affiliation(s)
- Marlange A Oliveira
- a Multiuser Center for Health (CMulti-Saúde) , Federal University of Sergipe , Sergipe , Brazil
| | - Adriana G Guimarães
- b Departament of Health Education , Federal University of Sergipe , Sergipe , Brazil
| | - Adriano A S Araújo
- a Multiuser Center for Health (CMulti-Saúde) , Federal University of Sergipe , Sergipe , Brazil
| | | | - Jullyana S S Quintans
- a Multiuser Center for Health (CMulti-Saúde) , Federal University of Sergipe , Sergipe , Brazil
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Favero G, Trapletti V, Bonomini F, Stacchiotti A, Lavazza A, Rodella LF, Rezzani R. Oral Supplementation of Melatonin Protects against Fibromyalgia-Related Skeletal Muscle Alterations in Reserpine-Induced Myalgia Rats. Int J Mol Sci 2017; 18:ijms18071389. [PMID: 28661421 PMCID: PMC5535882 DOI: 10.3390/ijms18071389] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/19/2017] [Accepted: 06/27/2017] [Indexed: 12/11/2022] Open
Abstract
Fibromyalgia is a chronic syndrome characterized by widespread musculoskeletal pain and an extensive array of other symptoms including disordered sleep, fatigue, depression and anxiety. Important factors involved in the pathogenic process of fibromyalgia are inflammation and oxidative stress, suggesting that ant-inflammatory and/or antioxidant supplementation might be effective in the management and modulation of this syndrome. Recent evidence suggests that melatonin may be suitable for this purpose due to its well known ant-inflammatory, antioxidant and analgesic effects. Thus, in the current study, the effects of the oral supplementation of melatonin against fibromyalgia-related skeletal muscle alterations were evaluated. In detail, 90 Sprague Dawley rats were randomly treated with reserpine, to reproduce the pathogenic process of fibromyalgia and thereafter they received melatonin. The animals treated with reserpine showed moderate alterations at hind limb skeletal muscles level and had difficulty in moving, together with significant morphological and ultrastructural alterations and expression of inflammatory and oxidative stress markers in the gastrocnemius muscle. Interestingly, melatonin, dose and/or time dependently, reduced the difficulties in spontaneous motor activity and the musculoskeletal morphostructural, inflammatory, and oxidative stress alterations. This study suggests that melatonin in vivo may be an effective tool in the management of fibromyalgia-related musculoskeletal morphofunctional damage.
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Affiliation(s)
- Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Valentina Trapletti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Francesca Bonomini
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Alessandra Stacchiotti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Antonio Lavazza
- OIE Reference Laboratory for RHD, Istituto Zooprofilattico Sperimentale della Lombardia e Emilia Romagna, 25124 Brescia, Italy.
| | - Luigi Fabrizio Rodella
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
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Perry R, Leach V, Davies P, Penfold C, Ness A, Churchill R. An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools. Syst Rev 2017; 6:97. [PMID: 28506257 PMCID: PMC5433031 DOI: 10.1186/s13643-017-0487-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/25/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) is a chronic, debilitating pain disorder. Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine (CAM). Two previous overviews of systematic reviews of CAM for FM have been published, but they did not assessed for risk of bias in the review process. METHODS Five databases Medline, Embase, AMED (via OVID), Web of Science and Central were searched from their inception to December 2015. Reference lists were hand-searched. We had two aims: the first was to provide an up-to-date and rigorously conducted synthesis of systematic reviews of CAM literature on FM; the second was to evaluate the quality of the available systematic review evidence using two different tools: AMSTAR (Shea et al. BMC Med Res Methodol 15; 7:10, 2007) and a more recently developed tool ROBIS (Whiting et al. J Clin Epidemiol 69:225-34, 2016) specifically designed to assess risk of bias in systematic reviews. Any review that assessed one of eight CAM therapies for participants diagnosed with FM was considered. The individual studies had to be randomised controlled trials where the intervention was compared to placebo, treatment as usual or waitlist controls to be included. The primary outcome measure was pain, and the secondary outcome measure was adverse events. RESULTS We identified 15 reviews that met inclusion criteria. There was low-quality evidence that acupuncture improves pain compared to no treatment or standard treatment, but good evidence that it is no better than sham acupuncture. The evidence for homoeopathy, spinal manipulation and herbal medicine was limited. CONCLUSIONS Overall, five reviews scored 6 or above using the AMSTAR scale and the inter-rater agreement was good (83.6%), whereas seven reviews achieved a low risk of bias rating using ROBIS and the inter-rater agreement was fair (60.0%). No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM. There is limited evidence for topical Capsicum, but further research is required. There is some evidence to support the effectiveness of acupuncture for FM, but further high-quality trials are needed to investigate its benefits, harms and mechanisms of action, compared with no or standard treatment. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016035846 .
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Affiliation(s)
| | | | | | | | - Andy Ness
- University of Bristol, Bristol, England
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Quintans-Júnior LJ, Brito RG, Quintans JSS, Santos PL, Camargo ZT, Barreto PA, Arrigoni-Blank MF, Lucca-Júnior W, Scotti L, Scotti MT, Kolker SJ, Sluka KA. Nanoemulsion Thermoreversible Pluronic F127-Based Hydrogel Containing Hyptis pectinata (Lamiaceae) Leaf Essential Oil Produced a Lasting Anti-hyperalgesic Effect in Chronic Noninflammatory Widespread Pain in Mice. Mol Neurobiol 2017; 55:1665-1675. [PMID: 28194646 DOI: 10.1007/s12035-017-0438-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/03/2017] [Indexed: 01/12/2023]
Abstract
We evaluated if a nanostructured thermoreversible Pluronic F127-based hydrogel incorporated with Hyptis pectinata leaf essential oil (NE-EOH) produces a long-lasting anti-hyperalgesic effect on chronic muscle pain in an animal model. We induced chronic muscle pain by injecting the gastrocnemius with saline injections. Paw and muscle withdrawal thresholds and motor performance were evaluated after treatment and compared with morphine, diazepam, or vehicle. Naloxone and methysergide administration tested the involvement of opioid and serotonin receptors, respectively. Sites of action in the central nervous system for the NE-EOH were examined by measuring substance P (SP) levels in the spinal cord and Fos protein in the brainstem. NE-EOH increased paw and muscle withdrawal thresholds when compared with vehicle but had no effect on motor function. This analgesic effect was reversed by both naloxone and methysergide. NE-EOH decreased elevated substance P levels and reduced Fos-labeled neurons in the spinal cord and increased the number of Fos-labeled neurons in the periaqueductal gray (PAG), nucleus raphe magnus (NRM), and locus coeruleus (LC). NE-EOH was shown to produce a lasting anti-hyperalgesic effect. It uses opioid and serotonin receptors, activates brainstem inhibitory pathways, and reduces the release of excitatory neurotransmitters in the spinal cord and is a substance with potential to be used in the treatment of noninflammatory pain conditions. Graphical Abstract.
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Affiliation(s)
- Lucindo J Quintans-Júnior
- Department of Physiology (DFS), Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe (UFS), Av. Marechal Rondom, s/n, São Cristóvão, SE, Brazil.
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa (UI), Iowa City, IA, USA.
| | - Renan G Brito
- Department of Physiology (DFS), Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe (UFS), Av. Marechal Rondom, s/n, São Cristóvão, SE, Brazil
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa (UI), Iowa City, IA, USA
| | - Jullyana S S Quintans
- Department of Physiology (DFS), Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe (UFS), Av. Marechal Rondom, s/n, São Cristóvão, SE, Brazil
| | - Priscila L Santos
- Department of Physiology (DFS), Laboratory of Neuroscience and Pharmacological Assays (LANEF), Federal University of Sergipe (UFS), Av. Marechal Rondom, s/n, São Cristóvão, SE, Brazil
| | - Zaine T Camargo
- Department of Chemistry, Federal University of Sergipe (UFS), São Cristóvão, SE, Brazil
| | - Péricles A Barreto
- Department of Chemistry, Federal University of Sergipe (UFS), São Cristóvão, SE, Brazil
| | | | - Waldecy Lucca-Júnior
- Department of Morphology, Federal University of Sergipe (UFS), São Cristóvão, SE, Brazil
| | - Luciana Scotti
- Department of Chemistry, Federal University of Paraíba (UFPB), João Pessoa, PB, Brazil
| | - Marcus T Scotti
- Department of Chemistry, Federal University of Paraíba (UFPB), João Pessoa, PB, Brazil
| | - Sandra J Kolker
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa (UI), Iowa City, IA, USA
| | - Kathleen A Sluka
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa (UI), Iowa City, IA, USA
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Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, Choy E, Kosek E, Amris K, Branco J, Dincer F, Leino-Arjas P, Longley K, McCarthy GM, Makri S, Perrot S, Sarzi-Puttini P, Taylor A, Jones GT. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2016; 76:318-328. [PMID: 27377815 DOI: 10.1136/annrheumdis-2016-209724] [Citation(s) in RCA: 702] [Impact Index Per Article: 87.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/10/2016] [Accepted: 06/14/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were 'expert opinion'. METHODS A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pharmacological/non-pharmacological management for fibromyalgia. A review, in May 2015, identified eligible publications and key outcomes assessed were pain, fatigue, sleep and daily functioning. The Grading of Recommendations Assessment, Development and Evaluation system was used for making recommendations. RESULTS 2979 titles were identified: from these 275 full papers were selected for review and 107 reviews (and/or meta-analyses) evaluated as eligible. Based on meta-analyses, the only 'strong for' therapy-based recommendation in the guidelines was exercise. Based on expert opinion, a graduated approach, the following four main stages are suggested underpinned by shared decision-making with patients. Initial management should involve patient education and focus on non-pharmacological therapies. In case of non-response, further therapies (all of which were evaluated as 'weak for' based on meta-analyses) should be tailored to the specific needs of the individual and may involve psychological therapies (for mood disorders and unhelpful coping strategies), pharmacotherapy (for severe pain or sleep disturbance) and/or a multimodal rehabilitation programme (for severe disability). CONCLUSIONS These recommendations are underpinned by high-quality reviews and meta-analyses. The size of effect for most treatments is relatively modest. We propose research priorities clarifying who will benefit from specific interventions, their effect in combination and organisation of healthcare systems to optimise outcome.
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Affiliation(s)
- G J Macfarlane
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - C Kronisch
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.,Department of Rheumatology, Cantonal Hospital, Fribourg, Switzerland
| | - L E Dean
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - F Atzeni
- ICRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - W Häuser
- Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany.,Department of Psychosomatic Medicine, Technische Universität München, München, Germany
| | - E Fluß
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - E Choy
- Section of Rheumatology, Institute of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - E Kosek
- Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Spine Centre, Stockholm, Sweden
| | - K Amris
- Department of Rheumatology, Bispebjerg and Frederiksberg, The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
| | - J Branco
- Rheumatology Department, CEDOC-NOVA Medical School, UNL, CHLO, Hospital Egas Moniz, Lisbon, Portugal
| | - F Dincer
- Hacettepe University Division of Internal Medicine, Department of Physical and Rehabilitation Medicine, Ankara, Turkey
| | - P Leino-Arjas
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - G M McCarthy
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - S Makri
- Patient Representative, Limassol, Cyprus
| | - S Perrot
- Centre de la Douleur, Hôpital Cochin-Hôtel Dieu, Université Paris Descartes, Paris, France
| | - P Sarzi-Puttini
- Rheumatology Unit, L. Sacco University Hospital, Milan, Italy
| | - A Taylor
- Institute of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - G T Jones
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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16
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Quintans-Júnior LJ, Araújo AA, Brito RG, Santos PL, Quintans JS, Menezes PP, Serafini MR, Silva GF, Carvalho FM, Brogden NK, Sluka KA. β-caryophyllene, a dietary cannabinoid, complexed with β-cyclodextrin produced anti-hyperalgesic effect involving the inhibition of Fos expression in superficial dorsal horn. Life Sci 2016; 149:34-41. [DOI: 10.1016/j.lfs.2016.02.049] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 12/23/2022]
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Lauche R, Cramer H, Häuser W, Dobos G, Langhorst J. A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:610615. [PMID: 26246841 PMCID: PMC4515506 DOI: 10.1155/2015/610615] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/26/2015] [Indexed: 01/08/2023]
Abstract
Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM) for the fibromyalgia syndrome (FMS). Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG) biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG) biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.
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Affiliation(s)
- Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany
| | - Winfried Häuser
- Department of Internal Medicine 1, Klinikum Saarbrücken, 66119 Saarbrücken, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Munich University of Technology (TUM), 81865 München, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276 Essen, Germany
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Sospeter NN, Meshack AO, Silas MN, Samwel NO, John MN, Paul KK. Antituberculous, antimicrobial, cytotoxicity and phytochemical activity study of Piliostigma thonningii extract fractions. ACTA ACUST UNITED AC 2015. [DOI: 10.5897/jmpr2015.5822] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Nascimento SS, Araújo AAS, Brito RG, Serafini MR, Menezes PP, DeSantana JM, Lucca W, Alves PB, Blank AF, Oliveira RCM, Oliveira AP, Albuquerque RLC, Almeida JRGS, Quintans LJ. Cyclodextrin-complexed Ocimum basilicum leaves essential oil increases Fos protein expression in the central nervous system and produce an antihyperalgesic effect in animal models for fibromyalgia. Int J Mol Sci 2014; 16:547-63. [PMID: 25551603 PMCID: PMC4307262 DOI: 10.3390/ijms16010547] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 12/08/2014] [Indexed: 12/11/2022] Open
Abstract
O. basilicum leaves produce essential oils (LEO) rich in monoterpenes. The short half-life and water insolubility are limitations for LEO medical uses. β-Cyclodextrin (β-CD) has been employed to improve the pharmacological properties of LEO. We assessed the antihyperalgesic profile of LEO, isolated or complexed in β-CD (LEO/β-CD), on an animal model for fibromyalgia. Behavioral tests: mice were treated every day with either LEO/β-CD (25, 50 or 100 mg/kg, p.o.), LEO (25 mg/kg, p.o.), tramadol (TRM 4 mg/kg, i.p.) or vehicle (saline), and 60 min after treatment behavioral parameters were assessed. Therefore, mice were evaluated for mechanical hyperalgesia (von Frey), motor coordination (Rota-rod) and muscle strength (Grip Strength Metter) in a mice fibromyalgia model. After 27 days, we evaluated the central nervous system (CNS) pathways involved in the effect induced by experimental drugs through immunofluorescence protocol to Fos protein. The differential scanning analysis (DSC), thermogravimetry/derivate thermogravimetry (TG/DTG) and infrared absorption spectroscopy (FTIR) curves indicated that the products prepared were able to incorporate the LEO efficiently. Oral treatment with LEO or LEO-βCD, at all doses tested, produced a significant reduction of mechanical hyperalgesia and we were able to significantly increase Fos protein expression. Together, our results provide evidence that LEO, isolated or complexed with β-CD, produces analgesic effects on chronic non-inflammatory pain as fibromyalgia.
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Affiliation(s)
- Simone S Nascimento
- Laboratory of Pre-Clinical Pharmacology (LAPEC), Department of Physiology, Federal University of Sergipe, Av. Tancredo Neves, S/N, Rosa Elza, CEP: 49.000-100, São Cristóvão, Sergipe 49.100-000, Brazil.
| | - Adriano A S Araújo
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe 49.100-000, Brazil.
| | - Renan G Brito
- Laboratory of Pre-Clinical Pharmacology (LAPEC), Department of Physiology, Federal University of Sergipe, Av. Tancredo Neves, S/N, Rosa Elza, CEP: 49.000-100, São Cristóvão, Sergipe 49.100-000, Brazil.
| | - Mairim R Serafini
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe 49.100-000, Brazil.
| | - Paula P Menezes
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão, Sergipe 49.100-000, Brazil.
| | - Josimari M DeSantana
- Department of Physical Therapy, Federal University of Sergipe, Aracaju, Sergipe 49.060-108, Brazil.
| | - Waldecy Lucca
- Department of Morphology, Federal University of Sergipe, São Cristóvão, Sergipe 49.100-000, Brazil.
| | - Pericles B Alves
- Department of Chemistry, Federal University of Sergipe, São Cristóvão, Sergipe 49.100-000, Brazil.
| | - Arie F Blank
- Department of Agronomic Engineering, Federal University of Sergipe, São Cristóvão, Sergipe 49.100-000, Brazil.
| | - Rita C M Oliveira
- Medicinal Plants Research Center, Federal University of Piauí, Teresina, Piauí 64.049-550, Brazil.
| | - Aldeidia P Oliveira
- Medicinal Plants Research Center, Federal University of Piauí, Teresina, Piauí 64.049-550, Brazil.
| | - Ricardo L C Albuquerque
- Institute of Technology and Research, University Tiradentes, Aracaju, Sergipe 49.032-490, Brazil.
| | - Jackson R G S Almeida
- Department of Pharmacy, Federal University of San Francisco Valley, Petrolina, Pernambuco 56.304-917, Brazil.
| | - Lucindo J Quintans
- Laboratory of Pre-Clinical Pharmacology (LAPEC), Department of Physiology, Federal University of Sergipe, Av. Tancredo Neves, S/N, Rosa Elza, CEP: 49.000-100, São Cristóvão, Sergipe 49.100-000, Brazil.
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20
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Nascimento SS, Camargo EA, DeSantana JM, Araújo AAS, Menezes PP, Lucca-Júnior W, Albuquerque-Júnior RLC, Bonjardim LR, Quintans-Júnior LJ. Linalool and linalool complexed in β-cyclodextrin produce anti-hyperalgesic activity and increase Fos protein expression in animal model for fibromyalgia. Naunyn Schmiedebergs Arch Pharmacol 2014; 387:935-42. [PMID: 24958161 DOI: 10.1007/s00210-014-1007-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 06/09/2014] [Indexed: 01/01/2023]
Abstract
The analgesic activity of (-)-linalool (LIN), a monoterpene present in essential oils of Lamiaceae species, has been previously demonstrated in rodents. However, its possible use in the treatment of fibromyalgia (FM) was never demonstrated. Additionally, as a short half-life is a limitation for the LIN medicinal application, the employment of drug delivery systems has been used to improve pharmaceutical properties of this compound. We investigated the anti-nociceptive effect of LIN, isolated or in β-cyclodextrin complex (LIN-CD), in an animal model of chronic non-inflammatory muscle pain (a FM animal model), as well as its effect on the central nervous system (CNS). Male Swiss mice were subjected to two injections of acidic saline (pH 4; 20 μL/gastrocnemius) and were treated on alternate days, with LIN-CD (25 mg/kg, p.o.), LIN (25 mg/kg, p.o.), tramadol (TRM 4 mg/kg, i.p.), or vehicle (neutral saline). After 60 min, they were screened for mechanical hyperalgesia (von Frey), motor coordination (rotarod), and muscle strength (grip strength meter) for 27 days. The CNS areas involved in the anti-hyperalgesic activity were evaluated by immunofluorescence. LIN or LIN-CD produced a significant reduction (p < 0.001) of mechanical hyperalgesia on chronic non-inflammatory muscle pain model, which remained for 24 h only in LIN-CD, and these compounds significantly (p < 0.05) activated neurons of the locus coeruleus, nucleus raphe magnus, and periaqueductal gray areas. So, our results suggest that LIN-CD improved analgesic profile of LIN, with a probable involvement of descending pain pathways and the anti-nociceptive effect of linalool in an animal model of chronic non-inflammatory muscle pain. So far, only the investigations in animal models of inflammatory pain and supraspinatus were published.
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Affiliation(s)
- Simone S Nascimento
- Department of Physiology, Federal University of Sergipe (DFS/UFS), Av. Marechal Rondom, s/n, São Cristóvão, SE, Brazil
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