1
|
Mittinty MM, Lee JY, Walton DM, El-Omar EM, Elliott JM. Integrating the Gut Microbiome and Stress-Diathesis to Explore Post-Trauma Recovery: An Updated Model. Pathogens 2022; 11:pathogens11070716. [PMID: 35889962 PMCID: PMC9323039 DOI: 10.3390/pathogens11070716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/10/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Musculoskeletal conditions of traumatic and non-traumatic origin represent an ongoing health challenge. While the last three decades have seen significant advancement in our understanding of musculoskeletal conditions, the mechanisms of a delayed or lack of recovery are still a mystery. Here, we present an expansion of the integrated stress-diathesis model through the inclusion of the gut microbiome. Connecting the microbiome with known adverse neurobiologic, microbiologic and pathophysiologic sequelae following an injury, trauma or stressful event may help improve our knowledge of the pathogenesis of poor recovery. Such knowledge could provide a foundation for the exploration and development of more effective interventions to prevent the transition from acute to chronic pain.
Collapse
Affiliation(s)
- Manasi Murthy Mittinty
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2065, Australia
- Correspondence: ; Tel.: +61-2-9463-1516
| | - Joshua Y. Lee
- School of Physical Therapy, Western University, London, ON N6G 1H1, Canada; (J.Y.L.); (D.M.W.)
| | - David M. Walton
- School of Physical Therapy, Western University, London, ON N6G 1H1, Canada; (J.Y.L.); (D.M.W.)
| | - Emad M. El-Omar
- UNSW Microbiome Research Centre, St George and Sutherland Clinical Campuses, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia;
| | - James M. Elliott
- School of Health Sciences, Faculty of Medicine and Health, The Kolling Institute, The University of Sydney, Sydney, NSW 2065, Australia;
- The Northern Sydney Local Health District, Sydney, NSW 2006, Australia
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| |
Collapse
|
2
|
Fernandes PF, Galassi TDO, Horewicz VV, Salgado ASI, Mack JM, Baldança HDS, Ferreira da Silva AP, Bruehl S, Bittencourt EB, Seim LA, Martins DF, Bobinski F. Immunoregulatory Effect of Preventive Supplementation of Omega-3 Fatty Acid in a Complex Regional Pain Syndrome Type I Model in Mice. Front Integr Neurosci 2022; 16:818692. [PMID: 35391753 PMCID: PMC8980433 DOI: 10.3389/fnint.2022.818692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/18/2022] [Indexed: 12/19/2022] Open
Abstract
ObjectiveComplex regional pain syndrome (CRPS) is usually triggered by trauma or a surgical procedure, and it typically becomes an established one after an intense inflammatory process with chronic pain and edema as the main symptoms. Available treatments for CRPS have low efficacy. This study aimed to evaluate the clinical and immunoregulatory effects of omega-3 polyunsaturated fatty acid (PUFA) supplementation on paw edema and anti- and pro-inflammatory cytokines and macrophage phenotypes in the chronic post-ischemia pain (CPIP) preclinical model of CRPS-Type I.MethodsFemale Swiss mice were supplemented with omega-3, corn oil, or saline and then submitted to the CPIP model of ischemia/reperfusion (I/R) injury. Supplementation was carried out for 30 days prior to and up to 2 or 15 days after the induction of CPIP, according to experimental protocols. The supplementation protocol included 1,500 mg/kg of omega-3 or corn oil through an intragastric route (gavage). Paw edema, interleukin- (IL-) 4, IL-10, transforming growth factor-β1 (TGF-β1), monocyte chemotactic protein-1 (MCP-1), and tumor necrosis factor (TNF) were then measured in the paw skin and muscle by enzyme-linked immunosorbent assay (ELISA), and macrophage phenotypes (M1 and M2) assessed in the paw muscle by Western blotting.ResultsThe CPIP model induced an increase in paw thickness up to 72 h post-I/R. Mice supplemented with omega-3 compared to the saline group displayed reduced edema but neither altered skin IL-4 or skin and muscle TGF-β1, TNF, and MCP-1 concentrations, nor did they exhibit significantly altered muscle macrophage phenotype on the 2nd-day post-CPIP. However, omega-3 supplementation reversed the I/R-related reduction in IL-4 in the paw muscle compared to groups supplemented with saline and corn oil. Furthermore, omega-3 promoted the reduction of IL-10 levels in the paw skin, compared to animals with lesions supplemented with saline, until the 2nd-day post-CPIP. On the 15th day post-CPIP, IL-10 was significantly increased in the muscle of animals supplemented with omega-3 compared to the saline group.ConclusionThe results suggest that omega-3 PUFA supplementation has anti-inflammatory effects in the CPIP model of CRPS-Type I, significantly reducing paw edema and regulating concentrations of anti-inflammatory cytokines, including IL-4 and IL-10.
Collapse
Affiliation(s)
- Paula Franson Fernandes
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Taynah de Oliveira Galassi
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Verônica Vargas Horewicz
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | | | - Josiel Mileno Mack
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
- Graduate Program in Medical Sciences, Department of Medical Clinic, Federal University of Santa Catarina, Florianópolis, Brazil
- Faculty of Medicine, University of Southern Santa Catarina, Palhoça, Brazil
| | - Heloiza dos Santos Baldança
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
- Faculty of Physical Therapy, University of Southern Santa Catarina, Palhoça, Brazil
| | - Ana Paula Ferreira da Silva
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Lynsey A. Seim
- Department of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Daniel Fernandes Martins
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
| | - Franciane Bobinski
- Experimental Neuroscience Laboratory (LaNEx), Graduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, Brazil
- *Correspondence: Franciane Bobinski,
| |
Collapse
|
3
|
Jay GW, Barkin RL. Trigeminal neuralgia and persistent idiopathic facial pain (atypical facial pain). Dis Mon 2022; 68:101302. [PMID: 35027171 DOI: 10.1016/j.disamonth.2021.101302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Gary W Jay
- Department of Neurology, Division: Headache/Pain, University of North Carolina, Chapel Hill, USA.
| | - Robert L Barkin
- Departmentts of Anesthesilogy, Family Medicine, Pharrmacology, Rush University Medical College, Chicago Illinois, USA
| |
Collapse
|
4
|
Zhang Y, Xing F, Luo R, Duan X. Platelet-Rich Plasma for Bone Fracture Treatment: A Systematic Review of Current Evidence in Preclinical and Clinical Studies. Front Med (Lausanne) 2021; 8:676033. [PMID: 34414200 PMCID: PMC8369153 DOI: 10.3389/fmed.2021.676033] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/06/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Recently, there is an increasing interest in the therapeutic potential of platelet-rich plasma (PRP) for bone fracture treatment. Nevertheless, the effect of PRP for bone fracture treatment remains controversial and is still a matter of discussion. Therefore, we performed a systematic review to evaluate the efficacy and safety of PRP injection for treatment of bone fracture. Methods: The main bibliographic databases, including Medline, PubMed, Embase, Web of Science, and the Cochrane library, were comprehensively searched for studies focusing on the application of platelet-rich plasma (PRP) on bone fracture treatment. All relevant articles were screened for eligibility and subdivided into the preclinical and clinical studies. Data were extracted and presented systematically. Results: Finally, twenty-six in vitro preclinical studies (basic studies), nine in vivo preclinical studies (animal studies), and nine clinical studies, met the selection criteria, and were included in the present systematic review. Preclinical studies showed an overall positive effect of PRP on osteoblast-like cells in vitro and bone healing in animal models. The most used treatment for bone fracture in animal and clinical studies is fixation surgery combined with PRP injection. The clinical studies reported PRP shortened bony healing duration, and had no positive effect on improving the healing rate of closed fractures. However, the results of functional outcomes are controversial. Additionally, compared with control group, PRP would not increase the rate of postoperative wound infection. Conclusion: The present systematic review confirmed the continuing interests of PRP as an additional treatment for bone fracture. Preclinical studies highlighted the potential value of PRP as promising therapy for bone fracture. However, the preclinical evidence did not translate into a similar result in the clinical studies. In addition, types of fractures and procedures of PRP preparation are heterogeneous in enrolled studies, which might result in controversial results. Meanwhile, characteristics of PRP, such as platelet concentration, the numbers of leukocytes, still need to be determined and further research is required.
Collapse
Affiliation(s)
- Yangming Zhang
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Xing
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Luo
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Duan
- Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
5
|
Affiliation(s)
- Nader D Nader
- a Anesthesiology and Surgery, Pathology and Anatomical Sciences , University at Buffalo , Buffalo , NY , USA
| |
Collapse
|
6
|
Jung YH, Kim H, Jeon SY, Kwon JM, Lee D, Choi SH, Kang DH. Aberrant interactions of peripheral measures and neurometabolites with lipids in complex regional pain syndrome using magnetic resonance spectroscopy: A pilot study. Mol Pain 2018; 14:1744806917751323. [PMID: 29336203 PMCID: PMC5774727 DOI: 10.1177/1744806917751323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background The aim of this study was to assess peripheral measures and central metabolites associated with lipids using magnetic resonance spectroscopy. Results Twelve patients with complex regional pain syndrome (CRPS) and 11 healthy controls participated. Using magnetic resonance spectroscopy, we measured the levels of lipid 13a (Lip13a) and lipid 09 (Lip09) relative to total creatine (tCr) levels in the right and left thalamus. We found negative correlations of Lip13a/tCr in the right thalamus with red blood cells or neutrophils, but a positive correlation between Lip13a/tCr and lymphocytes in the controls. We found negative correlations between Lip09/tCr and peripheral pH or platelets in the controls. There were positive correlations between Lip09a/tCr and myo-inositol/tCr, between Lip13a/tCr and N-acetylaspartate (NAA)/tCr, and between Lip09/tCr and NAA/tCr in healthy controls. On the other hand, there were positive correlations between Lip13a/tCr and Lip09/tCr and urine pH in CRPS patients. There were significant correlations between Lip13a/tCr or Lip09/tCr and different peripheral measures depending on the side of the thalamus (right or left) in CRPS patients. Conclusion This is the first report indicating that abnormal interactions of Lip13a and Lip09 in the thalamus with peripheral measures and central metabolites may mediate the complex pathophysiological mechanisms underlying CRPS.
Collapse
Affiliation(s)
- Ye-Ha Jung
- 1 Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Hyeonjin Kim
- 2 Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - So Yeon Jeon
- 1 Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Jeong Min Kwon
- 3 Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Dasom Lee
- 1 Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Soo-Hee Choi
- 1 Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Do-Hyung Kang
- 1 Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
7
|
Abstract
Background Persistent idiopathic facial pain (PIFP) is a chronic disorder recurring daily for more than two hours per day over more than three months, in the absence of clinical neurological deficit. PIFP is the current terminology for Atypical Facial Pain and is characterized by daily or near daily pain that is initially confined but may subsequently spread. Pain cannot be attributed to any pathological process, although traumatic neuropathic mechanisms are suspected. When present intraorally, PIFP has been termed ‘Atypical Odontalgia’, and this entity is discussed in a separate article in this special issue. PIFP is often a difficult but important differential diagnosis among chronic facial pain syndromes. Aim To summarize current knowledge on diagnostic criteria, differential diagnosis, pathophysiology and management of PIFP. Methods We present a narrative review reporting current literature and personal experience. Additionally, we discuss and differentiate the common differential diagnoses associated with PIFP including traumatic trigeminal neuropathies, regional myofascial pain, atypical neurovascular pains and atypical trigeminal neuropathic pains. Results and conclusion The underlying pathophysiology in PIFP is still enigmatic, however neuropathic mechanisms may be relevant. PIFP needs interdisciplinary collaboration to rule out and manage secondary causes, psychiatric comorbidities and other facial pain syndromes, particularly trigeminal neuralgia. Burden of disease and psychiatric comorbidity screening is recommended at an early stage of disease, and should be addressed in the management plan. Future research is needed to establish clear diagnostic criteria and treatment strategies based on clinical findings and individual pathophysiology.
Collapse
Affiliation(s)
| | - Charly Gaul
- Migraine and Headache Clinic Königstein, Königstein im Taunus, Germany
| |
Collapse
|
8
|
Visnjevac O, Costandi S, Patel BA, Azer G, Agarwal P, Bolash R, Mekhail NA. A Comprehensive Outcome-Specific Review of the Use of Spinal Cord Stimulation for Complex Regional Pain Syndrome. Pain Pract 2016; 17:533-545. [PMID: 27739179 DOI: 10.1111/papr.12513] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/27/2016] [Accepted: 07/08/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Complex regional pain syndrome (CRPS) is a painful, debilitating affliction that is often difficult to treat. It has become common international practice to use spinal cord stimulation (SCS) for the treatment of CRPS as other therapies fail to provide adequate relief, quality of life, or improvement in function. This comprehensive outcome-specific systematic review of the use of SCS for CRPS was performed to elucidate the available evidence with focus on clinically relevant patient-specific outcomes. METHODS A systematic review of the literature was conducted to evaluate the effects of SCS on patients with CRPS for the following outcomes and provide summary levels of evidence in regard to each outcome: perceived pain relief, pain score, resolution of CRPS signs, functional status, quality of life, psychological impact, sleep hygiene, analgesic medication utilization, and patient satisfaction with SCS therapy. Search terms included "complex regional pain syndrome," "spinal cord stimulation," and "reflex sympathetic dystrophy," without restriction of language, date, or type of publication, albeit only original data were included in analyses. Of 30 studies selected, seven systematic reviews were excluded, as were four studies reporting combination therapy that included SCS and other therapies (ie, concurrent peripheral nerve stimulation, intrathecal therapy) without clear delineation to the effect of SCS alone on outcomes. A total of 19 manuscripts were evaluated. RESULTS Perceived pain relief, pain score improvement, quality of life, and satisfaction with SCS were all rated 1B+, reflecting positive high-level (randomized controlled trial) evidence favoring SCS use for the treatment of CRPS. Evidence for functional status improvements and psychological effects of SCS was inconclusive, albeit emanating from a randomized controlled trial (evidence level 2B±), and outcomes evidence for both sleep hygiene and resolution of CRPS signs was either nonexistent or of too low quality from which to draw conclusions (evidence level 0). An analgesic sparing effect was observed in nonrandomized reports, reflecting an evidence level of 2C+. CONCLUSIONS Spinal cord stimulation remains a favorable and effective modality for treating CRPS with high-level evidence (1B+) supporting its role in improving CRPS patients' perceived pain relief, pain score, and quality of life. A paucity of evidence for functional improvements, resolution of CRPS signs, sleep hygiene, psychological impact, and analgesic sparing effects mandate further investigation before conclusions can be drawn for these specific outcomes.
Collapse
Affiliation(s)
- Ognjen Visnjevac
- Pain Management Department, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Shrif Costandi
- Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Bimal A Patel
- Pain Management Department, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Girgis Azer
- Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Priya Agarwal
- Pain Management Department, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Robert Bolash
- Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, Ohio, U.S.A
| | - Nagy A Mekhail
- Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, Ohio, U.S.A
| |
Collapse
|
9
|
Namazi H, Mehbudi A. Investigating the effect of intra-articular PRP injection on pain and function improvement in patients with distal radius fracture. Orthop Traumatol Surg Res 2016; 102:47-52. [PMID: 26774901 DOI: 10.1016/j.otsr.2015.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 10/26/2015] [Accepted: 11/06/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Distal radius fractures are common injuries that cause pain and disability. There is a clear need for biomedical engineering research to develop novel strategies to improve functional results following intra-articular distal radius fractures. However, no pharmacotherapeutic agent has been investigated to resolve this problem. The aim of this study was to evaluate whether the platelet-rich plasma (PRP) can be considered a novel additional therapy to improve the outcomes of this injury. HYPOTHESIS Pain reduction and functional improvement can be noticed after PRP use in distal radius fracture. MATERIALS AND METHODS A randomized trial study was designed with 30 patients who had intra-articular distal radius fractures (Frykman type 3, 4, 7, 8). Closed reduction and percutaneous pinning under guide of fluoroscopy were done for them. Fifteen cases received intra-articular autologus PRP. Patients were followed for 3 and 6 months and "patient-rated wrist evaluation" (PRWE) questionnaire was completed and range of motion of the wrist was measured. RESULTS The mean of pain score and the score of specific and usual activities at 3 months follow-up in the case group and in the control group were (8.33 versus 19.67), (10.66 versus 26.8), and (6.2 versus 13.4), respectively. The mean of pain score and score of specific and usual activities at 6 months follow-up in the case group and in the control group were (3.6 versus 12), (3 versus 15.7), and (1.2 versus 6.8), respectively. The case group was significantly different from the control group. The mean of loss of flexion and extension of the wrist at 3 months follow-up in the case group was significantly different from the control group as well. CONCLUSION PRP may have significant effect on reduction of pain and amount of difficulty in functions, including specific and usual activities after intra-articular distal radius fractures. LEVEL OF EVIDENCE Level III, Therapeutic trial.
Collapse
Affiliation(s)
- H Namazi
- Bone and Joint Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - A Mehbudi
- Bone and Joint Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
10
|
Rittenhouse-Olson K. Letter from the editor: immunological Investigations. Immunol Invest 2014; 43:727-33. [PMID: 25296230 DOI: 10.3109/08820139.2014.962855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
11
|
Wang YC, Li HY, Lin FS, Cheng YJ, Huang CH, Chou WH, Huang HH, Lin CC, Lin CC, Sung FC, Wei JN. Injury Location and Mechanism for Complex Regional Pain Syndrome: A Nationwide Population-Based Case-Control Study in Taiwan. Pain Pract 2014; 15:548-53. [PMID: 24801059 DOI: 10.1111/papr.12211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/03/2014] [Accepted: 03/01/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Few studies have investigated the relationship between injury location, mechanism and their association with complex regional pain syndrome (CRPS). We conducted a nationwide database survey to explore this issue. METHODS This was a population-based case-control study. Five hundred and eighty-nine patients with at least one ambulatory visit or admission with a principal diagnosis of CRPS from 2004 to 2009 were selected. For each CRPS patient, ten age- and sex-matched non-CRPS subjects were randomly selected. The odds ratios (PLoS One. 2013;8:e57205) and 95% confidence intervals (95% CIs) of risk factors for CRPS were derived from multivariate logistic regression models. RESULTS Injury was a risk factor for CRPS (OR, 2.96; 95% CI, 2.18 to 4.02) independent of age and sex. In adjusted models, open wound on the upper limbs (OR 1.25, 95% CI 1.02 to 1.54) conferred higher CRPS risk. Injury mechanisms including nerve and spinal cord injury (OR 2.42, 95% CI 1.44 to 4.08), muscle and joint sprain and strain (OR 1.69, 95% CI 1.40 to 2.03), superficial injury (OR 1.23, 95% CI 1.00 to 1.51), and contusion (OR 1.44, 95% CI 1.20 to 1.74), but not fracture, increased the risk of CRPS. CONCLUSION Injury in the extremities rather than the trunk is an important risk factor for CRPS. Certain injury mechanisms confer higher risk of CRPS. This nationwide study demonstrated that injury increased CRPS nearly threefold. Open wound, sprain and strain, superficial injury, contusion, and nerve and spinal cord injury are main injury mechanisms. Injury in the extremities confers a higher risk of CRPS.
Collapse
Affiliation(s)
- Yi-Chia Wang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Yuan Li
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Feng-Sheng Lin
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Jung Cheng
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Hsiang Huang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Han Chou
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsing-Hao Huang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan.,Department of Health Care Administration, Asian University, Taichung, Taiwan
| | - Che-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Fung-Chang Sung
- Institute of Environmental Health, China Medical University College of Public Health, Taichung, Taiwan
| | - Jung-Nan Wei
- Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| |
Collapse
|
12
|
Klauke AL, Racz I, Pradier B, Markert A, Zimmer AM, Gertsch J, Zimmer A. The cannabinoid CB₂ receptor-selective phytocannabinoid beta-caryophyllene exerts analgesic effects in mouse models of inflammatory and neuropathic pain. Eur Neuropsychopharmacol 2014; 24:608-20. [PMID: 24210682 DOI: 10.1016/j.euroneuro.2013.10.008] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/31/2013] [Accepted: 10/12/2013] [Indexed: 11/17/2022]
Abstract
The widespread plant volatile beta-caryophyllene (BCP) was recently identified as a natural selective agonist of the peripherally expressed cannabinoid receptor 2 (CB₂). It is found in relatively high concentrations in many spices and food plants. A number of studies have shown that CB₂ is critically involved in the modulation of inflammatory and neuropathic pain responses. In this study, we have investigated the analgesic effects of BCP in animal models of inflammatory and neuropathic pain. We demonstrate that orally administered BCP reduced inflammatory (late phase) pain responses in the formalin test in a CB₂ receptor-dependent manner, while it had no effect on acute (early phase) responses. In a neuropathic pain model the chronic oral administration of BCP attenuated thermal hyperalgesia and mechanical allodynia, and reduced spinal neuroinflammation. Importantly, we found no signs of tolerance to the anti-hyperalgesic effects of BCP after prolonged treatment. Oral BCP was more effective than the subcutaneously injected synthetic CB₂ agonist JWH-133. Thus, the natural plant product BCP may be highly effective in the treatment of long lasting, debilitating pain states. Our results have important implications for the role of dietary factors in the development and modulation of chronic pain conditions.
Collapse
MESH Headings
- Administration, Oral
- Animals
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/adverse effects
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Behavior, Animal/drug effects
- Cannabinoid Receptor Agonists/administration & dosage
- Cannabinoid Receptor Agonists/adverse effects
- Cannabinoid Receptor Agonists/therapeutic use
- Disease Models, Animal
- Gene Expression Regulation/drug effects
- Hyperalgesia/drug therapy
- Hyperalgesia/immunology
- Hyperalgesia/metabolism
- Male
- Mice
- Mice, Congenic
- Motor Activity/drug effects
- Nerve Tissue Proteins/agonists
- Nerve Tissue Proteins/genetics
- Nerve Tissue Proteins/metabolism
- Neuralgia/drug therapy
- Neuralgia/immunology
- Neuralgia/metabolism
- Neurons/drug effects
- Neurons/immunology
- Neurons/metabolism
- Pain Measurement
- Phytochemicals/administration & dosage
- Phytochemicals/adverse effects
- Phytochemicals/therapeutic use
- Polycyclic Sesquiterpenes
- Receptor, Cannabinoid, CB2/agonists
- Receptor, Cannabinoid, CB2/genetics
- Receptor, Cannabinoid, CB2/metabolism
- Sciatic Nerve/drug effects
- Sciatic Nerve/immunology
- Sciatic Nerve/metabolism
- Sciatic Neuropathy/drug therapy
- Sciatic Neuropathy/immunology
- Sciatic Neuropathy/metabolism
- Sesquiterpenes/administration & dosage
- Sesquiterpenes/adverse effects
- Sesquiterpenes/therapeutic use
- Spinal Cord/drug effects
- Spinal Cord/immunology
- Spinal Cord/metabolism
Collapse
Affiliation(s)
- A-L Klauke
- Institute of Molecular Psychiatry, University of Bonn, Sigmund-Freud-Straße 25, D-53127 Bonn, Germany
| | - I Racz
- Institute of Molecular Psychiatry, University of Bonn, Sigmund-Freud-Straße 25, D-53127 Bonn, Germany.
| | - B Pradier
- Institute of Molecular Psychiatry, University of Bonn, Sigmund-Freud-Straße 25, D-53127 Bonn, Germany
| | - A Markert
- Institute of Molecular Psychiatry, University of Bonn, Sigmund-Freud-Straße 25, D-53127 Bonn, Germany
| | - A M Zimmer
- Institute of Molecular Psychiatry, University of Bonn, Sigmund-Freud-Straße 25, D-53127 Bonn, Germany
| | - J Gertsch
- Institute of Biochemistry and Molecular Medicine, NCCR TransCure, University of Bern, CH-3012 Bern, Switzerland
| | - A Zimmer
- Institute of Molecular Psychiatry, University of Bonn, Sigmund-Freud-Straße 25, D-53127 Bonn, Germany
| |
Collapse
|
13
|
Reply to Letter: "Surgically Induced Neuropathic Pain: Understanding the Perioperative Process". Ann Surg 2013; 261:e162-3. [PMID: 24299687 DOI: 10.1097/sla.0000000000000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
14
|
Linnman C, Borsook D. Completing the Pain Circuit: Recent Advances in Imaging Pain and Inflammation beyond the Central Nervous System. Rambam Maimonides Med J 2013; 4:e0026. [PMID: 24228169 PMCID: PMC3820299 DOI: 10.5041/rmmj.10133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
This review describes some of the recent developments in imaging aspects of pain in the periphery. It is now possible to image nerves in the cornea non-invasively, to image receptor level expression and inflammatory processes in injured tissue, to image nerves and alterations in nerve properties, to image astrocyte and glial roles in neuroinflammatory processes, and to image pain conduction functionally in the trigeminal ganglion. These advances will ultimately allow us to describe the pain pathway, from injury site to behavioral consequence, in a quantitative manner. Such a development could lead to diagnostics determining the source of pain (peripheral or central), objective monitoring of treatment progression, and, hopefully, objective biomarkers of pain.
Collapse
Affiliation(s)
- Clas Linnman
- Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America
| | | |
Collapse
|