Background: Exogenous erythropoietin inhibits development of allodynia in experimental painful neuropathy because of its antiinflammatory and neuroprotective properties at spinal, supraspinal, and possibly peripheral sites. The authors assess the effect of a nonhematopoietic erythropoietin analog, ARA290, on tactile and cold allodynia in a model of neuropathic pain (spared nerve injury) in rats and mice lacking the β-common receptor (βcR mice), a component of the receptor complex mediating tissue protection.
Methods: Twenty-four hours after peripheral nerve injury, rats and mice were injected with ARA290 or vehicle (five 30-μg/kg intraperitoneal injections at 2-day intervals, followed by once/week, n = 8/group). In a separate group of eight rats, ARA290 treatment was restricted to five doses during the initial 2 weeks after surgery.
Results: In rats, irrespective of treatment paradigm, ARA290 produced effective, long-term (as long as 15 weeks) relief of tactile and cold allodynia (P < 0.001 vs. vehicle-treated animals). ARA290 was effective in wild-type mice, producing significant relief of allodynia. In contrast, in βcR mice no effect of ARA290 was observed.
Conclusions: ARA290 produces long-term relief of allodynia because of activation of the β-common receptor. It is argued that relief of neuropathic pain attributable to ARA290 treatment is related to its antiinflammatory properties, possibly within the central nervous system. Because ARA290, in contrast to erythropoietin, is devoid of hematopoietic and cardiovascular side effects, ARA290 is a promising new drug in the prevention of peripheral nerve injury-induced neuropathic pain in humans.
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http://dx.doi.org/10.1097/ALN.0b013e31822fcefd | DOI Listing |
Ann Intern Med
January 2025
Center for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (R.J.D., N.K.C., N.H., J.C.L.).
Background: The evidence informing the harms of gabapentin use are at risk of bias from comparing users with nonusers.
Objective: To describe the risk for fall-related outcomes in older adults starting treatment with gabapentin versus duloxetine.
Design: New user, active comparator study using a target trial emulation framework.
Guillain-Barré Syndrome (GBS) is an acute inflammatory polyradiculoneuropathy that affects the peripheral nervous system, predominantly impairing motor function. Pain, both somatic and neuropathic, is reported in 89% of cases and is refractory to first-line analgesics in most of these. We present the case of a 75-year-old woman with an acute presentation of areflexic flaccid tetraparesis compatible with GBS.
View Article and Find Full Text PDFA A Pract
January 2025
Division of Anaesthesiology and Perioperative Medicine, Department of Pain Medicine, Singapore General Hospital, Singapore.
Brugada syndrome is a rare condition that increases the risk of life-threatening arrhythmias. Although there are existing anesthesia recommendations for patients with Brugada syndrome, guidance on pain management is limited. We present a novel approach to pain management in these patients, illustrated by the case of a young woman with Brugada syndrome who underwent ropivacaine peripheral nerve infusion and intravenous ketamine infusion for acute-on-chronic left upper limb pain.
View Article and Find Full Text PDFHeliyon
December 2024
Department of Anesthesiology and Pain Medicine, Chonnam National University Hospital, Gwangju, South Korea.
Introduction: Macrophage-inducible C-type lectin (Mincle) has emerged as a potential contributor to neuropathic pain induction and neuroinflammatory responses within the spinal cord. Moreover, evidence suggests a close association between toll-like receptor (TLR) and Mincle expression in myeloid cells. This study evaluated the effectiveness of Mincle antibodies in neuropathic pain and identified the epitope of these antibodies.
View Article and Find Full Text PDFNeurobiol Pain
December 2024
School of Medical Sciences [Neuroscience], and the Brain & Mind Centre, The University of Sydney, NSW, 2006, Australia.
Chronic neuropathic pain is a debilitating condition that results from damage to the nervous system. Current treatments are largely ineffective, with limited understanding of the underlying mechanisms hindering development of effective treatments. Preclinical models of neuropathic pain have revealed that non-neural changes are important for the development of neuropathic pain, although these data are derived almost exclusively from post-mortem histological analyses.
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