Chronic pain is sustained, in part, through the intricate process of central sensitization (CS), marked by maladaptive neuroplasticity and neuronal hyperexcitability within central pain pathways. Accumulating evidence suggests that CS is also driven by neuroinflammation in the peripheral and central nervous system. In any chronic disease, the search for perpetuating factors is crucial in identifying therapeutic targets and developing primary preventive strategies. The brain-derived neurotrophic factor () emerges as a critical regulator of synaptic plasticity, serving as both a neurotransmitter and neuromodulator. Mounting evidence supports 's pro-nociceptive role, spanning from its pain-sensitizing capacity across multiple levels of nociceptive pathways to its intricate involvement in CS and neuroinflammation. Moreover, consistently elevated BDNF levels are observed in various chronic pain disorders. To comprehensively understand the profound impact of in chronic pain, we delve into its key characteristics, focusing on its role in underlying molecular mechanisms contributing to chronic pain. Additionally, we also explore the potential utility of as an objective biomarker for chronic pain. This discussion encompasses emerging therapeutic approaches aimed at modulating expression, offering insights into addressing the intricate complexities of chronic pain.
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http://dx.doi.org/10.3390/biom14010071 | DOI Listing |
Background: Fibromyalgia (FM) is a generalized, widespread chronic pain disorder affecting 2.7% of the general population. In recent years, different studies have observed a strong association between FM and psychological trauma.
View Article and Find Full Text PDFBMJ Open
December 2024
Department of Anesthesiology, Henan Provincial Chest Hospital & Chest Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Introduction: Chronic post-thoracotomy pain (CPTP) is a persistent and disabling condition affecting a significant proportion of patients after thoracotomy and posing a challenge for clinicians, despite advances in surgical and pain management strategies. Esketamine, the S-enantiomer of ketamine, has emerged as a promising therapeutic agent for various pain conditions, with evidence for its effectiveness in alleviating acute and chronic pain. This systematic review and meta-analysis will be conducted to assess the efficacy of esketamine in treating CPTP, and evaluate its effectiveness in reducing pain intensity, improving functional outcomes, and reducing opioid consumption, as well as its adverse effects.
View Article and Find Full Text PDFBMJ Open
December 2024
Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia.
Introduction: Sciatica is a debilitating condition that often becomes chronic, and for which there are few effective treatment options. Treatments such as the anti-depressant duloxetine have shown promise, but the evidence is inconclusive. We are describing a high quality, definitive trial to investigate the efficacy, safety and cost-effectiveness of duloxetine in chronic sciatica.
View Article and Find Full Text PDFRMD Open
December 2024
Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Objectives: The objective of this study is to investigate lipopolysaccharid-binding protein (LBP), zonulin and calprotectin as markers of bacterial translocation, disturbed gut barrier and intestinal inflammation in patients with radiographic axial spondyloarthritis (r-axSpA) during tumour necrosis factor inhibitor (TNFi) therapy and to analyze the association between disease activity, response to treatment and biomarker levels.
Methods: Patients with active r-axSpA of the German Spondyloarthritis Inception Cohort starting TNFi were compared with controls with chronic back pain. Serum levels of LBP, zonulin and calprotectin were measured at baseline and after 1 year of TNFi therapy.
Brain Behav
January 2025
Department of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, Saudi Arabia.
Background: Duloxetine, a serotonin and norepinephrine reuptake inhibitor (SNRI), is used to treat various health conditions, including major depressive disorder, generalized anxiety disorder, fibromyalgia, and off-label for chemotherapy-induced pain. We conducted this systematic review and meta-analysis aiming to test the current evidence regarding effectiveness and safety of duloxetine for postspine surgeries pain.
Methods: We searched the Cochrane Central Register of Controlled Trials, PubMed, Scopus and Web of science databases for relevant articles up to March 2024.
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