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In this section English articles are published on neuropathy.

Amitriptylin cream for neuropathic pain

david-kopsky-center-for-neuropathy.jpg The treatment of neuropathic pain with a topical cream containing 5% amitryptilin helped the patient considerably, and his pain score decreased from 8-9 to 2, the onset of action was 15 minutes and the analgesic effects remained for 4-5 hours. A patient presentation by David J Kopsky, MD, brought to you by the institute for neuropathy and neuropathic pain, Soest, the Netherlands, www.neuropathy.nl

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Neuroinflammation explains aspects of chronic pain: what about naltrexone?

‘Neuroinflammation explains aspects of chronic pain and opens new avenues for therapeutic interventions’ is the titel of an editorial of Harald Breivik and Torsten Gordh, in the Scandinavian Journal of Pain, Volume 1, Issue 2, April 2010, Pages 65-66. These editors raise important issues, as current drugs for chronic pain exclusively target neuronal mechanisms, and these drugs appear only partly effective. Therefore, new treatment strategies via the manipulation of the neuron–glia interactions in pain may lead to new break through approaches. It seems that more than one basic neuroscientist claims that inhibition of immune function might become a major avenue for treating neuropathic pain in the future.

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Central sensitization according to profesor Dickenson

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At the third international congres on neuropathic pain in Athens (NeuPSIG, may 2010) professor Anthony Dickenson gave a nice and crisp talk on central sensitization. 

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Palmitoylethanolamide (PEA) for neuropathic pain

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Palmitoylethanolamide: in 2012 more than 300 entries in pubmed for this interesting molecule!

The internationalizarion of PEA started at the Third International Congress on Neuropathic Pain, Athens, Greece, May 27 – 30, 2010.

A. Biasiotta, S. et al presented a poster which demonstrated a clinical relevant and electrophysiological measurable effect from this rather unknown compound classified as medical food, palmitoylethanolamide. The compound is available as dietfood for medical purposes (brandname een PEA-houdend product) in various European contries and under the brandname PeaPure (a supplement) via the internet.

This is very interesting for doctors as well as patients, as PEA is an endogenious fatty acid without any troublesome side-effects and easy to use to reduce pain, even together with other drugs.

Lipids like N-palmitoylethanolamine can act as signaling molecules, activating intracellular and membrane-associated receptors to regulate physiological functions. The signaling lipid PEA is known to activate intracellular, nuclear and membrane-associated receptors and regulate many physiological functions related to the inflammatory cascade, and thus is of high interest in the treatment of neuropathic, or gliopathic pain.

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Burning, tingling, pain and numbness in hands and feet: neuropathy!

From: Healthy Times Newspaper Archives: Why Do I Feel Burning, Tingling, Pain and Numbness in My Hands and Feet? By Dr. Hashimoto. 

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Neuromed’s NMED-160 in phase I

Neuromed Technologies focusses on developing new drugs based on calcium channel modulation. Neuromed has identified a selective N-type calcium channel blocker with analgesic effects, relevant for the treatment of neuropathic pain. 

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Palmitoylethanolamide in neuropathic sciatic pain: clinical results

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Palmitoylethanolamide (PEA) is an natural and endogenous compound. It is a fatty acid amide and present in many foodstuffs as well as in the human body. In Europe PEA is available as a nutraceutical (dietfood for medical purposes)  in Italy and Spain under the brandname een PEA-houdend product and in the Netherlands and elsewhere as a foodsupplement under the brandname PeaPure. 

PeaPure has the advantage of not containing farmaceutical and chemical excipients, nor sorbitol (as present in een PEA-houdend product and other PEA products).

In 2010 a Spanish publication described clinical meaningful effects of the treatment of lumbosciatic pain with palmitoylethanolamide, PEA. These results were published in Dolor (2010;25:35-42) and were based on a double blind placebo contriolled study.

TWe conducted a furher analysis of the Numbers Needed to Treat we presented at the SIAARTI in 2011 for around 1000 pain specialists, the efficacy of PEA based on the NNT analysis we presented was impressive: 1.5! For details see link.

The presentation at the SIAARTI was moderated and introduced by professor G. Varrassi. 

In various different clinical nerve compression studies, conducted up to 2011, a total of more than 1300 patients  wre treated all confirming positive effects for PEA in sciatic pain (see under)  

PEA is a safe compound, with virtually no side effects, and a robust efficacy (NNT=1.5, see graph: NNT at week 3 for 50% pain reduction on NRS). 

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Pain with hernia and treatment with palmitoylethalonamide ( PeaPure)

Heavy neuralgia radiating to the leg is also called sciatica or lumbosacral radiculopathy. Doctors have called this neuritis or neuritis of the sciatic nerve, the Nervus Ischiadicus, for a long time. This old concept has now been given a complete new turn.

Sciatica is caused by mechanic pressure by an intervertebral disc on the beginning of the sciatic nerve, the so-called nerve root within or just outside the vertebral column. Because of that pressure the nerve becomes inflamed and then the pain starts usually quite sudden. Then an inflammation that is maintained by the pressure on that nerve, the hernia, starts. 

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Pain in Chronic idiopathic axonal polyneuropathy treated with palmitoylethalonamide (PEA)

ciap-pea.jpg There is no evidence from randomised trials of drug therapy for chronic idiopathic axonal polyneuropathy, accrding to a Cochrane review. We quote from that review. Chronic idiopathic axonal polyneuropathy is a not uncommon disorder of the elderly causing very slowly progressive numbness or weakness of the feet and lower legs, and sometimes also the hands. By definition, the cause is not known. No randomised trials of drug treatment for chronic idiopathic axonal polyneuropathy have been conducted. Trials will need sensitive outcome measures and long follow-up periods.

That is why treatments like these need attention, palmitoylethalonamide clearly resulted in decreasing pain in an intractable pain patient suffering from CIAP.

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Integrated Medicine concept for neuropathic pain at the Berlin congress (2010)

Treatment of neuropathic pain, an overview presented at the 3rd European Congress for Integrative Medicine,in Berlin, December 3rd, 2010. The founding fathers of the Institute of Neuropathic pain attended the above mentioned congress to present the integrated treatment concept for neuropathic pain to an audience of physicians interested in pain treatment. The director of research and development from the institute, professor Jan M. Keppel Hesselink, presented the multimodal therapy as it has been developed within the institute for the past years.

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Mast cells and abdominal aneurysms

Mast cells are moving into the central field of attention for a variety of disorders. Mast cells have previously been seen as a kind of Cinderella cell, as professor Rita Levi Montalcini pointed out, shortly after her Nobelprice for growth factors, but are in fact ‘prima dona’ cells. These cells might also participate  in the pathogenesis of abdominal aortic aneurysm (AAA).

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FAAH, the endocannabinoid system and pain due to osteoarthritis

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Pfizer completed recently a Phase II clinical trial analysing the safety of the FAAH inhibitor PF-04457845 examining pain relief in patients with OA of the knee. Reason for some reflections. FAAH inhibition results in higher intracellular levels of endocannabinoids, such as anandamide and palmitoylethanolamide. The availability of palmitoylethanolamide as dietfood for medical purposes seems to make the inhibition approach somewhat debatable. This the more so, as there are a number of warning signals around that FAAH inhibition might also trigger opposite results as what we aim for. The structure of the FAAH enzyme, residing in membranes here above, developed by Scripps.

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PEA, Palmitoylethanolamide per os active in different animal models

Palmitoylethanolamide (PEA) has been evaulated in many different animal models. Per os model is important to highlight, as it comes close to dosing in man. In different models PEA has been dosed orally. In a ratmodel four different doses of palmitoylethanolamide were given per os; 1, 3, 5, 10 mg kg(-1); p.o. and compared to the inhibitor of COX, indomethacine. In two depression related models in mice PEA was compared to fluoxetine. In all models PEA was biological active.

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NGF can be counteracted: green light for NGF antibodies

A Advisory Panel Gives the Green Light to Restart NGF Antibody Trials
Investigators pleased that promising agents for pain relief have new life, states a new entry in https://www.painresearchforum.org. Interestingly palmitoylethanolamide with which we work is a natural inhibitor of the effects of NGF!

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