PAIN RESEARCH
Online ISSN : 2187-4697
Print ISSN : 0915-8588
ISSN-L : 0915-8588
22 巻, 4 号
日本疼痛学会誌
選択された号の論文の4件中1~4を表示しています
総説
  • 井上 和秀
    原稿種別: 総説
    2007 年 22 巻 4 号 p. 163-169
    発行日: 2007/10/31
    公開日: 2013/07/05
    ジャーナル フリー
       Neuropathic pain is often a consequence of nerve injury through surgery, bone compression, diabetes or infection. This type of pain can be so severe that even light touching can be intensely painful. Unfortunately, this state is generally resistant to currently available treatments. There is abundant evidence that activated microglia are a key player for causing the pain and ATP receptors expressed in microglia have an important role to activate microglia. In this review, we summarize the role of microglia and ATP receptors in neuropathic pain signalling. The activated microglia express P2X4 after nerve injury, which can be stimulated by endogenous ATP, resulting in the release of BDNF which is one of key molecules involving in neuropathic pain. We also found that paroxetine is a strong blocker of P2X4. Paroxetine inhibits neuropathic pain in rat and human. Understanding the key roles of these ATP receptors in microglia may lead to new strategies for the management of intractable chronic pain.
原著
  • Tomoshi Miura, Ryohei Okazaki, Hiroyuki Yoshida, Hiroyoshi Namba, Hisa ...
    原稿種別: Original Article
    2007 年 22 巻 4 号 p. 171-177
    発行日: 2007/10/31
    公開日: 2013/07/05
    ジャーナル フリー
       Neurotropin®, a non-protein extract from the inflamed skin of rabbits inoculated with vaccinia virus, is clinically used for treatment of chronic pain. In this study, we compared the pharmacological effects of repeated oral administration of Neurotropin® and non-steroidal anti-inflammatory drugs (NSAIDs) loxoprofen sodium, etodolac and celecoxib, in the adjuvant-induced arthritic rats. Neurotropin® produced analgesic effect but not anti-inflammatory effect and gastric ulcer. All NSAIDs tested produced analgesic and anti-inflammatory effects but loxoprofen and etodolac produced gastric ulcer as well. Neurotropin® may be an analgesic without anti-inflammatory action. Without causing stomach problems, Neurotropin® may be good for the treatment of chronic pain.
  • 有留 ひふみ, 浜村 淳, 石川 浩三, 掛田 崇寛, 仲西 修, 石川 敏三
    原稿種別: 原著
    2007 年 22 巻 4 号 p. 179-188
    発行日: 2007/10/31
    公開日: 2013/07/05
    ジャーナル フリー
       Background: Although the derangement of assending nociceptive transmission in spinal cord including neuroplasticity have been investigated, the role of serotoninergic (5–HT) descending inhibitory system originated from rostro–ventral medulla remained unclear. Recently, the ability of selective 5–HT reuptake inhibitor (SSRI), is focusing for modulating effects of spinal nociceptive transmission in both spinal and supraspinal cord. But, its mechanism is still remained unclear. Therefore, we characterized the effects of SSRI on spinal nociceptive transmission of 5–HT by using spinal microdialysis in relation to pain behavior after mustered oil (MO) paw injection in rats.
       Methods: The rats implanted with intrathecal microdialysis probe along with PE–10 tube was subjected for injecting mustered oil into paw. The major metabolite of 5–HT, 5–HIAA, in CSF (HPLC–ECD) level and flinchings were periodically measured following MO injection. SSRI (ip.), 5–HT (it.), morphine (it.), or pentobarbital (ip.) was given before injecting MO.
       Results: After that, the flinchings were gradually increased accompanied by slight increase of CSF–5–HIAA level. With SSRI, rats showed significant reduction of flinching after MO injection without change in CSF–5–HIAA level. But, there were remarkable increases in CSF–5–HIAA levels with 5–HT it. The significant reduction of flinching by morphine was associated with considerable decrease in CSF–5–HIAA. Pentobarbital produced satisfactory sedation, but no analgesic effect associated with any change in CSF–5–HIAA level.
       Conclusion: Based on the present study, when peripheral stimulation arrives to the brain through spinal cord, the sensory–limbic systems networks in brain evoke 5–HT or noradrenaline contained descending inhibitory system to block ascending nociceptive information. We demonstrated that SSRI has beneficial effects of analgesia without changes in 5–HT release observed by using spinal microdialysis. According to changes in CSF–5–HIAA levels, SSRI induced analgesia may be concerned with mechanisms underlying 1) inhibition of presynaptic neurons of c–fiver by activating 5–HT1 receptor, and 2) stimulation of the enkephaline contained inter–neurons by activating 5–HT2 receptor. The use of SSRI is expected as potential drug for management of patients with cancer, neuropathic pain, and any other chronic painful diseases.
症例報告
  • 吉岡 尚美, 水間 正澄
    原稿種別: 症例報告
    2007 年 22 巻 4 号 p. 189-193
    発行日: 2007/10/31
    公開日: 2013/07/05
    ジャーナル フリー
       We report a case of complex regional pain syndrome (CRPS), involving the lower extremity. Physical therapy was performed as a part of a pain management program.
       A 62-year-old female had left leg pain since 9/2003. The pain was not controlled with NSAIDs and the gradually increased. She had to use axillary crutch. One month later, osteochondral fracture of the talus was found. Arthroscopic resection of the fracture was done in 11/2003. But the pain got stronger, especially after physical therapy which was focused on the contracture of ankle and gait. She was diagnosed as CRPS in 12/2003. The unbearable pain made her depressive, and after discharge to home at 2/2004, she committed a suicide.She was transported to ER, and a week later she went to psychiatric ward. The energizer and sympathetic nerve block reduced 50% of the pain, but she still refused to walk.
       She was consulted to our department in 5/2004. Physical therapy was started without touching her painful leg. We focused on building a therapeutic relationship. Then, partial weight bearing exercise was started using a soft and elastic ball to facilitate a sense of pressure loading.After the exercise she had a pain in her leg, but she didn't need painkillers.
       In 10/2004, she was able to walk by herself with a T-cane, and her activities of daily living (ADL) became independent. At the discharge, her pain was 20% of the admission.
       Treatment of CRPS must be focused on not only pain, but also functional activity.
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