scholarly journals Chronic Pain in Dogs and Cats: Is There Place for Dietary Intervention with Micro-Palmitoylethanolamide?

Animals ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 952
Author(s):  
Giorgia della Rocca ◽  
Davide Gamba
Keyword(s):  
Chronic Pain ◽  
Dietary Intervention ◽  
Neuronal Cells ◽  
Small Animal ◽  
Food Sources ◽  
Dietary Interventions ◽  
Tolerance Development ◽  
Pharmacological Agents ◽  
Inflammatory Drugs

The management of chronic pain is an integral challenge of small animal veterinary practitioners. Multiple pharmacological agents are usually employed to treat maladaptive pain including opiates, non-steroidal anti-inflammatory drugs, anticonvulsants, antidepressants, and others. In order to limit adverse effects and tolerance development, they are often combined with non-pharmacologic measures such as acupuncture and dietary interventions. Accumulating evidence suggests that non-neuronal cells such as mast cells and microglia play active roles in the pathogenesis of maladaptive pain. Accordingly, these cells are currently viewed as potential new targets for managing chronic pain. Palmitoylethanolamide is an endocannabinoid-like compound found in several food sources and considered a body’s own analgesic. The receptor-dependent control of non-neuronal cells mediates the pain-relieving effect of palmitoylethanolamide. Accumulating evidence shows the anti-hyperalgesic effect of supplemented palmitoylethanolamide, especially in the micronized and co-micronized formulations (i.e., micro-palmitoylethanolamide), which allow for higher bioavailability. In the present paper, the role of non-neuronal cells in pain signaling is discussed and a large number of studies on the effect of palmitoylethanolamide in inflammatory and neuropathic chronic pain are reviewed. Overall, available evidence suggests that there is place for micro-palmitoylethanolamide in the dietary management of chronic pain in dogs and cats.

scholarly journals The challenges of control groups, placebos and blinding in clinical trials of dietary interventions

2017 ◽  
Vol 76 (3) ◽  
pp. 203-212 ◽  
Author(s):  
Heidi M. Staudacher ◽  
Peter M. Irving ◽  
Miranda C. E. Lomer ◽  
Kevin Whelan
Keyword(s):  
Clinical Trials ◽  
Dietary Intervention ◽  
Research Review ◽  
Dietary Advice ◽  
Dietary Interventions ◽  
Advantages And Disadvantages ◽  
Sham Intervention ◽  
Potential Risks ◽  
Intervention Trials

High-quality placebo-controlled evidence for food, nutrient or dietary advice interventions is vital for verifying the role of diet in optimising health or for the management of disease. This could be argued to be especially important where the benefits of dietary intervention are coupled with potential risks such as compromising nutrient intake, particularly in the case of exclusion diets. The objective of the present paper is to explore the challenges associated with clinical trials in dietary research, review the types of controls used and present the advantages and disadvantages of each, including issues regarding placebos and blinding. Placebo-controlled trials in nutrient interventions are relatively straightforward, as in general placebos can be easily produced. However, the challenges associated with conducting placebo-controlled food interventions and dietary advice interventions are protean, and this has led to a paucity of placebo-controlled food and dietary advice trials compared with drug trials. This review appraises the types of controls used in dietary intervention trials and provides recommendations and nine essential criteria for the design and development of sham diets for use in studies evaluating the effect of dietary advice, along with practical guidance regarding their evaluation. The rationale for these criteria predominantly relate to avoiding altering the outcome of interest in those delivered the sham intervention in these types of studies, while not compromising blinding.

scholarly journals Drug Induced Hepatotoxicity – An Ongoing Challenge

2020 ◽  
Vol 10 (3) ◽  
pp. 244-248
Author(s):  
Mehr Fatima ◽  
Syed Zaidi
Keyword(s):  
Liver Injury ◽  
Liver Failure ◽  
Liver Damage ◽  
Obese People ◽  
Drug Induced ◽  
Pharmacological Agents ◽  
Drug Induced Liver Injury ◽  
High Incidence ◽  
Inflammatory Drugs

Drug induced liver injury is one of the main factor of liver failure and acute liver damage world wide with high incidence in western countries. Liver injury can be intrinsic (dose dependant) or idiosyncratic (dose independent). However idiosyncratic type is considered to be mainly responsible for drug induced liver damage. Binding of reactive metabolites of drugs to tissue proteins and oxidative stress is the possible cellular mechanism involved in this process. Moreover, some antibiotics, anti-epileptics, nonsteroidal anti-inflammatory drugs etc are more likely to induce liver damage in high risks groups that includes females, elderly and obese people. HLA halotype and variation in protein expression also plays an important role in this context. Various studies are available regarding clinical features, histopathological features, diagnosis and management related to antibiotics and acetaminophen induced liver damage. N acetylcysteine is commonly available antidote for drug induced hepatic damage. Role of other pharmacological agents as an antidote requires further studies. However, liver transplantation should be considered with drug induced lethal liver failure

scholarly journals Possibilities of Pharmacological Preconditioning

2016 ◽  
Vol 71 (1) ◽  
pp. 16-24 ◽  
Author(s):  
O. S. Levchenkova ◽  
V. E. Novikov
Keyword(s):  
Opioid Analgesics ◽  
Metabolic Adaptation ◽  
Tolerance Development ◽  
Inhalation Anesthesia ◽  
Pharmacological Agents ◽  
Adenosine Receptor Agonists ◽  
Clinical Data Analysis ◽  
Potassium Channel Activators ◽  
Pharmacological Preconditioning

The review is devoted to the experimental and clinical data analysis about the effectiveness of preconditioning as a method of organism’s tolerance development to ischemia/hypoxia. Characteristics of the trigger, signaling and effector stages of the preconditioning mechanism are described. Medicinal agents which can stimulate processes of endogenous metabolic adaptation are discussed. As is shown in the review the role of inducers of preconditioning can play drugs from different pharmacological groups: adenosine receptor agonists, some agents for inhalation anesthesia, potassium channel activators, opioid analgesics, antagonists of excitatory amino acids, inducers of transcription factors, drugs of erythropoietin, inhibitors of the mitochondrial pore, bioflavonoids, drugs with antihypoxic action. Examples of successful preconditioning with help of pharmacological agents are presented. The prospects of pharmacological preconditioning usage in cerebral ischemia and myocardial infarction are discussed in the article.

scholarly journals Dietary Interventions Are Beneficial for Patients with Chronic Pain: A Systematic Review with Meta-Analysis

Pain Medicine ◽  
2020 ◽  
Author(s):  
Rowena Field ◽  
Fereshteh Pourkazemi ◽  
Jessica Turton ◽  
Kieron Rooney
Keyword(s):  
Oxidative Stress ◽  
Chronic Pain ◽  
Visual Analog Scale ◽  
Dietary Intervention ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Significant Finding ◽  
Dietary Interventions ◽  
Analog Scale ◽  
Nutrient Density

Abstract Background The standard Western diet is high in processed hyperpalatable foods that displace nutrient-dense whole foods, leading to inflammation and oxidative stress. There is limited research on how these adverse metabolic drivers may be associated with maladaptive neuroplasticity seen in chronic pain and whether this could be attenuated by a targeted nutritional approach. The aim of this study was to review the evidence for whole-food dietary interventions in chronic pain management. Method A structured search of eight databases was performed up to December 2019. Two independent reviewers screened studies and evaluated risk of bias by using the National Institutes of Health assessment tool for controlled or pre–post studies and the Joanna Briggs checklist for case reports. A meta-analysis was performed in Review Manager. Results Forty-three studies reporting on 48 chronic pain groups receiving a whole-food dietary intervention were identified. These included elimination protocols (n = 11), vegetarian/vegan diets (n = 11), single-food changes (n = 11), calorie/macronutrient restriction (n = 8), an omega-3 focus (n = 5), and Mediterranean diets (n = 2). A visual analog scale was the most commonly reported pain outcome measure, with 17 groups reporting a clinically objective improvement (a two-point or 33% reduction on the visual analog scale). Twenty-seven studies reported significant improvement on secondary metabolic measures. Twenty-five groups were included in a meta-analysis that showed a significant finding for the effect of diet on pain reduction when grouped by diet type or chronic pain type. Conclusion There is an overall positive effect of whole-food diets on pain, with no single diet standing out in effectiveness. This suggests that commonalities among approaches (e.g., diet quality, nutrient density, weight loss) may all be involved in modulating pain physiology. Further research linking how diet can modulate physiology related to pain (such as inflammation, oxidative stress, and nervous system excitability) is required.

scholarly journals The role of B vitamins in the treatment of back pain

2018 ◽  
pp. 38-43
Author(s):  
N. Svyrydova
Keyword(s):  
Risk Factors ◽  
Chronic Pain ◽  
Back Pain ◽  
Pain Syndrome ◽  
Epidemiological Studies ◽  
B Vitamins ◽  
Chronic Pain Syndrome ◽  
Occupational Risk Factors ◽  
Inflammatory Drugs

In 2018, an analysis of epidemiological studies was conducted that provided information on the prevalence of back pain and identified individual, psychosocial and occupational risk factors for the onset of this pathology. It is important that when choosing the tactics of treatment, it is necessary to take into account the risk of complications in the presence of multimorbid pathology in patients with acute or chronic pain syndrome. Increasing the effectiveness and safety of therapy based on the use of nonsteroidal anti-inflammatory drugs, the risk of which can be minimized, is associated with the inclusion of B vitamins. The results of various clinical studies on the use of the B complex of vitamins showed a significant decrease in the severity of the pain syndrome and a significant improvement in motor functions, regression of sensitive disorders.

The Orexinergic (Hypocretin) System and Nociception: An Update to Supraspinal Mechanisms

2018 ◽  
Vol 25 (32) ◽  
pp. 3917-3929 ◽  
Author(s):  
Ali Roohbakhsh ◽  
Mohaddeseh Sadat Alavi ◽  
Hassan Azhdari-Zarmehri
Keyword(s):  
Chronic Pain ◽  
Side Effects ◽  
Hormone Secretion ◽  
Experimental Studies ◽  
Pain Modulation ◽  
Potential Candidate ◽  
Analgesic Drugs ◽  
Orexin Receptors ◽  
Inflammatory Drugs

Chronic pain is a multifaceted and complex condition that is divided into somatic, visceral, and neuropathic pain. Although opioids and nonsteroidal anti-inflammatory drugs cause analgesia and are effective in the treatment of chronic pain, their utility is hampered by side effects, abuse potential, and development of tolerance to their pain-relieving effects. So, finding alternative analgesics with good efficacy and low side effects is of great interest and the orexinergic system is a potential candidate. Orexin-A and -B are exclusively expressed in the lateral hypothalamus and are involved in the feeding, sleep/wake cycle, cardiovascular function, hormone secretion, seizure, and pain modulation. Orexin peptides and their receptors have been proposed as opportunities for developing analgesic drugs. In experimental studies, orexin peptides induce analgesia that is comparable to morphine. Furthermore, there is evidence that orexin receptors 1 and 2 participate in responsiveness to both stressful stimuli and pain. Thus, direct and indirect activation of the orexinergic system is a new therapeutic approach to pain control. This article will review the most recent and important studies describing the role of orexins in pain modulation.

The Role of Polyphenols in the Modulation of Plasma Non-Enzymatic Antioxidant Capacity (NEAC)

2012 ◽  
Vol 82 (3) ◽  
pp. 228-232 ◽  
Author(s):  
Mauro Serafini ◽  
Giuseppa Morabito
Keyword(s):  
Antioxidant Capacity ◽  
Dietary Intervention ◽  
Ex Vivo ◽  
The Body ◽  
Dietary Polyphenols ◽  
Enzymatic Antioxidant ◽  
Endogenous Antioxidant

Dietary polyphenols have been shown to scavenge free radicals, modulating cellular redox transcription factors in different in vitro and ex vivo models. Dietary intervention studies have shown that consumption of plant foods modulates plasma Non-Enzymatic Antioxidant Capacity (NEAC), a biomarker of the endogenous antioxidant network, in human subjects. However, the identification of the molecules responsible for this effect are yet to be obtained and evidences of an antioxidant in vivo action of polyphenols are conflicting. There is a clear discrepancy between polyphenols (PP) concentration in body fluids and the extent of increase of plasma NEAC. The low degree of absorption and the extensive metabolism of PP within the body have raised questions about their contribution to the endogenous antioxidant network. This work will discuss the role of polyphenols from galenic preparation, food extracts, and selected dietary sources as modulators of plasma NEAC in humans.

Role of Ethnicity on Pain Perception, Fatigue, and Quality of Life in a Pediatric Chronic Pain Population

2007 ◽  
Author(s):  
Jeffrey I. Gold ◽  
Trina Haselrig ◽  
D. Colette Nicolaou ◽  
Katharine A. Belmont
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Perception ◽  
Pediatric Chronic Pain

Haemostatic Platelet Plug Formation in the Isolated Rabbit Mesenteric Preparation - An Analysis of Red Blood Cell Participation

1980 ◽  
Vol 44 (01) ◽  
pp. 006-008 ◽  
Author(s):  
D Bergqvist ◽  
K-E Arfors
Keyword(s):  
Whole Blood ◽  
Platelet Rich Plasma ◽  
Adenosine Diphosphate ◽  
In Vitro Test ◽  
Pharmacological Agents ◽  
Vitro Test ◽  
Releasing Effect ◽  
Plug Formation

SummaryIn a model using an isolated rabbit mesenteric preparation microvessels were transected and the time until haemostatic plugs formed was registered. Perfusion of platelet rich plasma gave no haemostasis whereas whole blood did. Addition of chlorpromazine or adenosine to the whole blood significantly prolonged the time for haemostasis, and addition of ADP to the platelet rich plasma significantly shortened it. It is concluded that red cells are necessary for a normal haemostasis in this model, probably by a combination of a haemodynamic and ADP releasing effect.The fundamental role of platelets in haemostatic plug formation is unquestionable but there are still problems concerning the stimulus for this process to start. Three platelet aggregating substances have been discussed – thrombin, adenosine diphosphate (ADP) and collagen. Evidence speaking in favour of thrombin is, however, very minimal, and the discussion has to be focused on collagen and ADP. In an in vitro system using polyethylene tubings we have shown that "haemostasis" can be obtained without the presence of collagen but against these results can be argued that it is only another in vitro test for platelet aggregation (1).To be able to induce haemostasis in this model, however, the presence of red blood cells is necessary. To further study this problem we have developed a model where haemostatic plug formation can be studied in the isolated rabbit mesentery and we have briefly reported on this (2).Thus, it is possible to perfuse the vessels with whole blood as well as with platelet rich plasma (PRP) and different pharmacological agents of importance.

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