Alice L Hung1, Michael Lim1, Tina L Doshi2. 1. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 2. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: tina.doshi@jhmi.edu.
Abstract
BACKGROUND: Neuropathic pain is a challenging condition often refractory to existing therapies. An increasing number of studies have indicated that the immune system plays a crucial role in the mediation of neuropathic pain. Exploration of the various functions of individual cytokines in neuropathic pain will provide greater insight into the mechanisms of neuropathic pain and suggest potential opportunities to expand the repertoire of treatment options. METHODS: A literature review was performed to assess the role of pro-inflammatory and anti-inflammatory cytokines in the development of neuropathic pain. Both direct and indirect therapeutic approaches that target various cytokines for pain were reviewed. The current understanding based on preclinical and clinical studies is summarized. RESULTS AND CONCLUSIONS: In both human and animal studies, neuropathic pain has been associated with a pro-inflammatory state. Analgesic therapies involving direct manipulation of various cytokines and indirect methods to alter the balance of the immune system have been explored, although there have been few large-scale clinical trials evaluating the efficacy of immune modulators in the treatment of neuropathic pain. TNF-α is perhaps the widely studied pro-inflammatory cytokine in the context of neuropathic pain, but other pro-inflammatory (IL-1β, IL-6, and IL-17) and anti-inflammatory (IL-4, IL-10, TGF-β) signaling molecules are garnering increased interest. With better appreciation and understanding of the interaction between the immune system and neuropathic pain, novel therapies may be developed to target this condition.
BACKGROUND:Neuropathic pain is a challenging condition often refractory to existing therapies. An increasing number of studies have indicated that the immune system plays a crucial role in the mediation of neuropathic pain. Exploration of the various functions of individual cytokines in neuropathic pain will provide greater insight into the mechanisms of neuropathic pain and suggest potential opportunities to expand the repertoire of treatment options. METHODS: A literature review was performed to assess the role of pro-inflammatory and anti-inflammatory cytokines in the development of neuropathic pain. Both direct and indirect therapeutic approaches that target various cytokines for pain were reviewed. The current understanding based on preclinical and clinical studies is summarized. RESULTS AND CONCLUSIONS: In both human and animal studies, neuropathic pain has been associated with a pro-inflammatory state. Analgesic therapies involving direct manipulation of various cytokines and indirect methods to alter the balance of the immune system have been explored, although there have been few large-scale clinical trials evaluating the efficacy of immune modulators in the treatment of neuropathic pain. TNF-α is perhaps the widely studied pro-inflammatory cytokine in the context of neuropathic pain, but other pro-inflammatory (IL-1β, IL-6, and IL-17) and anti-inflammatory (IL-4, IL-10, TGF-β) signaling molecules are garnering increased interest. With better appreciation and understanding of the interaction between the immune system and neuropathic pain, novel therapies may be developed to target this condition.
Authors: J Mika; E Rojewska; W Makuch; M Korostynski; S Luvisetto; S Marinelli; F Pavone; B Przewlocka Journal: Neuroscience Date: 2010-11-25 Impact factor: 3.590
Authors: Christoph Kleinschnitz; Harald H Hofstetter; Sven G Meuth; Stefan Braeuninger; Claudia Sommer; Guido Stoll Journal: Exp Neurol Date: 2006-05-03 Impact factor: 5.330
Authors: Frank Richter; Gabriel Natura; Matthias Ebbinghaus; Gisela Segond von Banchet; Susanne Hensellek; Christian König; Rolf Bräuer; Hans-Georg Schaible Journal: Arthritis Rheum Date: 2012-12
Authors: Steven P Cohen; Ronald L White; Connie Kurihara; Thomas M Larkin; Audrey Chang; Scott R Griffith; Christopher Gilligan; Ralph Larkin; Benny Morlando; Paul F Pasquina; Tony L Yaksh; Conner Nguyen Journal: Ann Intern Med Date: 2012-04-17 Impact factor: 51.598
Authors: Katarzyna Pawlik; Anna Piotrowska; Klaudia Kwiatkowski; Katarzyna Ciapała; Katarzyna Popiolek-Barczyk; Wioletta Makuch; Joanna Mika Journal: Immunology Date: 2020-02-05 Impact factor: 7.397
Authors: Robert E Sorge; Ying Si; Lyse A Norian; Abhishek Guha; Grace E Moore; L Burt Nabors; Natalia Filippova; Xiuhua Yang; Reed Smith; Rajeshwari Chellappan; Peter H King Journal: Neurotherapeutics Date: 2022-07-21 Impact factor: 6.088
Authors: Alysson V Braga; Sarah O A M Costa; Felipe F Rodrigues; Ivo S F Melo; Marcela I Morais; Márcio M Coelho; Renes R Machado Journal: Inflammopharmacology Date: 2019-08-06 Impact factor: 4.473