Use of naturally occurring peptides for neuropathic spinal cord injury pain

Aldric Hama, Jacqueline Sagen

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Spinal cord injury (SCI) is accompanied by intractable pain as well as loss of motor and visceral control. As part of an overall strategy in patient rehabilitation and improvement in quality of life, pain management is crucial. Interestingly, SCI patients report pain below the level of injury that has characteristics of neuropathic-type pain. Preclinical studies suggest that a key substrate that underlies the symptoms of neuropathic pain such as spontaneous pain and belowlevel cutaneous hypersensitivity is aberrant activity of spinal dorsal horn neurons. While pharmacotherapies for peripheral neuropathic pain exist, these treatments may lead to adverse side effects in SCI patients, such as muscle weakness and constipation, which may exacerbate existing dysfunctions. Thus, novel therapeutic strategies are needed. One way to limit the adverse effects associated with systemically administered drugs is intrathecal delivery. Intrathecal delivery also directs drug to dorsal horn neurons. Another way to reduce the severity of side effects and to potentially enhance drug efficacy is to utilize combination drug therapy. While the conopeptide ziconotide has demonstrated clinical efficacy for severe chronic pain, a limitation of this drug is its potential for significant side effects. Combinations of conopeptides with currently available drugs as well as with other conopeptides could be an effective means of reducing neuropathic SCI pain.

Original languageEnglish (US)
Pages (from-to)218-230
Number of pages13
JournalCurrent Protein and Peptide Science
Volume14
Issue number3
DOIs
StatePublished - Nov 29 2013

Keywords

  • Allodynia
  • Combination drug therapy
  • Conotoxin
  • Hyperalgesia
  • Intrathecal drug delivery
  • Synergism

ASJC Scopus subject areas

  • Biochemistry
  • Cell Biology
  • Molecular Biology

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