PainRelief.com Interview with: John M. Streicher, PhD Member of the Graduate Faculty Professor, Neuroscience – GIDP Professor, Pharmacology College of Medicine, Tucson University of Arizona
PainRelief.com: What is the background for this study?
Response: Cannabis has many chemical components that have potential therapeutic benefits, however, the great majority of research to date has focused on the major cannabinoids THC and CBD. In the past, different groups have tested the pharmacological effects of terpenes, which are small aromatic compounds in Cannabis and other plants that impart taste and aroma. They found pain relieving and anti-inflammatory effects, in both pre-clinical and clinical studies. However, those studies mostly did not test the therapeutic aspects of terpenes like side effects and dosing routes, and the mechanism of action in pain is also mostly unclear.
We thus began our studies by comprehensively testing a set of 5 terpenes for their pharmacological and therapeutic effects. In 2021, we published a paper showing the terpenes had cannabinoid-like behavioral effects, and also worked through the Cannabinoid Receptor 1 and the Adenosine A2a Receptor to carry out these effects. We also found that they had stronger effects when combined with a cannabinoid.
PainRelief.com Interview with: Kai-Uwe KernMD, PhD Institute of Pain Medicine/Pain Practice Wiesbaden, Germany
PainRelief.com: What is the background for this study?
Response: In recent studies a progressive response to high-concentration capsaicin patch (HCCP) with repeated treatment was observed, meaning that patients with insufficient pain relief after the first application of HCCP, still may respond to a second, third, or even fourth application. Based on these latest findings, and also on my personal clinical experience, we aimed to systematically analyse the pool of patients in my Pain Practice with at least two HCCP treatments.
PainRelief.com Interview with: Libak Abou PhD, MPT Department of Physical Medicine & Rehabilitation Michigan Medicine Institute for Healthcare Policy and Innovation University of Michigan, Ann Arbor, Michigan
PainRelief.com: What is the background for this study?
Response: Chronic pain is a common symptom experienced by persons with multiple sclerosis (MS) that affects their daily living functioning including physical activity. Growing evidence indicates that persons with MS may experience various types of chronic pain including widespread pain with nociplastic features (WPNF), nociceptive pain, and/or neuropathic pain. WPNF is a chronic and diffuse pain which can be challenging to localize or describe precisely. In person with multiple sclerosis, this type of pain arises from altered processing signals within the central nervous system. This is opposed to pain that arises from specific tissue damage, classified as nociceptive pain, or pain related to demyelination and axonal damage, classified as neuropathic pain.
Our main goal with this study was to investigate whether differences exists on the level of physical activity achieved by persons with MS based on the type of chronic pain they experience
PainRelief.com Interview with: Kimberley Tolias, Ph.D. Professor Department of Neuroscience Biochemistry & Molecular Biology Baylor College of Medicine Houston, TX 77030
PainRelief.com: What is the background for this study?
Response: Neuropathic pain is a chronic pain condition that affects millions of people worldwide, significantly impairing their quality of life. Symptoms of neuropathic pain include spontaneous shooting or burning pain, pain from activities that don’t normally cause pain (allodynia), and heightened pain sensitivity (hyperalgesia). Current treatment options for neuropathic pain, such as opioids, focus on symptom suppression and are generally ineffective and often cause unwanted side effect. In order to develop safer, more effective chronic pain treatments, we need to better understand the processes that lead to neuropathic pain.
Neuropathic pain is caused by nerve damage from a variety of insults (e.g., injury, disease, infection, chemotherapy drugs), which trigger structural and functional changes in the neurons and synaptic connections that transmit pain signals. These activity-dependent alterations in somatosensory neural circuits are thought to be responsible for the persistent symptoms associated with chronic pain, but how they are induced and maintained following nerve injury or disease remains unclear. To address this problem, our research team, including lead and co-corresponding author Dr. Lingyong Li (now at University of Alabama at Birmingham), investigated the mechanisms that underlie neuropathic pain, with the goal of identifying strategies to prevent or control it.
PainRelief.com Interview with: Venetia Zachariou PhD Edward Avedisian Professor Chair of Pharmacology, Physiology & Biophysics Boston University Chobanian & Avedisian School of Medicine
PainRelief.com: What is the background for this study?
Response: COVID-19, the disease resulting from SARS-CoV-2 infection, is associated with highly variable clinical outcomes that range from asymptomatic disease to death. For those with milder infections, COVID-19 can produce respiratory infection symptoms (cough, congestion, fever) as well as loss of the sense of smell.
A substantial number of actively infected patients suffering from both mild and severe infections experience sensory-related symptoms, such as headache, visceral pain, Guillain-Barre syndrome (GBS), nerve pain and inflammation. In most patients these symptoms subside after the infection ends, but, for other patients, they can persist.
PainRelief.com Interview with: Ken M. Hargreaves, DDS, PhD Professor and Chair Department of Endodontics The University of Texas Health Science Center at San Antonio
Dr. Hargreaves
PainRelief.com: What is the background for this study? What are the main findings?
About ten years ago our lab found that the omega-6 lipids can generate pain-producing lipids by activating the capsaicin (found in red hot chili) receptor. At about that time, other scientists reported that a related lipid, the omega-3, can generate pain-relieving lipids.
Scientists have known for a long time that both omega-6 and omega-3 lipids are “essential fatty acids”, meaning that our body does not make them so they must come in our diet.
So, we tested the idea that a high omega-6 diet would be a risk factor for pain. That is exactly what we found: mice fed a high omega-6 diet had greater pain-like responses after inflammatory or neuropathic injury.
Mice with diabetic neuropathy actually had worsening of symptoms after a high-6 diet. Importantly, this was largely reversed in mice fed a high omega-3 diet.
We also found a drug that blocked the release of the omega-6 lipids from cell membranes and this drug significantly reduced diabetic neuropathy pain in mice.
We then transitioned to clinical research. We collected ankle skin biopsies from participants with type II diabetic neuropathy and from age- and sex-matched controls. The tissue levels of omega-6 lipids predicted pain levels, with higher omega-6 lipids associated with higher reports of pain.
PainRelief.com: What should readers take away from your report?
Dietary recommendations have been made for patients with many disorders such as cardiovascular disease, diabetes and autoimmune disease. Our findings suggest that pain should be added to this list and that a diet enriched with a higher ratio of omega-3 to omega-6 lipids may help to reduce pain.
Examples of foods with a high omega 3:6 ratio are tune (25:1 of omega 3:6), broccoli (6:1), flax seeds (4:1), mango (3:1), spinach (5:1) and lettuce (2:1). Examples of foods with excessive omega-6:3 would include many processed foods cooked in vegetable oils such as French fries, hamburgers and the like.
PainRelief.com: What recommendations do you have for future research as a result of this study?
Response: Our study has identified several paths for future research including a clinical trial evaluating the effects of a high omega 3:6 diet on pain, development of new drugs to block omega-6 release and the possible development of lipids as a biomarker for pain.
The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.
PainRelief.com Interview with: Erika A. Petersen, MD, FAANS, FACS Professor of Neurosurgery Residency Program Director UAMS Department of Neurosurgery
PainRelief.com: What is the background for this study?
Response: Painful diabetic neuropathy is a common occurrence for patients with diabetes and can have a tremendous negative impact on their quality of life. Currently, the best available treatments include several types of medications and topical solutions, but there are many patients who do not achieve adequate pain relief or cannot tolerate side effects from these treatments. We need new options for patients who have tried the recommended first- and second-line treatments but still suffer with severe pain.
PainRelief.com: What is the background for this study? Would you explain how VM202 is unique?
Response: Diabetic peripheral neuropathy is one of the most common complications of diabetes and many of DPN patients suffer from severe pain that affects their daily activities and life quality. Though there are medications, both Rx and OTC drugs, used to ameliorate pains from diabetic peripheral neuropathy, many of them fall short of analgesic efficacy or often lead to not so trivial side effects.
Engensis (VM202) is plasmid DNA therapy, non-viral gene therapy, which encodes hepatocyte growth factor (HGF) gene that is designed to simultaneously express two isoforms of HGF protein at high levels. HGF is known to have angiogenic and neurotrophic effects and, when expressed in the human body, induces formation of new micro vessels and nerve regeneration through remyelination and axon outgrowth, resulting in improvement in peripheral neuropathy condition. Engensis does not integrate into the human genome.
Historically, our research first focused on therapeutic angiogenesis of HGF with a proof of concept research in critical limb ischemia, an extreme form of peripheral artery disease. In the process, we realized that Engensis would also be effective for peripheral neuropathy, and a coffee chat with the current PI, Dr. Kessler of Northwestern University, led to an idea of using Engensis in neurological diseases.
Throughout Phase 1 through 3 clinical trials for DPN in the US, Engensis has been observed safe and well-tolerated in patients, and, during the Phase 3 study, received RMAT (regenerative medicine advanced therapy) designation from the FDA.
The information on PainRelief.com is provided for educational purposes only, and is in no way intended to diagnose, endorese, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. None of the content on PainRelief.com is warranted by the editors or owners of PainRelief.com or Eminent Domains Inc.
Thank you for visiting PainRelief.com
Senior Editor, Marie Benz MD.
For more information, or for advertising options please email: [email protected] or [email protected]
