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Naja atra venom peptide reduces pain by selectively blocking the voltage-gated sodium channel Nav1.8.

The voltage-gated sodium channel Nav1.8 is preferentially expressed in peripheral nociceptive neurons and contributes to inflammatory and neuropathic pain. Therefore, Nav1.8 has emerged as one of the most promising analgesic targets for pain relief. Using large-scale screening of various animal-derived toxins and venoms for Nav1.8 inhibitors, here we identified μ-EPTX-Na1a, a 62-residue three-finger peptide from the venom of the Chinese cobra (), as a potent inhibitor of Nav1.8, exhibiting high selectivity over other voltage-gated sodium channel subtypes. Using whole-cell voltage-clamp recordings, we observed that purified μ-EPTX-Na1a blocked the Nav1.8 current. This blockade was associated with a depolarizing shift of activation and repolarizing shift of inactivation, a mechanism distinct from that of any other gating modifier toxin identified to date. In rodent models of inflammatory and neuropathic pain, μ-EPTX-Na1a alleviated nociceptive behaviors more potently than did morphine, indicating that μ-EPTX-Na1a has a potent analgesic effect. μ-EPTX-Na1a displayed no evident cytotoxicity and cardiotoxicity, and produced no obvious adverse responses in mice even at a dose 30-fold higher than that producing a significant analgesic effect. Our study establishes μ-EPTX-Na1a as a promising lead for the development of Nav1.8-targeting analgesics to manage pain.

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Association of Serum Cholesterol Levels With Peripheral Nerve Damage in Patients With Type 2 Diabetes.

Lowering serum cholesterol levels is a well-established treatment for dyslipidemia in patients with type 2 diabetes (T2D). However, nerve lesions in patients with T2D increase with lower serum cholesterol levels, suggesting that lowering serum cholesterol levels is associated with diabetic polyneuropathy (DPN) in patients with T2D.

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Effects of two isometheptene enantiomers in isolated human blood vessels and rat middle meningeal artery – potential antimigraine efficacy.

Racemic isometheptene [(RS)-isometheptene] is an antimigraine drug that due to its cardiovascular side-effects was separated into its enantiomers, (R)- and (S)-isometheptene. This study set out to characterize the contribution of each enantiomer to its vasoactive profile. Moreover, rat neurogenic dural vasodilatation was used to explore their antimigraine mechanism of action.

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Advanced visual network and cerebellar hyperresponsiveness to trigeminal nociception in migraine with aura.

Despite the growing body of advanced studies investigating the neuronal correlates of pain processing in patients with migraine without aura (MwoA), only few similar studies have been conducted in patients with migraine with aura (MwA). Therefore, we aimed to explore the functional brain response to trigeminal noxious heat stimulation in patients with MwA.

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Sensitization of nociceptors by prostaglandin E-glycerol contributes to hyperalgesia in mice with sickle cell disease.

Pain is a characteristic feature of sickle cell disease (SCD), one of the most common inherited diseases. Patients may experience acute painful crises as well as chronic pain. In the Berkley transgenic murine model of SCD, HbSS-BERK mice express only human hemoglobin S. These mice share many features of SCD patients, including persistent inflammation and hyperalgesia. Cyclooxygenase-2 (COX-2) is elevated in skin, dorsal root ganglia (DRGs) and spinal cord in HbSS-BERK mice. In addition to arachidonic acid, COX-2 oxidizes the endocannabinoid 2-arachidonoylglycerol (2-AG) to produce prostaglandin E-glycerol (PGE-G); PGE-G is known to produce hyperalgesia. We tested the hypothesis that PGE-G is increased in DRGs of HbSS-BERK mice and sensitizes nociceptors, sensory neurons that respond to noxious stimuli, and that blocking its synthesis would decrease hyperalgesia in HbSS-BERK mice. Systemic administration of -flurbiprofen preferentially reduced production of PGE-G over that of PGE in DRGs, decreased mechanical and thermal hyperalgesia as well as decreased sensitization of nociceptors in HbSS-BERK mice. The same dose of -flurbiprofen had no behavioral effect in HbAA-BERK mice, the transgenic control, but local injection of PGE-G into the hind paw of HbAA-BERK mice produced sensitization of nociceptors and hyperalgesia. Co-administration of a P2Y6 receptor antagonist blocked the effect of PGE-G indicating this receptor is a mediator of pain in SCD. The ability of -flurbiprofen to block the synthesis of PGE-G and to normalize levels of 2-AG suggests that -flurbiprofen may be beneficial to treat pain in SCD, thereby reducing the use of opioids to relieve pain.

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Spreading depression as a preclinical model of migraine.

Spreading depression (SD) is a slowly propagating wave of near-complete depolarization of neurons and glial cells across the cortex. SD is thought to contribute to the underlying pathophysiology of migraine aura, and possibly also an intrinsic brain activity causing migraine headache. Experimental models of SD have recapitulated multiple migraine-related phenomena and are considered highly translational. In this review, we summarize conventional and novel methods to trigger SD, with specific focus on optogenetic methods. We outline physiological triggers that might affect SD susceptibility, review a multitude of physiological, biochemical, and behavioral consequences of SD, and elaborate their relevance to migraine pathophysiology. The possibility of constructing a recurrent episodic or chronic migraine model using SD is also discussed.

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Blocking COX-2 for sickle cell pain relief.

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Association of sleep sufficiency and duration with chronic pain prevalence: A population-based cross-sectional study.

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Genetics and postsurgical neuropathic pain: An ancillary study of a multicentre survey.

Neuropathic pain following surgery could be a useful model for the study of the genetic mechanisms of peripheral neuropathic pain.

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Role of endocannabinoid system in dopamine signalling within the reward circuits affected by chronic pain.

The association between chronic pain, depression and anxiety has gained particular attention due to high rates of comorbidity. Recent data demonstrated that the mesolimbic reward circuitry is involved in the pathology of chronic pain. Interestingly, the mesolimbic reward circuit participates both in pain perception and in pain relief. The endocannabinoid system (ECS) has emerged as a highly relevant player involved in both pain perception and reward processing. Targeting ECS could become a novel treatment strategy for chronic pain patients. However, little is known about the underlying mechanisms of action of cannabinoids at the intersection of neurochemical changes in reward circuits and chronic pain. Because understanding the benefits and risks of cannabinoids is paramount, the aim of this review is to evaluate the state-of-art knowledge about the involvement of the ECS in dopamine signalling within the reward circuits affected by chronic pain.

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