Expert review of neurotherapeutics
-
Expert Rev Neurother · Jul 2013
ReviewNeurotrophins, inflammation and oxidative stress as illness activity biomarkers in bipolar disorder.
Recent studies highlight the presence of systemic toxicity as an integral dimension of bipolar disorder pathophysiology, possibly linking this mood disorder with other medical conditions and comorbidities. This review summarizes recent findings on possible peripheral biomarkers of illness activity, with a focus on neurotrophins, inflammation and oxidative stress. The possible mechanisms underlying the systemic toxicity associated with acute episodes in bipolar disorder are also discussed. Finally, the authors outline novel therapies that emerge from this new research and the assessment of multiple biomarkers as a potential approach to improving management strategies in bipolar disorder.
-
Neuropathic pain (NP) is a pain arising as a direct consequence of a lesion or disease affecting the somatosensory system. A variety of factors associated with the development of persistent NP have been suggested. ⋯ Most reported predictors in the literature were found in the International Classification of Functioning, Disability and Health-category of personal factors, especially age and psychological factors, functions and structure, including sensory signs and symptoms. Predictors in the category of environmental factors, activities and participation were less frequently described.
-
Expert Rev Neurother · May 2013
ReviewLessons learned in the abuse of pain-relief medication: a focus on healthcare costs.
The increasing prevalence of chronic pain with its major societal impact and the escalating use of opioids in managing it, along with their misuse, abuse, associated fatalities and costs, are epidemics in modern medicine. Over the past two decades, multiple lessons have been learned addressing various issues of abuse. Multiple measures have already been incorporated and more are expected to be incorporated in the future, which in turn may curtail the abuse of drugs and reduce healthcare costs, but these measures may also jeopardize access to appropriate pain treatment. This manuscript describes the lessons learned from the misuse, abuse and diversion of opioids, escalating healthcare costs and the means to control this epidemic.
-
Expert Rev Neurother · May 2013
ReviewNovel findings in pain processing pathways: implications for miRNAs as future therapeutic targets.
miRNAs are small noncoding RNAs that are important players in development, as well as in a number of physiological and pathophysiological processes. Due to their regulatory role in protein expression, it has been assumed that they are associated with peripheral and central sensitization mechanisms in the nervous system after nociceptive insults. ⋯ First reports mostly focused on miRNA regulations in different pain states while studies examining the functional role of individual miRNAs are only now arising. In this review, the authors summarize the current knowledge and progress in miRNA research in pain and discuss their potential role as therapeutic antinociceptive targets.