Following on from recent posts looking at unusual potential sources of pain relief, today's post from emaxhealth.com (see link below) examines the promising properties of a sort of sea snail saliva. It could possible rival morphine in its pain-killing properties and anything that could be a non-addictive substitute for morphine must be welcome in the neuropathy community. Don't expect it to appear soon on the list of approved drugs. They've managed to develop a synthetic version but that has to be injected into the spine and nobody's waiting for that sort of treatment. Still a long way to go then but it's great that people are seriously searching the natural world for alternatives to morphine.
Snail Saliva As Effective as Morphine?
By Deborah Mitchell on July 28, 2010
To treat severe pain, a sea snail may hold an answer. Scientists have developed a new medication first isolated from sea snail saliva that may be as effective as morphine.
Sea snails may not move fast, but what they lack in speed, they more than make up for in chemicals. These animals have the ability to inject a mixture of toxins called conotoxins into their targeted prey using their needle-like teeth.
These conotoxins consist of peptides that can relieve severe neuropathic pain as effectively as morphine, but it does not lead to addiction. Attempts to transform these conotoxins into a drug that could be used as a pain reliever has been challenging. Thus far a synthetic version has been developed, but it must be injected directly into the spinal cord using an implanted pump.
Now, a team of scientists in Australia have developed a conotoxin that can be taken orally. In tests with rats, the new drug proved to be as effective a pain killer as gabapentin, which is the most popular drug to treat neuropathic pain. Compared with the dose of gabapentin needed to treat pain, however, the conotoxin-based peptide (named Prialt) is less than 1 percent.
The research team, led by David J. Craik of the Institute for Molecular Bioscience at the University of Queensland, noted that peptides have generally been regarded to be poor pain killers because they are not stable and mostly not available in oral form. One exception has been the immunosuppressant cyclosporine.
Could a drug based on sea snail saliva be next? Jon-Paul Bignham, a professor of molecular biosciences and bioengineering at the University of Hawaii, Manoa, pointed out that an oral drug that has the pain killer abilities of Prialt “would absolutely revolutionize how we manage chronic and terminal pain.” Move over, morphine.
SOURCE:
Chemical & Engineering News 2010 July 26; 88(30): 39-40
http://www.emaxhealth.com/1275/snail-saliva-effective-morphine
Today's post from sciencedaily.com (see link below) looks at new attempts to combine two types of medication to produce a better result than using one on its own. In the current climate where opioids are receiving so much negative publicity and genuine chronic pain patients are suffering the backlash, this may be an attempt to lessen the impact of the opiate by combining it (in this case) with an epilepsy drug (carbamazepine) which is also often used to treat neuropathy in isolation. Over the years this returns to the headlines as an option but never really seems to have taken off and become first-line treatment. if the claims are as beneficial as is being stated, it may be worth talking to your doctor or specialist about.
Combining epilepsy drug, morphine can result in less pain, lower opioid doses
Date: September 15, 2014 Source: Indiana University
Summary:
Adding a common epilepsy drug to a morphine regimen can result in better pain control, fewer side effects and reduced morphine dosage, according to research. The result could bring significant relief to many patients with neuropathic pain, a difficult-to-treat condition often felt in the arms and legs and associated with nerve tissue damage.
Adding a common epilepsy drug to a morphine regimen can result in better pain control with fewer side effects. Moreover, the combination can reduce the dosage of the opioid needed to be effective, according to a team of pain researchers at Indiana University.
The result could bring significant relief to many patients with neuropathic pain, a difficult-to-treat condition often felt in the arms and legs and associated with nerve tissue damage.
"There is a huge unmet need for better treatments for neuropathic pain," said Fletcher A. White, Ph.D., the Vergil K. Stoelting Professor of Anesthesia at the Indiana University School of Medicine.
In laboratory tests using rodents, White and his colleagues found that while morphine lost its pain-relieving effectiveness three weeks after nerve injury, a combination therapy of morphine and carbamazepine -- used to prevent epileptic seizures -- could effectively reverse this loss of drug action. Their findings were reported in the journal PLOS ONE.
Although morphine and related opioid drugs are effective in treating pain, they can result in dependence and produce side effects including respiratory depression, nausea, constipation and other problems. In addition, such drugs can, paradoxically, actually cause pain, a condition called opioid-induced hyperalgesia.
"People immediately think, 'Oh, it's tolerance, the patient needs more of the drug for pain control,'" Dr. White said.
In fact, research indicates that the pain of hyperalgesia occurs because the morphine latches on not only to cellular targets that reduce pain sensation but to other "non-opioid" targets that result in activation of pain-sensing neurons. Dr. White and his colleagues had previously identified a key cellular factor -- known to be a specific voltage-gated sodium ion channel -- involved in that non-opioid process of pain nerve stimulation. Meanwhile another IU School of Medicine researcher, Theodore Cummins, Ph.D., professor of pharmacology and toxicology, had previously determined that carbamazepine alone has the opposite effect on the same ion channel.
Combining the two drugs could prevent the escalating doses of opioids that are sometimes prescribed to provide pain relief in the clinic.
"We know that opioids have benefits," Dr. White said. "If we can diminish the off-target effects, that's good. If we can diminish the opioid dosages required for pain relief, then you've really got something."
Because both drugs are approved for use by the Food and Drug Administration, physicians have tested the combination with patients, resulting in anecdotal reports of significantly improved pain management, Dr. White said. More formally, Dr. White and physician-researchers have begun testing the combination of morphine and a close relative of carbamazepine with patients in a small clinical trial at the Indiana University Melvin and Bren Simon Cancer Center.
In addition to Dr. White, researchers contributing to the study were Michael R. Due, Xiao-Fang Yang, Yohance M. Allette, Aaron L. Randolph, Matthew S. Ripsch, Sarah M. Wilson and Erik T. Dustrude of the IU School of Medicine; and Rajesh Khanna of the College of Medicine, University of Arizona.
The research was funded by National Institutes of Health grants NIDDK DK100905 and NIDA DA026040 and the Indiana Spinal Cord and Brain Injury Research Fund.
Story Source:
The above story is based on materials provided by Indiana University. Note: Materials may be edited for content and length.
Journal Reference:
Michael R. Due, Xiao-Fang Yang, Yohance M. Allette, Aaron L. Randolph, Matthew S. Ripsch, Sarah M. Wilson, Erik T. Dustrude, Rajesh Khanna, Fletcher A. White. Carbamazepine Potentiates the Effectiveness of Morphine in a Rodent Model of Neuropathic Pain. PLoS ONE, 2014; 9 (9): e107399 DOI: 10.1371/journal.pone.0107399 http://www.sciencedaily.com/releases/2014/09/140915153613.htm
