Blocking Calcium Channels May Help With Neuropathic Pain

Today's post from themayerinstitute.ca (see link below) talks about how neuropathic pain and other symptoms can be helped by blocking calcium channels with certain drugs. It is directed (as so many are) at diabetes patients who end up with neuropathy as a result of glucose imbalance but although diabetes is by far the most common cause of neuropathy, the treatments are very much the same whatever the cause. If you're an experienced neuropathy patient, you may have heard that many drugs block sodium channels to achieve the same result; this treatment is an alternative and claims to work on the nerves rather than the brain although which specific treatment they are talking about is not mentioned. Many neuropathy treatments involve taking anti-depressants or anti-convulsants and these act on these channels in the brain so whether this medication is in the same family or not is unclear. If one of the side effects is that it makes patients sleepy then it is clearly having an effect on nerve cells in the brain anyway. 

Reversing Painful Diabetic Neuropathy: Blocking the calcium channel floodgates may be the answer.
August 27, 2013

This article originally posted 22 August, 2013 and appeared in Neuropathy, Issue 691


Discovery Shows the Way to Reverse Diabetic Nerve Pain


New information on one of diabetes' most debilitating complications….

Diabetic neuropathy affects approximately 60-70% of people with diabetes. For such a common problem that affects patients with diabetes, little is known about peripheral neuropathy. Patients with diabetes who are suffering from peripheral neuropathy talk of how terrible it is to live with the condition: how a gentle touch can be agonizing and how a warm shower can be torturous. But, at the University of Virginia School of Medicine, new research has shed some more light on peripheral neuropathy's causes and may eventually suggest a way to reverse it.

"Normally pain is useful information because it alerts us that there is a damaging effect – something happening to tissues. But this pain is typically without any obvious reason," UVA researcher and anesthesiologist Dr. Slobodan M. Todorovic explains. "It's because nerves are being affected by high levels of glucose in the blood. So nerves start working on their own and start sending pain signals to the brain. It can be a debilitating condition that severely affects quality of life."

Dr. Slobodan Todorovic and Dr. Vesna Jevtoviv-Todorovic, Harold Carron Professor of Anethesiology and Neuroscience at UVA, have demonstrated the reversal of peripheral diabetic neuropathy in mice through the use of a substance that is naturally present in both humans and animals.

The researchers and their colleagues discovered that the high levels of blood sugar cause a change to the structure of channels that allow for the release of calcium into the nerve cells. This in effect forces them open and the overload of calcium into the cells causes them to become hyperactive. This high level of activity can lead to various effects, such as a slight tingling in the arms and legs or an excruciating pain.

Knowing this may prove to extremely important not only in the treatment of diabetic neuropathy, but in other conditions such as nerve injury from an accident, a wound received in combat or other causes for chronic pain. Dr. Todorovic stated that he and his research team found that the function of these calcium channels is similarly affected in these conditions.

The Todorovics said that finding more treatment options for diabetic neuropathy is very important because of the increasing prevalence of diabetes and the lack oftherapeutic options. They go on to say that a commonly used drug was helpful for some but not all patients, often times causing considerable fatigue.

"A lot of patients decide to cope with the pain rather than to be sleepy all day," Todorovic said. However, the substance the University of Virginia researchers are testing in their study does not cause drowsiness. This is due to the fact that it works on the nerves rather than in the brain. "In some ways, you can think about it as going back to the baseline," Jevtovic-Todorovic said. "It's not a complete blockade; it’s a normalization."

The new findings have been published online by the journal Diabetes and will appear in a forthcoming print edition. The UVA researchers hope that reversing the early stages of diabetic neuropathy could prevent the complete loss of feeling associated with the advanced stages of the disease.

University of Virginia Press Release

http://www.themayerinstitute.ca/reversing-painful-diabetic-neuropathy-blocking-the-calcium-channel-floodgates-may-be-the-answer/

Block Pain Channels And You Can Block Neuropathic Pain

Today's post from diabetes.co.uk (see link below) reveals new research which looks promising for future treatments of neuropathy. There seem to be quite a few close investigations of pain processes within the brain recently and like most others, this one has discovered that blocking a particular channel (which pain signals use), neuropathic pain can be also blocked and therefore not felt by the patient. It centres on the anterior cingulate cortex (ACC), which is the region of the brain most commonly and consistently involved in the pain processing and looks at so-called, HCN channels which carry pain signals. By blocking these in rats, pain can be 'blocked out' so to speak. Interesting development and hope for therapeutic treatments for humans in the future.

Researchers target molecular mechanisms that could relieve pain from peripheral neuropathy
Kurt Wood September 2015

A group of researchers have found molecular mechanisms that could be responsible for the pain caused by peripheral neuropathy.

The study, conducted by researchers at McGill University in Montreal, Canada, sheds new light on what was a poorly understood condition.

Peripheral neuropathy is the scientific term for nerve damage. Neuropathy can have a number of causes, including diabetes. In fact, diabetic neuropathy is one of the most common complications of diabetes. Diabetic neuropathy is caused by prolonged exposure to high blood glucose levels over a number of years.
Neuropathy, pain and the anterior cingulate cortex

This study focused on the anterior cingulate cortex (ACC), the region of the brain most commonly and consistently involved in the pain processing. The researchers made new discoveries about one type of channel (hyperpolarisation-activated cyclic nucleotide-gated channels, or HCN) that influences pain signals to the ACC.

They then tested their findings on a group of rats. By blocking HCN channels, the researchers lessened the stimulation of the ACC, which significantly reduced the pain transmitted to the rats.

The researchers hope that targeting the HCN channels will reduce the pain of neuropathy in humans, but further studies are needed to confirm that this is viable and safe.

"Our study has revealed one important mechanism linking chronic pain to abnormal activity of the ACC and it provides a cellular and molecular explanation for the overstimulation of neurons in the prefrontal cortex," said senior author Philippe Séguéla.

"This gives us new perspectives on therapeutic strategies that could target the HCN channels to help relieve chronic pain.

"Our findings open new doors to research possible treatment of these debilitating symptoms that are linked to chronic pain."

The findings were published in the Journal of Neuroscience.

http://www.diabetes.co.uk/News/2015/Oct/researchers-target-molecular-mechanisms-that-could-relieve-pain-from-peripheral-neuropathy-90193351.html