pain-management-2018-scientifictracks

4 / 31

Page 46
conferenceseries.com
Volume 7 Journal of Pain & Relief
ISSN: 2167-0846 Pain Management 2018
October 11-12, 2018
October 11-12, 2018 | Zurich, Switzerland
7th International Conference and Exhibition on
Pain Research and Management
Neurogenic information in autoimmune diseases and chronic pain syndromes
Matthias Seidel
Pain Clinic Basel, Switzerland
Pain is a key symptom in many musculoskeletal diseases. Persistent nociceptor stimulation activates the peripheral and
central nervous system (figure 1A, 1B)), and induces the release of neurotransmitters such as substance P (SP) or calcitonin-
gene related peptide (CGRP). Such molecules mediate peripheral tissue inflammation with reddening, swelling, hyperalgesia
or allodynia (1). These events are termed neurogenic inflammation (NI). Nerve growth factor (NGF) is a primary stimulator
of SP and CGRP. A variety of degenerative and autoimmune inflammatory diseases are characterized by NI and either show a
robust upregulation of neuronal mediators or clinical features of disease exasperation after stimulation of the nervous system
(2). The latter include internal or external Köbner phenomenon in psoriatic arthritis, pathergy in Behçet’s disease, UV light-
induced dermatitis in systemic lupus erythematosus or chronic regional pain syndrome (CRPS) that is typically induced by
trauma. Further strong evidence for NI in musculoskeletal diseases is provided by clinical trials with molecules that block
neuron-derived molecules. Recently, erenumab has been approved for the treatment of chronic migraine (3). This monoclonal
antibody binds to the CGRP receptor. Treatment with monoclonal antibodies against NGF such as tanezumab (4) or fasinumab
(5) have been effective in chronic pain syndromes including osteoarthritis or low back pain. In conclusion, NI is now more
increasingly recognized as an important mechanism in clinical medicine.
Recent Publications
1. Seidel M, Tsalik J, Vetter H, Müller W. (2007) Substance P in Rheumatic Diseases. Current Rheumatology Reviews. 3: 17.
2. Seidel MF, Herguijuela M, Forkert R, Otten U. (2009) Nerve growth factor in rheumatic diseases. Doi: 10.1016/j.
semarthrit.2009.03.002.
Matthias Seidel, J Pain Relief 2018, Volume 7
DOI: 10.4172/2167-0846-C1-020
Figure: Principles of pain transmission under physiological and chronic conditions. Neurotransmitters (e. g. SP or CGRP)
are released at the synapse to conduct the action potential to the CNS (1A). In case of chronic pain, neuropeptides are
transported to and released from the nociceptor (1B). The molecules are powerful inductors of local inflammation.