Reduced heat sensitivity and epidermal nerve fiber immunostaining following single applications of a high-concentration capsaicin patch
Reduced heat sensitivity and epidermal nerve fiber immunostaining following single applications of a high-concentration capsaicin patch
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DOI：
10.1016/j.pain.2004.07.017
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发表时间：
2004-10-01
期刊：
影响因子：
7.4
通讯作者：
Bley, KR
中科院分区：
文献类型：
--
作者：
Malmberg, AB;Mizisin, AP;Bley, KR
几个世纪以来，含有辣椒素的植物提取物一直被用作各种疼痛综合症的局部治疗方法。目前含有低浓度辣椒素的产品(通常为0.025-0.075%w/w)已在临床研究中显示出对各种疼痛状况的疗效。然而，为了产生显著的止痛效果，这些配方需要频繁地重复服用，经常需要在几周内每天重复服用三到五次。以往长时间接触低浓度辣椒素乳膏后的功能和免疫组织化学研究表明，止痛效果的持续时间和起效时间与皮肤伤害性感觉神经纤维反应性和免疫染色的减少有关。本研究的目的是确定单次局部应用高浓度辣椒素贴片(8%w/w)120分钟或更短时间是否会对皮肤伤害性神经纤维产生类似的影响。贴敷7天后，通过定量感觉测试测定冷、热感觉阈值的变化，并采集穿孔活检标本，以PGP9.5为标记评价贴敷部位的表皮神经纤维(ENF)免疫染色密度。结果显示，与安慰剂贴片相比，使用高浓度辣椒素贴片60或120分钟，显著降低了热而不是冷的敏感性，并减少了ENF免疫染色。暴露于低浓度辣椒素贴片(0.04%w/w)120分钟或高浓度辣椒素贴片30分钟的涂抹部位在温度阈值检测或ENF免疫染色方面与安慰剂均无显著差异。一次60分钟的高浓度贴片涂抹能够模拟长期接触低浓度辣椒素乳膏所产生的效果，这表明了一种治疗慢性疼痛综合征的新方法。(C)2004年国际疼痛研究协会。爱思唯尔出版，版权所有。
Capsaicin-containing plant extracts have been used as topical treatments for a variety of pain syndromes for many centuries. Current products containing capsaicin in low concentrations (usually 0.025-0.075% w/w) have shown efficacy against a variety of pain conditions in clinical studies. However, in order to produce significant analgesic effects, these formulations require frequent re-dosing, often as much as three to five times daily for several weeks. Previous functional and immumohistochemical studies following prolonged exposures to low-concentration capsaicin cream suggested that the duration and onset of analgesic efficacy correlate with a reduction of cutaneous nociceptive sensory nerve fiber responsiveness and immunostaining. The purpose of the present study was to determine whether a single topical application of a high-concentration capsaicin-containing (8% w/w) patch for 120 min or less would induce similar effects on cutaneous nociceptive nerve fibers. Seven days following patch application, changes in heat and cold perception thresholds were determined by quantitative sensory testing and punch biopsies were collected to assess epidermal nerve fiber (ENF) immunostaining density at the application site using PGP 9.5 as a marker. The results show a significant reduction of heat, but not cold, sensitivity and reduction of ENF immunostaining with high-capsaicin concentration patch applications for 60 or 120 min, compared to placebo patch applications. Application sites exposed to low-capsaicin concentration (0.04% w/w) patches for 120 min or high-concentration patches for 30 min were not significantly different from placebo with respect to either thermal threshold detection or ENF immunostaining. The ability of a single 60 min high-concentration patch application to mimic effects produced by prolonged exposure to low-concentration capsaicin creams suggests a new approach to the management of chronic pain syndromes. (C) 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.