Topical Mannitol Reduces Capsaicin-Induced Pain: Results of a Pilot-Level, Double-Blind, Randomized Controlled Trial
Topical Mannitol Reduces Capsaicin-Induced Pain: Results of a Pilot-Level, Double-Blind, Randomized Controlled Trial
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DOI：
10.1016/j.pmrj.2015.05.002
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发表时间：
2015-11-01
期刊：
影响因子：
2.1
通讯作者：
Rabago, David
中科院分区：
文献类型：
--
作者：
Bertrand, Helene;Kyriazis, Marylene;Rabago, David
背景：辣椒素特异性激活瞬时受体电位香草样蛋白1 （TRPV1）受体，然后逐渐耗尽，TRPV1受体是神经性疼痛的关键受体。TRPV-1受体的激活伴随着灼痛。一种可以减轻辣椒素引起的灼痛的天然物质或药物可能具有治疗神经性疼痛的潜力。目的：评价含甘露醇乳膏在辣椒素疼痛模型中的镇痛作用。设计：随机、安慰剂对照、双盲临床试验。工作地点：门诊疼痛门诊。参与者：25名嘴唇无痛的成年人。方法：辣椒素。将75%的药膏涂在每个参与者的上唇两侧，通过刺激瞬时受体电位香草素1 （TRPV1，辣椒素）受体来引起疼痛，然后在5分钟后或当参与者报告烧灼感达到8/10时取出，以先到者为准。然后立即使用含有甘露醇的面霜和不含甘露醇的面霜（对照），每侧嘴唇各涂1面，以分配掩盖的方式。结果测量：参与者自我记录一个数字评定量表（NRS, 0-10）每分钟每侧嘴唇的疼痛评分，持续10分钟。采用t检验来评估每次记录时唇侧疼痛评分与基线的变化。曲线下面积（AUC）分析确定组间总体差异。结果：参与者在3.3 +/- 1.6分钟内达到了辣椒素引起的7.8 +/- 1.0分的疼痛水平，唇两侧疼痛水平相等。两组均报告在10分钟的研究期间疼痛逐渐减轻。然而，与对照组相比，受试者报告甘露醇乳膏半唇的疼痛评分在3到10分钟显著降低(P
Background: Capsaicin specifically activates, and then gradually exhausts, the transient receptor potential vanilloid type 1 (TRPV1) receptor, a key receptor in neuropathic pain. Activation of the TRPV-1 receptor is accompanied by burning pain. A natural substance or medication that can reduce the burning pain resulting from capsaicin application may have therapeutic potential in neuropathic pain.Objective: To assess the pain-relieving effects of a mannitol-containing cream in a capsaicin-based pain model.Design: Randomized, placebo-controlled, double-blind clinical trial.Setting: Outpatient pain clinic.Participants: Twenty-five adults with pain-free lips.Methods: Capsaicin .075% cream was applied to both halves of each participant's upper lip, inducing pain via stimulation of the transient receptor potential vanilloid 1 (TRPV1, capsaicin) receptor, then removed after 5 minutes or when participants reported a burning pain of 8/10, whichever came first. A cream containing mannitol and the same cream without mannitol (control) were then immediately applied, 1 on each side of the lip, in an allocation-masked manner.Outcome Measures: Participants self-recorded a numeric rating scale (NRS, 0-10) pain score for each side of the lip per minute for 10 minutes. A t-test was performed to evaluate the pain score change from baseline between each side of the lip at each recording. Area under the curve (AUC) analysis was used to determine the overall difference between groups.Results: Participants reached a capsaicin-induced pain level of 7.8 +/- 1.0 points in 3.3 +/- 1.6 minutes that was equal on both sides of the lip. Both groups reported progressive diminution of pain over the 10-minute study period. However, participants reported significantly reduced pain scores on the mannitol cream half-lip compared to control at 3 through 10 minutes (P