Summary: Researchers have identified a completely new way of managing chronic pain. They have identified that blocking neuropilin-1 (NRP1) receptors may block the pain-causing effect of nerve growth factor without compromising its beneficial effects.
There may be hundreds of painkillers, but most of them work in a similar manner. Thus, most commonly used painkillers belong to a group called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are good for mild to moderate pain, and they block enzymes that cause inflammation.
However, NSAIDs may not work well in some kinds of severe pain, and they are also of little use in neuropathic pain, chronic pains, and more.
Therefore, doctors often need to use opioids for chronic pains or severe pain syndromes. These drugs work by working pain receptors in the brain. However, they are not very selective, which means that they also block other receptors, causing side effects.
In short, despite so many painkillers, there is much gap. Certain kinds of pains are quite challenging to manage, such as chronic pain, nerve pain, and other severe pains. This is particularly relevant to services like interventional pain management St. Louis explore novel methods to address such challenges.
Therefore, researchers are looking for other ways to manage pain. It is worth understanding that science still does not fully understand how pain is transmitted to the brain. Nonetheless, things are quickly improving, and science is developing a better understanding of pain transmission.
New studies have identified multiple pain receptors. These pain receptors appear to be stimulated or activated by nerve growth factors. Nerve growth factors play a significant role in chronic pain, as in those living with arthritis.
As one can understand, nerve growth factor is also needed for nerve growth and healing. So, blocking this specific chemical is not an option and will do more harm than good.
The nerve growth factor acts on different receptors. Some of these receptors promote healing, while others cause pain. So, researchers want to block those receptors that cause pain without blocking beneficial receptors. Now, it appears that researchers have identified such a receptor and even found a way of blocking it.
Blocking receptors is a frequently used approach to modulate body functions. For example, blocking specific receptors can block harm caused by excessive histamine release, such as allergic reactions.
The benefit of blocking receptors is that one is able to preserve the beneficial effect of a specific chemical and selectively block its harmful effects. Thus, in this new approach, researchers want to maintain the beneficial effects of nerve growth factors and block the pain-causing effect.
This is not the first attempt at blocking pain receptors. Previously, researchers tried blocking a receptor called tropomyosin receptor kinase A, or TrkA, and they were quite successful. Blocking TrkA receptors helps overcome pain. However, one of the issues with TrkA blocking is that it also slows healing and, thus, may ultimately make arthritis worse. That is why researchers had to discontinue testing drugs that can block TrkA.
However, the latest study reports that they have found a safer way of blocking the pain-causing effect of nerve growth factor. They have identified a receptor called neuropilin-1 (NRP1). It appears that blocking this receptor selectively blocks pain sensation without blocking the beneficial effects of nerve growth factor.
In chronic painful conditions like arthritis, the nerve growth factor is persistently produced to promote healing, and it also causes pain. Now, new studies show that blocking NRP1 only blocks its pain-causing effect but does not block its beneficial effects.
What is good is that researchers have also identified peptides that can effectively block NRP1, and they appear to be safe for clinical use.
Of course, these are still findings from pre-clinical studies, and now researchers are testing various peptides to block this newly identified receptor, NRP1. Researchers would still need to find an effective and safe way of doing this. Nevertheless, these findings raise hope for those living with chronic pain. Science may be very close to creating a new class of painkillers that would be highly effective for chronic pain, comparable to opioids in pain relief, but with a much better safety profile. Chronic pain specialists are likely to adopt these advanced approaches for better patient outcomes.
Source:
Peach, C. J., Tonello, R., Damo, E., Gomez, K., Calderon-Rivera, A., Bruni, R., Bansia, H., Maile, L., Manu, A.-M., Hahn, H., Thomsen, A. R. B., Schmidt, B. L., Davidson, S., Georges, A. des, Khanna, R., & Bunnett, N. W. (2024). NEUROPILIN-1 INHIBITION SUPPRESSES NERVE-GROWTH FACTOR SIGNALING AND NOCICEPTION IN PAIN MODELS. The Journal of Clinical Investigation. https://doi.org/10.1172/JCI183873
