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Title: Leptin and Associated Mediators of Immunometabolic Signaling: Novel Molecular Outcome Measures for Neurostimulation to Treat Chronic Pain
Authors: Kinfe TM
Buchfelder M
Chaudhry SR
Chakravarthy KV
Deer TR
Russo M 
Georgius P
Hurlemann R
Rasheed M
Muhammad S
Yearwood TL
Keywords: Chronic Pain
systemic inflammation
Source: 20(19). pii: E4737
Journal Title: International Journal of Molecular Sciences
Abstract: Chronic pain is a devastating condition affecting the physical, psychological, and socioeconomic status of the patient. Inflammation and immunometabolism play roles in the pathophysiology of chronic pain disorders. Electrical neuromodulation approaches have shown a meaningful success in otherwise drug-resistant chronic pain conditions, including failed back surgery, neuropathic pain, and migraine. A literature review (PubMed, MEDLINE/OVID, SCOPUS, and manual searches of the bibliographies of known primary and review articles) was performed using the following search terms: chronic pain disorders, systemic inflammation, immunometabolism, prediction, biomarkers, metabolic disorders, and neuromodulation for chronic pain. Experimental studies indicate a relationship between the development and maintenance of chronic pain conditions and a deteriorated immunometabolic state mediated by circulating cytokines, chemokines, and cellular components. A few uncontrolled in-human studies found increased levels of pro-inflammatory cytokines known to drive metabolic disorders in chronic pain patients undergoing neurostimulation therapies. In this narrative review, we summarize the current knowledge and possible relationships of available neurostimulation therapies for chronic pain with mediators of central and peripheral neuroinflammation and immunometabolism on a molecular level. However, to address the needs for predictive factors and biomarkers, large-scale databank driven clinical trials are needed to determine the clinical value of molecular profiling.
DOI: 10.3390/ijms20194737
PubMed URL:
Type: Journal Article
Affiliates: Department of Neurosurgery, Division of Functional Neurosurgery and Stereotaxy, University of Erlangen-Nueremberg
Department of Basic Medical Sciences Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University
Department of Anesthesiology and Pain Medicine, University of California
VA San Diego Healthcare System
The Spine and Nerve Center of the Virginias
Hunter Pain Clinic
Nambour Selangor Private Hospital
Department of Psychiatry, Division of Medical Psychology, University Hospital Bonn
Department of Neuro-Urology Marien Hospital Herne, University Clinic of the Ruhr University Bochum
Department of Neurosurgery, University Hospital Duesseldorf
Neuromodulation Specialists LLC
Study/Trial: Reviews/Systematic Reviews
Appears in Collections:Scholarly and Clinical

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