Are neuroactive steroids promising therapeutic agents in the management of acute and chronic pain?
Neuroactive steroids with potentiating effects on GABA(A) channels and inhibitory effects on T-type Ca2+ channels which are located in peripheral sensory neurons are potent modulators of pain perception. The focus of this review is on peripheral anti-nociceptive properties of 5alpha- and 5beta-reduced neuroactive steroids with either selective or combined modulatory action on GABA(A) and T-type Ca2+ channel-mediated neurotransmission. We report that these neuroactive steroids are very effective in alleviating peripheral nociception in both acute and chronic pain conditions in animal models of pain. We believe that promising animal data warrant the exploration of their usefulness in clinical settings especially considering the fact that chronic pain sufferers are often young and otherwise healthy people.
Jevtovic-Todorovic
Vesna
V
Department of Anesthesiology, University of Virginia Health System, PO Box 800710, Charlottesville, VA, USA. vj3w@virginia.edu
Covey
Douglas F
DF
Todorovic
Slobodan M
SM
D000700:Analgesics / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D020747:Calcium Channels, T-Type / Q000187:drug effects; D002908:Chronic Disease / Q000188:drug therapy; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D058785:GABA-A Receptor Agonists; D008564:Membrane Potentials / Q000187:drug effects; D015394:Molecular Structure; D009434:Neural Pathways / Q000187:drug effects; D018377:Neurotransmitter Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D017288:Pain Threshold / Q000187:drug effects; D013116:Spinal Cord / Q000187:drug effects
D000700:Analgesics; D020747:Calcium Channels, T-Type; D058785:GABA-A Receptor Agonists; D018377:Neurotransmitter Agents