title: Spinal cord injury induced neuropathic pain: Molecular targets and therapeutic approaches.
abstract: Neuropathic pain, especially that resulting from spinal cord injury, is a tremendous clinical challenge. A myriad of biological changes have been implicated in producing these pain states including cellular interactions, extracellular proteins, ion channel expression, and epigenetic influences. Physiological consequences of these changes are varied and include functional deficits and pain responses. Developing therapies that effectively address the cause of these symptoms require a deeper knowledge of alterations in the molecular pathways. Matrix metalloproteinases and tissue inhibitors of metalloproteinases are two promising therapeutic targets. Matrix metalloproteinases interact with and influence many of the studied pain pathways. Gene expression of ion channels and inflammatory mediators clearly contributes to neuropathic pain. Localized and time dependent targeting of these proteins could alleviate and even prevent neuropathic pain from developing. Current therapeutic options for neuropathic pain are limited primarily to analgesics targeting the opioid pathway. Therapies directed at molecular targets are highly desirable and in early stages of development. These include transplantation of exogenously engineered cell populations and targeted gene manipulation. This review describes specific molecular targets amenable to therapeutic intervention using currently available delivery systems.
authors.affiliation: Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA.
authors.forename: Dominic
authors.initials: D
authors.lastname: Schomberg
authors.forename: Gurwattan
authors.initials: G
authors.lastname: Miranpuri
authors.forename: Tyler
authors.initials: T
authors.lastname: Duellman
authors.forename: Andrew
authors.initials: A
authors.lastname: Crowell
authors.forename: Raghu
authors.initials: R
authors.lastname: Vemuganti
authors.forename: Daniel
authors.initials: D
authors.lastname: Resnick
mesh_terms: D000700:Analgesics / Q000008:administration & dosage* / Q000378:metabolism; D000818:Animals; D064987:Cell- and Tissue-Based Therapy / Q000379:methods; D015316:Genetic Therapy / Q000379:methods; D006801:Humans; D020782:Matrix Metalloproteinases / Q000378:metabolism; D009437:Neuralgia / Q000209:etiology* / Q000378:metabolism / Q000628:therapy*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000378:metabolism / Q000628:therapy*; D019714:Tissue Inhibitor of Metalloproteinases / Q000378:metabolism
chemical_list: D000700:Analgesics; D019714:Tissue Inhibitor of Metalloproteinases; D020782:Matrix Metalloproteinases