title: Role of Collagen Conduit With Duloxetine and/or Pregabalin in the Management of Partial Peripheral Nerve Injury.
abstract: OBJECTIVE
  The objective of this study was to investigate the analgesic effect of a collagen conduit (Neuragen, Integra LifeSciences Corp, Plainsboro, NJ) using duloxetine (Cymbalta, Lilly, Indianapolis, IN) with or without pregabalin (Lyrica, Pfizer, NY) on pain induced by partial sciatic nerve transection in a rat model.
  
  
  METHODS
  Adult male Sprague-Dawley rats were divided into 5 groups (n = 10 per group): group 1, nerve damage with no treatment; group 2, nerve damage treated with the application of a collagen conduit and saline; group 3, nerve damage treated with the application of a collagen conduit and duloxetine; group 4, nerve damage treated with the application of a collagen conduit and pregabalin; and group 5, nerve damage treated with the application of a collagen conduit and pregabalin plus duloxetine. Pain levels were evaluated by responses to mechanical and thermal stimuli at baseline before and 3 and 7 days after surgery. Interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF) levels were evaluated in blood, sciatic nerve, and dorsal root ganglion samples collected 7 days after surgery.
  
  
  RESULTS
  The group treated with the collagen conduit and pregabalin exhibited markedly less pain 7 days postoperatively in response to mechanical and thermal stimuli compared with the other groups. IL-10 levels were considerably increased in the group treated with pregabalin. The groups treated with a collagen conduit and duloxetine and a combination of pregabalin and duloxetine also exhibited markedly less pain in response to mechanical and thermal stimuli 7 days after surgery compared with the group that had only nerve injury. The decrease in pain using duloxetine was not as robust but was associated with a decrease of TNF-α. The combination of pregabalin and duloxetine resulted in a substantial decrease in IL-6.
  
  
  CONCLUSIONS
  Using a collagen conduit and duloxetine, pregabalin, and their combination helped alleviate neuropathic pain. The mechanism of action might be associated, at least in part, to cytokines.
authors.affiliation: Assistant Professor and Assistant Director, Temporomandibular Disorders and Orofacial Pain Program, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ. Electronic address: junadkhan@gmail.com.
authors.forename: Junad
authors.initials: J
authors.lastname: Khan
authors.affiliation: Resident, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ.
authors.forename: Hamed
authors.initials: H
authors.lastname: Alghamdi
authors.affiliation: Adjunct Faculty, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ.
authors.forename: Muhammad Moin
authors.initials: MM
authors.lastname: Anwer
authors.affiliation: Professor and Director, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.
authors.forename: Eli
authors.initials: E
authors.lastname: Eliav
authors.affiliation: Professor, Chair, and Residency Director, Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, NJ.
authors.forename: Vincent
authors.initials: V
authors.lastname: Ziccardi
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D003094:Collagen / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D000068736:Duloxetine Hydrochloride / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D059348:Peripheral Nerve Injuries / Q000150:complications / Q000188:drug therapy*; D014677:Pharmaceutical Vehicles; D000069583:Pregabalin / Q000008:administration & dosage / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012584:Sciatic Nerve / Q000293:injuries
chemical_list: D000700:Analgesics; D014677:Pharmaceutical Vehicles; D000069583:Pregabalin; D003094:Collagen; D000068736:Duloxetine Hydrochloride