Posted on June 13, 2017

Qatar University College of Medicine (QU-CMED) Professor of Biochemistry Prof Bared Safieh-Garabedian was recently invited as Visiting Distinguished Faculty to give a lecture at the Neuroscience School of Advanced Studies, Certosa di Pontignano, Italy, among an exciting array of international speakers from France, Germany, Sweden, UK, and the USA.

Around 40 postdoctoral scientists and clinicians from around the world attended the stimulating course entitled “Chronic Pain: Plasticity and Therapeutic Perspectives” that ran presentations over a period of seven days where Prof Bared presented his lecture on “Inflammation and Chronic Pain”, and in which he discussed the different components of inflammation and how targeting inflammatory mediators might result in novel therapeutic approaches in neuropathic pain. Prof Bared noted that unresolved inflammatory reactions can contribute to several pathological states. He said: “A common underlying mechanism of neuropathic pain is the presence of inflammation at the site of the damaged or affected nerve(s). This inflammatory response, especially when unresolved, initiates and maintains a cascade of events resulting in the activation of innate immune cells at the site of tissue injury.”

He highlighted that the release of inflammatory mediators such as cytokines, neurotrophic factors, and chemokines initiate local actions and can result in a more generalized immune response. “The resultant neuroinflammatory environment can cause activation of glial cells which can release in an uncontrolled manner, more of these mediators exasperate the situation, thus having a prominent role in nociception”, he said, adding, “The neuropathic pain pathophysiology is complex and includes peripheral and central neuronal alterations as well as neuro-immune interactions, which become more prominent during inflammatory reactions.”

Prof Bared noted that neuropathic pain, often referred to as chronic pain, unlike acute pain, is considered to be pathological in nature. He said: “neuropathic pain is a severe chronic disease that can develop following lesions to the central nervous system (CNS) (spinal cord injury, stroke, and multiple sclerosis) or to peripheral nerves.” He observed that the peripheral nerve damage can be caused by diseases -- diabetes and herpes zoster -- or trauma -- compression, stretch, and amputation. He said: “Given that current therapies are unsatisfactory, neurogenic pains are often characterized by their resistance to traditional treatments with analgesics including opiates.”

In closing, Prof Bared said: “Symptomatic treatments with various strategies have been used, including sympatholytics, antidepressants, antiepileptics and various anti-inflammatory drugs or their various combinations. Investigations of mechanisms by which nerve damage triggers pain are ongoing, the goal of which is to find new targets for better treatment.”