Sensitized vasoactive C-nociceptors: key fibers in peripheral neuropathic pain

Pain Reports
Julia ForstenpointnerRalf Baron

Abstract

Multiple mechanisms are involved in the development and persistence of neuropathic pain. Some patients with nerve damage will remain painless and develop a "loss of function" phenotype, whereas others develop painful neuropathies. The aim of this study is to investigate the role of a peripheral nervous system sensitization by analyzing patients with and without pain. The topical application of capsaicin was investigated in peripheral nociceptors. Two groups of patients (painful vs painless) with length-dependent neuropathies and small-fiber impairment were tested. Quantitative sensory testing was assessed before and after topical application of 0.6% capsaicin in the affected skin. In addition, blood perfusion measurements and an axon reflex flare assessment were performed. Quantitative testing revealed that heat hyperalgesia was induced in all patients and volunteers (P < 0.01) without observing any significant differences between patient groups. By contrast, the extent of the axon reflex flare reaction (P < 0.01) as well as the blood perfusion (P < 0.05) was significantly greater in patients with pain than in neuropathy patients not experiencing pain. Hyperexcitable vasoactive nociceptive C fibers might contribute to pain in p...Continue Reading

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