Researchers at the University of Arizona School of Medicine show that resveratrol, a natural compound found in grapes and red wine, may be useful in the treatment for acute and chronic pain states.
Pain following a surgical procedure is a major clinical problem around the world. In particular, incision associated with surgery causes acute pain and is a potential major cause of chronic pain conditions. In the United States, more than 45 million surgeries are performed annually and up to 75% of patients experience acute pain after surgery. In 10-50% of these patients, the pain and discomfort persists even after the surgical wound has healed. This persistent pain may last for more than 3-6 months following surgical procedures such as groin hernia repair, breast and thoracic surgery, leg amputation, or coronary artery bypass surgery.
Despite improvements in post-surgical pain treatment strategies, the incidence of moderate to severe pain after surgery is still high in several patient populations. Hence, understanding the mechanisms involved in the development of persistent pain and developing more efficacious treatments are needed to better treat post-surgical pain and prevent the transition to chronic pain following surgery.
Following incision or inflammatory mediator, interleukin-6 (IL-6), treatment, injection of a low dose of prostaglandin E2 evokes long-lasting mechanical hypersensitivity suggesting the presence of a chronic pain state. Treatment with resveratrol either at the time of IL-6 injection (A) or at the time of incision (B) completely blocks PGE2 precipitated chronic pain. Moreover, treatment with resveratrol 1 and 3 days following incision (C) also completely blocks PGE2 precipitated chronic pain. Image credit: Dr. Theodore Price.
To approach this problem, Dipti Tillu, Ohannes Melemedjian and colleagues in the laboratory of Ted Price at the University of Arizona School of Medicine hypothesized that resveratrol, a natural product found in grapes, might be an effective local treatment for post-surgical pain. They report, in the current issue of Molecular Pain, that resveratrol effectively inhibits post-surgical acute pain and prevents the development of a chronic pain state following incision through a local mechanism of action.
The researchers further demonstrate that resveratrol’s anti-postsurgical pain qualities are consistent with pharmacological activation of an enzyme called adenosine monophosphate activated kinase (AMPK). This finding is consistent with previous work from the same group showing that other AMPK activators might be effective for the treatment of neuropathic pain. Hence, the present findings indicate that AMPK might be an effective pharmacological target for the treatment of a broad spectrum of pain disorders and that resveratrol, specifically, might be an effective therapeutic for post-surgical pain.
“ Because resveratrol is a natural product, it is possible that products that can be applied locally, e.g. infused into the postsurgical wound, could be created and tested immediately in human clinical trials,” said Dr. Price, the senior author on the paper.
© SciGuru.com and Dr Theodore J Price.
Dipti V Tillu, Ohannes K Melemedjian, Marina N Asiedu, Ning Qu, Melina De Felice, Gregory Dussor and Theodore J Price. Resveratrol engages AMPK to attenuate ERK and mTOR signaling in sensory neurons and inhibits incision-induced acute and chronic pain. Molecular Pain 2012, 8:5 doi:10.1186/1744-8069-8-5.
Link to Ted Price lab