Capsaicin

辣椒素
  • DOI:
    文章类型: Journal Article
    漂白程序后的牙齿漂白敏感性(TBS)是一个常见问题。进行这项研究是为了确定术前全身辣椒素对办公室漂白程序后牙齿敏感性(TS)的影响。
    30名参与者在这项临床试验中接受了治疗。将受试者随机分为两组(n=15)。安慰剂和0.25%辣椒素每天给药3次,持续24小时。第一剂在漂白程序前1小时给药。通过在六个上前牙上施加40%的过氧化氢凝胶,受试者以2周的间隔进行了两次漂白。视觉模拟量表(VAS)用于评估TS。数据用SPSS24进行分析。统计分析采用Wilcoxon检验和配对t检验。P≤0.05时具有统计学意义。
    在辣椒素组中,术后即刻和术后1小时的TBS显著增加,术后1-24小时的TBS显著减少(P=0.01和P=0.000).在安慰剂组中,术后即刻和术后24小时之间以及术后1和24小时之间的间隔时间显著减少(P=0.007,P=0.02).安慰剂组在漂白后24h检测到轻度TS(P<0.05)。
    在本研究的局限性下,术前全身使用辣椒素对办公室漂白手术后的TS没有显著影响.
    UNASSIGNED: Tooth bleaching sensitivity (TBS) after bleaching procedures is a common problem. This study was undertaken to determine the effect of preoperative systemic capsaicin on tooth sensitivity (TS) after in-office bleaching procedures.
    UNASSIGNED: Thirty participants received the treatment in this clinical trial. The subjects were randomly assigned to two groups (n = 15). Placebo and 0.25% capsaicin were administered three times daily for 24 h, with the first dose being administrated 1 h before the bleaching procedure. The subjects underwent two bleaching sessions at a 2-week interval by applying 40% hydrogen peroxide gel on six upper anterior teeth. A visual analog scale (VAS) was used to evaluate TS. Data were analyzed with SPSS 24. Statistical analyses were carried out with the Wilcoxon test and paired t-test. Statistical significance was set at P ≤ 0.05.
    UNASSIGNED: In the capsaicin group, there was a significant increase in TBS between the immediate and 1-h postoperative intervals and a significant decrease between 1- and 24-h postoperative intervals (P = 0.01 and P = 0.000, respectively). In the placebo group, there was a significant decrease between immediate and 24-h and between 1- and 24-h postoperative intervals (P = 0.007, P = 0.02). Milder TS was detected in the placebo group 24 h after bleaching (P < 0.05).
    UNASSIGNED: Under the limitations of this study, preoperative use of systemic capsaicin did not significantly affect TS after the in-office bleaching procedure.
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  • 文章类型: Journal Article
    这是非临床的,控制,和三盲研究,以研究可待因相关香叶醇对口面部伤害感受的调节及其潜在的中枢神经系统抑制作用。通过以下测试评估了香叶醇与可待因组合的口腔镇痛活性:(i)福尔马林引起的疼痛,(ii)谷氨酸引起的疼痛,和(iii)辣椒素诱导的疼痛。将六只动物平均分为六组,并接受以下治疗:实验前30分钟腹膜内(i.p.)给予:a)香叶醇/可待因50/30mg/kg;b)香叶醇/可待因50/15mg/kg;c)香叶醇/可待因50/7.5mg/kg;d)香叶醇50mg/kg;e)可待因30mg/kg(阳性对照);或f)0.9%氯化钠(阴性对照)。我们在注射福尔马林(20微升,20%),谷氨酸(20微升,25µM),和辣椒素(20微升,2.5µg)进入鼻旁区。使用后爪或前爪对鼻旁区的摩擦时间作为参数。在福尔马林测试的神经发生阶段,50/7.5mg/kg的香叶醇/可待因能够促进最大的镇痛作用,减少71.9%的伤害感受(p<0.0001)。在福尔马林试验的炎症阶段,香叶醇/可待因在50/30mg/kg时显著降低口面部伤害感受(p<0.005)。在谷氨酸测试中,香叶醇/可待因在50/30mg/kg时,摩擦时间减少了54.2%,辣椒素试验中的伤害感受减少了66.7%(p<0.005)。单独或组合使用香叶醇不会促进对中枢神经系统的非特异性抑制作用。根据我们的发现,我们建议香叶醇和可待因在调节口面部疼痛中可能存在协同作用。
    This is a nonclinical, controlled, and triple-blind study to investigate the effects of codeine-associated geraniol on the modulation of orofacial nociception and its potential central nervous system depressing effect in an animal model. The orofacial antinociceptive activity of geraniol in combination with codeine was assessed through the following tests: (i) formalin-induced pain, (ii) glutamate-induced pain, and (iii) capsaicin-induced pain. Six animals were equally distributed into six groups and received the following treatments, given intraperitoneally (i.p.) 30 minutes before the experiments: a) geraniol/codeine 50/30 mg/kg; b) geraniol/codeine 50/15 mg/kg; c) geraniol/codeine 50/7.5 mg/kg; d) geraniol 50 mg/kg; e) codeine 30 mg/kg (positive control); or f) 0.9% sodium chloride (negative control). We performed pain behavior analysis after the injection of formalin (20 µL, 20%), glutamate (20 µL, 25 µM), and capsaicin (20 µL, 2.5 µg) into the paranasal region. Rubbing time of the paranasal region by the hind or front paw was used as a parameter. In the neurogenic phase of the formalin test, the geraniol/codeine at 50/7.5 mg/kg was able to promote the maximum antinociceptive effect, reducing nociception by 71.9% (p < 0.0001). In the inflammatory phase of the formalin test, geraniol/codeine at 50/30 mg/kg significantly reduced orofacial nociception (p < 0.005). In the glutamate test, geraniol/codeine at 50/30 mg/kg reduced the rubbing time by 54.2% and reduced nociception in the capsaicin test by 66.7% (p < 0.005). Geraniol alone or in combination does not promote nonspecific depressing effects on the central nervous system. Based on our findings, we suggest the possible synergy between geraniol and codeine in the modulation of orofacial pain.
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  • 文章类型: Journal Article
    这个安慰剂对照的主要目标,三盲,平衡交叉研究旨在评估摄入苯辣椒素(PC)(2.5mg)对眼内压(IOP)的急性影响,眼灌注压(OPP),在30分钟的循环任务中,心率(HR)以个人最大功率的15%进行。22名健康的年轻人在摄入PC或安慰剂45分钟后执行了自行车任务。运动前用回弹眼压计测量眼压,在骑自行车期间(每6分钟),以及恢复5分钟和10分钟后。在运动前后进行OPP评估。在整个循环任务中监测HR。我们发现,在骑自行车时,与PC消耗有关的IOP水平急剧增加(平均差异=1.91±2.24mmHg;p=.007,ηp2=.30),而PC和安慰剂组之间的OPP水平没有差异(平均差=1.33±8.70mmHg;p=.608).与安慰剂摄入相比,PC后的平均HR值更高(平均差=3.11±15.87bpm,p=.019,ηp2=.24),而最大HR在两个实验条件之间没有差异(p=0.199)。这些发现表明,当需要降低IOP水平时,应避免在运动前摄入PC(例如,青光眼患者或有风险的患者)。未来的研究应确定不同的体因性辅助对IOP和OPP水平的影响,以及其他运动配置和长期的影响。
    The main objective of this placebo-controlled, triple-blind, balanced crossover study was to assess the acute effects of phenylcapsaicin (PC) intake (2.5 mg) on intraocular pressure (IOP), ocular perfusion pressure (OPP), and heart rate (HR) during a 30-min cycling task performed at 15% of the individual maximal power. Twenty-two healthy young adults performed the cycling task 45 min after ingesting PC or placebo. IOP was measured with a rebound tonometer before exercise, during cycling (every 6 min), and after 5 and 10 min of recovery. OPP was assessed before and after exercise. HR was monitored throughout the cycling task. We found an acute increase of IOP levels related to PC consumption while cycling (mean difference = 1.91 ± 2.24 mmHg; p = .007, ηp2=.30), whereas no differences were observed for OPP levels between the PC and placebo conditions (mean difference = 1.33 ± 8.70 mmHg; p = .608). Mean HR values were higher after PC in comparison with placebo intake (mean difference = 3.11 ± 15.87 bpm, p = .019, ηp2=.24), whereas maximum HR did not differ between both experimental conditions (p = .199). These findings suggest that PC intake before exercise should be avoided when reducing IOP levels is desired (e.g., glaucoma patients or those at risk). Future studies should determine the effects of different ergogenic aids on IOP and OPP levels with other exercise configurations and in the long term.
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  • 文章类型: Journal Article
    目的:我们研究了局部用辣椒素减轻化疗延迟性恶心呕吐(CINV)的疗效。
    方法:在这项盲法随机对照试验中,除了标准的止吐方案外,成年人在腹部每天四次使用2g辣椒素软膏(0.075%)或匹配的安慰剂,持续5天。立即(第1天)监测患者的恶心和呕吐,延迟(第2-5天),和延长阶段(第2-15天)。两组之间比较了自我报告的CINV发生率和每日发作。开始,严重程度,需要解救止吐药,累计呕吐发作,并对安全性进行了比较。
    结果:总计,160名患者入选。最终改良的意向治疗人群包括辣椒素组和安慰剂组各75名患者。在延迟阶段,辣椒素臂出现恶心(36.0%[n=27]v53.3%[n=40];P=.033)和呕吐(28.0%[n=21]v42.7%[n=32];P=.060)的患者较少。在扩展阶段,辣椒素组的恶心发生率显著较低(44%对64.0%;P=0.014).在立即阶段,恶心(26.7%v25.3%)或呕吐(22.7%v18.7%)没有明显差异。在延迟和延长阶段,辣椒素臂的平均每日恶心和呕吐发作明显减少。用辣椒素,没有观察到3级恶心(9.3%v0.0%;P=0.007),首次恶心和呕吐的时间明显延长。两组在解救止吐药方面没有差异,计划外的医院访问,和不良事件。
    结论:外用辣椒素可降低延迟期和延长期的恶心发生率和平均呕吐次数,而不会增加不良反应。
    OBJECTIVE: We examined the efficacy of topical capsaicin in reducing delayed chemotherapy-induced nausea and vomiting (CINV).
    METHODS: Adults on highly emetogenic chemotherapy regimens applied 2 g of capsaicin ointment (0.075%) or matching placebo four times a day to the abdomen for 5 days in addition to standard antiemetic regimen in this blinded randomized controlled trial. Patients were monitored for nausea and vomiting in the immediate (day 1), delayed (days 2-5), and extended phases (days 2-15). Self-reported incidence and daily episodes of CINV were compared between the groups. Onset, severity, need for rescue antiemetics, cumulative vomiting episodes, and safety were also compared.
    RESULTS: In total, 160 patients were enrolled. The final modified intention-to-treat population included 75 patients each in the capsaicin and placebo groups. Fewer patients experienced nausea (36.0% [n = 27] v 53.3% [n = 40]; P = .033) and vomiting (28.0% [n = 21] v 42.7% [n = 32]; P = .060) in the capsaicin arm during the delayed phase. During the extended phase, there was a significantly lower incidence of nausea (44% v 64.0%; P = .014) in the capsaicin arm. No difference in nausea (26.7% v 25.3%) or vomiting (22.7% v 18.7%) was evident in the immediate phase. The average daily episodes of nausea and vomiting were significantly fewer in the capsaicin arm during the delayed and extended phases. With capsaicin, no grade 3 nausea (9.3% v 0.0%; P = .007) was observed, and the time to first nausea and vomiting was significantly prolonged. There were no differences between the groups with respect to rescue antiemetics, unscheduled hospital visits, and adverse events.
    CONCLUSIONS: Topical capsaicin reduced the incidence of nausea and the average number of vomiting episodes during delayed and extended phases without increasing adverse effects.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fnut.2024.1348328。].
    [This corrects the article DOI: 10.3389/fnut.2024.1348328.].
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  • 文章类型: Journal Article
    背景技术骨缺损的愈合是世界范围内的严峻挑战。牙科的一个分支处理骨缺损。辣椒素有消炎作用,抗氧化,和降低胆固醇的作用。这项研究的目的是评估不同剂量的全身辣椒素对骨骼愈合的影响。材料和方法共使用32只雄性Wistar大鼠,它们的体重在250和300克之间变化。将大鼠随机分成4组,每组8只大鼠。分析用于评估不同剂量的辣椒素和移植物对愈合的影响。辣椒素应用组的成骨细胞数量显着增加,与对照组相比。结果这些分析用于评估不同剂量的辣椒素和移植物对愈合的影响。辣椒素应用组的成骨细胞数量显着增加,与对照组相比。炎症评分仅在对照组和给予50mg/kg辣椒素的组中显示出显著差异(P=0.010)。所有组之间的破骨细胞计数显着不同。结论作为分析的结果,当腹膜内给予辣椒素0.25mg/kg和0.50mg/kg时,观察到对骨愈合的积极作用。然而,需要更多的研究来获得更准确的信息。
    BACKGROUND The healing of bone defects is a serious challenge worldwide. One branch of dentistry deals with bone defects. Capsaicin has anti-inflammatory, anti-oxidative, and cholesterol-reducing effects. The aim of this study was to evaluate the effects of systemic capsaicin administered at different doses on bone healing. MATERIAL AND METHODS A total of 32 male wistar rats was used, their weight varying between 250 and 300 g. The rats were randomly divided into 4 groups of 8 rats each. The analyses served to evaluate the effect on healing of different doses of capsaicin and grafts. A significant increase was observed in the number of osteoblasts in the capsaicin-applied groups, compared with the control group. RESULTS The analyses served to evaluate the effect on healing of different doses of capsaicin and grafts. A significant increase was observed in the number of osteoblasts in the capsaicin-applied groups, compared with that of the control group. The inflammation scores showed a significant difference only in the control group and in the group administered with 50 mg/kg capsaicin (P=0.010). The osteoclast counts were significantly different between all groups. CONCLUSIONS As a result of the analyses, positive effects on bone healing were observed when capsaicin 0.25 mg/kg and 0.50 mg/kg was administered intraperitoneally. However, more studies are needed for more accurate information.
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  • 文章类型: Journal Article
    研究目的是研究辣椒素恢复谷氨酸和脂多糖(LPS)诱导的Neuro2a(N2a)细胞神经毒性的毒性作用以及阻止认知障碍的能力。线粒体缺陷,和3-硝基丙酸(3-NP)在亨廷顿氏病啮齿动物模型中诱导的氧化损伤。通过MTT和LDH测定进行了N2a细胞的体外研究,并进行了生化检查。通过口服(p.o.)途径用辣椒素(5、10和20mg/kg)连续7天处理施用3-NP的小鼠(n=6)。在药物处理的小鼠中进行生理和行为研究。在行为研究之后,生化参数进行细胞因子水平,各种氧化应激参数,和线粒体酶复合物活性与线粒体通透性有关。用辣椒素处理的N2a细胞表现出神经保护作用和降低的神经毒性。根据实验观察,在一项体外研究中,CAP的有效剂量为50µM。此外,100µM剂量的辣椒素对神经元细胞(N2a细胞)有毒性作用。另一方面,3-NP的有效剂量为20mg/kg,(p.o.)在动物中(体内)。所有测试剂量的辣椒素都可以改善3-NP引起的认知障碍和运动协调作用。注射3-NP的小鼠表现出显著增加的促炎细胞因子浓度,线粒体复合物活性缺陷,和增强的氧化侮辱。然而,不同剂量的辣椒素降低了氧化损伤和细胞因子水平,并改善了线粒体复合物的活性以及线粒体的通透性。此外,辣椒素(10和20mg/kg)提高了TNF-α浓度。这些发现表明,由于抗炎和抗氧化作用,辣椒素可以被认为是一种通过恢复抗氧化酶活性来管理神经退行性疾病的新治疗方法,促炎细胞因子浓度,和线粒体功能。
    The study objectives are to investigate the ability of capsaicin to revert the toxic effects in glutamate and lipopolysaccharide (LPS)-induced neurotoxicity in Neuro2a (N2a) cells as well as thwarting cognitive impairments, mitochondrial deficits, and oxidative insults induced by 3-nitropropanoic acid (3-NP) in a rodent model of Huntington\'s disease. In-vitro study with N2a cells was performed through MTT and LDH assay and their biochemical examinations were also performed. 3-NP-administered mice (n = 6) were treated with capsaicin (5, 10, and 20 mg/kg) through the per-oral (p.o.) route for 7 consecutive days. Physiological and behavioral studies were performed in drug-treated mice. After behavioral studies, biochemical parameters were performed for cytokines levels, various oxidative stress parameters, and mitochondrial enzyme complex activities with mitochondrial permeability. N2a cells treated with capsaicin demonstrated neuroprotective effects and reduced neurotoxicity. Based on experimental observation, in an in-vitro study, the effective dose of CAP was 50 µM. Moreover, a 100 µM dose of capsaicin had toxic effects on neuronal cells (N2a cells). On the other hand, the effective dose of 3-NP was 20 mg/kg, (p.o.) in animals (in-vivo). All tested doses of capsaicin upturned the cognitive impairment and motor in-coordination effects induced by 3-NP. 3-NP-injected mice demonstrated substantially increased pro-inflammatory cytokine concentrations, defective mitochondrial complex activity, and augmented oxidative insult. However, capsaicin at different doses reduced oxidative damage and cytokines levels and improved mitochondrial complex activity along with mitochondrial permeability. Furthermore, capsaicin (10 and 20 mg/kg) improved the TNF-α concentration. These findings suggested because of the anti-inflammatory and antioxidant effect, capsaicin can be considered a novel treatment for the management of neurodegenerative disorders by reverting the antioxidant enzyme activity, pro-inflammatory cytokines concentration, and mitochondrial functions.
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  • 文章类型: Journal Article
    目的:很少有研究使用热定量感官测试来评估在口腔中反复施用辣椒素凝胶的效果。本研究旨在研究反复施用辣椒素凝胶前后的热感觉和疼痛阈值。
    方法:10名健康女性(22±2岁)每天两次在牙龈粘膜上使用辣椒素凝胶,持续14天,和热痛阈值,热检测阈值,冷痛阈,并对口腔黏膜进行冷检测阈值评估。在14天之前和之后进行测量,并与对照样品进行比较(n=10,所有雌性,23±3年)。
    结果:辣椒素使上颌骨前部的热痛阈值增加2.9°C(95%CI:1.6-4.2)(p<0.001),下颌骨前部的热痛阈值增加2.2°C(95%CI:1.0-3.4)(p=0.001),类似于增加Δ1.1°C的温暖检测阈值(95%CI:0.3-1.9)(p=0.009)。在对照中未发现显著变化。
    结论:这些发现鼓励在口腔中使用热定量感觉测试来评估热感觉,这可能有助于评估旨在减轻疼痛的疗法的效果。
    OBJECTIVE: Few studies used thermal quantitative sensory testing to assess the effects of repeated capsaicin gel administration in the oral cavity. This study aimed to investigate thermal sensory and pain thresholds before and after repeated capsaicin gel administration.
    METHODS: Ten healthy females (22 ± 2 years) applied a capsaicin gel on the gingival mucosa twice daily for 14 days, and heat pain threshold, warm detection threshold, cold pain threshold, and cold detection threshold were assessed on the oral mucosa. Measurements were performed before and after the 14 days and were compared to a control sample (n = 10, all females, 23 ± 3 years).
    RESULTS: Capsaicin increased heat pain threshold in the anterior maxilla by 2.9°C (95% CI: 1.6-4.2) (p < 0.001) and in the anterior mandible by 2.2°C (95% CI: 1.0-3.4) (p = 0.001), similar to warm detection threshold that increased by Δ1.1°C (95% CI: 0.3-1.9) (p = 0.009). No significant changes were found in the controls.
    CONCLUSIONS: These findings encourage the use of thermal quantitative sensory testing in the oral cavity to assess thermal sensation, which might be useful for assessing the effects of therapies aimed at reducing pain.
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  • 文章类型: Journal Article
    背景:瞬时受体电位香草素1(TRPV1)与皮肤敏感性有关,主要由辣椒素和热激活。有趣的是,曲克鲁丁可以抑制TRPV1的激活。然而,其降低皮肤敏感性的功效尚不确定。
    目的:我们通过临床试验和体外实验评估了曲克鲁丁减轻皮肤敏感性的功效。
    方法:对于体外实验,HaCaT角质形成细胞用不同浓度的曲克鲁丁预处理,然后用50μM辣椒素孵育1、24或48小时。测定与皮肤刺激有关的四种炎性细胞因子的基因和蛋白表达。在为临床试验招募的35名皮肤敏感的韩国女性中,13参与评估辣椒素刺激后0.1%和0.0095%曲克鲁丁的即时舒缓效果,22人参与评估10%和1%曲克鲁丁在4周内对辣椒素和热刺激的预防性舒缓效果。我们用皮肤发红来评估舒缓率,视觉模拟量表,和高温敏感指数作为评价指标。
    结果:Troxerutin抑制辣椒素处理的角质形成细胞中细胞因子的mRNA和蛋白表达。在临床研究中,0.1%和0.0095%曲克鲁丁迅速缓解辣椒素诱导的皮肤发红,而10%的曲克鲁丁显着降低了辣椒素和热相关刺激的视觉模拟量表和高温敏感指数。然而,1%曲克鲁丁仅可有效降低辣椒素刺激的视觉模拟量表。
    结论:曲克鲁丁在临床和体外实验中均能抑制TRPV1的活化。
    BACKGROUND: Transient receptor potential vanilloid 1 (TRPV1) is associated with skin sensitivity and mainly activated by capsaicin and heat. Interestingly, troxerutin can inhibit TRPV1 activation. However, its efficacy in reducing skin sensitivity remains undetermined.
    OBJECTIVE: We evaluated the efficacy of troxerutin in alleviating skin sensitivity using clinical tests and in vitro experiments.
    METHODS: For the in vitro experiment, HaCaT keratinocytes were pretreated with different concentrations of troxerutin, followed by incubation with 50 μM capsaicin for 1, 24, or 48 h. The gene and protein expressions of four inflammatory cytokines involved in skin irritation were determined. Among 35 Korean women with sensitive skin recruited for the clinical trial, 13 were involved in assessing the immediate soothing effects of 0.1% and 0.0095% troxerutin following capsaicin irritation, whereas 22 participated in evaluating the preventive soothing effect of 10% and 1% troxerutin over 4 weeks against capsaicin- and heat-induced irritation. We evaluated the soothing rate using skin redness, visual analog scale, and high temperature sensitive index as evaluation indices.
    RESULTS: Troxerutin inhibited the mRNA and protein expressions of cytokines in capsaicin-treated keratinocytes. In the clinical study, 0.1% and 0.0095% troxerutin promptly alleviated capsaicin-induced skin redness, whereas 10% troxerutin notably decreased both the visual analog scale and high temperature sensitive index for capsaicin- and heat-related irritation. However, 1% troxerutin was only effective in reducing the visual analog scale in response to capsaicin irritation.
    CONCLUSIONS: Troxerutin can inhibit TRPV1 activation in clinical and in vitro tests.
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  • 文章类型: Journal Article
    虽然治疗副作用可能会对患者产生不利影响,它们也可能作为有效治疗的指标。在这项研究中,我们调查了副作用是否以及如何触发积极的治疗预期并提高治疗结局.在这个预先注册的审判(DRKS00026648)中,77名健康参与者相信他们将在受控实验环境中接受热痛之前接受芬太尼鼻喷雾剂。然而,鼻腔喷雾剂不含芬太尼,相反,它们含有辣椒素以引起副作用(轻度灼烧感)或盐水(惰性)。在第一次会议之后,参与者被随机分为两组,并接受功能磁共振成像(fMRI).一组继续认为鼻喷雾剂可能含有芬太尼,而另一组被明确告知不包括芬太尼。这允许对副作用的独立操纵和疼痛缓解的期望。我们的结果表明,有副作用的鼻喷雾剂比无副作用的惰性鼻喷雾剂疼痛更低。副作用对疼痛的影响取决于个体对副作用如何与治疗结果相关的信念。以及对接受治疗的期望。FMRI数据表明,在经历有副作用的鼻喷雾剂后,疼痛包括前扣带回皮质和导水管周围灰色在内的下降疼痛调节系统。总之,我们的数据表明,轻度副作用可以作为有效治疗的信号,从而影响治疗预期和结果,这是由下降的疼痛调节系统介导的。在临床实践中使用这些机制可以提供优化治疗结果的有效方法。此外,我们的结果表明临床试验中有一个重要的混淆,将治疗(具有潜在副作用)与安慰剂进行比较。
    While treatment side effects may adversely impact patients, they could also potentially function as indicators for effective treatment. In this study, we investigated whether and how side effects can trigger positive treatment expectations and enhance treatment outcomes. In this pre-registered trial (DRKS00026648), 77 healthy participants were made to believe that they will receive fentanyl nasal sprays before receiving thermal pain in a controlled experimental setting. However, nasal sprays did not contain fentanyl, rather they either contained capsaicin to induce a side effect (mild burning sensation) or saline (inert). After the first session, participants were randomized to two groups and underwent functional MRI. One group continued to believe that the nasal sprays could contain fentanyl while the other group was explicitly informed that no fentanyl was included. This allowed for the independent manipulation of the side effects and the expectation of pain relief. Our results revealed that nasal sprays with a side effect lead to lower pain than inert nasal sprays without side effects. The influence of side effects on pain was dependent on individual beliefs about how side effects are related to treatment outcome, as well as on expectations about received treatment. Functional MRI data indicated an involvement of the descending pain modulatory system including the anterior cingulate cortex and the periaqueductal gray during pain after experiencing a nasal spray with side effects. In summary, our data show that mild side effects can serve as a signal for effective treatment thereby influencing treatment expectations and outcomes, which is mediated by the descending pain modulatory system. Using these mechanisms in clinical practice could provide an efficient way to optimize treatment outcome. In addition, our results indicate an important confound in clinical trials, where a treatment (with potential side effects) is compared to placebo.
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