This paper shows interaction of stress and pain. It is worthy of
reading and telling patients under our care of the affect of stress in their
life and spine pain. JMC
summary: The adrenal medulla modulates mechanical
allodynia in a rat model of neuropathic pain. The stress response mediated by
the adrenal medulla in rats subjected to chronic constriction injury of the
sciatic nerve (cci) modulates their nocifensive behavior. Treatment with
sk29661 (300 mg/kg; intraperitoneal (i.p.)), a selective inhibitor of
phenylethanolamine n-methyltransferase (PNMT) that converts noradrenaline (na)
into adrenaline (a), fully reverted mechanical allodynia in the injured hind
paw without affecting mechanical sensitivity in the contralateral paw. The
effect was fast and reversible and was associated with a decrease in the a to
na ratio (a/na) in the adrenal gland and circulating blood, an a/na that was
elevated by CCI. Denervation of the adrenal medulla by surgical splanchnectomy
attenuated mechanical allodynia in neuropathic animals, hence confirming the
involvement of the adrenal medulla in the pathophysiology of the cci model.
Inhibition of phenylethanolamine n-methyltransferase (PNMT) appears to be an
effective and probably safe way to modulate adrenal medulla activity and, in
turn, to alleviate pain secondary to the injury of a peripheral nerve.
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