Management neuropathic pain remains challenging: endogenous regulatory mechanisms wins appreciation!

Professors Nadine Attal, David Bennett and Rolf-Detlef Treede, key opinion leaders in the field of neuropathic pain, clearly stated at the world congress on Pain (2012) that treating neuropathic pain remains a challenge. They stressed the importance of multi-modal therapy in chronic and neuropathic pain.

They specifically stressed the importance of activating mechanisms in our own body to find new ways to treat neuropathic pain, and we quote:

..a further approach to treating neuropathic pain is to harness endogenous regulatory mechanisms that suppress excessive inflammation..”

PEA belongs to such a class of treatments and clearly the use of PEA activated such endogenous mechanisms, suppressing excessive neuro-inflammation. The idea of the activation of endogenous mechanisms, as repair and homeostatic mechanisms has been forseen already long ago by one of the founding fathers of the benzodiazepine receptors, professor Erminio Costa.

In 1986 Professor Costa delivered a keynote lecture in Washington, bearing the title ‘to follow where nature leads’. This lecture has been put again in new fresh light by Dr Della Valle’s een Italiaans bedrijf neuroscience project. In this lecture Costa talked with great vision about how nature itself can become our tutor in developing new drugs.

Aspects like synaptic plasticity and modulation, as well as related highly modern topics were already extensively discussed hy him. He pointed out that new innovative ways are in need to be explored, by leaving old monocausal scemes of thinking. New compounds will emerge based on this innovative strategy of ‘to following where nature leads’.

It was exactly this focus helped to develop nature’s great modulating endogenous molecule palmitoylethanolamide into a useful compound for the clinic. Palmitoylethanolamide now serves many patients as a useful and valuable analgesic and anti-inflammatory compound.

The idea of Costa was taken up in a new way by the Nobel laureates Rita Levi-Montalcini and Gerald Edelmann, who, together with Costa founded the International Scool of Neuroscience of Praglia (Padova, Italy) in 1988. This school of neuroscience brought the work of cutting-edge neuroscientists to a large audience of graduate students to expose them to the newest advances in the field.

Nadine Attal et al, Neuropathic Pain Update, in PAIN 2012, refresher courses, 14th world congress on Pain.

E. Costa, An early attempt to foster neuroscience globalization. An autobiography, Good Life Press, Nashville (2003)

E Costa, etc , Gerald M Edelman, Rita Levi Montalcini: Proceedings of the Course on Developmental Neurobiology, Thieme Publishing Group, 1992

Rita Levi-Montalcini: The Hourglass of Life, The Dana Press, 2011

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