At the ￼3rd VEPRA CONFERENCE, June 1 , 2013 – Rimini (Italy), in coorporation with the Italian Society of Veterinary Physiotherapy and Rehabilitation Drs Della Valle, Mortellaro, Miolo and professor Brenda Costa presented a highly interesting paper, titel:
Aliamides for pain management of osteoarthritis (OA)
Aliamides are compounds such as palmitoylethanolamide. The authors explain that Palmitoylethanolamide (PEA) is the aliamide parent molecule. It has been suggested that a key role of endogenous PEA may be to maintain cellular homeostasis when faced with external stressors provoking, for example, inflammation and pain. For osteoartrosis related to PEA they state:
One may envision pathological settings where PEA endogenous production is insufficient to control the ensuing inflammatory and nociceptive cascade. This is the case of knee osteoartrosis, where the levels of PEA in the synovial fluid are dramatically decreased compared to healthy knees, thus suggesting that the lower levels of PEA may contribute to the disease process associated with this condition.
They point out that PEA has been successfully used for pain relief in human patients with osteoartrosis of the jaw (temporomandibular joint), and a two-week randomized clinical trial comparing the effect of PEA versus a NSAID (i.e., ibuprofen) showed that PEA group experienced a significantly higher decrease of pain compared to ibuprofen group. Furthermore, the functionality of the jaw was also significantly better improved under PEA compared to ibuprofen.
The authors describe the result of a clinically relevant model of OA pain, i.e., the monosodium iodoacetate (MIA) injection in the rat knee, spinal levels of PEA were increased, suggesting PEA may have a crucial role in controlling neuronal excitability at the level of the spinal cord.
A 3-week study was performed in MIA-injected animals daily treated by oral PEA and a partial antiallodynic effect was shown as early as after 8 days. At the end of the study, the antiallodynic and anti-edemigen effect evoked by PEA was comparable to that exerted by an NSAID, but PEA proved to have a superior anti-hyperalgesic activity and a greater effect on the motor functional recovery (Costa et al 2011; Costa, unpublished results).
The oral administration of PEA also slowed cartilage erosion, while the NSAID did not produce any improvement.
Finally, the animals suffering from atrosis treated with an NSAID for 21 days developed duodenal ulcers, while such injury was not evident in the PEA-treated group (Costa, unpublished results).
The conclusion was:
While acute pain is generally well modulated by classic analgesics (e.g., NSAIDs), chronic pain can be quite frustrating to treat, as it often responds poorly to these and other drugs. It has been proposed that practitioners change the concept of pain control in OA-related chronic pain to one of “pain-modifying analgesic drugs”.
Such a change would perfectly fit the Aliamides, since they directly intervene in the neuroimmune alter- ations responsible for the generation of pain. One can consider that the discovery and the recent advancements in the field of Aliamides (e.g.PEA)
PEA in our hands has been quite effective in treating osteoartrosis complaints in many patients, as well as in certain pet animals, such as big dogs and horses. Both animal species are also quite often affected by artrosis.