In a somewhat remarkable model for visceral pain, in rats suffering from endometriosis and bladdeer stones the group of Prof. Iuvone proved that palmitoylethanolamide reduces pain induced by these inflictions. She also proved the mast cell plays an important role in this endometriosis bladder stone model. Women with “silent endometriosis” plus ureteral stones often show enhanced urinary pain. Pathological inputs from the endometriotic lesions may sensitize neurons serving to receiving sensory input from the amongst others the bladder, thus facilitating the triggering of urinary pain. Iuvone et al pounted out that palmitoylethanolamide (PEA) is emerging as an innovative therapeutic approach to chronic inflammation associated with pain. She stated:
It down-modulates mast cell (MC) activation and controls glial cell behaviours and angiogenetic processes alongside inflammatory reactions, thus having potential effectiveness in viscero-visceral hyperalgesia from endometriosis.
She tested PEA in the animal model and found prolonged oral treatment with PEA during cyst formation (starting 3 weeks before stone induction), when compared with placebo, significantly and notably reduced the behavioural indices of both uterine and ureteral pain, in parallel with a reduction of cyst diameter. The treatment also treatment also increased the percentage of stone expulsions. It was somewhat sad only one dose was used in the study, and no clear specific data were gathered related to the plasma levels, making the study somewhat less impressive. Also the absence of control arms and the rationale for the specific formulation of PEA used was missing. Nevertheless, PEA once more could reduce pain and inflammatory markers in an animal model for endometriosis and urinary tract pathology. Pea4Pain Source: Teresa Iuvone et al. ULTRAMICRONIZED PALMITOYLETHANOLAMIDE REDUCES VISCERO-VISCERAL HYPERALGESIA IN A RAT MODEL OF ENDOMETRIOSIS PLUS URETERAL CALCULOSIS: ROLE OF MAST CELLS. Source: PAIN Publish Ahead of Print DOI: 10.1097/j.pain.0000000000000220