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Pain relief gets spicy

A novel painkiller, which selectively targets nociceptors therefore preventing the impairment of movement, touch and awareness that is associated with current anesthetics, has been developed by researchers from Harvard Medical School (MA, USA) and Massachusetts General Hospital (MA, USA). “Current nerve blocks cause paralysis and total numbness. This new strategy could profoundly change pain treatment in the perioperative setting,” Clifford Woolf, coauthor of the paper commented. The painkiller combines capsaicin, an extract from chilies, with a drug called QX314. QX-314 is unable to cross cell membranes, however, once it has entered a cell it is able to block electrical activity. Capsaicin acts by opening TRPV1 channels, which are only present on nociceptors. Thus, combined administration of these two ingredients selectively opens pain-sensing neurons and blocks their activity. Published in the 4th October issue of Nature, the novel painkiller was tested both in vitro and in vivo with impressive results. Firstly, the researchers administered capsaicin and QX-314 to petri dishes containing nociceptors or other neurons and measured their responses; excitation was blocked only in the nociceptors and not in the other neurons. Following on from this, rats were injected with a combination of QX-314 and capsaicin near to their sciatic nerves. Those injected with the ‘painkiller’ tolerated much more heat than usual when placed on an uncomfortable heat source. In addition to this, five of the six rats that were injected continued to show normal movement and behavior. The capsaicin/QX-314 combination took 30 mins to take effect and lasted several hours. Bruce Bean, coauthor of the study commented, “We’ve introduced a local anesthetic selectively into specific populations of neurons. Now we can block the activity of painsensing neurons without disrupting other kinds of neurons that control movements or non-painful sensations.” The authors are hopeful that this research may revolutionize pain therapy, with Woolf commenting, “Eventually this method could completely transform surgical and postsurgical analgesia, allowing patients to remain fully alert without experiencing pain or paralysis. In fact, the possibilities seem endless. I could even imagine using this method to treat itch, as itch-sensitive neurons fall into the same group as pain-sensing ones.”