A new non-narcotic, non-inflammatory method to treat pain

A lot of people go to their doctors because of chronic pain. Including pain from work injures, sports injuries, accidents, pain from tumors, post surgical pain, pain from medical conditions and other causes. Unfortunately, there are a limited number of ways to treat pain without medication. They include heat, rest, cold, or even mild exercise.

For more severe pain, medications might be needed. These can range from the fairly innocuous, like aspirin and ibuprofen, to quite strong opiates. And while many people think of drugs as a cure-all, there is always a risk of allergic reactions and side effects. Just as problematic, depending on the severity of the pain, sometimes drugs, even in combination, cannot produce complete relief. Sometimes neurosurgical procedures may help. Or topical or implantable devices. But sometimes they don’t.

Promising research in rats has shown that the activity of an enzyme that is already present in the body may have a strong effect on moderating pain. Researchers have discovered that aldehydes, naturally occurring molecules in the body, can cause pain. There is an enzyme that degrades aldehydes to compounds that do not produce pain.

Pain, via Shutterstock

Pain, via Shutterstock

Mice that have a genetically weakened form of this enzyme are more sensitive to pain. They show pain responses with even the mildest of pain-producing stimuli, while mice with normal enzymes don’t perceive pain at these levels.

Scientists used a drug (ALD1) to stimulate this aldehyde-degrading enzyme (aldehyde dehydrogenase-2 [ALDH2]). When they did, the mice that previously displayed pain with the most minimal stimulus, were much more resistant to the stimulus (showed less or no pain.)

The drug that stimulates the enzyme worked well both when given before the painful stimulus was given (to prevent pain) and after the painful stimulus was given (to relieve pain.) So this can have a twofold effect-prevent pain and also relieve it. This could have positive effects in anesthesiology, pain management and many other areas of medicine.

There are a number of Asian peoples who seem to have a lower pain tolerance that may be related to having a lower level of activity of the ALDH enzyme. It’s suspected that there may be about 500 million patients in this geographical area that have increased pain sensitivity. If this research is successful in humans it may be a tremendous help to this population.

Of course, it very well could work in the rest of us, as well. A drug that can decrease pain, that doesn’t have the side effects of opiates: drowsiness, constipation, cardiovascular and respiratory depression, etc. One that has no addiction potential and wouldn’t be sought-after as a drug of abuse on the streets.

It sounds wonderful. But we’ll have to wait for some human studies to see if it works this well in humans.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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