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Neurotoxin injection relieves chronic pain

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Neurotoxin injections are commonly associated with cosmetic procedures for reducing lines and wrinkles on the face. But a new study shows that a similar compound could help to relive chronic pain.

Researchers in the UK and Canada found that a modified form of neurotoxin gives long-lasting pain relief without adverse effects. In time, it could replace opioid drugs as a safe and effective way of treating chronic pain, according to a paper published in Science Translational Medicine.

Chronic or persistent pain is pain that continues for longer than 12 weeks despite medication or treatment. Around one in five adults live with chronic pain of ‘moderate to severe’ intensity.

For the study, scientists deconstructed the botulinum molecule and reassembled it with an opioid called dermorphin to make Derm-BOT — a compound that targets and silences pain signals from neurons in the spinal cords of mice.

Key neurons in the spinal cord are targets for pain management as they directly ‘sense’ pain and send this information to the brain, the researchers explained.

Dermorphin targets and binds to opioid receptors on the surface of neurons, allowing the Derm-BOT compound to enter the cells where the botulinum ‘warhead’ then reversibly inhibits the release of neurotransmitter, silencing the cells essential for sending pain signals to the brain.

“Injected into the spine, Derm-BOT relieves chronic pain — such as that caused by nerve damage — and avoids the adverse events of tolerance and addiction often associated with repeated opioid drug use,” said co-corresponding author Professor Steve Hunt from UCL’s Department of Cell and Developmental Biology.

“It doesn’t affect muscles like the botulinum used to reduce wrinkles, but it does block nerve pain for up to four months without affecting normal pain responses. It really could revolutionise how chronic pain is treated if we can translate it into clinic, removing the need for daily opioid intake.”

http://stm.sciencemag.org/content/10/450/eaar7384