In this issue of the Scandinavian Journal of Pain, Mienke Rijsdijk, MD, presents the original experiments entitled “Effect of intrathecal glucocorticoids on the central glucocorticoid receptor in a rat nerve ligation model” . Intrathecal administration of methylprednisolone acetate (MPA) in a randomized controlled clinical trial on intractable postherpetic neuralgia (PHN) patients did not result in any analgesic effects , which is in contrast to findings by others [3, 4, 5, 6]. Consequently, studies on rats seek to explain these observations further.1The clinical problemPHN is one of many forms of neuropathic pain and is characterized by severe burning pain, hypersensitivity and/or numbness in affected areas. PHN is caused by the varicella zoster virus (VZV), to which >95% of the world’s population has been exposed [7,8]. Varicella, also known as chickenpox, is a generally harmless childhood illness that manifests itself through fever and small fluid-filled vesicles that can cover the entire body. VZV further infects multiple cranial nerve ganglia, dorsal root ganglia as well as autonomic and enteric ganglia [9,10,11]. After the varicella outbreak, the immune system maintains a host-virus equilibrium (latent infection) commonly providing lifelong VZV immunity [12,13]. Herpes zoster (HZ), also known as shingles, occurs when the virus is
Scandinavian Journal of Pain – de Gruyter
Published: Jul 1, 2017
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