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Leptin and Associated Mediators of Immunometabolic Signaling: Novel Molecular Outcome Measures for Neurostimulation to Treat Chronic Pain

Kinfe TM 1 , Buchfelder M 2 , Chaudhry SR 3 , Chakravarthy KV 4 , Deer TR 5 , Russo M 6 Show all authors , Georgius P 7 , Hurlemann R 8 , Rasheed M 9 , Muhammad S 10 , Yearwood TL 11

Affiliations 

  • 1 Department of Neurosurgery, Division of Functional Neurosurgery and Stereotaxy, University of Erlangen-Nueremberg, 91054 Erlangen, Germany. [email protected]
  • 2 Department of Neurosurgery, Division of Functional Neurosurgery and Stereotaxy, University of Erlangen-Nueremberg, 91054 Erlangen, Germany. [email protected]
  • 3 Departmen of Basic Medical Sciences Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad 44000, Pakistan. [email protected]
  • 4 Department of Anesthesiology and Pain Medicine, University of California, San Diego, CA 92161, USA. [email protected]
  • 5 The Spine and Nerve Center of the Virginias, Charleston, WV 25301, USA. [email protected]
  • 6 Hunter Pain Clinic, 2300 Newcastle, Australia. [email protected]
  • 7 Nambour Selangor Private Hospital, Nambour, 4560 Queensland, Australia. [email protected]
  • 8 Department of Psychiatry, Division of Medical Psychology, University Hospital Bonn, 53127 Bonn, Germany. [email protected]
  • 9 Department of Neuro-Urology Marien Hospital Herne, University Clinic of the Ruhr University Bochum, 44625 Herne, Germany. [email protected]
  • 10 Department of Neurosurgery, University Hospital Duesseldorf, 40225 Düsseldorf, Germany. [email protected]
  • 11 Neuromodulation Specialists LLC, Fairhope, AL 36532, USA. [email protected]
Int J Mol Sci, 2019 Sep 24;20(19).
PMID: 31554241 DOI: 10.3390/ijms20194737

Abstract

Chronic pain is a devastating condition affecting the physical, psychological, and socioeconomic status of the patient. Inflammation and immunometabolism play roles in the pathophysiology of chronic pain disorders. Electrical neuromodulation approaches have shown a meaningful success in otherwise drug-resistant chronic pain conditions, including failed back surgery, neuropathic pain, and migraine. A literature review (PubMed, MEDLINE/OVID, SCOPUS, and manual searches of the bibliographies of known primary and review articles) was performed using the following search terms: chronic pain disorders, systemic inflammation, immunometabolism, prediction, biomarkers, metabolic disorders, and neuromodulation for chronic pain. Experimental studies indicate a relationship between the development and maintenance of chronic pain conditions and a deteriorated immunometabolic state mediated by circulating cytokines, chemokines, and cellular components. A few uncontrolled in-human studies found increased levels of pro-inflammatory cytokines known to drive metabolic disorders in chronic pain patients undergoing neurostimulation therapies. In this narrative review, we summarize the current knowledge and possible relationships of available neurostimulation therapies for chronic pain with mediators of central and peripheral neuroinflammation and immunometabolism on a molecular level. However, to address the needs for predictive factors and biomarkers, large-scale databank driven clinical trials are needed to determine the clinical value of molecular profiling.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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