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

1
Department of Neurosurgery, Division of Functional Neurosurgery and Stereotaxy, University of Erlangen-Nueremberg, 91054 Erlangen, Germany
2
Departmen of Basic Medical Sciences Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad 44000, Pakistan
3
Department of Anesthesiology and Pain Medicine, University of California, San Diego, CA 92161, USA
4
VA San Diego Healthcare System, California, San Diego, CA 92161, USA
5
The Spine and Nerve Center of the Virginias, Charleston, WV 25301, USA
6
Hunter Pain Clinic, 2300 Newcastle, Australia
7
Nambour Selangor Private Hospital, Nambour, 4560 Queensland, Australia
8
Department of Psychiatry, Division of Medical Psychology, University Hospital Bonn, 53127 Bonn, Germany
9
Department of Neuro-Urology Marien Hospital Herne, University Clinic of the Ruhr University Bochum, 44625 Herne, Germany
10
Department of Neurosurgery, University Hospital Duesseldorf, 40225 Düsseldorf, Germany
11
Neuromodulation Specialists LLC, Fairhope, AL 36532, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Mol. Sci. 2019, 20(19), 4737; https://doi.org/10.3390/ijms20194737
Received: 31 July 2019 / Revised: 15 September 2019 / Accepted: 19 September 2019 / Published: 24 September 2019
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. View Full-Text
Keywords: chronic pain; immunometabolism; systemic inflammation; neuromodulation; biomarkers development; quantitative outcome measures chronic pain; immunometabolism; systemic inflammation; neuromodulation; biomarkers development; quantitative outcome measures
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MDPI and ACS Style

Kinfe, T.M.; Buchfelder, M.; Chaudhry, S.R.; Chakravarthy, K.V.; Deer, T.R.; Russo, M.; Georgius, P.; Hurlemann, R.; Rasheed, M.; Muhammad, S.; Yearwood, T.L. Leptin and Associated Mediators of Immunometabolic Signaling: Novel Molecular Outcome Measures for Neurostimulation to Treat Chronic Pain. Int. J. Mol. Sci. 2019, 20, 4737. https://doi.org/10.3390/ijms20194737

AMA Style

Kinfe TM, Buchfelder M, Chaudhry SR, Chakravarthy KV, Deer TR, Russo M, Georgius P, Hurlemann R, Rasheed M, Muhammad S, Yearwood TL. Leptin and Associated Mediators of Immunometabolic Signaling: Novel Molecular Outcome Measures for Neurostimulation to Treat Chronic Pain. International Journal of Molecular Sciences. 2019; 20(19):4737. https://doi.org/10.3390/ijms20194737

Chicago/Turabian Style

Kinfe, Thomas M.; Buchfelder, Michael; Chaudhry, Shafqat R.; Chakravarthy, Krishnan V.; Deer, Timothy R.; Russo, Marc; Georgius, Peter; Hurlemann, Rene; Rasheed, Muhammad; Muhammad, Sajjad; Yearwood, Thomas L. 2019. "Leptin and Associated Mediators of Immunometabolic Signaling: Novel Molecular Outcome Measures for Neurostimulation to Treat Chronic Pain" Int. J. Mol. Sci. 20, no. 19: 4737. https://doi.org/10.3390/ijms20194737

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