"Most chronic pain conditions, not just fibromyalgia, are a treatment challenge. Pharmacologist Joyce De Leo, Ph.D., of Dartmouth Medical School in NH, gave several reasons at the 2007 American Pain Society (APS) meeting as to why available pain therapies don't cut it for most patients. Obviously, the mechanisms responsible for chronic pain are not fully understood because othewise tens of millions of people would not be suffering in pain. And while the drug industry continues to develop different types of opiods, nothing 'new' has been added to the pain field.
The key reason chronic pain remains poorly treated is because drugs have always been developed to target neurons. Neurons can transmit pain from one cell to another through a junction called a synapse. Various signals are relayed through the use of well-known transmitters, such as substance P, serotonin, norepinephrine, glutamate, enkephalins (the body's version of opiods), and many others. Traditionally , drugs target the way transmitters work (e.g., inhibiting or boosting their action). But there are other cells that surround the neurons and synapses, called glia, that regulate neurons and could be playing a major role in generating yor pain.
De Leo says glia make up 70% of the total cell population in the central nervous system (e.g., braind and spinal cord). However, studying the role that glia play in painful conditions is still in its infancy. When glia are activated they spew out nasty, pain-producing substances. Once glia become better understood and embraced by the medical community, more pharmaceutical and biotech companies will have the opportunity to develop novel and effective medicines to relieve chronic pain. As a start, a new receptor that activates glia has just been identified, and a handful of medications that target glia to relieve pain are already in the early testing phase."
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