Novel target for Spinal Cord Injury Neuropathic Pain

In the world today, millions of people suffer from spinal cord injury (SCI) with little known effective clinical therapy. Neuropathic pain (NP) is often the result of SCI, making clinical treatment difficult. Even though key mediators in the development of NP have been discovered, the pathogenesis is still unclear. Some of the key mediators in the formation of NP include the inflammatory process, cannabinoid receptors, matrix metalloproteases, and their tissue inhibitors. Animal models have shown promising results with these mediators, yet the clinical models are still unsuccessful. One such study focusing on matrix metalloproteases (MMPs) has produced encouraging results. The relationship between MMPs and their tissue inhibitors (TIMPs) plays a significant role in the pathogenesis and recovery of SCI and the CNS. Key factors that lead to the functional consequences of MMP activity are cellular localization, tissue distribution, and temporal pattern of MMP expression. Controlling the MMP activity and expression are transcription factors, signaling molecules, and inhibition by TIMPs. Studies saying that MMPs can be seen as contributors of tissue damage and as contributors in the repair mechanisms have provided a need to reexamine their roles after acute and chronic process like traumatic SCI and NP, respectively. In this review, we focus on novel findings related to NP mediators like cannabinoid receptors, MMPs, and TIMPs. We will also review current clinical findings; stressing areas that show great therapeutic potential.