Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prostaglandins of the E series (PGEs) have been detected in high quantities in inflamed tissues; when injected in the circulation that supplies the skin they cause inflammation and pain. Evidence of PGE sensitization of C-nociceptors (polymodals) already exists. The present work establishes that PGE1 has a wider sensitizing effect: when injected subdermally it affects mechanoreceptive elements as well. Of moderate-threshold, slow-adapting A delta mechanoreceptors isolated in the skin of the rat leg and responding to punctate stimulation, 79% were sensitized by PGE1 injections nearby (8--12 mm) as judged by their increased responses to innocuous stimulation (0.5--5 g delivered by a stylus with 0.5 mm tip diameter). Of such units, 10.5% were not sensitized and another 10.5% were inhibited or lost. Controls showed at most a small and transient increase immediately following the injection whereas the PGE1 effect lasted from between 30 min to 3 h or longer. These results are discussed in connection with mechanoreceptor sensitization by other pain-producing and irritant substances. At the receptor level, 'nociception' under abnormal conditions (e.g. inflammation) may not be solely mediated by unambiguously 'nociceptive' units; in such conditions a wider sensitization of receptive elements may be a contributing factor in hyperalgesic or hyperaesthetic phenomena.
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PMID:Prostaglandin E1-induced sensitization of A delta moderate pressure mechanoreceptors. 719 29

A 33-year-old man with a nonatherosclerotic vasculopathy of undetermined origin had progressive occlusive disease of the lower limb vessels. The resultant severe rest pain and ischemic ulceration of his foot were inoperable and unresponsive to conventional drug therapy. Treatment was begun with intra-arterially administered alprostadil (prostaglandin E1), a vasodilator and inhibitor of platelet aggregation. Although immediate benefit was equivocal, his rest pain had disappeared six weeks after infusion, and the ischemic ulcer almost healed completely. Blood flow studies showed increased flow to the feet, consistent with the subjective improvement. The beneficial effect of alprostadil suggests that further studies with this agent are warranted for patients with nonatherosclerotic vasculopathy.
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PMID:Intra-arterial alprostadil for nonatherosclerotic vasculopathy. 723 Mar 71

It has recently been demonstrated that prostaglandins play an important role in human reproductive system. The purpose of this study is to demonstrate the involvement of PGs in the onset of menstruation and in the cause of dysmenorrhea. In human endometrium PGF2 alpha were found in large amount in late luteal phase and especially in premenstrual period. PGE1 and PGF2 alpha concentrations in menstrual bloods were 3 to 4 times higher in dysmenorrheic subjects as compared to normal women. The high PGE1 and PGF2 alpha concentration of patients decreased to normal level in naproxen treated cycle. And the intensity of abdominal pain and lumbago decreased simultaneously. On the other hand, in normal woman, naproxen gave little effect on PGs concentration of menstrual fluids. High levels of PGs in dysmenorrheic subjects, decrease of PGs concentration by naproxen treatment and simultaneous alleviation of pain suggest the involvement of PGs in the cause of dysmenorrhea.
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PMID:[Prostaglandins and dysmenorrhea effect of naproxen on prostaglandin concentrations in menstrual blood (author's transl)]. 723 42

Twelve patients with systemic sclerosis (SS) and severe Raynaud's phenomenon received infusions of prostaglandin E1 (PGE1) at a dose of 6-10 ng/kg/min, with either saline or 5% dextrose, for 72 hours in a single-blind cross-over study. The infusions were administered intravenously by centrally positioned catheters. Infusions were well tolerated with only mild side effects. Following the PGE1 infusion cold tolerance improved and attacks of Raynaud's phenomenon were less frequent, less severe, and shorter in duration. This subjective improvement was maintained for several weeks in most patients, and 2 noted healing of ischaemic ulcers. There was no significant change in objective measurements of hand function after either infusion. However, pain measured on a 10 cm visual analogue scale improved 2.19 cm with PGE1 and only 0.91 cm with normal saline (P less than 0.05). Temperature of the fingers and hands recorded by thermography did not change significantly with saline infusions, but did rise during PGE1 infusions (mean rise 2.0 degrees C at 48 hours, p less than 0.001), and was maintained when measured again 2 weeks later (mean rise 1.56 degrees C, p less 0.001). PGE1 may therefore be suitable treatment for Raynaud's phenomenon and the vascular insufficiency of systemic sclerosis and other connective tissue diseases.
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PMID:Prostaglandin E1 infusions for vascular insufficiency in progressive systemic sclerosis. 725 26

In rats pretreated with indomethacin, injection of PGE1 (prostaglandin E1) with carrageenan potentiated the carrageenan paw oedema. This effect of PGE1, was maximal when it was injected together with carrageenan, there being a reduction in the action of PGE1 if carrageenan injection was delayed after PGE1 injection. PGE1 induced potentiation of increase in plasma protein leakage induced by intradermal injections of bradykinin and histamine also depended on the injection of PGE1 along with these agents. Thus oedema enhancement by PGE1 differs from its action in pain, where PGs cause a long lasting sensitization of the injected area for the actions of other algesics. Since vasodilation may be a mechanism of oedema enhancement by PGs, the ability of adenosine and papaverine to mimic PGE1 in paws and skins of rats were examined. Adenosine was active whereas papaverine was inactive in this respect. To clarify this difference, the vasodilatory properties of PGE1, adenosine and papaverine were assessed by their ability to antagonize NA response in perfused rat mesenteric blood vessels. Only papaverine was effective in antagonising the NA response. Thus, PGE1 and adenosine which potentiated the oedema inducing actions of other agents showed no vasodilatory properties and papaverine, a vasodilator, had no oedema potentiating actions.
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PMID:Characteristics of prostaglandin E1 potentiation of inflammatory activity of some agents. 738 37

Lower limb critical ischemia is a clinical condition typical of patients with severe chronic obstructive arterial disease (Fontaine's IIIb and IV degree). This condition often leads to amputation of the limb involved. The authors present to the use PGE1 in 50 patients with Fontaine's IIIb-IV degree chronic obstructive arterial disease of lower limbs in which the indication of amputation was done. All the patients, admitted to the emergency ward, complain of rest pain and distal ulcers. The administration of PG5(1) was given as follows: 40 mg/bid/e.v./20 days. A 6 months long follow-up was installed with the instrumental evaluation of: Transcutaneous oxygen pressure; Distal blood perfusion with Doppler; cardiac pulse; blood pressure. Eighteen patients became to a Fontaine's II degree during the next 2 months after therapy, 25 patients came back to a severe claudicatio: of them 18 underwent successfully vascular surgery, 7 underwent amputation of the lower limb. In 7 patients the PGE1 did not influence the natural progression of the disease. Among the side-effects of therapy we can mention: headache (4%), erythema and pain of injected vein (8%), sick (4%). All the side effects were transient and never led to interruption of therapy.
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PMID:[Use of PGE1 in severe ischemia of the lower extremities. Clinical study]. 756 37

In a randomized open controlled study the clinical effects and tolerability of prostaglandin E1 (PGE1) and the stable prostacyclin (PGI2) analogue, iloprost in the management of diabetic and non-diabetic patients with advanced peripheral arterial occlusive disease (PAOD Fontaine stage IV) were compared. 267 patients were enrolled in this multicentre study and treated for 21-28 days, either by daily infusions of 6 h with iloprost or 2 x 2 h with PGE1. At the end of treatment patients were assessed for evidence of improvement of trophic lesions, relief of rest pain and change of global clinical status. 228 patients were considered as evaluable for efficacy analysis, which revealed 52.7% responders in the iloprost group and 43.1% for PGE1 (p = 0.148). Whereas iloprost showed similar effects in diabetics and non-diabetics (53.3% and 51.4% response rates, respectively), the diabetics treated with PGE1 had a considerably poorer outcome (36.6% versus 53.3%). At 6 months follow-up 62.2% of patients in both groups were alive with a viable limb. Slightly more iloprost patients underwent major amputation (32.1% versus 27.2%), but the number of deaths was reduced by 50% in the iloprost group compared to the PGE1 group (7.5% versus 14.6%, p = 0.10). Side-effects such as headache, flushing and gastrointestinal symptoms were significantly more common in the iloprost group (73.9%) than in the PGE1 group (31.0%), particularly during the first 3 days of dose titration. No specific toxic or unexpected reactions were reported in either group.
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PMID:Treatment of patients with peripheral arterial occlusive disease Fontaine stage IV with intravenous iloprost and PGE1: a randomized open controlled study. 769 55

We compared the effect of intracavernous administration of sodium nitroprusside, a nitric oxide donor and, therefore, stimulator of the cyclic guanosine monophosphate pathway, with the activity of prostaglandin E1, which is a stimulator of the cyclic adenosine monophosphate pathway. To date 105 patients with erectile dysfunction have entered the study. As part of the diagnostic evaluation every patient received an intracavernous injection of 20 micrograms prostaglandin E1 and a second injection of sodium nitroprusside at different concentrations (100 micrograms in 10 patients, 300 micrograms in 60 and 400 micrograms in 35). Sodium nitroprusside at a dose of 100 micrograms was not effective for inducing erections. Prostaglandin E1 induced better responses overall than sodium nitroprusside at 300 and 400 micrograms (p < 0.001). The overall duration of erections was also significantly longer with prostaglandin E1 (mean 88.5 minutes) than with 300 micrograms sodium nitroprusside (mean 50.8 minutes, p < 0.001) but did not reach statistical significance compared to 400 micrograms sodium nitroprusside (mean 42.2 minutes). Side effects were minimal with both drugs. Although sodium nitroprusside has several benefits over prostaglandin E1 for intracavernous use (such as lower cost, absence of local pain and shorter action, allowing detumescence after orgasm and decreasing the risk of priapism), prostaglandin E1 still remains the agent of choice for intracavernous use.
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PMID:Preliminary results of a comparative study with intracavernous sodium nitroprusside and prostaglandin E1 in patients with erectile dysfunction. 771 75

In 87 patients with a missed abortion prior to 13 weeks, the application of a prostaglandin (PG) E1 derivative (1 mg gemeprost, Cergem) was compared to conventional surgical termination of pregnancy by cervical dilatation and curettage. In 33 patients with PGE1 application, complete expulsion of the abnormal pregnancy occurred after an average of 2.8 +/- 1.5 vaginal suppositories. PGE1 treatment was effective in 76.7%, and surgical management was effective in 90.9% of patients. Sixty percent of the patients in the PGE1 group required analgesia because of uterine pain in comparison to 4.5% in the surgical group. The possibility of medical termination with synthetic PG derivatives should be further investigated.
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PMID:Gemeprost for first trimester missed abortion. 772 51

Trigeminal neuralgia is an uncommon but troublesome symptom of multiple sclerosis that can be refractory to conventional treatments. Misoprostol, a long-acting prostaglandin E1 analogue, relieved pain in six of seven patients who had failed to respond to conventional pharmacologic therapy.
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PMID:Trigeminal neuralgia in multiple sclerosis relieved by a prostaglandin E analogue. 778 70


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