Review on Chronic Pain in Rheumatoid Arthritis: NR2B Activation Focus
Journal name: The Malaysian Journal of Medical Sciences
Original article title: A Review on Chronic Pain in Rheumatoid Arthritis: A Focus on Activation of NR2B Subunit of N-Methyl-D-Aspartate Receptors
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Ain’ Sabreena Mohd Noh, Che Aishah Nazariah Ismail
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: A Review on Chronic Pain in Rheumatoid Arthritis: A Focus on Activation of NR2B Subunit of N-Methyl-D-Aspartate Receptors
Year: 2020 | Doi: 10.21315/mjms2020.27.1.2
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation of the joints, leading to debilitating pain, swelling, and stiffness. With an estimated annual prevalence of 22.7% among adults in the United States, the condition affects daily functioning and quality of life, particularly in women and older individuals. The pain experienced by RA patients often persists despite treatments aimed at controlling inflammation, such as non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs). Current studies suggest that the pain may be related to central nervous system modifications rather than solely driven by inflammation, necessitating further exploration into the underlying mechanisms.
Mechanistic Insights into NR2B Subunit Activation
A critical focus of recent research has been the role of the N-methyl-D-aspartate receptor (NMDAR), specifically its NR2B subunit, in the pathogenesis of chronic pain associated with RA. The NR2B subunit is involved in the central and peripheral processing of pain and can be activated through various pathways, including presynaptic glutamate release and the action of inflammatory cytokines such as IL-1β and tumor necrosis factor-alpha (TNF-α). When activated, the NR2B subunit mediates calcium influx that can lead to hypersensitivity in neurons, exacerbating pain perception. Several signaling pathways involving G-protein-coupled receptors (GPCRs), integrins, and pro-inflammatory cytokines contribute to this activation, indicating that NR2B may serve as a promising therapeutic target for managing RA-related pain.
Conclusion
Despite advancements in treating RA through biologics that target inflammatory pathways, the persistent pain experienced by patients illustrates a significant gap in effective management strategies. Understanding the role of the NR2B subunit of NMDAR in pain transmission highlights the potential for developing targeted therapies that can modulate pain signaling without solely focusing on inflammation. Future experimental studies and clinical trials are essential to elucidate the therapeutic efficacy of NR2B antagonists and their role in alleviating the chronic pain experienced by RA patients. As pain remains a primary concern for those with RA, optimizing pain management strategies is vital for improving patient outcomes and overall quality of life.
FAQ section (important questions/answers):
What causes chronic pain in rheumatoid arthritis (RA)?
Chronic pain in RA results from autoimmune-induced inflammation in the joints, leading to both peripheral and central pain processing sensitization. Patients experience persistent pain even when inflammation is controlled due to underlying mechanisms in the nervous system.
How effective are NSAIDs and DMARDs in managing RA pain?
Although NSAIDs and DMARDs are effective in reducing inflammation and managing RA symptoms, they do not adequately alleviate pain in the long term, with many patients continuing to experience unresolved pain despite treatment.
What is the role of NR2B subtype in RA pain?
The NR2B subunit of N-methyl-D-aspartate receptors (NMDAR) is implicated in chronic pain mechanisms. Its activation contributes to central sensitization and pain perception in RA, highlighting its potential as a therapeutic target for pain management.
What are the strategies to alleviate RA pain based on NR2B?
Therapeutic strategies targeting NR2B, such as the use of specific antagonists, have shown promise in alleviating pain by reversing hyperalgesia and allodynia, emphasizing the need for further clinical trials to confirm their efficacy.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Review on Chronic Pain in Rheumatoid Arthritis: NR2B Activation Focus”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Pain:
Pain is a complex and multifaceted experience that can be triggered by various conditions, including rheumatoid arthritis. It involves both sensory (physical discomfort) and emotional components (suffering), impacting individuals' quality of life. Understanding pain mechanisms is essential for developing effective treatments and alleviating patients' suffering. Chronic pain is particularly debilitating and often requires comprehensive management strategies.
2) Activity:
Activity refers to physical movement and engagement in various tasks, essential for maintaining physical health and overall well-being. In the context of rheumatoid arthritis, activity levels can be significantly impacted due to pain, fatigue, and joint stiffness, highlighting the importance of supporting patients in maintaining an active lifestyle despite their condition.
3) Channel:
In a biological context, a channel generally refers to protein structures that allow substances to move across cell membranes. Ion channels, such as those involved in pain signaling, play a crucial role in transmitting pain signals during inflammation, especially in conditions like rheumatoid arthritis, affecting how pain is perceived.
4) Inflammation:
Inflammation is a biological response to harmful stimuli, such as injury or infection. It involves complex interactions between cells, blood vessels, and signaling molecules. In rheumatoid arthritis, inflammation leads to joint pain and swelling, severely affecting mobility and quality of life. Understanding inflammation processes is vital for developing effective treatments for related diseases.
5) Rheumatoid arthritis:
Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation of the joints, leading to pain, swelling, and stiffness. It affects millions globally and can lead to significant disability if not managed properly. Understanding its pathogenesis is crucial for developing effective pharmacological and non-pharmacological interventions to improve patients' quality of life.
6) Disease:
A disease is a pathological condition of a bodily part, an organism, or system resulting from various causes, including infection, genetic, or environmental factors. Diseases such as rheumatoid arthritis illustrate the importance of understanding disease mechanisms to develop targeted treatments, thereby alleviating suffering and enhancing patients' life quality.
7) Study (Studying):
A study refers to a detailed examination and analysis of a subject or phenomenon. In medical research, studies are fundamental for gathering evidence about diseases, treatments, and outcomes. Conducting well-designed studies is essential to advance medical knowledge and improve health interventions, particularly in understanding complex conditions like rheumatoid arthritis.
8) Horn:
In neuroanatomy, the term 'horn' refers to specific regions within the spinal cord, such as the dorsal horn, where sensory information is processed. Understanding the neural pathways and connections within these areas is crucial for comprehending how pain signals are transmitted and how chronic pain conditions, like rheumatoid arthritis, manifest.
9) Transmission:
Transmission refers to the process of conveying signals, information, or diseases from one entity to another. In the context of pain, transmission involves the relaying of nociceptive signals from peripheral receptors to the central nervous system, critical for understanding pain mechanisms in disorders such as rheumatoid arthritis.
10) Surface:
Surface generally refers to the outermost layer or boundary of a structure. In the context of cells, surface receptors and membrane proteins play significant roles in cell signaling and interaction with the external environment. This is particularly important in immunological responses and understanding mechanisms related to diseases like rheumatoid arthritis.
11) Death:
Death in a biological context can refer to cellular apoptosis or necrosis, processes implicated in various diseases, including neurodegenerative and inflammatory diseases. Understanding the mechanisms of cell death is crucial in research relating to chronic pain conditions to develop potential treatments targeting pathways involved in cell survival and function.
12) Drug:
A drug is a chemical substance intended for use in the diagnosis, treatment, or prevention of diseases. In the field of rheumatoid arthritis, various drugs are employed to manage pain and inflammation, highlighting the importance of ongoing research to identify effective pharmacological interventions to improve patient outcomes.
13) Substance:
Substance can refer to any material with a definite chemical composition. In pharmacology and pain management, understanding substances that affect the nervous system is crucial for developing medications targeting specific receptors in conditions such as rheumatoid arthritis, thereby helping to alleviate pain and enhance patients' quality of life.
14) Family:
In biological taxonomy, a family is a classification that groups related organisms. Understanding familial relationships among proteins and receptors, such as the NMDA receptor family related to pain transmission, aids in the comprehension of biological functions and the development of specific treatments for diseases like rheumatoid arthritis.
15) Nature:
Nature refers to the inherent characteristics and relationships of various biological entities regarding health and disease. Understanding the nature of diseases, including their pathophysiology and impact on individuals, is fundamental for developing effective treatments and addressing the broader implications on patients' lives and well-being.
16) Guti:
The term 'Guti' could refer to a clade within evolutionary biology or possibly represents a name or acronym related to a specific research context. Utilizing proper terminology in research is vital for clear communication, particularly in complex discussions about the biology of diseases like rheumatoid arthritis.
17) Hand:
In medical contexts, 'hand' typically refers to the anatomical structures alongside the skeletal and muscular systems crucial for movement and grasping. Diseases such as rheumatoid arthritis often lead to dysfunction and pain in the hand, significantly affecting patients' daily lives and requiring targeted rehabilitation efforts.
18) Post:
In anatomical and physiological terms, 'post' often denotes a positioning indicative of post-synaptic sites where signals are received. Understanding the post-synaptic mechanisms involved in pain transmission is critical in elucidating how chronic pain conditions, such as rheumatoid arthritis, develop and persist.
19) Ter:
Referring to therapy or therapeutics, this term underscores the importance of treatment strategies in managing diseases. In relation to conditions like rheumatoid arthritis, effective therapeutic interventions are vital for alleviating symptoms, improving life quality, and preventing severe progression of the disease.
20) Perception:
Perception is the process through which sensory information is interpreted, influencing how we experience pain and discomfort. Understanding pain perception in patients with rheumatoid arthritis is important for developing effective pain management strategies that address not only the physical but also the emotional dimensions of pain.
21) Suffering:
Suffering denotes the state of undergoing pain, distress, or hardship. In the context of chronic conditions like rheumatoid arthritis, suffering becomes not only physical due to ongoing joint pain but can also manifest emotionally, affecting overall well-being and quality of life, necessitating comprehensive treatment approaches.
22) Table:
Table can refer to data representation or scientific organization within research. In medical literature, well-structured tables summarize treatment outcomes or research findings, which is crucial for facilitating knowledge transfer among researchers and clinicians focusing on diseases such as rheumatoid arthritis.
23) Field:
The term 'field' in scientific contexts could reference specific disciplines or areas of study, such as pain research or rheumatology. Understanding diverse fields helps integrate knowledge across disciplines, leading to holistic approaches in managing diseases like rheumatoid arthritis and related pain conditions.
24) Life:
Life represents an essential aspect of biological inquiry encompassing growth, development, and health. Understanding how diseases like rheumatoid arthritis impact individuals’ lives is vital for developing interventions aimed at improving quality of life and effective management of chronic conditions that affect daily functioning.
25) Depression:
Depression is a significant mental health condition that can co-occur with chronic illnesses such as rheumatoid arthritis, where ongoing pain often contributes to emotional distress. It is crucial to address both physical and mental health in treatment plans to improve patients' overall quality of life and well-being.
26) Swelling:
Swelling refers to an increase in volume of affected tissues, commonly associated with inflammation. In rheumatoid arthritis, swelling is a major symptom indicating inflammation in joints, reflecting ongoing disease activity and significantly contributing to discomfort and decreased functional ability in affected individuals.
27) Epilepsy:
Epilepsy is a neurological disorder characterized by recurrent seizures. The relevance of such conditions in the broader framework of neurological research highlights the importance of understanding various mechanisms, including those related to pain, to develop effective treatment strategies that may also benefit other chronic pain conditions.
28) Species:
In biology, a species is a fundamental category of classification that describes a group of organisms capable of interbreeding. Understanding different species, particularly in pharmacological studies, enhances knowledge about the mechanisms of action of drugs affecting pain in conditions like rheumatoid arthritis and facilitates therapeutic applications.
29) Science (Scientific):
Science represents the systematic pursuit of knowledge through observation, experimentation, and theoretical explanations. In the context of chronic diseases like rheumatoid arthritis, scientific research plays a crucial role in exploring new treatments, understanding underlying biological mechanisms, and informing best practices for patient care.
30) Sign:
The term 'sign' often refers to indicators or observable phenomena that signal underlying processes or conditions. In medical settings, recognizing signs of chronic pain or inflammatory disease activity helps clinicians in developing targeted interventions for conditions like rheumatoid arthritis, enhancing patient outcomes through timely interventions.
31) Pur:
Poor health reflects a state of illness or a lack of well-being that significantly diminishes quality of life. In chronic conditions such as rheumatoid arthritis, poor management of symptoms can lead to increased disability and dysfunction, highlighting the urgency for effective therapeutic strategies and holistic patient care.
32) Pharmacological:
Pharmacological refers to the study of drugs and their effects on biological systems. In rheumatology, pharmacological approaches focus on developing interventions to alleviate symptoms and control disease activity in conditions like rheumatoid arthritis, emphasizing the critical need for ongoing research for effective pain management.
33) Transformation (Transform, Transforming):
To transform means to change in form, appearance, or structure. In a medical context, understanding how certain interventions can lead to the transformation of disease states or symptoms is key for developing effective treatment strategies for managing chronic conditions like rheumatoid arthritis and improving patient outcomes.
34) Alleviation:
Alleviation pertains to the relief of symptoms, especially pain and discomfort associated with chronic conditions. For rheumatoid arthritis patients, effective alleviation strategies are crucial in improving life quality, highlighting the importance of ongoing research and the development of new treatment modalities to address chronic pain.
35) Education:
Education is the process of acquiring knowledge, skills, and understanding through learning. In health care, education is essential in promoting awareness about chronic diseases like rheumatoid arthritis, equipping patients and clinicians with knowledge to manage conditions effectively, thereby enhancing health outcomes.
36) Stiffness:
Stiffness refers to the rigidity of joints and muscles that can occur as a symptom in various rheumatic conditions. In rheumatoid arthritis, stiffness, particularly in the morning or after inactivity, highlights the need for targeted interventions that can improve flexibility and overall function to enhance patients' quality of life.
37) Quality:
Quality pertains to the standard of something as measured against other standards. In health care, especially in managing chronic conditions like rheumatoid arthritis, the quality of life must be prioritized, as it encompasses not just physical health but also emotional and social well-being for effective patient care.
38) Account:
In a biomedical context, 'account' can refer to a detailed report or narrative of observations, results, or experiences related to diseases. Clinical accounts are critical for understanding the patient experience, treatment efficacy, and outcomes in the context of diseases such as rheumatoid arthritis.
39) Medium:
Medium can refer to various contexts, such as media or methods used to facilitate processes. In research, the medium influences how experiments are conducted and outcomes obtained, impacting broader understanding and innovations related to the treatment and management of diseases like rheumatoid arthritis.
40) Animal:
In research, 'animal' usually denotes the use of non-human subjects to study biological processes, diseases, and potential treatments. Animal models are vital for understanding rheumatoid arthritis pathophysiology and testing new therapies before clinical trials in humans, providing foundational knowledge pivotal to advancing treatments.
41) Firing:
Firing in neuroscience refers to the action potentials generated by neurons in response to stimuli. Understanding firing patterns, particularly in pain pathways related to conditions like rheumatoid arthritis, provides insights into the mechanisms underlying pain signaling and sensitivities, aiding in the development of targeted therapeutic strategies.
42) Blood:
Blood is a vital fluid in the body responsible for transporting nutrients, oxygen, hormones, and immune cells. In the context of rheumatoid arthritis, blood parameters often inform clinicians about inflammation levels and disease activity, guiding treatment decisions and monitoring overall patient health.
43) Soma:
Soma refers to the cell body of a neuron, containing the nucleus and organelles necessary for metabolic functions. Understanding somatic functions and signals in the context of pain pathways is critical for elucidating the mechanisms of chronic pain conditions such as rheumatoid arthritis and optimizing treatment approaches.
44) Dana:
The term 'Dana' may refer to a specific name or figure in certain contexts. In biomedical research, individuals are often integral to advancing knowledge and understanding in their fields, and their contributions help shape investigation directions in the management of chronic diseases like rheumatoid arthritis.
45) Cani:
The term 'Cani' can be a reference to a name or specific context in research discussions. Clear terminology enhances communication among researchers and clinicians, particularly when exchanging information about diseases, research findings, or treatment strategies pertinent to complex conditions such as rheumatoid arthritis.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Review on Chronic Pain in Rheumatoid Arthritis: NR2B Activation Focus’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
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