A New, Opioid-Sparing Approach to Pain Management?

New research on mouse models suggests that a naturally occurring protein, apolipoprotein A-1 binding protein or AIBP may offer a new, opioid-sparing approach to treating severe, persistent pain. Investigators from University of California San Diego School of Medicine report that a single spinal injection of AIBP alleviated chemotherapy pain in mice for 2 months with no adverse effects noted. Co-senior author Tony Yaksh, PhD, professor and vice chair for research in the Department of Anesthesiology at UC San Diego School of Medicine, observed, “Opioids and most other pain medications simply dampen a person’s perception of pain. But the source of the pain is still there. At the same time, opioids also impart a feeling of pleasure, which leads to their misuse and addiction.” By contrast, AIPB was found to reverse inflammation and cellular events associated with pain processing by binding to, and switching off, toll-like receptor 4 (TLR4), another protein that occupies the surface of cells and reacts to infection or tissue damage.

A side effect of chemotherapy can be the development of persistent pain from even light touch. Dr. Yaksh estimated that at least 39% of the 1.7 million patient initiating treatment for cancer each year experience pain during and following therapy. By inhibiting the TLR4 receptor with AIBP, the novel approach blocks the underlying pain-producing mechanism, vs simply masking the symptoms. Co-senior author Yury Miller, MD, PhD, profession in the UC San Diego Department of Medicine, commented, “As it stands now, AIBP could be developed as therapy for unremitting severe pain that only responds to high dose morphine. AIBP would remove the need for opioids, and reduce the potential for drug abuse.” The team’s work was reported earlier this week in the journal Cell Reports.

Read a news story about the findings.

The journal article may be read here.