Anti-inflammatory drugs can cause chronic pain

A new study from McGill University has shown that blocking inflammation can lead to chronic disease.

Findings may change the treatment of acute illness

When you have a headache, back pain, arthritis, or fever, you may be taking anti-inflammatory drugs. NSAIDs or non-steroidal anti-inflammatory drugs are the most common type of anti-inflammatory drugs. According to the American Gastroenterological Association, nearly 30 million Americans use them daily to reduce pain or discomfort.

The most common types of NSAIDs include aspirin, ibuprofen (commonly called Advil) and naproxen (known as Aleve and Naprosyn). However, despite their popularity, these drugs can have side effects.

According to McGill University and colleagues in Italy, the use of anti-inflammatory drugs and steroids to treat the disease increases the risk of developing chronic disease. Their findings challenge traditional methods of pain relief. Normal recovery from a severe injury involves inflammation, and these anti-inflammatory drugs can make the disease more difficult to treat.

“For decades, anti-inflammatory drugs have been the standard medical practice. However, we have found that this short-term correction can lead to long-term problems, ”said Jeffrey Mogil, a professor of psychology at McGill University and chairman of the EP Taylor in pain research.

The difference between being better and being worse

In a study published on May 11, 2022 Science Translational Medicine, the researchers studied the mechanisms of the disease in both humans and mice. They found that neutrophils, a type of white blood cell that helps the body fight infection, play a key role in resolving the disease.

“In the analysis of the genes of people suffering from low back pain of the year, we observed that the genes of people with the disease change actively over time. Changes in blood cells and their activity have been shown to be the most important factor, especially in cells called neutrophils, ”said Luda Diatchenko, a professor at the Faculty of Medicine and the Excellence Research Chair at the Faculty of Dentistry and Canadian Human Disease Genetics.

Inflammation plays a key role in resolving the disease

“Neutrophils predominate in the early stages of inflammation and help to repair tissue damage. Inflammation can occur for any reason and it seems dangerous to intervene, ”said Professor Mogil, who is also a member of the Alan Edwards Center for Disease Research with Professor Diatchenko.

Inhibition of neutrophils in mice increased the duration of the disease by ten times. Anti-inflammatory drugs and steroids such as dexamethasone and diclofenac had the same effect, although they were useful in the early treatment of the disease.

These results were also confirmed by a separate study of 500,000 people in the UK, which found that those who used anti-inflammatory drugs to reduce pain were more likely to get sick in two to ten years. took acetaminophen or antidepressants.

Review of standard medical treatment for severe pain

“Our results show that it is time to reconsider the treatment of acute illness. Fortunately, the disease can be killed in other ways that do not prevent inflammation, ”said Massimo Allegri, a doctor at the Monza Hospital Polyclinic in Italy and Ensemble Hospitalier de la Cote in Switzerland.

“We have found that eradication is actually an active biological process,” says Professor Diatchenko. These findings should be made after clinical trials that directly compare anti-inflammatory drugs with other pain killers that reduce pain and pain but do not stop the inflammation.

Reference: “Acute inflammatory response by neutrophil activation protects against the development of chronic disease” Mark Parisian, Lucas W. Lima, Conzetta Dagostino, Nehme El-Hahem, Gillian L. Drury, Audrey W. Grant, Jonathan Hughes, Vivek Verma, Carolina B. Meloto, Jacqueline R. Silva, Gabriel GS Dutra, Theodora Markova, Hong Dang, Philip A. Tessier, Gary D. Slade, Andrea G. Nakli, Nader Gasemlu, Jeffrey S. Tomb, Massimo Allegri and Luda Diatchenko, May 11, 2022, Science Translational Medicine.
DOI: 10.1126 / scitranslmed.abj9954

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