Will HGF Injections Be The Answer For Neuropathy

Today's post from type2nation.com (see link below) talks about injecting HGF (hepatocyte growth factor - a protein associated with tissue regeneration) to treat neuropathy. Notice, I say neuropathy and not neuropathy symptoms because this is designed to help regenerate nerve growth where damaged and not just the symptoms of nerve pain or tingling. However and this is a big however, in the study, the majority of subjects did not respond to the treatment, which leaves the whole idea open to doubt. The article author suggests that this still shows HGF injections to be potentially useful for neuropathy patients but it seems that many more studies and lots more research may be needed first before this can be assumed.
 

Injections May Combat Diabetic Neuropathy
Published on January 25th, 2016 | by Travis Manni

One common side effect of living with diabetes can be painful diabetic neuropathy, which is nerve damage in the arms, hands, legs, or feet; the condition is caused by chronically high blood sugar levels. There are limited treatment options to deal with diabetic peripheral neuropathy, or the pain it causes.

However, a new multi-center study showed hepatocyte growth factor (HGF) injections helped treat the condition for a good amount of study participants. The study was published in the May 2015 issue of the journal Annals of Clinical and Translational Neuropathy. However, the treatment did not work for the majority of individuals studied, meaning HGF may be a good treatment option, but not necessarily a silver bullet in treating diabetic peripheral neuropathy.

According to the National Center for Biotechnology Information, HGF is a protein in the body that is associated with organ development, tissue regeneration, and wound healing in adults. It also supports the growth and nourishment of neuron cells. In the double-blind Phase II study, 96 individuals were given either a placebo or HGF intramuscular injections in the leg twice over two weeks; the experimental group received either 8 mg (low-dose) or 16 mg (high-dose) of HGF. Participants were asked to record information in a pain and sleep diary.

The low-dose experimental group showed the greatest reduction in pain after three months, according to a MedScape article. In particular, those who were not not already taking other prescription drugs that treat this type of pain reported a statistically significant decrease on the pain measurement scale. Additionally, 48% of those surveyed in the low-dose group reported their pain was either “improved” or “very much improved” after three months; 31% of people in the high-dose group also reported “improved’ or “very much improved” pain levels. Improvement in touch sensitivity was also observed in those treated with HGF.

Researchers hope this form of treatment, which would require only eight injections a year, will eliminate the need for patients experiencing painful diabetic neuropathy to take daily medication. The HGF injections also could be seen as an alternative option for those who do not experience pain relief with currently available prescription drugs. Further study will be needed before the treatment might become available on the market, and researchers expect to conduct a new trial in 2016.

http://www.type2nation.com/treatment/new-injection-treatment-may-combat-diabetic-neuropathy/

What Will Help Tracking Genetic Reasons For Neuropathic Pain

Today's post from sciencedaily.com (see link below) looks at a problem scientists have faced when confronted with the question: is neuropathy genetic? The problem is the lack of a standard approach to assessing its clinical characteristics (otherwise known as a 'phenotype'). However, recently there seems to have been a breakthrough and they have developed criteria which categorise what neuropathy 'looks like' genetically and clinically. It's thought that this will help in understanding how neuropathic pain develops, leading to new approaches to treatment and prevention. Hopefully this is the case and we can look forward to effective treatments reaching our doctors' prescription pads sooner rather than later.
 

Standard phenotypes will aid in genetic research on neuropathic pain 
Date:October 26, 2015 Source:Wolters Kluwer HealthSummary:

Research on the genetic factors contributing to neuropathic pain has been hindered by the lack of a standard approach to assessing its clinical characteristics or "phenotype." Now, a report from an expert panel published in the journal PAIN® presents a consensus approach to assessing the phenotype of neuropathic pain. The journal is the official publication of the Wolters Kluwer.

Standardized "entry level" criteria for defining the phenotype of neuropathic pain were developed by an international panel of experts assembled by the IASP's Special Interest Group on Neuropathic Pain (NeuPSIG). Along with other recommendations for research reporting, the consensus criteria will achieve "greater consistency and transparency in studies of neuropathic pain in adult humans." Dr. Blair H. Smith of the University of Dundee, Scotland, is lead author of the expert panel report.

Setting Standard Criteria to Define Neuropathic Pain Phenotypes

Neuropathic pain is a common and complex pain condition caused by damage or diseases of the sensory nerves. Patients may experience shooting or burning pain, numbness, or exaggerated pain responses. Neuropathic pain can be caused by diabetes, trauma, shingles, and a wide range of other conditions.

Information on genetic factors may help in understanding how neuropathic pain develops, leading to new approaches to treatment and prevention. But so far, genetic studies have produced inconsistent results that are difficult to confirm. This is partly because of differing approaches used to identify and classify the clinical expression and characteristics of this condition, which can vary widely.

To address this problem, the expert panel "aimed to provide guidelines on collecting and reporting phenotypes" of neuropathic pain. After a thorough review of previous research evidence, panel members followed a formal consensus process to develop a set of "entry level" phenotype data to identify and classify patients with neuropathic pain, as well as appropriate comparison (control) groups.

Following this process, the NeuPSIG panel identified three basic elements:
Pain with neuropathic characteristics (described as "hot/burning" or "evoked by light touch") or assessed using a validated screening tool
Pain distributed or located in a pattern that is anatomically consistent with underlying nerve damage or disease (in other words, the pain is consistent with the anatomy of the affected sensory nerves)
Additional information on pain history and characteristics and other factors relevant to the disease or group of patients being studied

Reflecting the challenges of diagnosing neuropathic pain, the report emphasizes that these "entry level" criteria identify only "possible" cases of neuropathic pain. Depending on the situation, additional criteria could be used to identify "probable" or "definite" cases, or additional sensory or psychological assessments could be conducted to further characterize the phenotype.

The new criteria are published as IASP concludes its 2014-2015 Global Year Against Neuropathic Pain campaign. By improving awareness among patients and health-care providers, IASP hopes to improve recognition and management of this disabling and difficult-to-treat condition.

The consensus phenotype criteria will be an important step toward a more productive approach to studying the genetic factors contributing to neuropathic pain, the NeuPSIG panel members believe. They conclude, "These improvements will facilitate advancements in the field by enabling collaboration between research groups, replication of discoveries of contributing genetic variants, meta-analyses, and translation from the laboratory to the general population, and back again."

Story Source:

The above post is reprinted from materials provided by Wolters Kluwer Health. Note: Materials may be edited for content and length.

Journal Reference:
Oliver van Hecke, Peter R. Kamerman, Nadine Attal, Ralf Baron, Gyda Bjornsdottir, David L.H. Bennett, Michael I. Bennett, Didier Bouhassira, Luda Diatchenko, Roy Freeman, Rainer Freynhagen, Maija Haanpää, Troels S. Jensen, Srinivasa N. Raja, Andrew S.C. Rice, Zeʼev Seltzer, Thorgeir E. Thorgeirsson, David Yarnitsky, Blair H. Smith. Neuropathic pain phenotyping by international consensus (NeuroPPIC) for genetic studies. PAIN, 2015; 156 (11): 2337 DOI: 10.1097/j.pain.0000000000000335

http://www.sciencedaily.com/releases/2015/10/151026132144.htm

FRIENDS KNOW HOW LONG YOU WILL LIVE

Young lovers walking down the aisle may dream of long and healthy lives together, but close friends in the wedding party may have a better sense of whether those wishes will come true, suggests new research on personality and longevity from Washington University in St. Louis.

You expect your friends to be inclined to see you in a positive manner, but they also are keen observers of the personality traits that could send you to an early grave," said Joshua Jackson, PhD, assistant professor of psychology in Arts & Sciences.

Published Jan. 12 in an advance online issue of the journal Psychological Science, the study demonstrates that your personality at an early age (20s) can predict how long you will live across 75 years and that close friends are usually better than you at recognizing these traits.

Male participants seen by their friends as more open and conscientious ended up living longer. Female participants whose friends rated them as high on emotional stability and agreeableness also enjoyed longer lifespans, the study found.

"Our study shows that people are able to observe and rate a friend's personality accurately enough to predict early mortality decades down the road," Jackson said. "It suggests that people are able to see important characteristics related to health even when their friends were, for the most part, healthy and many years from death."

It's no secret that a person's personality traits can have an impact on health. Traits such as depression and anger have been linked to an increased risk of various diseases and health concerns, including an early death.

Men who are conscientious are more likely to eat right, stick with an exercise routine and avoid risks, such as driving without a seat belt. Women who are emotionally stable may be better at fighting off anger, anxiety and depression, Jackson suggests.

While other studies have shown that a person's view of his or her own personality can be helpful in gauging mortality risk, there has been little research on whether a close friend's personality assessment might also predict the odds of a long life.

To explore this question, Jackson and colleagues analyzed data from a longitudinal study that in the 1930s began following a group of young people in their mid-20s, most of whom were engaged to be married.

The longitudinal study included extensive data on participant personality traits, both self-reported and as reported by close friends, including bridesmaids and groomsmen in the study participants' wedding parties.

Using information from previous follow-up studies and searches of death certificates, Jackson and colleagues were able to document dates of death for all but a few study participants. Peer ratings of personality were stronger predictors of mortality risk than were self-ratings of personality.

"There are two potential reasons for the superiority of peer ratings over self ratings," Jackson said.

"First, friends may see something that you miss; they may have some insight that you do not. Second, because people have multiple friends, we are able to average the idiosyncrasies of any one friend to obtain a more reliable assessment of personality. With self reports, people may be biased or miss certain aspects of themselves and we are not able to counteract that because there is only one you, only one self-report."

The study also revealed some gender differences in self-assessment: Men's self-ratings of personality traits were somewhat useful in predicting their lifespans, whereas the self-reports of women had little predictive value.

Jackson suggests this gender difference in self-reporting may be a function of the era in which the study began, since societal expectations were different then and fewer women worked outside the home.

Young women seen as highly agreeable and emotionally stable may have increased odds for a long and happy life since their personalities were well suited for the role of a supportive and easy-going wife, which would have been the norm in the 1930s. It is likely that fewer gender differences would arise in more modern samples if we were able to wait 75 years to replicate the study, he said.

"This is one of the longest studies in psychology," Jackson said. "It shows how important personality is in influencing significant life outcomes like health and demonstrates that information from friends and other observers can play a critical role in understanding a person's health issues. For example, it suggests that family members and even physician ratings could be used to personalize medical treatments or identify who is at risk for certain health ailments."

The study is co-authored by James J. Connolly, PhD, and Madeleine M. Leveille, PhD, of Connolly Consulting, Waterford, Connecticut; S. Mason Garrison of the Department of Psychology and Human Development, Vanderbilt University; and Seamus L. Connolly of College of Medicine, Touro University, California.

How Much Will Genetic Testing Help Your Neuropathy Problems

Today's interesting post from individualizedmedicineblog.mayoclinic.org (see link below) looks at the potential of genetic testing for improving the lot of neuropathy patients. However, it's a bit of a teaser because it suggests that genetic testing itself can help solve the problem, when in fact, while genetic testing will identify the cause of neuropathy much easier, it has little impact on the treatment. The article does say that by identifying and targeting the cause of nerve damage, the treatment can be better directed and people can avoid unnecessary therapies. That may be so but as any long-term neuropathy patient will tell you, the cause of their nerve damage has long been forgotten as they try to find ways of reducing the impact of the symptoms. The cause itself then becomes almost irrelevant because after the damage has been done, irrespective of why, symptom reduction becomes paramount. Genetic testing may certainly help identify the cause and verify the diagnosis and may reduce the number of 'idiopathic' diagnoses but testing itself will not reduce your pain and discomfort. That all said, the future may well lie in genetic and DNA  manipulation, that may rejuvenate damaged nerves, or ensure that the damage doesn't happen in the first place. That remains a somewhat sci-fi concept at the moment! However, genetic testing is not genetic manipulation, it's just the first stage in a relatively new science. An interesting article that may offer up more questions than answers.

Using genetic testing to transform care for neurological disorders
By Sharon Rosen @shr02 Thu, Feb 23 2017

Our nervous system is made up of complex biological pathways that control everything we do, including breathing, thinking, speaking, moving and feeling. For patients suffering from a neurological disorder such as Parkinson’s disease, epilepsy, nerve pain (neuropathy) and dementia, the symptoms of these conditions can impact many aspects of daily life. Some patients with unexplained neurological symptoms search for years for a diagnosis and treatment.

Scientists and physicians have suspected that many neurological conditions had underlying genetic causes. The question has been how to verify that. Advances in DNA testing technology provide new, more accurate ways to pinpoint genetic variations that lead to neurological disease. Armed with this knowledge, physicians can then offer patients targeted treatments for their condition. Christopher Klein, M.D., and Tatiana Faroud, Ph.D., discuss the best ways to use genetic testing to find a diagnosis and individualized treatment for neurology patients in their paper published in the February 2017 issue of Mayo Clinic Proceedings.

The paper, Neurology Individualized Medicine: When to Use Next-Generation Sequencing Panels, provides an overview of the different types of DNA testing now available through advanced technology known as next generation sequencing, the advantages and shortfalls of each method and how to select a genetic test for a patient based on their particular neurological symptoms.



Dr. Christopher Klein

“New genetic testing technologies have transformed care for patients with neurological disorders. Many different genetic causes can lead to similar symptoms in patients. By using genetic tests, we can identify the cause of disease and select more precise, individualized treatments based on a patient’s genetics,” says Dr. Klein.

Three types of DNA testing to consider

Whether you are a patient or a provider, it is important to understand the different types of genetic testing available. The paper explains concepts that can help you understand what tests are best for you or your patient in a clinical setting. The authors highlight three methods of next generation sequencing used to identify genetic links to disease:
Targeted panel testing examines a select group of genes connected to disease, often testing from 50 to 300 genes.
Whole exome sequencing examines only a small portion of the whole genome but includes all genes that have been shown to have a connection to disease.
Whole genome sequencing is the most comprehensive DNA analysis to date and examines a patient’s entire genetic makeup of 3 billion genes.

How do physicians determine which genomic testing method to use when trying to diagnose a neurological disorder? According to the authors, it depends on the number of genes that may be involved in causing a particular disease.

Targeted panel testing

The authors advocate using targeted-panel next generation sequencing for neurological disorders which may be caused by more than one type of genetic variation. This approach has been a successful diagnostic tool for inherited neurological conditions such as neuropathy, myopathy (muscle disease), motor neuron disease (a progressive disease that affects the nerves in the brain and spinal cord) and epilepsy syndromes.

Advantages to using targeted-panel testing include:
Lower costs for conducting DNA sequencing of a smaller set of genes and analyzing the data generated by the tests.
Provides in depth analysis of specified genes that are known to cause disease and accurate identification of genetic variants, which can be used to make decisions about patient care.
Produces a smaller number of variations with unknown importance, which can be difficult to interpret, compared to other genetic testing methods that examine a broader range of genes.

Whole genome or whole exome sequencing

On the other hand, there are benefits to using broader genomic testing methods to diagnose certain neurological disorders. The authors recommend using whole genome sequencing or whole exome sequencing to explore disorders with unknown genetic origins.

For example, these approaches may be able to provide a diagnosis for patients who have searched unsuccessfully for a diagnosis using traditional clinical testing or for patients with developmental delays or autism. In these cases, the broader approaches offer the opportunity to discover new genetic variants that could be responsible for these conditions.

When selecting these broader approaches, providers should recognize the disadvantages of these tests which include:
Higher costs for genetic testing and data analysis
Longer turnaround time to receive test results
More genetic variations with unknown significance are identified, making the results more challenging to interpret
Higher likelihood of identifying unexpected genetic predispositions to disease, in addition to the neurological disorder

Proper use of genetic tests can enhance patient care

According to the authors, the key to effective use of genetic testing is collaboration. Clinicians, laboratory geneticists and bioinformatics experts must work together to develop guidelines to select the right genetic tests, accurately interpret results and then use this information to guide patient care.

This collaboration can have a tremendous impact on patient care by:
Avoiding improper therapies and additional costly invasive therapies such as biopsy.
Identifying specific prognostic and disease management information.
Offering family genetic counseling for conditions that could impact other family members.
Providing opportunities for patients to participate in clinical trials and have access to emerging drug therapies.

Mayo Clinic Proceedings Symposium on Precision Medicine

This paper is the second in Mayo Clinic Proceedings Symposium on Precision Medicine, a series of articles that cover a wide range of topics in personalized medicine. Watch for upcoming articles in the symposium, which will focus on how personalized medicine and genomics are impacting patient care. Learn more about the series.

Christopher Klein, M.D., is professor of Neurology and consultant in the Department of Medical Genetics at Mayo Clinic’s campus in Rochester, Minnesota.

Tatiana Faroud, Ph.D., is division chair, Joe C. Christian Professor of Medical and Molecular Genetics, Chancellor's Professor, director, Division of Hereditary Genomics at Indiana University School of Medicine in Indianapolis.

Learn more about precision medicine and join our community

Get the latest news from the Center for Individualized Medicine. Visit our blog, Facebook, LinkedIn or Twitter at @MayoClinicCIM.

Save the date for the next Individualizing Medicine Conference on Oct. 9-11, 2017.

http://individualizedmedicineblog.mayoclinic.org/discussion/using-genetic-testing-to-transform-care-for-neurological-disorders/

How Regular Routines Will Help With Neuropathy

Today's short but useful post from dressamed.com (see link below) comes via other sites, from Dr. John Hayes Jr, whose work on neuropathy is always directed towards the patient and easy to understand. It talks about the importance of sticking to 'good habits and schedules' in your daily life, or at least as much as possible. People who have good routines regarding eating, exercise and treatment often do much better when it comes to neuropathy, if only because the nervous system can better deal with problems if the patient's daily life has some sort of regularity or order to it. An interesting post that makes you examine your own life to see if there's room for improvement.

Habits and Routines: Powerful Neuropathy Treatment Weapons 
Posted on May 11, 2016 Posted in Staff Pick by Staff Pick

Effective neuropathy treatment plans are easier to implement with patients who are able to keep good habits and schedules.

It is a well-known fact that our daily habits contribute more to our long-term well being than any other single activity.

What does your daily routine consist of? Are you naturally active, or does it become a challenge for you to motivate yourself? Do you make extra effort to walk more when you park your car to go shopping, for example? How about when performing household or yard tasks?

Our daily habits that affect ourselves includes things like aerobic exercise, drinking soda, tobacco usage, excessive over the counter drug usage, et cetera.

It also includes our mental activity; we have the choice to regularly have active mental stimulation such as reading and meditation, versus passive activities such as long periods of watching television.

Unfortunately, most of us never take a hard look at our daily activities, and the impact they’re having upon our health.

Now, when you’re young, these are relatively easy to ignore. But throw in advancing age, and some health challenges, and it becomes a different ballgame!

With chronic pain and neuropathy, sticking to good daily health habits becomes a much more difficult task.

But, what I can tell you after taking care of hundreds of patients is that those who have routines and habits fair far better! Both in terms of physical capacity to enjoy life, and their mental outlook!

One of the reasons for this is more effective neuropathy treatment plans are easier to implement with patients who have good habits and schedules.

You can start right now by developing then sticking to a daily routine of your own design! Scheduling and timing of daily things such as meals, light activity, supplements, and even your own self-care goes along way.

One of the reasons this is true is your body has its own biorhythms.

Timing of certain supplements, and even self-treatment throughout the day can make a BIG difference in your outcome!

And these are all things your neuropathy treatment specialist is able to assist you with.

Just make sure you engage us and ask for guidance with regard to the most effective neuropathy and chronic pain treatments and activities.

But most importantly ask and learn about the best scheduling, and timing.

Make a DAILY schedule for yourself, and then stick to it! You’ll be very glad you did!

About The Author

Dr. John Hayes, Jr. is an Evvy Award Nominee and author of “Living and Practicing by Design” and “Beating Neuropathy-Taking Misery to Miracles in Just 5 Weeks!” His work on peripheral neuropathy and chronic pain has expanded the specialty of effective neuropathy treatments to physicians, physical therapists and nurses. Do you have a powerful daily routine? Join our conversation today on BeatingNeuropathy. To book interviews and speaking engagements with Dr John Hayes Jr call 781-754-0599.

Syndicated by EzineArticles

https://www.dressamed.com/root/habits-and-routines-powerful-neuropathy-treatment-weapons/

Slow Release Safety Opioids Will Solve Abuse Problem At A Stroke

Today's post from wlky.com (see link below) makes you wonder why these abuse-deterrent opioids aren't already available everywhere and why they aren't mandatory!! This isn't news...these slow-release drugs have been available for years; so what's the hold-up? Speaking on behalf of all those neuropathy patients who have tried everything else to curb their symptoms and have been forced to take opioids as the only way to ensure some sort of normal life; there wouldn't be a so-called opioid epidemic if the opioids themselves were 'slow-release' and thus impossible to snort or crush or whatever else the junkies do. That said, genuine patients don't need anything more than what they currently take because they're responsible adults who take control of their medication, with advice and control from their doctors. However, their drugs are being denied to them because of; a) an irresponsible and often criminal few; b) drugs companies who don't want to spend money on creating new forms of the same drug and c) a media who lusts after sensation and blows the problem out of all proportion. If the answer is 'abuse-deterrent' pills than get the hell on with it...we don't mind...but stop restricting what for us is essential because you may tackle a much wider criminality in the world of drug abuse. Sledge hammer!...nut much!!
 

Abuse-deterrent opioids aim to curb epidemic 
UPDATED 6:53 PM EDT Apr 13, 2016
 
Show Transcript 
LOUISVILLE, Ky. —As Kentucky continues to battle a drug epidemic, doctors are finding innovative ways to treat addiction, by prescribing uniquely designed abuse-deterrent opioids (ADOs).

"We stock a few of them here. We work a lot with our pain management clinic, to keep on hand what we need," said Norton pharmacist Kassandra Fernsler.

ADOs are specifically designed to be taken only as directed. The pills have physical and chemical barriers that make them tough to crush or tamper with, making it difficult for someone to snort, inject or smoke the drug. If manipulated, the drug's effectiveness significantly diminishes.

Advocates, including emergency room physician Robert Couch, said the reformulated versions of hydrocodone, oxycodone or morphine can help a patient who has a legitimate need for pain relief, but may have a history of abuse.

Recovering addict at The Healing Place in Louisville, Jack, became addicted to painkillers after back surgery in 2012. He said while ADOs sound like a step in the right direction, he's not sure they would have helped him during his darkest moments.

"Where there's a will, there's a way, there's always different tricks to get around stuff like that, it all goes back to dealing with the mental state the person is going through," he said.

"I don't think it's a bad thing to have these tamper proof medications or deterrents to abusing them, I just think that can't be the only solution," said The Healing Place program services director Heather Gibson.

Currently most insurance companies do not cover abuse-deterrent opioids, but House Bill 330 in Kentucky's Legislature aims to change that.

Kentucky has the third highest rate of overdose deaths in the country. And in Jefferson county, more people die from overdoses than any other part of the state.

http://www.wlky.com/news/abusedeterrent-opioids-aim-to-curb-epidemic/39009976