NEW PHARMACOLOGICAL STRATEGIES FOR ANALGE SIA

Recent advances in our knowledge about the processes of pain initiatio n, chronification and modulation have led to new strategies in the pha rmacological approach to analgesia. In particular, the pathopysiology of chronic and neuropathic pain differs from that of acute pain. Thus, a number of drugs under development specifically target pathophysiolo gic mechanisms of chronic pain. Such are blockers of sodium and calciu m channels, capsaicin analogues, specific inhibitors of cyclooxygenase , and cytokine antagonists. Acting in the central nervous system, ther e are peptide-and NMDA-antagonists, adenosin A1-antagonists and agonis ts of serotonin receptors. A further strategy consists in blocking the degradation of endogenous pain-controlling substances like the inhibi tory peptide met-enkephalin. Also, modification of signal transduction and gene regulation, altered by chronic pain, may allow the developme nt of new analgesic.