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2.
Bol. latinoam. Caribe plantas med. aromát ; 21(2): 215-223, mar. 2022. ilus, tab
Article in English | LILACS | ID: biblio-1395235

ABSTRACT

Control of the Chagas disease vector, Triatoma infestans (Klug) (Hemiptera: Reduviidae) with synthetic pesticides in Bolivia has become increasingly inefficient due to the development of resistance in the insects. In the Chaco region of Bolivia, guaraní populations have approached the problem by fumigating their houses with the smoke of native plants. Through interviews and field work with local guides, the main plant used by the guaraníes was collected and later identified as Capsicum baccatumL. var. baccatum (Solanaceae). In choice bioassays, filter papers exposed to the smoke of the plant repelled nymphs of T. infestans. Activity remained significant after storing the exposed filter papers for 9 days. Chemical analysis of smoke and literature data suggested that capsaicinoids present in the smoke were responsible for the repellent effect. The data presented provide a rationale for the use of C. baccatumvar. baccatumto control the Chagas vector bythe guaraní populations.


El control del vector de la enfermedad de Chagas, Triatoma infestans (Klug) (Hemiptera: Reduviidae) con plaguicidas sintéticos en Bolivia se ha vuelto cada vez más ineficiente debido al desarrollo de resistencias en los insectos. En la región del Chaco de Bolivia, las poblaciones guaraníes han abordado el problema fumigando sus casas con el humo de las plantas nativas. A través de entrevistas y trabajo de campo con guías locales, se recogió la principal planta utilizada por los guaraníes y posteriormente se identificó como Capsicum baccatumL. var. baccatum (Solanaceae). En bioensayos selectos, los papeles de filtro expuestos al humo de la planta repelieron a las ninfas de T. infestans. La actividad siguió siendo significativa después de almacenar los papeles de filtro expuestos durante 9 días. El análisis químico del humo y los datos de la literatura sugieren que los capsaicinoides presentes en el humo eran responsables del efecto repelente. Los datos presentados proporcionan una justificación para el uso de C. baccatum var. baccatum para el control del vector Chagas por las poblaciones guaraníes.


Subject(s)
Humans , Smoke/analysis , Triatoma , Capsicum/chemistry , Pest Control, Biological , Fumigation/methods , Indigenous Peoples , Biological Assay , Bolivia , Capsaicin/analysis , Interviews as Topic , Chagas Disease , Solanaceae/chemistry , Volatile Organic Compounds/analysis , Hemiptera , Insect Repellents/chemistry
3.
Rev. bras. anestesiol ; 69(5): 432-438, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057460

ABSTRACT

Abstract Background: Myofascial pain syndrome is a common cause of musculoskeletal pain. The objective of this study was to evaluate the potential analgesic action of 8% capsaicin cream for topical use in patients with myofascial pain syndrome. Methods: Initially, cream formulations of PLA (Placebo) and CPS (Capsaicin 8%) were developed and approved according to the current requirements of the health authority agency. The 40 participating patients were randomly assigned to the PLA and CPS groups in a double-blind fashion. Before the creams were topically administered, according to the allocation group, the local anesthetic was used for a period of 50 minutes directly in the area of interest. The cream was applied to the area of the skin over the trigger point, represented by the area with pain at palpation, in an amount of 10 g for 30 minutes in a circular area of 24 mm diameter. Subsequently, the cream was removed and the skin tolerability parameters were evaluated. The pain was measured before and during the formulation application, as well as at 1 hour, 7 days, 30 days, and 60 days after the procedure, evaluated using a verbal numerical scale (from 0 to 10: with 0 = no pain and 10 = worst pain imaginable). Results: No patient in PLA Group had hyperemia or burning sensation at the site of application, while 85% of patients in CPS Group had hyperemia or burning sensation at 15 minutes. These complaints disappeared 24 hours after the cream was removed. The pain score in CPS Group decreased steadily up to the 60th day of evaluation (p < 0.0001). Conclusion: Application of the formulations did not cause macroscopic acute or chronic skin lesions in patients, and the 8% capsaicin formulation was beneficial and well tolerated.


Resumo Justificativa: A síndrome da dor miofascial é uma causa comum de dor musculoesquelética. O objetivo deste estudo foi avaliar a potencial ação analgésica de 8% do creme de capsaicina para uso tópico em pacientes com síndrome da dor miofascial. Métodos: Inicialmente, as formulações de creme de PLA (Placebo) e CPS (Capsaicina 8%) foram desenvolvidas e aprovadas de acordo com os requisitos atuais da agência de autoridade de saúde. Os 40 pacientes participantes foram distribuídos aleatoriamente e de forma duplo-cega para os grupos PLA e CPS. Antes dos cremes serem administrados topicamente, de acordo com o grupo de alocação, o anestésico local foi usado por um período de 50 minutos diretamente na área de interesse. A administração ocorreu na área da pele sobre o ponto-gatilho, o qual apresentou a área dolorida à palpação, em uma quantidade de 10 g por 30 minutos em área circular com diâmetro de 24 mm. Posteriormente, o creme foi removido e os parâmetros de tolerabilidade à pele foram avaliados. A dor foi medida antes e durante a aplicação da formulação, bem como 1 hora, 7 dias, 30 dias e 60 dias após o procedimento avaliado pela escala numérica verbal (0 a 10, com zero sem dor e dez a pior dor imaginável). Resultados: Nenhum paciente no grupo PLA experimentou hiperemia ou sensação de queimação no local de aplicação do creme, enquanto 85% dos que experimentaram no grupo CPS apresentaram hiperemia ou sensação de queimação 15 minutos. Essas queixas desapareceram 24 horas após a remoção do creme. O escore de dor no grupo CPS diminui de forma sustentada até o 60° dia de avaliação (p < 0,0001). Conclusão: A administração das formulações não causou lesões cutâneas agudas ou crônicas macroscópicas nos pacientes e a formulação de 8% de capsaicina foi benéfica e bem tolerada.


Subject(s)
Humans , Male , Female , Capsaicin/administration & dosage , Analgesia , Myofascial Pain Syndromes/drug therapy , Ointments , Double-Blind Method , Prospective Studies , Administration, Topical , Middle Aged
4.
Biomolecules & Therapeutics ; : 435-441, 2019.
Article in English | WPRIM | ID: wpr-763039

ABSTRACT

The capsaicin receptor TRPV1 (transient receptor potential vanilloid 1) has been an object of intense interest for pharmacological development on account of its critical role in nociception. In the course of structure activity analysis, it has become apparent that TRPV1 ligands may vary dramatically in the rates at which they interact with TRPV1, presumably reflecting differences in their abilities to penetrate into the cell. Using a fast penetrating agonist together with an excess of a slower penetrating antagonist, we find that we can induce an agonist response of limited duration and, moreover, the duration of the agonist response remains largely independent of the absolute dose of agonist, as long as the ratio of antagonist to agonist is held constant. This general approach for limiting agonist duration under conditions in which absolute agonist dose is variable should have more general applicability.


Subject(s)
Capsaicin , Ligands , Nociception
5.
Allergy, Asthma & Immunology Research ; : 871-884, 2019.
Article in English | WPRIM | ID: wpr-762164

ABSTRACT

PURPOSE: An older female predominance has been reported among chronic cough patients in Western countries, which is considered to be associated with a higher cough sensitivity in females. However, the characteristics of Chinese chronic cough patients remain unclear. This study aimed to explore the age and sex distribution as well as their relationship with cough reflex sensitivity to capsaicin in Chinese chronic cough patients. METHODS: We analyzed the demographic features of 1,882 consecutive chronic cough patients who attended our cough clinic in Guangzhou, China. Cough sensitivity to capsaicin, which was defined as the lowest concentration of capsaicin causing 5 coughs or more (C5), was measured in 539 of the 1,882 patients and 68 healthy volunteers. RESULTS: The mean age of the patients was 43.0 ± 13.7 years and patients aged <50 years accounted for more than two-thirds of the study population. Around 87% of the patients were never-smokers. The proportion of females (51.5%) was almost equal to that of males (48.5%). The pattern of the age and sex distribution was consistently reflected within most common causes of chronic cough, while a female predominance was shown in patients with cough-variant asthma and patients aged ≥50 years. Female patients had higher cough sensitivity to capsaicin than male patients (log C5: 1.58 ± 0.84 vs. 2.04 ± 0.84 μmol/L, P = 0.001), and patients aged ≥50 years had higher cough sensitivity to capsaicin than patients aged <50 years. CONCLUSIONS: In China, patients with chronic cough have a roughly equal sex distribution and a middle-aged predominance, irrespective of a higher cough sensitivity to capsaicin in females and older patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02591550


Subject(s)
Female , Humans , Male , Age Distribution , Asian People , Asthma , Capsaicin , China , Cough , Healthy Volunteers , Reflex , Sex Distribution
6.
Experimental Neurobiology ; : 289-299, 2019.
Article in English | WPRIM | ID: wpr-739537

ABSTRACT

Transient receptor potential vanilloid subtype 1 (TRPV1) on astrocytes prevents ongoing degeneration of nigrostriatal dopamine (DA) neurons in MPP⁺-lesioned rats via ciliary neurotrophic factor (CNTF). The present study determined whether such a beneficial effect of astrocytic TRPV1 could be achieved after completion of injury of DA neurons, rather than ongoing injury, which seems more relevant to therapeutics. To test this, the MPP⁺-lesioned rat model utilized here exhibited approximately 70~80% degeneration of nigrostriatal DA neurons that was completed at 2 weeks post medial forebrain bundle injection of MPP⁺. TRPV1 agonist, capsaicin (CAP), was intraperitoneally administered. CNTF receptor alpha neutralizing antibody (CNTFRαNAb) was nigral injected to evaluate the role of CNTF endogenously produced by astrocyte through TRPV1 activation on DA neurons. Delayed treatment of CAP produced a significant reduction in amphetamine-induced rotational asymmetry. Accompanying this behavioral recovery, CAP treatment increased CNTF levels and tyrosine hydroxylase (TH) activity in the substantia nigra pars compacta (SNpc), and levels of DA and its metabolites in the striatum compared to controls. Interestingly, behavioral recovery and increases in biochemical indices were not reflected in trophic changes of the DA system. Instead, behavioral recovery was temporal and dependent on the continuous presence of CAP treatment. The results suggest that delayed treatment of CAP increases nigral TH enzyme activity and striatal levels of DA and its metabolites by CNTF endogenously derived from CAP-activated astrocytes through TRPV1, leading to functional recovery. Consequently, these findings may be useful in the treatment of DA imbalances associated with Parkinson's disease.


Subject(s)
Animals , Rats , Antibodies, Neutralizing , Astrocytes , Capsaicin , Ciliary Neurotrophic Factor , Dopamine , Dopaminergic Neurons , Medial Forebrain Bundle , Models, Animal , Neurons , Parkinson Disease , Pars Compacta , Receptor, Ciliary Neurotrophic Factor , Tyrosine 3-Monooxygenase
7.
São Paulo; s.n; s.n; 2019. 197 p. graf, tab, ilus.
Thesis in English | LILACS | ID: biblio-1049264

ABSTRACT

Capsaicin is a substance produced by Capsicum peppers with extensive biological activity reported in the literature. Among these studies, it was suggested that the anti-tumor activity is related to modulation of the Transient Potential Receptor Vanilloid (TRPV) channels. Capsaicin is known to bind with very high affinity to TRPV1 (IC50 ≈ 7 nM), triggering the burning sensation followed by analgesia. However, recent studies have suggested that the pro-apoptotic effects of capsaicin are TRPV6-mediated. Herein we report the development of a novel inhibitor of the TRPV6 using two different strategies for compounds design. We generated a series of direct and chimeric capsaicinoids based on the literature compounds, capsaicin, and cis-22a. These analogs were probed against HEK-hTRPV6 and the hits were further optimized. Based on the previous SAR and chemical optimization, we found 56h, named MRC-130, a derivative that remarkably inhibited TRPV6 in the nanomolar range (IC50 = 83 ± 4 nM), possess high selectivity and stability in vitro, and lesser hERG inhibition compared to the reference compound, cis-22a. It is expected that these new molecules would contribute significantly to the study on the TRPV6 function and its role in tumor pathophysiology


Capsaicina é uma substância produzida por pimentas do gênero Capsicum com extensa atividade biológica relatada na literatura. Entre esses estudos, sugeriu-se que a atividade antitumoral esteja relacionada à modulação dos canais TRPV (do inglês, Transient Potential Receptor Vanilloid). Sabe-se que a capsaicina se liga com altíssima afinidade ao TRPV1 (IC50 ≈ 7 nM), desencadeando a sensação de queimação seguida de analgesia. No entanto, estudos recentes sugeriram que os efeitos pró-apoptóticos da capsaicina são mediados pelo TRPV6. Visando o exposto, este trabalho relata o desenvolvimento de um novo inibidor do TRPV6 usando duas estratégias diferentes para o planejamento dos compostos. Geramos séries de capsaicinoides diretos e quiméricos com base nos compostos da literatura, capsaicina e cis-22a. Esses análogos foram analisados contra HEK-hTRPV6 e os análogos mais promissores foram otimizados. Com base na REA e em otimizações químicas anteriores, encontramos 56h, chamado MRC-130, um derivado que inibiu notavelmente o TRPV6 na faixa nanomolar (IC50 = 83 ± 4 nM), possui alta seletividade e estabilidade in vitro e menor inibição de hERG em comparação com o composto de referência, cis-22a. Espera-se que essas novas moléculas contribuam significativamente para o estudo da função do TRPV6 e seu papel na fisiopatologia tumoral


Subject(s)
Capsicum/classification , Capsaicin/analogs & derivatives , TRPV Cation Channels/antagonists & inhibitors
8.
Arq. neuropsiquiatr ; 76(9): 603-608, Sept. 2018. graf
Article in English | LILACS | ID: biblio-973951

ABSTRACT

ABSTRACT The neuropeptide orexin-A and its receptors are widely distributed in both hippocampal circuitry and pain transmission pathways. Objective: Involvement of the CA1 orexin 1 receptor (OX1R) on the modulation of orofacial pain and pain-induced changes in hippocampal expression of cyclooxygenase-2 (COX-2) and brain-derived neurotrophic factor (BDNF) was investigated. Methods: Orofacial pain was induced by an intra-lip injection of capsaicin (100 μg). Reverse transcription polymerase chain reaction and immunoblot analysis were used to indicate changes in hippocampal BDNF and COX-2 expression, respectively. Results: Capsaicin induces a significant pain response, which is not affected by either orexin-A or SB-334867-A, an OX1R antagonist. However, an increased expression of COX-2 and decreased expression of BDNF was observed in the hippocampus of animals that received capsaicin or SB-334867-A (80 nM) plus capsaicin. Meanwhile, orexin-A (40 pM) attenuated the effects of capsaicin on the expression of COX-2 and BDNF. Conclusions: CA1 OX1R activation moderates capsaicin-induced neuronal inflammation and neurotrophic deficiency.


RESUMO O neuropeptídeo orexina-A e seus receptores estão amplamente distribuídos nos circuitos do hipocampo e nas vias de transmissão da dor. Objetivo: O envolvimento do receptor de orexina 1 CA1 (OX1R) na modulação da dor orofacial e alterações induzidas pela dor na expressão do hipocampo de ciclooxigenase-2 (COX-2) e fator neurotrófico derivado do cérebro (BDNF) foi investigado. Métodos: A dor orofacial foi induzida por injeção intra-labial de capsaicina (100 μg). A reação em cadeia da polimerase de transcrição reversa e a análise de imunotransferência foram utilizadas para indicar alterações na expressão de BDNF e COX-2 no hipocampo, respectivamente. Resultados: A capsaicina induz uma resposta significativa à dor, que não é afetada pela orexina-A ou pelo SB-334867-A, um antagonista do OX1R. No entanto, uma expressão aumentada de COX-2 e uma expressão diminuída de BDNF foi observada no hipocampo de animais que receberam capsaicina ou SB-334867-A (80 nM) mais capsaicina. Enquanto isso, a orexina A (40 pM) atenuou os efeitos da capsaicina na expressão de COX-2 e BDNF. Conclusões: A ativação de CA1 OX1R modera a inflamação neuronal induzida por capsaicina e a deficiência neurotrófica.


Subject(s)
Animals , Male , Rats , Facial Pain/metabolism , Brain-Derived Neurotrophic Factor/metabolism , Cyclooxygenase 2/metabolism , Orexin Receptors/metabolism , Orexins/pharmacology , Hippocampus/metabolism , Urea/analogs & derivatives , Urea/pharmacology , Benzoxazoles/pharmacology , Capsaicin , Rats, Wistar , Reverse Transcriptase Polymerase Chain Reaction , Disease Models, Animal , Hippocampus/drug effects , Naphthyridines , Neurons/drug effects , Neurons/metabolism
9.
Acta cir. bras ; 33(6): 499-507, June 2018. tab, graf
Article in English | LILACS | ID: biblio-949358

ABSTRACT

Abstract Purpose: To evaluate the impact of systemic cyclophosphamide treatment on the rat uterus and investigate the potential therapeutic effects of natural antioxidant preparations curcumin and capsaicin against cyclophosphamide side effects. Methods: A 40 healthy adult female Wistar albino rats were used in this study. Rats were randomly divided into four groups to determine the effects of curcumin and capsaicin against Cyclophosphamide side effects on the uterus (n=10 in each group); Group 1 was the control group (sham-operated), Group 2 was the cyclophosphamide group, Group 3 was the cyclophosphamide + curcumin (100mg/kg) group, and Group 4 was the cyclophosphamide + capsaicin (0.5 mg/kg) group. Results: Increased tissue oxidative stress and histological damage in the rat uterus were demonstrated due to the treatment of systemic cyclophosphamide chemotherapy alone. The level of tissue oxidant and antioxidant markers and histopathological changes were improved by the treatment of curcumin and capsaicin. Conclusion: Cytotoxic effects of natural alkylating chemotherapeutic agents like cyclophosphamide on the uterus can be prevented by curcumin and capsaicin.


Subject(s)
Animals , Female , Uterus/drug effects , Capsaicin/pharmacology , Antineoplastic Agents, Alkylating/adverse effects , Curcumin/pharmacology , Cyclophosphamide/adverse effects , Antioxidants/pharmacology , Superoxide Dismutase/analysis , Uterine Diseases/chemically induced , Uterine Diseases/prevention & control , Uterus/pathology , Catalase/analysis , Random Allocation , Reproducibility of Results , Rats, Wistar , Oxidative Stress/drug effects , Glutathione/analysis , Glutathione Peroxidase/analysis , Malondialdehyde/analysis
10.
Acta cir. bras ; 33(5): 439-445, May 2018. graf
Article in English | LILACS | ID: biblio-949344

ABSTRACT

Abstract Purpose: To investigate the effects of capsiate treatment on hepatic hyperplasia in partially hepatectomized rats. Methods: The animals were divided into a Capsiate group (CPH), a Capsiate Post-Partial Hepatectomy group (CPPH) and a Partial Hepatectomy Control group (PH). CPH and CPPH animals received 60 mg/kg/day Capsiate for 30 days. Next, the rats underwent partial hepatectomy. CPPH animals continued to receive treatment for 48 h after partial hepatectomy. Liver tissue and intracardiac blood samples were obtained 24 or 48 h after PH. Results: Capsiate treatment interfered with hepatic parameters, reducing the number of mitoses and apoptosis and increasing blood ALT and alkaline phosphatase concentrations. Conclusion: Capsiate treatment preceding hepatic surgery may compromise the initial period of postoperative recovery.


Subject(s)
Animals , Male , Rats , Capsaicin/analogs & derivatives , Hepatectomy , Liver/enzymology , Aspartate Aminotransferases/metabolism , Capsaicin/pharmacology , Rats, Wistar , Apoptosis/drug effects , Alanine Transaminase/metabolism , Alkaline Phosphatase/metabolism , Liver/drug effects , Liver/pathology , Liver Regeneration/drug effects , Mitosis/drug effects
11.
Journal of the Korean Medical Association ; : 116-122, 2018.
Article in Korean | WPRIM | ID: wpr-766479

ABSTRACT

Herpes zoster (HZ) is the result of reactivation and multiplication of latent varicella zoster virus that persisted in latent form within the sensory ganglia following an earlier attack of varicella. It occurs most frequently in older adults and immunosuppressed individuals. Classically, the rash presents as painful, erythematous, maculopapular, and vesicular lesions that typically involve single dermatome, and usually do not cross the midline. The diagnosis is mainly made clinically, except in patients with atypical manifestations in which laboratory virologic testing is required. HZ has been associated with several complications, of which postherpetic neuralgia is the most common and debilitating. The treatment of HZ includes the use of antiviral agents, analgesics for control of acute zoster pain, good skin care for healing, and prevention of secondary bacterial infection. Antiviral agents should be started within 72 hours of onset to reduce the severity of the infection, the duration of the eruptive phase, and the intensity of acute pain. The options for treating postherpetic neuralgia include lidocaine patch, high dose capsaicin patch, gabapentin, pregabalin, opioids, and tricyclic antidepressants. A live attenuated zoster vaccine reduces the incidence of by one-half and the incidence of postherpetic neuralgia by two-thirds. We herein review the recent data on the epidemiology, pathophysiology, diagnosis and management of HZ including HZ vaccine.


Subject(s)
Adult , Humans , Acute Pain , Analgesics , Analgesics, Opioid , Antidepressive Agents, Tricyclic , Antiviral Agents , Bacterial Infections , Capsaicin , Chickenpox , Diagnosis , Epidemiology , Exanthema , Ganglia, Sensory , Herpes Zoster Vaccine , Herpes Zoster , Herpesvirus 3, Human , Incidence , Lidocaine , Neuralgia, Postherpetic , Pregabalin , Skin Care
12.
International Neurourology Journal ; : 83-89, 2018.
Article in English | WPRIM | ID: wpr-715333

ABSTRACT

PURPOSE: The urinary bladder (UB) is innervated by both sensory and autonomic nerves. Recent studies have shown that sensory neuropeptides induced contractions in the detrusor muscle. Therefore, in a mouse model, we investigated the presence of interactions between the submucosal sensory nerves and the autonomic nerves that regulate the motor function of the detrusor muscle. METHODS: UB samples from male C57BL/6 mice were isolated, cut into strips, and mounted in an organ bath. Dose-response curves to norepinephrine and phenylephrine were studied in UB strips with and without mucosa, and the effects of preincubation with a receptor antagonist and various drugs on relaxation were also studied using tissue bath myography. RESULTS: Phenylephrine-induced relaxation of the UB strips showed concentration-related effects. This relaxation appeared in both mucosa-intact and mucosa-denuded UB strips, and was significantly inhibited by lidocaine, silodosin, and guanethidine (an adrenergic neuronal blocker). Meanwhile, phenylephrine-induced relaxation was inhibited by pretreatment with propranolol and calcitonin gene-related peptide (CGRP)–depletory capsaicin in UB strips with and without mucosa. CONCLUSIONS: The present study suggests that phenylephrine activates the α-1A adrenergic receptor (AR) of the sensory nerve, and then activates capsaicin-sensitive sensory nerves to release an unknown substance that facilitates the release of norepinephrine from adrenergic nerves. Subsequently, norepinephrine stimulates β-ARs in the detrusor muscle in mice, leading to neurogenic relaxation of the UB. Further animal and human studies are required to prove this concept and to validate its clinical usefulness.


Subject(s)
Animals , Humans , Male , Mice , Adrenergic Neurons , Autonomic Pathways , Baths , Calcitonin Gene-Related Peptide , Capsaicin , Guanethidine , Lidocaine , Mucous Membrane , Myography , Neuropeptides , Norepinephrine , Phenylephrine , Propranolol , Receptors, Adrenergic , Receptors, Adrenergic, alpha-1 , Relaxation , Urinary Bladder
13.
International Neurourology Journal ; : 90-98, 2018.
Article in English | WPRIM | ID: wpr-715332

ABSTRACT

PURPOSE: The neurological molecular mechanisms underlying the voiding dysfunction associated with nonbacterial chronic prostatitis/chronic pelvic pain syndrome remain poorly understood. In this study, we assessed whether prostate inflammation activated bladder afferent neurons, leading to bladder dysfunction, and sought to elucidate the underlying mechanisms. METHODS: Thirty male Sprague-Dawley rats were divided into 3 groups: sham-saline, formalin-injected, and capsaicin-pretreated and formalin-injected. Chemical prostatitis was induced by 0.1 mL of 10% buffered formalin injected into the ventral prostate. Capsaicin was injected subcutaneously to desensitize capsaicin-sensitive nerves. In each group, conscious cystometry was performed, and c-fos expression within the spinal cord was determined immunocytochemically. Double immunofluorescent staining with c-fos and choline acetyltransferase (ChAT) was performed. On the third day after pseudorabies virus (PRV) infection, c-fos and PRV double-staining was performed. RESULTS: Intraprostatic formalin significantly increased the maximal voiding pressure and decreased the intercontraction interval, compared with controls. Pretreatment with capsaicin significantly reversed these effects. More c-fos-positive cells were observed in the sacral parasympathetic nucleus (SPN) and dorsal gray commissure (DCM) in the prostatitis group than in the sham group. c-fos-positive cells decreased in the capsaicin-pretreated group. Preganglionic neurons labeled by c-fos and ChAT were observed in the SPN in rats with prostatitis. Interneurons labeled by c-fos and PRV were identified in the DCM after PRV infection. CONCLUSIONS: Our results suggest that prostate inflammation activates afferent nerve fibers projecting to the lumbosacral spinal cord, producing reflex activation of spinal neurons innervating the bladder and bladder hyperreflexia. This is mediated by capsaicin-sensitive prostate afferent neurons.


Subject(s)
Animals , Humans , Male , Rats , Capsaicin , Choline O-Acetyltransferase , Formaldehyde , Herpesvirus 1, Suid , Inflammation , Interneurons , Models, Animal , Nerve Fibers , Neurons , Neurons, Afferent , Pelvic Pain , Prostate , Prostatitis , Rats, Sprague-Dawley , Reflex , Reflex, Abnormal , Spinal Cord , Urinary Bladder
14.
The Korean Journal of Pain ; : 235-243, 2018.
Article in English | WPRIM | ID: wpr-742202

ABSTRACT

Postherpetic neuralgia (PHN) is the most troublesome side effect of Herpes Zoster (HZ), which mainly affects the elderly and immunocompromised populations. Despite the current advancement of treatments, PHN persists in many individuals influencing their daily activities and reducing their quality of life. Anticonvulsants, antidepressants, topical therapies including lidocaine and capsaicin, and opioids, are the most widely used therapies for the treatment of PHN. These medications come with their adverse effects, so they should be used carefully with the elderly or with patients with significant comorbidities. Other measures like botulinum toxin, nerve blocks, spinal cord stimulation, and radiofrequency have also contributed significantly to the management of PHN. However, the efficacy, safety, and tolerability of these invasive methods need to be carefully monitored when administering them. Early diagnosis and early initiation of treatment can reduce the burden associated with PHN. The zoster vaccine has effectively reduced the incidence of HZ and PHN. In this article, we discuss the treatment options available for the management of PHN, mainly focusing on the efficacy and safety of different therapeutic modalities.


Subject(s)
Aged , Humans , Analgesics, Opioid , Anticonvulsants , Antidepressive Agents , Botulinum Toxins , Capsaicin , Comorbidity , Early Diagnosis , Herpes Zoster , Herpes Zoster Vaccine , Incidence , Lidocaine , Nerve Block , Neuralgia, Postherpetic , Quality of Life , Spinal Cord Stimulation
15.
The Korean Journal of Pain ; : 155-173, 2018.
Article in English | WPRIM | ID: wpr-742191

ABSTRACT

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.


Subject(s)
Humans , Acetaminophen , Analgesics, Opioid , Anti-Inflammatory Agents, Non-Steroidal , Antidepressive Agents , Botulinum Toxins , Calcium Channel Blockers , Capsaicin , Chronic Pain , Clonidine , Cognitive Behavioral Therapy , Drug Therapy , Incidence , Ketamine , Lidocaine , Life Style , Nerve Block , Neuralgia , Pain Management , Pain, Intractable , Pain, Postoperative , Perioperative Period , Physical Therapy Modalities , Psychological Trauma , Risk Factors , Surgical Procedures, Operative , Transcutaneous Electric Nerve Stimulation
16.
The Korean Journal of Pain ; : 174-182, 2018.
Article in English | WPRIM | ID: wpr-742190

ABSTRACT

BACKGROUND: The trigeminal nucleus caudalis (Vc) is a primary central site for trigeminal transmitting. Noxious stimulation of the trigeminal nociceptors alters the central synaptic releases and neural expression of some inflammatory and trophic agents. Orexin-A and the orexin 1 receptor (OX1R) are expressed in pain pathways including trigeminal pain transmission. However, the the mechanism(s) underling orexin-A effects on trigeminal pain modulation have not been fully clarified. METHODS: Trigeminal pain was induced by subcutaneous injection of capsaicin in the upper lip in rats. The effect of trigeminal pain on cyclooxygenase-2 (COX-2) and brain-derived neurotrophic factor (BDNF) expression in the Vc of animals was determined by immunofluorescence. Subsequently, OX1R agonist (orexin-A) and antagonist (SB-334867-A) was administrated in the Vc to investigate the possible roles of the Vc OX1R on changes in COX-2 and BDNF levels following pain induction. RESULTS: The data indicated an increase in COX-2 and decrease in BDNF immuno-reactivity in the Vc of capsaicin, and capsaicin- pretreated with SB-334867-A (80 nM), groups of rat. However, the effect of capsaicin on COX-2 and BDNF expressions was reversed by a Vc microinjection of orexin-A (100 pM). CONCLUSIONS: Overall, the present data reveals that orexin-A can attenuate capsaicin-induced trigeminal pain through the modulation of pain effects on COX-2 and BDNF expressions in the Vc of rats.


Subject(s)
Animals , Rats , Brain-Derived Neurotrophic Factor , Capsaicin , Cyclooxygenase 2 , Facial Pain , Fluorescent Antibody Technique , Injections, Subcutaneous , Lip , Microinjections , Nociceptors , Orexin Receptor Antagonists , Orexins , Pain Measurement , Pain Perception , Trigeminal Caudal Nucleus , Trigeminal Neuralgia , Trigeminal Nuclei
17.
International Neurourology Journal ; : 169-176, 2018.
Article in English | WPRIM | ID: wpr-716842

ABSTRACT

PURPOSE: To evaluate whether mild chemical irritation of the bladder in neonatal rats is associated with persistent vanilloid receptor transient receptor potential vanilloid subfamily 1 (TRPV1) activity in adult rats. METHODS: Female Sprague-Dawley rats were used. Ten-day-old rat pups underwent bladder sensitization via intravesical infusion of 0.2% acetic acid in saline with or without prior bladder desensitization with capsaicin. After 8 weeks, 3 groups of rats (control [group 1], bladder sensitization [group 2], and bladder desensitization [group 3]) underwent cystometry. Inflammation of bladder tissue and the expression of TRPV1 in bladder tissue and dorsal root ganglia (DRG) were also evaluated. RESULTS: The bladder sensitization group showed more frequent voiding contractions. TRPV1 expression in adult bladder tissue was elevated in group 2. TRPV1 mRNA levels in the bladder and DRG were significantly higher in group 2 than in group 1. Moreover, group 2 had significantly more DRG neurons (identified by uptake of the retrograde label Fast Blue) that exhibited TRPV1 immunoreactivity. CONCLUSIONS: We found a significant association between neonatal bladder sensitization and persistent TRPV1 activity in adult rats. This is the first study to focus on the underlying pathogenesis of bladder overactivity from childhood to adulthood. Our findings could lead to the development of new strategies for the treatment and prevention of adult urinary symptoms arising from childhood urinary tract dysfunction.


Subject(s)
Adult , Animals , Female , Humans , Rats , Acetic Acid , Capsaicin , Cystitis, Interstitial , Diagnosis-Related Groups , Ganglia, Spinal , Inflammation , Neurons , Rats, Sprague-Dawley , RNA, Messenger , TRPV Cation Channels , Urinary Bladder , Urinary Tract , Urinary Tract Infections
18.
São Paulo; s.n; s.n; 2018. 139 p. tab, graf, ilus.
Thesis in Portuguese | LILACS | ID: biblio-997679

ABSTRACT

As neoplasias malignas, doenças mundialmente conhecidas como câncer, possuem um dos tratamentos mais onerosos, tóxicos e de baixa seletividade na terapêutica atual. Adicionalmente, o contínuo crescimento da incidência da doença também representa em uma grande problemática. Os produtos de origem natural se apresentam como alternativas para o tratamento de diversas doenças, incluindo o câncer. A capsaicina, produto natural proveniente das pimentas do gênero Capsicum, apresenta propriedades antineoplásicas, portanto, pode ser utilizada como protótipo para obtenção de análogos. Quatro séries foram planejadas e sintetizadas, obtendo-se compostos ureídicos e tioureídicos. A estratégia sintética se baseou na reação da piperonilamina ou vanililamina com isocianatos ou isotiocianatos, ligados a substituintes aromáticos ou alquílicos. Vinte e sete análogos foram sintetizados com rendimentos variando entre 22 a 90 %. Todos os compostos apresentaram aspecto sólido variando a cor de branco a levemente amarelados. Para a caracterização das substâncias obtidas foram utilizados dados de RMN 1H e 13C, ponto de fusão e a determinação de pureza foi realizada mediante HPLC. Todos os compostos foram submetidos a ensaios de avaliação da atividade citotóxica por redução do MTT contra linhagens de células cancerígenas e células sadias. Os compostos RPF652, RPF 512 - 514) apresentaram atividade comparável ou superior ao protótipo com valores de IC50 na faixa de micromolar. Os resultados apontados pela modelagem molecular indicam que descritores eletrônicos como Ehomo e Elumo podem estar associados à atividade do composto, ClogP (3,92) pode favorecer melhor permeabilidade na membrana celular, e o maior número de sítios de acepção de ligação de hidrogênio podem corroborar com a citotoxidade em linhagem A2058. Particularmente, o análogo RPF652 apresentou atividade pronunciada com valores de IC50 de 55, 67, e 87 µM contra as células A2058, SK-MEL 25, e U87, respectivamente, o que representa atividade de superior à capsaicina. Como uma tendência o composto RPF652 causou parada no ciclo de linhagem B-RAF B16F10 não levando a célula à morte. Porém esta linhagem não apresenta mutação no códon V600E. Em contraponto, o análogo RPF652 apresentou maior potência contra linhagem V600EB-RAF A2058 mutada, indicando possível seletividade em linhagens que apresentam a mutação no códon V600E da proteína B-RAF. Ademais, novos esforços devem ser concentrados no análogo RPF652 para melhor elucidação mecanística de sua atividade


Malignant neoplasms have one of the most expensive, non-selective and toxic treatment of present times. This situation, combined with the rising incidence rate, represents a major problem for humanity. The use of natural products can be an alternative for treatment of several diseases, including cancer. Capsaicin is a natural product derived from Capsicum peppers, with reported anticancer activity and can be used as prototype for the design of new molecules with remarkable activity. Capsaicin analogues were designed and synthesized in four series of derivatives, replacing the prototype amide bond with urea and thiourea functions. The synthetic approach builds the urea/ thiourea scaffold using the reaction of piperonyl/ vanilyl amine with alkyl and aryl isocyanides/ isothiocyanides. Twenty-seven new compounds were obtained with yields from 22 to 90 %, and were fully characterized using 1H and 13C NMR, the purity was determined by melting point and HPLC. All of the obtained compounds were evaluated in MTT cytotoxic assays against different cancer cell-lines (B16F10, A2058, SK-MEL 25 and U-87), and compared with healthy human cells (T75). Additionally, the most active compound was submitted to a cell cycle arrest assay. The thiourea derivative RPF652 was the most active compound, and the urea derivatives RPF512, RPF513 and RPF514 showed good micromolar IC50 values. This results, when correlated with several in silico-calculated properties for the obtained molecules, suggests that ClogP, Ehomo, Elumo and the number of hydrogen-bond acception sites may be correlated to the anticancer activity reported. RPF652 especially, showed IC50 values with superior activity and better selectivity index when compared with capsaicin. The cell-cycle assay of RPF652 showed significant arrest in V600E-codon B-RAF non-mutated cell lines (B16F10) without killing it. V600E-codon B-RAF mutated cells A2058, were significantly more sensitive to the compound. These findings may suggest some insights about the mechanism of action and targets of this compounds


Subject(s)
Drug Screening Assays, Antitumor , Capsaicin/analysis , Antineoplastic Agents/classification , Capsicum/classification , Chemistry, Pharmaceutical/instrumentation , Pimenta/adverse effects , Neoplasms/drug therapy
19.
São Paulo; s.n; s.n; 2018. 87 p. tab, graf, ilus.
Thesis in Portuguese | LILACS | ID: biblio-997806

ABSTRACT

A inibição do quorum sensing (QS) altera a comunicação bacteriana, reduzindo a expressão de fatores de virulência e a formação de biofilmes, o que pode conferir menor pressão seletiva em comparação aos antibióticos tradicionais. As frutas e hortaliças constituem uma fonte rica em compostos com propriedades potenciais de inibição do QS. Entretanto, há pouca referência sobre o potencial de pimentas do gênero Capsicum e de seus compostos isolados como inibidores do QS. Esse trabalho teve como objetivo avaliar o efeito de extratos orgânicos obtidos das variedades de pimenta-malagueta e pimentão vermelho sobre o sistema QS dependente do sinalizador AI-1 (acil homoserina lactona - AHL) em bactérias Gram-negativas. Os extratos foram obtidos por extração em fase sólida e separados em uma fração metanólica e outra amônica; sendo os compostos característicos identificados e quantificados por cromatografia líquida de alta eficiência (CLAE). A atividade antimicrobiana dos extratos foi avaliada pela determinação da concentração inibitória mínima (MIC) e pela curva de crescimento de Chromobacterium violaceum ATCC 12472, Serratia liquefaciens MG1 e Pseudomonas aeruginosa PAO1. O efeito anti-QS dos extratos foi avaliado pelos testes de difusão em ágar e quantificação da produção de violaceína em meio líquido por C. violaceum e sobre a formação de biofilme, avaliado pelo ensaio de cristal violeta e microscopia confocal, em S. liquefaciens e P. aeruginosa nas temperaturas 30 ºC e 37 ºC. Os resultados obtidos pela CLAE indicaram que o extrato metanólico de pimenta-malagueta (EMPM) continha capsaicinoides como a capsaicina e dihidrocapsaicina, luteolina e outros compostos não identificados; já o extrato amônico desta não continha os compostos capsaicinoides. Ambos os extratos de pimentão vermelho continham luteolina e compostos não identificados, mas não apresentaram capsaicinoides. Como o EMPM era representativo dos demais extratos, por conter tanto capsaicinóides quanto luteolina, o foco deste trabalho foi avaliar os efeitos do EMPM sobre fenótipos microbianos nas concentrações 5; 2,5; 1,25 e 0,625 mg/ml, além de utilizar a capsaicina como controle comparativo em concentrações equivalentes às do extrato (25, 50 e 100 µg/ml). Os resultados da atividade antimicrobiana mostraram inibição parcial do crescimento das bactérias nas concentrações sub-MIC (MIC >5 mg/ml) de 5 e 2,5 mg/ml de EMPM. A capsaicina também inibiu parcialmente o crescimento das bactérias a 100 µg/ml, com exceção de S. liquefaciens a 37 ºC, cujo crescimento foi induzido em 50 e 25 µg/ml. A produção de violaceína foi reduzida pelo EMPM a 1,25 e 0,625 mg/ml, sem afetar o crescimento de C. violaceum. Ensaios com C. violaceum CV026, estirpe biosensora capaz de produzir o pigmento na presença de AI-1 exógeno, sugerem que o possível mecanismo de atuação do extrato sobre o sistema QS em C. violaceum 12472 é sobre a síntese do sinalizador, já que não foi observada inibição da produção de violaceína em CV026 pelo extrato. Contrariamente, a capsaicina incrementou a produção do pigmento na estirpe 12472, mas ensaios com a estirpe CV026 indicaram que a capsaicina não atua como sinalizador do QS, uma vez que esta não induziu a produção de violaceína nesta estirpe. Já a formação de biofilme foi incrementada na presença do EMPM, sendo consideravelmente maior em P. aeruginosa a 30 ºC. Igualmente, observou-se indução da formação de biofilme por capsaicina em S. liquefaciens (37 ºC) e P. aeruginosa (30 ºC). Porém, a capsaicina não teve efeito sobre a formação de biofilme de S. liquefaciens quando cultivada a 30 ºC, nem P. aeruginosa a 37 ºC. Os resultados revelam que a produção de violaceína em C. violaceum ATCC 12472 é inibida pelo EMPM, mas não pela capsaicina. Já, o EMPM e a capsaicina, de forma geral, não inibem a formação de biofilme de S. liquefaciens MG1 nem P. aeruginosa PAO1. Outros estudos são necessários para elucidar os mecanismos pelos quais o EMPM e a capsaicina agem sobre os fenótipos avaliados neste trabalho


Quorum sensing inhibition alters bacterial communication by reducing virulence factors expression and biofilm formation, exerting less selective pressure compared to antibiotics. Fruits and vegetables are rich sources of compounds with potential QS-inhibition properties. However, there are few references about the potential of peppers belonging to the genus Capsicum and its isolated compounds as QS inhibitors. This study aimed to assess the effect of organic extracts obtained from Capsicum varieties, pimenta-malagueta (red chili) and pimentão vermelho (red bell pepper), on the AI-1 dependent QS system. The extracts were obtained by solid phase extraction and split into a methanolic and an ammonic fraction. Characteristic compounds were identified and quantified by high performance liquid chromatography (HPLC). The antimicrobial activity of the extracts was assessed by determining the minimal inhibitory concentration (MIC) and the growth curve of Chromobacterium violaceum ATCC 12472, Serratia liquefaciens MG1 and Pseudomonas aeruginosa PAO1. The anti-QS effect of the extracts was evaluated by the agar diffusion assay and the quantification of violacein production was assessed in liquid medium by C. violaceum, as well as in the biofilm formation test determined by the crystal violet assay and confocal microscopy with S. liquefaciens and P. aeruginosa at 30 ºC and 37 ºC. HPLC results showed that the methanolic extract of pimenta-malagueta (EMPM) contained capsaicinoids such as capsaicin and dihidrocapsaicin, luteolin and other unidentified compounds in lower concentrations; while its ammonic extract did not have capsaicinoids. Both pimentão vermelho extracts contained luteolin and other unidentified compounds in low concentrations, but they did not contain capsaicinoids. As EMPM was representative among the extracts because it contained capsaicinoids and luteolin, the focus of this work was to assess the effect of EMPM over microbial phenotypes at concentrations of 5, 2.5, 1.25 and 0.625 mg/ml, using capsaicin as a comparative control at equivalent concentrations to those in EMPM (25, 50 and 100 µg/ml). Antimicrobial activity assays showed a partial inhibition growth of bacteria at sub-MIC concentrations (MIC >5 mg/ml) of EMPM at 5 and 2.5 mg/ml. Similarly, capsaicin partially inhibited bacterial growth at 100 µg/ml, except for S. liquefaciens at 37 ºC in which growth was induced at 50 and 25 µg/ml. Violacein production was reduced by EMPM at 1,25 and 0,625 mg/ml without affecting C. violaceum growth. Assays with C. violaceum CV026, a biosensor strain that produces violacein in the presence of exogenous AI-1, suggest that EMPM reduced violacein production in C. violaceum 12472 by interfering with the AI-1 synthesis. In contrast, capsaicin incremented violacein synthesis in strain 12472, but experiments with strain CV026 revealed that capsaicin does not function as an analog of AI-1. Biofilm formation was increased in EMPM presence, being remarkably superior in P. aeruginosa cultivated at 30 ºC, as opposed to cultivation at 37 ºC. Similarly, capsaicin induced biofilm formation in S. liquefaciens (37 ºC) and P. aeruginosa (30 ºC). However, capsaicin did not affect biofilm formation on S. liquefaciens cultured at 30 ºC, neither on P. aeruginosa at 37 ºC. These results show that violacein production in C. violaceum ATCC 12472 is inhibited by EMPM, but not by capsaicin. In general, EMPM and capsaicin did not inhibit biofilm formation in S. liquefaciens MG1 neither in P. aeruginosa PAO1. More studies are necessary to elucidate the mechanisms by which EMPM and capsaicin affect the studied phenotypes in this work


Subject(s)
Capsicum/adverse effects , Plant Extracts/analysis , /adverse effects , Quorum Sensing , Gram-Negative Bacteria , Capsaicin/classification , Chromatography, Liquid/methods , Solid Phase Extraction/instrumentation
20.
Rev. odontol. UNESP (Online) ; 46(1): 45-50, jan.-fev. 2017. tab
Article in English | LILACS, BBO | ID: biblio-845604

ABSTRACT

Introduction: Burning Mouth Syndrome (BMS) is a condition characterized by burning symptom of the oral mucosa in the absence of clinical signs. Its etiology is still unknown and, and to date there is no effective treatment. Purpose: The aim of this study was to evaluate patients with BMS profile and the therapies results in a retrospective study. Material and method: Clinical and therapeutic data were collected from records of patients with BMS diagnosed between January 2013 to April 2015 at the Clinic of Stomatology Clinic, Faculdade de Odontologia of Universidade de São Paulo, according to the criteria established by the International Headache Society in 2013. The therapies used for BMS control were also evaluated. Result: Twelve patients were diagnosed with BMS at this period. All of them were women with a mean age of 61.18 years and the apex of the tongue was the most common affected site and the duration of the burning sensation ranged from 6 months to 25 years. Many therapies were prescribed for BMS control, such as topical capsaicin, topical clonazepan, low level laser therapy and homeopathy. Among the established therapies, capsaicin has immediate effect in reducing symptoms. Conclusion: The present study showed that the challenges towards an effective treatment for BMS are varied and are mainly related to the lack knowing of the pathogenesis of this disease. The demographic profile of patients studied here was similar to that described in the available literature, however, the variables represented by secondary symptoms (medical history, anxiety and depression levels) may be modifying factors of therapeutic response and the pathogenesis of the disease itself.


Introdução: A Síndrome de Ardência Bucal (SAB) é uma condição caracterizada pelo sintoma de ardência na mucosa oral na ausência de qualquer sinal clínico. Sua etiologia ainda é desconhecida e, até o momento, não dispõe de tratamento efetivo. Objetivo: Avaliar o perfil do paciente portador de SAB, as terapias instituídas e seus resultados em estudo retrospectivo. Material e método: Foram coletados os dados clínicos e terapêuticos dos prontuários de pacientes diagnosticados com SAB, no período de janeiro de 2013 a abril de 2015, no Ambulatório da Disciplina de Estomatologia Clínica da Faculdade de Odontologia da Universidade de São Paulo. Os critérios para o diagnóstico utilizados se basearam nos estabelecidos pela International Headache Society em 2013 e foram observadas as terapêuticas empregadas e seus resultados. Resultado: Doze pacientes foram diagnosticadas com SAB neste período, todas do sexo feminino, média de idade 61,18 anos, e a principal região acometida pelo sintoma de ardor foi o ápice de língua. O tempo de duração deste sintoma variou de 6 meses a 25 anos. As terapias utilizadas para o controle de sintomas da SAB foram capsaicina, clonazepan tópico, laserterapia e homeopatia. Dentre as terapias instituídas, a capsaicina apresentou efeito imediato na redução dos sintomas. Conclusão: O presente estudo demonstrou que os desafios que circundam a obtenção de um tratamento efetivo para a SAB são diversos e estão principalmente relacionados ao desconhecimento da etiopatogenia da doença. O perfil demográfico dos pacientes aqui estudados foi semelhante ao descrito na literatura disponível, entretanto, as variáveis representadas por sintomas secundários (história médica, níveis de ansiedade e depressão) podem constituir fatores modificadores da resposta terapêutica e da própria etiopatogenia da doença.


Subject(s)
Humans , Female , Middle Aged , Patients , Therapeutics , Tongue , Burning Mouth Syndrome , Chronic Pain , Mouth Mucosa , Capsaicin , Clonazepam , Laser Therapy , Homeopathy
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