New Pain Pathway s Messages from the Pancreas

[Guest guest]

New Pain Pathway s Messages from the Pancreas, TooLibrary: MED

Keywords: PAIN PANCREAS VISCERAL NERVOUS SYSTEM NERVES

Description: Scientists at the University of Texas Medical Branch at Galveston

(UTMB) have confirmed that a newly discovered bundle of nerve fibers known to

carry painful impulses from pelvic organs like the colon also transmits pain

messages from the pancreas, an organ positioned higher in the body.

11/8/98

University of Texas Medical Branch at Galveston

Public Affairs

301 University Boulevard, Suite 136, Galveston, Texas 77555-0802

DATE: November 5, 1998

CONTACT: Alana Mikkelsen, ; email: amikkels@...

EMBARGOED

until 1 p.m., Pacific time, on Sunday, Nov. 8

to coincide with a poster presentation at the annual meeting of the Society for

Neuroscience.

SOURCES:

During the Neuroscience meeting:

Karin High will be at the Westin Bonaventure Hotel between Nov. 7 and 12. Call

.

Otherwise, reach High in Galveston at or kwhigh@....

NEW PAIN PATHWAY CARRIES MESSAGES FROM THE PANCREAS, TOO

LOS ANGELES-Scientists at the University of Texas Medical Branch at Galveston

(UTMB) have confirmed that a newly discovered bundle of nerve fibers known to

carry painful impulses from pelvic organs like the colon also transmits pain

messages from the pancreas, an organ positioned higher in the body.

Those findings-which will be presented Nov. 8 during the annual meeting of the

Society for Neuroscience in Los Angeles-add weight to results from human and

animal studies that suggest the nerve bundle, known as the dorsal column

pathway, may mediate pain messages from all internal organs, including the

intestines, reproductive organs, bladder, stomach and heart.

The dorsal column pathway, which is named for its position in the spinal cord,

was only recently discovered to carry pain messages. Before its description by

UTMB researchers and Houston neurosurgeon Hirschberg in 1996, scientists

thought that only one pathway-known as the spinothalamic tract-relayed pain

messages from the body to the brain.

Since then, UTMB scientists have been studying the dorsal column pathway-which

is also known as the visceral pain pathway because it carries pain messages from

the internal organs, or viscera-to determine where in the spinal cord it is

located, what kinds of stimuli it responds to, and what responses it produces in

the brain. Based on their and others' research, conducted mostly in rats and

monkeys, it now appears that the spinothalamic tract is responsible for carrying

painful impulses from the skin, while the dorsal column pathway carries painful

impulses from the internal organs.

The researchers believe that the studies may lead to new treatments for pain

arising from the internal organs, which is often resistant to drug therapy and

has traditionally been unresponsive to surgical treatment.

For example, pancreatitis-a severe inflammation of the pancreas caused by

gallstones, excessive alcohol intake or irritation-produces an excruciating pain

that is " almost untreatable, " says Karin Westlund High, a UTMB professor of

anatomy and neurosciences and principle investigator in the current study. " And

it's not very responsive to morphine. "

Westlund High, an expert on anatomical studies of pain-related nerve cells,

previously showed that at the level of the pelvis, the dorsal column nerve cells

are located near the middle of the spinal cord, just under its surface, toward

the skin of the back. Knowing that position allowed UTMB neurosurgeon Hank Nauta

to relieve intractable bowel pain in a woman by poking a small needle into her

spinal cord, severing the dorsal column nerves. Almost two years later, the

woman, a cervical cancer patient whose colon had been damaged by radiation

treatment, experiences no pelvic pain. Since then, Nauta has performed the

procedure on six other patients, with similar positive results.

Nauta's surgery built on the successes of Hirschberg, who in the early 1990s

severed the dorsal column pathways of eight cancer patients and eliminated

intractable pain arising from the colon, ovaries and bladder. Previous surgeries

to sever the spinothalamic tract, based on old misconceptions about pain

pathways, seldom helped patients with pain originating in internal organs.

Despite Nauta and Hirschberg's promising results, however, many physicians are

concerned about the possible side effects of performing surgery on a set of

nerve cells that has been so little studied.

" Surgery is not anybody's first option, " says Westlund High. She adds that

operations could be especially risky above the level of the pelvis, where, she

has found, the dorsal column nerve fibers fork and veer away from the midline.

That more inaccessible position in the spinal cord raises the chances that

surgery aimed at interupting the dorsal column pathway might inadvertently cut

other important nerve cells, too. Therefore, surgical treatments for pain in

abdominal organs like the liver or pancreas probably would be much more

complicated than surgical treatments aimed at ablating pain in pelvic organs

like the colon, Westlund High predicts.

Such complications make it even more important that researchers continue to

study the dorsal column pathway and compare it to the more well-known pain

pathway, the spinothalamic tract, Westlund High says.

" It's very possible that the pharmacology of this new pathway is different from

that of the spinothalamic tract, " she continues. " We may find agents that block

signals from these nerve cells selectively while leaving other pain signals

intact. However, we haven't had a chance to do those studies yet. "

Mark E. Armstrong

www.top5plus5.com

Oregon State Chapter Rep

Pancreatitis Association, International

[Guest guest]

Thanks Mark. I use to work at UTMB for over ten years in my old nursing day

s! Great place !

Lily

New Pain Pathway s Messages from the Pancreas

> New Pain Pathway s Messages from the Pancreas, TooLibrary: MED

> Keywords: PAIN PANCREAS VISCERAL NERVOUS SYSTEM NERVES

> Description: Scientists at the University of Texas Medical Branch at

Galveston (UTMB) have confirmed that a newly discovered bundle of nerve

fibers known to carry painful impulses from pelvic organs like the colon

also transmits pain messages from the pancreas, an organ positioned higher

in the body.

> 11/8/98

>

>

> University of Texas Medical Branch at Galveston

> Public Affairs

> 301 University Boulevard, Suite 136, Galveston, Texas 77555-0802

>

>

>

> DATE: November 5, 1998

> CONTACT: Alana Mikkelsen, ; email: amikkels@...

>

> EMBARGOED

> until 1 p.m., Pacific time, on Sunday, Nov. 8

> to coincide with a poster presentation at the annual meeting of the

Society for Neuroscience.

>

> SOURCES:

> During the Neuroscience meeting:

> Karin High will be at the Westin Bonaventure Hotel between Nov. 7 and 12.

Call .

> Otherwise, reach High in Galveston at or kwhigh@....

>

>

> NEW PAIN PATHWAY CARRIES MESSAGES FROM THE PANCREAS, TOO

>

> LOS ANGELES-Scientists at the University of Texas Medical Branch at

Galveston (UTMB) have confirmed that a newly discovered bundle of nerve

fibers known to carry painful impulses from pelvic organs like the colon

also transmits pain messages from the pancreas, an organ positioned higher

in the body.

>

> Those findings-which will be presented Nov. 8 during the annual meeting of

the Society for Neuroscience in Los Angeles-add weight to results from human

and animal studies that suggest the nerve bundle, known as the dorsal column

pathway, may mediate pain messages from all internal organs, including the

intestines, reproductive organs, bladder, stomach and heart.

>

> The dorsal column pathway, which is named for its position in the spinal

cord, was only recently discovered to carry pain messages. Before its

description by UTMB researchers and Houston neurosurgeon Hirschberg

in 1996, scientists thought that only one pathway-known as the spinothalamic

tract-relayed pain messages from the body to the brain.

>

> Since then, UTMB scientists have been studying the dorsal column

pathway-which is also known as the visceral pain pathway because it carries

pain messages from the internal organs, or viscera-to determine where in the

spinal cord it is located, what kinds of stimuli it responds to, and what

responses it produces in the brain. Based on their and others' research,

conducted mostly in rats and monkeys, it now appears that the spinothalamic

tract is responsible for carrying painful impulses from the skin, while the

dorsal column pathway carries painful impulses from the internal organs.

>

> The researchers believe that the studies may lead to new treatments for

pain arising from the internal organs, which is often resistant to drug

therapy and has traditionally been unresponsive to surgical treatment.

>

> For example, pancreatitis-a severe inflammation of the pancreas caused by

gallstones, excessive alcohol intake or irritation-produces an excruciating

pain that is " almost untreatable, " says Karin Westlund High, a UTMB

professor of anatomy and neurosciences and principle investigator in the

current study. " And it's not very responsive to morphine. "

>

> Westlund High, an expert on anatomical studies of pain-related nerve

cells, previously showed that at the level of the pelvis, the dorsal column

nerve cells are located near the middle of the spinal cord, just under its

surface, toward the skin of the back. Knowing that position allowed UTMB

neurosurgeon Hank Nauta to relieve intractable bowel pain in a woman by

poking a small needle into her spinal cord, severing the dorsal column

nerves. Almost two years later, the woman, a cervical cancer patient whose

colon had been damaged by radiation treatment, experiences no pelvic pain.

Since then, Nauta has performed the procedure on six other patients, with

similar positive results.

>

> Nauta's surgery built on the successes of Hirschberg, who in the early

1990s severed the dorsal column pathways of eight cancer patients and

eliminated intractable pain arising from the colon, ovaries and bladder.

Previous surgeries to sever the spinothalamic tract, based on old

misconceptions about pain pathways, seldom helped patients with pain

originating in internal organs.

>

> Despite Nauta and Hirschberg's promising results, however, many physicians

are concerned about the possible side effects of performing surgery on a set

of nerve cells that has been so little studied.

>

> " Surgery is not anybody's first option, " says Westlund High. She adds that

operations could be especially risky above the level of the pelvis, where,

she has found, the dorsal column nerve fibers fork and veer away from the

midline. That more inaccessible position in the spinal cord raises the

chances that surgery aimed at interupting the dorsal column pathway might

inadvertently cut other important nerve cells, too. Therefore, surgical

treatments for pain in abdominal organs like the liver or pancreas probably

would be much more complicated than surgical treatments aimed at ablating

pain in pelvic organs like the colon, Westlund High predicts.

>

> Such complications make it even more important that researchers continue

to study the dorsal column pathway and compare it to the more well-known

pain pathway, the spinothalamic tract, Westlund High says.

>

> " It's very possible that the pharmacology of this new pathway is different

from that of the spinothalamic tract, " she continues. " We may find agents

that block signals from these nerve cells selectively while leaving other

pain signals intact. However, we haven't had a chance to do those studies

yet. "

> Mark E. Armstrong

> www.top5plus5.com

> Oregon State Chapter Rep

> Pancreatitis Association, International

>

>

>