Clinical study of the efficacy and safety of Urimil in patients with low back pain
Keywords:
low back pain, treatment, uridineAbstract
Introduction: Low back pain back is one of the most frequent and disabling conditions to visit a neurologist and is the leading cause of impaired daily activity at young people. However, in some patients, particularly in the presence of radiculopathy, despite the variety of medications, the effect is insufficient and we need additional options to manage the pain, as well as other possible symptoms - motor (muscle weakness) and autonomic. There is experimental and clinical evidence that uridine via P2Y receptors mediates the purinergic neurotransmission and inhibits spinal pain transmission and promotes successful PNS axonal regeneration via Schwann cells proliferation, migration, and remyelination. In humans, uridine results in a statistically significant reduction in the intensity of neuropathic pain in various peripheral neuropathies, including radiculopathies, entrapment diabetic and alcoholic neuropathies.
Aim: The aim of this clinical observation is to evaluate the effect and tolerability of uridine in patients with underlying / chronic back pain.
Patients and methods: A total of 35 patients with subacute/chronic low back pain were included. A three months treatment with urine-containing nutritional supplement Urimil was performed.
Results: All patients who completed the study reported a reduction of spontaneous back pain at rest and activity. Most of the patients (22 patients or 76%) reported more than 50% pain reduction. Urimil has a favorable safety and efficacy profile in patients with subacute/chronic low back pain. No side effects were reported.
Conclusion: Uridine-containing nutritional supplement is recommended for adjuvant therapy in patients with low back pain.
References
Milanov, I. Back pains. Sofia, 2002
Milanov, I. National Consensus on Diagnosis and Treatment of Pain from Neurological Disorders, 2015. Cephalgia, 2015, 17, Supplement 1. https://glavobolie.org/journal/index.php/ce/issue/view/31
Milanov, I. (2016). Purines and neuroregeneration in neuropathies. Movement Disorders, 13(1), 5–10. https://multiplesclerosis-bg.com/journal/index.php/md/article/view/1
Burnstock, G. Introductory overview of purinergic signalling. Front Biosci (Elite Ed). 2011, 3, 1, 896-900.
Cieslak, M., Czarnecka, J., Roszek, K., Komoszyński, M. The role of purinergic signaling in the etiology of migraine and novel antimigraine treatment. Purinergic Signal, 2015, 11, 3, 307-316.
Gallai, V., Mazzotta, G., Montesi, S., Sarchielli, P., Del Gatto, F. Effects of uridine in the treatment of diabetic neuropathy: an electrophysiological study. Acta Neurol Scand, 1992,86, 1, 3-7.
Gerevich, Z., Illes, P. P2Y receptors and pain transmission. Purinergic Signalling, 2004, 1, 1, 3-10.
Goldberg, H., Mibielli, M., Nunes, C.P., Goldberg, S., Buchman, L., Mezitis, S., Rzetelna, H., Oliveira, L., Geller, M., Wajnsztajn, F. A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias. J Pain Res, 2017, 10, 397-404.
Li, N., Lu, Z., Yu, L., Burnstock, G., Deng, X., Ma, B. Inhibition of G protein-coupled P2Y2 receptor induced analgesia in a rat model of trigeminal neuropathic pain. Mol Pain, 2014, 18; 10 - 21.
Martiáñez, T., Carrascal, M., Lamarca, A., Segura, M., Durany, N., Masgrau, R., Abian, J., Gella, A. UTP affects the Schwannoma cell line proteome through P2Y receptorsleading to cytoskeletal reorganisation. Proteomics, 2012, 12, 1, 145-156.
Mibielli, M., Nunes, C., Scussel, Q., Neto, M., Oliveira, L., Geller, M. Symptomatic improvement in an acute, non-traumatic spine pain model with a combination of uridine triphosphate, cytidine monophosphate, and hydroxocobalamin; Pain Studies and Treatment, 2014, 2, 1, 6-10.
Negrao, L., Almeida, P., Alcino, S., Duro, H., Libório, T. Effect of the combination of uridine nucleotides, folic acid and vitamin B12 on the clinical expression of peripheral neuropathies.Pain Manag, 2014, 4, 3, 191-196.
Negrão, L., Nunes, P. Portuguese Group for the Study of Peripheral Neuropathy.Uridine monophosphate, folic acid and vitamin B12 in patients with Symptomatic peripheral entrapment neuropathies. Pain Manag, 2016, 6, 1, 25-29.
Nunes, C., Scussel, Jr , Goldberg, H. Alcoholic polyneuropathy: clinical assessment of treatment outcomes following therapy with nucleotides and vitamin B12. Res Neurol Inter J, 2013, 1-16.
Okada, M., Nakagawa, T., Minami, M., Satoh, M. Analgesic effects of intrathecal administration of P2Y nucleotide receptor agonists UTP and UDP in normal and neuropathic pain model rats. J Pharmacol Exp Ther, 2002,303,1,66-73.
Seck, L., Basse, A., Diedhiou, D. Efficacy and tolerance of combination of Cytidine 5 'monophosphate (CMP) and Uridine-5' Triphosphate Trisodium (UTP) in patients with diabetic neuropathy: results of a study conducted in Dakar-Senegal International Journal of Medicine and Medical Sciences, 2015, 5, 8, 284-287.
Toy, D., Namgung, U. Role of Glial Cells in Axonal Regeneration. Experimental Neurobiology, 2013, 22, 2, 68-76.
Venhoff, N., Lebrecht, D., Deveaud, C., Beauvoit, B., Bonnet, J., Muller, K., Kirschner, J., Venhoff, A.C., Walker, U.A. Oral uridine supplementation antagonizes the peripheralneuropathy and encephalopathy induced by antiretroviral nucleoside analogues. AIDS, 2010, 28, 24, 3, 345-352.
Wattig, B., Schalow, G., Heydenreich, F., Warzok, R., Cervós-Navarro, J. Enhancement of nerve fibre regeneration by nucleotides after peripheral nerve crush damage. Electrophysiologic and morphometric investigations. Arzneimittelforschung, 1992, 42, 1075-1078.
Weisman, G.A., Woods, L.T., Erb, L., Seye, C.I. P2Y receptors in the mammalian nervous system: pharmacology, ligands and therapeutic potential. CNS Neurol Disord Drug Targets, 2012, 11, 6, 722-738.
Yoshida, K., Nakagawa, T., Minami, M., Satoh, M. ATP inhibits slow depolarization induced by repetitive dorsal root stimulation in substantia gelatinosa neurons of the adult rat spinal cord slices via P2Y purinoceptors. Neurosci Lett, 2002, 320, 121–124.
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Copyright (c) 2017 Desislava Bogdanova, V. Todorov, N. Goranova, A. Atanasov, M. Ivanova
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