Chronic painful inflammatory disease

The production of pro-inflammatory substances is an important step during chronic painful inflammatory diseases and its inhibition is a target of novel analgesics. The resin of Protium kleinii is used in folk medicine for inflammatory skin conditions. Its effects seem to be mediated by several pentacyclic triterpenes such as amyrin and brein [92], The topical and systemic administration of the extract of P. kleinii and some of its triterpenes has antinociceptive and anti-inflammatory actions, accompanied by reduced neutrophil infiltration and cytokine... 

Ulcerative colitis is a chronic idiopathic inflammatory disease of unknown origin. Depending on extension and activity, the presence and severity of leading symptoms of the disease such as diarrhoea, rectal blood loss, abdominal pain and fever can vary and laboratory parameters of the acute phase response (e.g., C-reactive protein, erythrocyte sedimentation rate) may be normal or abnormal. These findings usually depend on the severity and extent of colonic involvement... 

Tea extracts have been demonstrated to inhibit a wide range of inflammatory responses and may be useful in treating chronic inflammatory states. For example, rheumatoid arthritis is an inflammatory disease that causes pain, swelling, stiffness and loss of function in the joints. The antioxidants in green tea may prevent or reduce the severity of these symptoms by reducing inflammation and slowing cartilage breakdown (Adcocks et al, 2002 Haqqi et al, 1999). 

In addition to their beneficial effects, some medications may actually cause cellular injury and disease. An example of this phenomenon involves nonsteroidal anti-inflammatory drugs (NSAIDS). These drugs include aspirin (a derivative of salicylic acid), ibuprofen (arylpropionic acid, Advil ), and acetaminophen (para-aminophenol derivative, Tylenol ). Because of their beneficial pharmacological effects, consumption of these agents has increased significantly in recent years. NSAIDS have the ability to treat fever, pain, acute inflammation, and chronic inflammatory diseases such as arthritis. They are also used prophylactically to prevent heart disease, stroke, and colon cancer. 

Biological DMARDs are indicated when autoimmune inflammatory diseases are refractory to therapy with single traditional DMARDs or with combinations of oral or IV traditional DMARDs. Improvements of ACR 20 and ASAS 20 in over 70% of patients with refractory RA and AS do not mean much to the patients in terms of pain relief, improvement of function and health-related quality of life. The present biological DMARDs combined with MTX still cannot fully address the problems of the majority of patients with DMARDs refractory chronic progressive autoimmune inflammatory diseases. Those who are refractory to MTX - - biological DMARDs respond well to SBC-5-IMNs in over 80% of cases. 

Pelvic Inflammatory disease (PID) acute pelvic infection occurs when infection occurs in the fallopian tube. Pain is severe and accompanied by fever and discharge. Chronic PID can follow from an acute infection, causing less severe pain associated with menstruation. Sexual intercourse may be painful. 

The clinical presentation of CP varies depending on the etiology of the disease, the severity of the inflammatory process, and the extent of irreversible damage to the pancreas (Table 39-6). " The classic features of CP are abdominal pain, malabsorption, weight loss, and diabetes. Most alcoholic patients have chronic pain, while others have intermittent attacks or painless pancreatitis. Abstinence from ethanol may provide relief from pain, but does not prevent exocrine... 

Untreated Chlamydia can lead to pelvic inflammatory disease and longterm effects, including chronic pain, increased risk for ectopic pregnancy, postpartum endometritis, and infertility. 

Traditional use In folk medicine a decoction of the seeds and roots is used to treat dysentery, scrofula, and bladder diseases. A tincture of the entire plant in vodka is drunk to treat goiters, rheumatism and common colds, and inflammatory diseases and is also used as a diaphoretic, antipyretic, and sedative. A tea made from the entire plant is used to treat cancer. An infusion is used to stimulate digestion, to treat intestinal atonia, stomach spasms, liver inflammation, jaundice, acnte and chronic bronchitis, pertussis, painful menstruation, kidney stones, goiters, cancer, and to reduce sexual excitabihty. It is used externally in dry and damp compresses and aromatic baths. Fruits and seeds are used to treat eczema, itchy dermatosis, insect stings, and paralysis. A decoction of the root is used externally to treat skin diseases and furunculosis. A decoction of the entire plant is applied to the face after shaving, especially on pimples and fungal skin diseases (Maznev 2004). 

Inflammation is considered the key feature of the immune system response to injury. The main symptoms of inflammations are redness, swelling, pain, and heat. The body s immime system commonly controls the inflammation itself When the inflammations become imcon-trollable, the body becomes diseased, leading to chronic discomfort [109]. This chronic inflammation is the major component of various chronic diseases, including inflammatory bowel disease, rheiunatoid arthritis, osteoporosis, and allergies [110,111]. Along with activation and proliferation of inflammatory cells, cytokines and chemokines are produced in excessive quantities in chronic inflammatory diseases. The primary targets of the anti-inflammatory compounds are the inhibition of inflammatory cell recruitment and proinflammatory mediator production [112]. 

One of the cardinal features of inflammatory states is severe pain and this has contributed to lower quality of life in patients suffering from chronic inflammatory diseases like inflammatory bowel disease, pelvic inflammatory disease, and osteoarthritis. Many nonsteroidal anti-inflammatory dmgs are widely used for their anti-inflammatory properties and are often considered to be a necessary choice in pain management (Ong et al. 2007). However, these agents are known for their potential side effects, with an increased risk of gastrointestinal... 

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