Tissue damage direct

Hydrogen ions accumulate in tissue damaged by inflammation and ischaemia and so pH is lowered. These protons may activate nociceptors directly via their own family of ion channels as well as sensitising them to mechanical stimulation. Acid-sensing ion channels (ASICS) are a family of sodium channels that are activated by protons — of special interest is one type found only in small dorsal root ganglion neurons that possibly are responsible for activation of nociceptors. Although the transduction of mechanical stimuli is poorly understood, ASICs are closely related to channels that respond to stretch. 

Other considerations such as demonstrating a direct correlation between the level of oxidative stress and tissue damage in diabetes and showing that antioxidant therapy leads to prevention, arrest or regression of diabetic complications are also important and must be the basis of future well-designed studies. 

Further research is required to establish whether free-radical-induced damage is a primary event in diabetes. Tissue damage, which is associated with inactivation of antioxidants and release of metal ions that are potent catalysts of free radical reactions, can lead to lipid peroxidation. This raises the possibility that the diabetic process itself or other frctors may increase free-radical activity following direct tissue damage. 

Release of active pancreatic enzymes directly causes local or distant tissue damage. Trypsin digests cell membranes and leads to the activation of other pancreatic enzymes. Lipase damages fat cells, producing noxious substances that cause further pancreatic and peripancreatic injury. 

Capsaicin (52 Qutenza , NeurogesX, 2009), an active component of chili peppers belonging to genus Capsicum, was first isolated in pure and crystalline form by John Clough Thresh in 1876." Capsaicin is currently used in topical ointments to reheve the pain of peripheral neuropathy the burning and painful sensations associated with capsaicin (capsaicin does not actually cause a chemical bum, or any direct tissue damage at all) result from its chemical interaction with sensory neurons. Capsaicin, being a member of the vanilloid family, binds to the ion channel receptor vanilloid... 

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