Resiniferatoxin for Pain Treatment: An Interventional Approach toPersonalized Pain Medicine

摘要

This review examines existing preclinical and clinical studies related to resiniferatoxin (RTX) and its potentialuses in pain treatment. Like capsaicin, RTX is a vanilloid receptor (TRPV1) agonist, only more potent. This increasedpotency confers both quantitative and qualitative advantages in terms of drug action on the TRPV1 containing nerveterminal, which result in an increased efficacy and a long duration of action. RTX can be delivered by a central route ofadministration through injection into the subarachnoid space around the lumbosacral spinal cord. It can also beadministered peripherally into a region of skin or deep tissue where primary afferents nerves terminate, or directly into anerve trunk or a dorsal root ganglion. The central route is currently being evaluated as a treatment for intractable pain inpatients with advanced cancer. Peripheral administration offers the possibility to treat a wide diversity of pain problemsbecause of the ability to bring the treatment to the site of the pain (the peripheral generator). While not all pain disordersare appropriate for RTX, tailoring treatment to an individual patient's needs via a selective and local intervention thatchemically targets a specific population of nerve terminals provides a new capability for pain therapy and a simplified andeffective approach to personalized pain medicine.