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Neurochemical Substance P is Key to Understanding Pain Process


by Paul Rodde
Fibromyalgia.com


09-14-2001

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Dr. Jon Russell, M.D., Ph.D., a leading researcher of Fibromyalgia, recently expressed the importance of neurochemicals in describing the pain process. In a lecture given to the National Fibromyalgia Partnership, Inc. Dr Russell clearly defined the mechanisms involved in the pain process, and identified the neurochemical Substance P as the key transmitter of pain to the brain.

Russell describes the pain process as two opposing forces. The first involves the chemical message that is sent to, and interpreted by the brain as pain. The other is the brain’s chemical response that attempts to inhibit the pain message. Russell believes that an imbalance of these chemicals plays an important part in the discomfort FM patients’ experience.

According to Russell, the pain process begins when outside stimulation such as, physical pressure or contact with a hot substance, affects the surface of tissue. This sensation is then transferred across the nervous system from the contact point to an area of the spinal cord called the dorsal horn. It is at this location where the spinal cord releases several chemicals from the ends of surrounding nerve cells. Among these chemicals is Substance P.

Much like the rings produced by a rock splashing into a calm body of water, the chemicals released by the spinal cord expand outward and try to attach themselves to neuro-receptors. Substance P binds itself to a receptor Russell identifies as NK1. After Substance P binds itself to an NK1 receptor, the adjacent neuron takes the chemical message and transfers it upward along the spinal cord until the message reaches the brain. In the brain the message is interpreted as pain.

In response, the brain dispatches its own batch of neurochemicals, and directs them toward the area of the spinal cord where Substance P had been released. These chemicals include seratonin, norepinephrin, zinc and opioids. It is at this point where the brain’s chemicals try to suppress the release of Substance P, and “down regulate” the perception of pain.

When Substance P is released in the presence of the brain’s suppressive chemicals two events may occur. Substance P may bind to an NK1 receptor and carry on the message of pain, or it may be broken into two by an enzyme released by the brain. These two parts of Substance P have different actions. The first part contains the portion of the chemical that can bind to the same NK1 receptor as the complete Substance P, and produce the sensation of pain. The other part contains an opposite portion that can bind to receptors that inhibit production of NK1, and the spread of the pain message. This portion of the broken down Substance P is also an inhibitor of the intact Substance P, the carrier of the pain signal.

Russell states that in a Fibromyalgia patient, this process is disrupted. A Fibromyalgia patient may have too much Substance P, or too little inhibitor chemicals. He brought up the term Alodinian, which describes a patient that has a change in the perception of pain. A FM patient’s experience of pain results from stimulus that should not be painful. According to Russell, it is the understanding of this chemical process that may lead to the relief of FM symptoms.

Editor’s Note: This taped lecture of approx 1.5 hours is produced by the National Fibromyalgia Partnership, Inc. The two-tape set is available for purchase from ImmuneSupport. Profits will be donated to the National Fibromyalgia Partnership, Inc. to fund further research.

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