The time course of brief and prolonged topical 8% capsaicin-induced desensitization in healthy volunteers evaluated by quantitative sensory testing and vasomotor imaging

Topically applied high-concentration capsaicin induces reversible dermo-epidermal denervation and depletion of capsaicin-sensitive nociceptors. This causes desensitization of distinct sensory modalities and is used to treat peripheral neuropathic pain and itch. For high-concentration capsaicin, the...

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Veröffentlicht in:Experimental brain research 2018-08, Vol.236 (8), p.2231-2244
Hauptverfasser: Lo Vecchio, Silvia, Andersen, Hjalte Holm, Arendt-Nielsen, Lars
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Arendt-Nielsen, Lars
description Topically applied high-concentration capsaicin induces reversible dermo-epidermal denervation and depletion of capsaicin-sensitive nociceptors. This causes desensitization of distinct sensory modalities and is used to treat peripheral neuropathic pain and itch. For high-concentration capsaicin, the selectivity of loss of function and functional recovery rates of various afferent fibers subpopulations are unknown. This study used comprehensive quantitative sensory testing and vasomotor imaging to assess effectiveness, duration and sensory selectivity of high-concentration 8% capsaicin–ablation. Skin areas in 14 healthy volunteers were randomized to treatment with 8% capsaicin/vehicle patches for 1 and 24 h and underwent comprehensive sensory and vasomotor testing at 1, 7 and 21 days postpatch removal. Tests consisted of thermal detection and pain thresholds, tactile and vibration detection thresholds, mechanical pain threshold and mechanical pain sensitivity as well as micro-vascular and itch reactivity to histamine provocations. The 24 h capsaicin drastically inhibited warmth detection ( P  
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This causes desensitization of distinct sensory modalities and is used to treat peripheral neuropathic pain and itch. For high-concentration capsaicin, the selectivity of loss of function and functional recovery rates of various afferent fibers subpopulations are unknown. This study used comprehensive quantitative sensory testing and vasomotor imaging to assess effectiveness, duration and sensory selectivity of high-concentration 8% capsaicin–ablation. Skin areas in 14 healthy volunteers were randomized to treatment with 8% capsaicin/vehicle patches for 1 and 24 h and underwent comprehensive sensory and vasomotor testing at 1, 7 and 21 days postpatch removal. Tests consisted of thermal detection and pain thresholds, tactile and vibration detection thresholds, mechanical pain threshold and mechanical pain sensitivity as well as micro-vascular and itch reactivity to histamine provocations. The 24 h capsaicin drastically inhibited warmth detection ( P  &lt; 0.001), heat pain ( P  &lt; 0.001) as well as histamine-induced itch ( P  &lt; 0.05) and neurogenic flare ( P  &lt; 0.001), but had no impact on tactile sensitivity, cold detection and cold pain. A marginal decrease in mechanical pain sensitivity was observed ( P  &lt; 0.05). Capsaicin for 1 h had limited and transient sensory effects only affecting warmth and heat sensations. Time-dependent functional recovery was almost complete 21 days after the 24 h capsaicin exposure, while recovery of neurogenic inflammatory responsiveness remained partial. The psychophysically assessed sensory deficiencies induced by the used 8% capsaicin–ablation correspond well with a predominant effect on TRPV1 + –cutaneous fibers. 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All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c530t-92f26b58653b08c7b729630de23d8c46d96879677a9e6606af3092879ec1efa53</citedby><cites>FETCH-LOGICAL-c530t-92f26b58653b08c7b729630de23d8c46d96879677a9e6606af3092879ec1efa53</cites><orcidid>0000-0002-7596-7764</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00221-018-5299-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00221-018-5299-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29845449$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lo Vecchio, Silvia</creatorcontrib><creatorcontrib>Andersen, Hjalte Holm</creatorcontrib><creatorcontrib>Arendt-Nielsen, Lars</creatorcontrib><title>The time course of brief and prolonged topical 8% capsaicin-induced desensitization in healthy volunteers evaluated by quantitative sensory testing and vasomotor imaging</title><title>Experimental brain research</title><addtitle>Exp Brain Res</addtitle><addtitle>Exp Brain Res</addtitle><description>Topically applied high-concentration capsaicin induces reversible dermo-epidermal denervation and depletion of capsaicin-sensitive nociceptors. 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The method is easy to apply, well tolerated, and utilizable for studies on, e.g., interactions between skin barrier, inflammation and capsaicin-sensitive afferents.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Capsaicin</subject><subject>Capsaicin - administration &amp; dosage</subject><subject>Capsaicin - pharmacology</subject><subject>Capsaicin receptors</subject><subject>Care and treatment</subject><subject>Denervation</subject><subject>Desensitization (Psychology)</subject><subject>Dosage and administration</subject><subject>Dose-response relationship</subject><subject>Fibers</subject><subject>Habituation (Psychophysiology)</subject><subject>Health aspects</subject><subject>Histamine</subject><subject>Histamine - pharmacology</subject><subject>Histamine Agonists - pharmacology</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Male</subject><subject>Nerve Fibers, Unmyelinated - drug effects</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Nociception - drug effects</subject><subject>Nociceptors</subject><subject>Nociceptors - drug effects</subject><subject>Pain</subject><subject>Pain perception</subject><subject>Pain Threshold - drug effects</subject><subject>Perfusion Imaging</subject><subject>Peripheral neuropathy</subject><subject>Pruritus - chemically induced</subject><subject>Pruritus - drug therapy</subject><subject>Recovery of function</subject><subject>Research Article</subject><subject>Sensory neurons</subject><subject>Sensory System Agents - administration &amp; 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Andersen, Hjalte Holm ; Arendt-Nielsen, Lars</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c530t-92f26b58653b08c7b729630de23d8c46d96879677a9e6606af3092879ec1efa53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Capsaicin</topic><topic>Capsaicin - administration &amp; dosage</topic><topic>Capsaicin - pharmacology</topic><topic>Capsaicin receptors</topic><topic>Care and treatment</topic><topic>Denervation</topic><topic>Desensitization (Psychology)</topic><topic>Dosage and administration</topic><topic>Dose-response relationship</topic><topic>Fibers</topic><topic>Habituation (Psychophysiology)</topic><topic>Health aspects</topic><topic>Histamine</topic><topic>Histamine - pharmacology</topic><topic>Histamine Agonists - pharmacology</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Male</topic><topic>Nerve Fibers, Unmyelinated - drug effects</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Nociception - drug effects</topic><topic>Nociceptors</topic><topic>Nociceptors - drug effects</topic><topic>Pain</topic><topic>Pain perception</topic><topic>Pain Threshold - drug effects</topic><topic>Perfusion Imaging</topic><topic>Peripheral neuropathy</topic><topic>Pruritus - chemically induced</topic><topic>Pruritus - drug therapy</topic><topic>Recovery of function</topic><topic>Research Article</topic><topic>Sensory neurons</topic><topic>Sensory System Agents - administration &amp; 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The method is easy to apply, well tolerated, and utilizable for studies on, e.g., interactions between skin barrier, inflammation and capsaicin-sensitive afferents.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29845449</pmid><doi>10.1007/s00221-018-5299-y</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-7596-7764</orcidid></addata></record>
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source MEDLINE; Springer Nature - Complete Springer Journals
subjects Adolescent
Adult
Biomedical and Life Sciences
Biomedicine
Capsaicin
Capsaicin - administration & dosage
Capsaicin - pharmacology
Capsaicin receptors
Care and treatment
Denervation
Desensitization (Psychology)
Dosage and administration
Dose-response relationship
Fibers
Habituation (Psychophysiology)
Health aspects
Histamine
Histamine - pharmacology
Histamine Agonists - pharmacology
Humans
Inflammation
Male
Nerve Fibers, Unmyelinated - drug effects
Neurology
Neurosciences
Nociception - drug effects
Nociceptors
Nociceptors - drug effects
Pain
Pain perception
Pain Threshold - drug effects
Perfusion Imaging
Peripheral neuropathy
Pruritus - chemically induced
Pruritus - drug therapy
Recovery of function
Research Article
Sensory neurons
Sensory System Agents - administration & dosage
Sensory System Agents - pharmacology
Skin
Skin - diagnostic imaging
Skin - drug effects
Skin - physiopathology
Subpopulations
Thermosensing - drug effects
Time Factors
Touch Perception - drug effects
Young Adult
title The time course of brief and prolonged topical 8% capsaicin-induced desensitization in healthy volunteers evaluated by quantitative sensory testing and vasomotor imaging
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