Back and joint pains are among the top reasons for visits to the doctor. Yet complete resolution of the complaint is often slow in coming or never completely resolved. Why?
There are 2 major physiologic pathways leading to inflammatory and pain responses: the cyclooxygenase (COX) mediated and the lipoxygenase (5-LO) dependent one. While the former is widely known, and inhibited by the well popularized NSAID’s (like Celebrex, Vioxx(!)), etc, the second one is virtually ignored in the current management of pain syndromes. Principal cause for this is the failure of major drug companies to develop synthetic drugs that can inhibit the 5-LO and its downstream metabolites, the all important leukotrienes. To make up for the failure to deal with the 5-LO, pharmaceutical solutions like corticosteroids are usually put in place – with their well known side effects.
The bottom line is that when only one of two pathways to pain is addressed the patient is only “half treated” and half satisfied.
Lipoxygenase and pain
The 5-LO enzyme works to produce the “misery” of the leukotrienes.1 They are abundantly involved in over 35 chronic conditions including: asthma, allergies, colitis, arthritis, gastric disorders (promote ulcer formation, stimulate acid secretion, etc), scleroderma, neurological diseases, and so on. 2
More recently the involvement of the leukotrienes in pain best keto supplements — best keto pills 2020 syndromes has become clear from a multitude of studies. 1
5-LO and leukotriene B4 are involved in orofacial pain perception and mechanical and thermal sensitivity.3-7
Postoperative incision pain in animal models could be considerably reduced using experimental 5-LO inhibitors.8
The beneficial effects of 5-LO inhibition were demonstrated in the reduction of inflammatory events accompanying experimental spinal cord injury. 9
Several studies have identified inflammatory mediators in disk herniation, such as leukotrienes. Cytokines occurring in degenerated facets have been shown to contribute to the pain of degenerative lumbar disorders. 10, 11
5-LO has been shown to be involved in both pain modulation and induction of opioid tolerance at the spinal level. 12 5-LO metabolites are found in clinical cases of herniated nucleus pulposus and experimental data gathered in the study of associated radicular pain in animals demonstrated that 5-LO inhibition may prove to be beneficial in such conditions.13
Pharmacological inhibition of the 5-LO
While the market availability of COX inhibitors is widespread the opposite seems to be the case with pharmaceuticals in the lipoxygenase class direction. Partially this is not due to lack of trying. Promising experimental drugs had to be abandoned due to unacceptable side effects – death of animal subjects! Even those that made it to market carry warnings of hepatotoxicity (Zileuton) or have been associated with an increase in abnormal mental behavior (Singulair). On the other hand there is a persistent lack of research on the part of the pharmaceutical industry secondary to a tragic underestimation of the potential market size.