Friday, 6 June 2014

Will Gilenya stop pain

Janes K, Little JW, Li C, Bryant L, Chen C, Chen Z, Kamocki K, Doyle T, Snider A, Esposito E, Cuzzocrea S, Bieberich E, Obeid L, Petrache I, Nicol G, Neumann WL, Salvemini D. The Development and Maintenance of Paclitaxel-Induced Neuropathic Pain Requires Activation of the Sphingosine 1-Phosphate Receptor Subtype 1. J Biol Chem. 2014 May. pii: jbc.M114.569574. [Epub ahead of print]

 The ceramide-sphingosine 1-phosphate (S1P) rheostat is important in regulating cell fate. Several chemotherapeutic agents including paclitaxel (Taxol) involve pro-apoptotic ceramide in their anti-cancer effects. The ceramide-to-S1P pathway is also implicated in the development of pain, raising the intriguing possibility that these sphingolipids may contribute to chemotherapy-induced painful peripheral neuropathy (CIPN), which can be a critical dose-limiting side effect of many widely used chemotherapeutic agents. 

We demonstrate that the development of paclitaxel-induced neuropathic pain was associated with ceramide and S1P formation in the spinal dorsal horn that corresponded with the engagement of S1P receptor subtype 1 (S1PR1)-dependent neuroinflammatory processes: activation of redox-sensitive transcription factors (NFκB) and MAPKs (ERK and p38) as well as enhanced formation of pro-inflammatory and neuroexcitatory cytokines (TNF-α, IL-1β). Intrathecal delivery of the S1PR1 antagonist W146, reduced these neuroinflammatory processes but increased IL-10 and IL-4, potent anti-inflammatory/neuroprotective cytokines. Additionally, spinal W146 reversed established neuropathic pain. Noteworthy, systemic administration of the S1PR1 modulator FTY720 (FDA-approved for multiple sclerosis) attenuated the activation of these neuroinflammatory processes and abrogated neuropathic pain without altering anticancer properties of paclitaxel and with beneficial effects extended to oxaliplatin. Similar effects were observed with other structurally and chemically unrelated S1PR1 modulators (ponesimod, CYM-5542) and S1PR1 antagonists (NIBR-14/15), but not S1PR1 agonists (SEW2871). Our findings identify for the first time the S1P/S1PR1 axis as a promising molecular and therapeutic target in CIPN, establish a mechanistic insight into the biomolecular signaling pathways and provide the rationale for the clinical evaluation of FTY720 in chronic pain patients.

So simple experiment is to ask people using Gilenya who have pain related to MS, is does this treatment have any benefit.


  1. My equally simple answer would be; how would I know? (the science admittedly goes over my head), but never having taking anything else, would my 'pain related to MS' be worse or better not taking it?

    1. There must be some msers with pain before they started drug then what happened

  2. I had pain. Still have some, but less. Been taking this drug more than a year now. How would I know whether it is the drug or the natural remitting course of the disease?


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