Abstract
“Molecular neurosurgery” is emerging as a new medical concept, and is the combination of two partners: (i) a molecular neurosurgery agent, and (ii) the cognate receptor whose activation results in the selective elimination of a specific subset of neurons in which this receptor is endogenously expressed. In general, a molecular surgery agent is a selective and potent ligand, and the target is a specific cell type whose elimination is desired through the molecular surgery procedure. These target cells have the highest innate sensitivity to the molecular surgery agent usually due to the highest receptor density being in their plasma membrane. The interaction between the ligand and its receptor evokes an overactivity of the receptor. If the receptor is a ligand-activated non-selective cation channel, the overactivity of receptor leads to excess Ca2+ and Na+ influx into the cell and finally cell death. One of the best known examples of such an interaction is the effect of ultrapotent vanilloids on TRPV1-expressing pain-sensing neurons. One intrathecal resiniferatoxin (RTX) dose allows for the receptor-mediated removal of TRPV1+ neurons from the peripheral nervous system. The TRPV1 receptor-mediated ion influx induces necrotic processes, but only in pain-sensing neurons, and usually within an hour. Besides that, target-specific apoptotic processes are also induced. Thus, as a nano-surgery scalpel, RTX removes the neurons responsible for generating pain and inflammation from the peripheral nervous system providing an option in clinical management for the treatment of morphine-insensitive pain conditions. In the future, the molecular surgery concept can also be exploited in cancer research for selectively targeting the specific tumor cell.
Highlights
Reviewed by: Enrique Soto, Benemérita Universidad Autónoma de Puebla, Mexico Sergio D
Our goal with this review is to summarize the basics behind “molecular surgery,” a new concept of biomedical technology, which have prototyped with the vanilloid receptor type 1 (TRPV1) target
Prolonged or repeated applications of CAP causes persistent desensitization of TRPV1 in an electrophysiology-based experiment (Touska et al, 2011). This effect can contribute to pain insensitivity after vanilloid treatment to some extent, our experiments show that sensory neurons or axons were absent in the treated region
Summary
Our goal with this review is to summarize the basics behind “molecular surgery,” a new concept of biomedical technology, which have prototyped with the vanilloid receptor type 1 (TRPV1) target. Endogenous agonists are involved in the generation of chronic pain, while exogenous agonists are capable of alleviating chronic pain (Carnevale and Rohacs, 2016) Potent vanilloids such as CAP or RTX can be administered in a different manner for the removal of TRPV1+ neurons. In contrast to topical administration, other routes of application generate irreversible changes, because these treatments eliminate the periferal axons, and the body of the TRPV1-positive sensory neurons. In contrast to intrathecal administration, intraganglionic injection may need an advanced imaging technology R&D process, in order to fully support robotic anatomical guidance (i.e., needle placement by computer tomography) With this technology at hand, we can treat severe focal pain syndromes right at the source, and remove acheurons from a sub-domain of DRG or TG branches. The benefit of longterm and permanent elimination of unbearable inflammatory pain justifies the effective ablation of acheurons (Karai et al, 2004; Tender et al, 2005)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
