Abstract
Chronic pain remains a major problem worldwide, despite the availability of various non-pharmacological and pharmacological treatment options. Therefore, new analgesics with novel mechanisms of action are needed. Monoclonal antibodies (mAbs) are directed against specific, targeted molecules involved in pain signaling and processing pathways that look to be very effective and promising as a novel therapy in pain management. Thus, there are mAbs against tumor necrosis factor (TNF), nerve growth factor (NGF), calcitonin gene-related peptide (CGRP), or interleukin-6 (IL-6), among others, which are already recommended in the treatment of chronic pain conditions such as osteoarthritis, chronic lower back pain, migraine, or rheumatoid arthritis that are under preclinical research. This narrative review summarizes the preclinical and clinical evidence supporting the use of these agents in the treatment of chronic pain.
Highlights
Chronic pain remains a major problem worldwide, despite the availability of various non-pharmacological and pharmacological treatment options
Anti-nerve growth factor (NGF) antibodies are a promising therapeutic option in the treatment of OA, as they improve pain and function in patients; despite these benefits, meta-analyses of clinical trial data found that these agents increased the risk of neurological adverse effects, being greater in patients treated with tanezumab than in patients treated with placebo and non-steroidal anti-inflammatory drugs (NSAIDs)
There are numerous clinical trials of Rheumatoid arthritis (RA) patients testing the efficacy of tumor necrosis factor (TNF) inhibitors and anti-IL-6 [90], alone or in combination with other drugs such as methotrexate [101,102]; the results show some overall improvement of the disease, as these drugs provide rapid symptom relief by decreasing inflammation and improving other complications associated with RA, but there are few studies that focus on evaluating pain
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Antibodies (Abs) are glycoproteins belonging to the immunoglobulin (Ig) superfamily that are secreted by B cells to identify and neutralize foreign organisms or antigens. In the late quarter of the past century, monoclonal antibodies (mAbs) were synthetically created with therapeutic purposes. They are typically derived from the γimmunoglobulin (or IgG) isotype, and share a common structure based on two heavy chains and two light chains connected by inter chain–disulphide bonds forming a Y-shaped structure (Figure 1A). MAb are produced by cloning a unique B cell. All subsequent Abs derived from these clones can be traced back to a unique parent cell.
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