Reactive aldehydes: a new player in inflammatory pain

Pain is a costly problem worldwide. USA expenditures on pain are higher than those for cancer, heart disease, and diabetes combined, at approximately $560 billion annually (1). As noted recently (2), pain therapeutics are dominated by well-established drug classes that are focused on symptom reduction, and are plagued by limited efficacy and/or significant adverse effects. NSAID’s are used to treat acute pain and are accompanied by risk of cardiovascular damage, liver damage, kidney damage, and delayed bone healing (3). COX-2 inhibitors have limited efficacy and can cause cardiovascular problems (4,5). Mechanism-based treatments that are individualized to patients with particular underlying pathophysiology have long remained the goal for preclinical and clinical researchers alike (6,7). In a recent article, Zambelli et al. (8) document their discovery of a new mechanism of inflammatory pain that may lead us closer to a mechanism-based therapeutic approach.