Molecular neurochirurgie for pain control administering locally capsaicin or resinferatoxin

Abstract

The present invention provides methods and kits for the selective ablation of pain-sensing neurons. The methods comprise administration of a vanilloid receptor agonist to a ganglion in an amount that causes death of vanilloid receptor-bearing neurons. Accordingly, the present invention provides methods of controlling pain and inflammatory disorders that involve activation of vanilloid receptor-bearing neurons.

What is claimed is:  
     
         1 . A method of selectively ablating pain-sensing neurons from a ganglion, said method comprising intraganglionic administration of a vanilloid receptor 1 agonist to a ganglion selected from the group consisting of a dorsal root ganglion, a trigeminal ganglion, or an autonomic ganglion in an amount sufficient to ablate the neurons.  
     
     
         2 . The method of  claim 1 , wherein the vanilloid receptor 1 agonist is administered to a patient suffering from chronic pain.  
     
     
         3 . The method of  claim 1 , wherein the vanilloid receptor 1 agonist is administered to a patient suffering from post-herpetic neuralgia.  
     
     
         4 . The method of  claim 1 , wherein the ganglion is a dorsal root ganglion.  
     
     
         5 . The method of  claim 1 , wherein the ganglion is a trigeminal ganglion.  
     
     
         6 . The method of  claim 1 , wherein the ganglion is an autonomic ganglion.  
     
     
         7 . The method of  claim 1 , wherein the vanilloid receptor 1 agonist is selected from the group consisting of a resiniferatoxin or a capsaicin.  
     
     
         8 . A method of  claim 7 , wherein the vanilloid receptor agonist is a resiniferatoxin.  
     
     
         9 . A method of  claim 1 , wherein the amount is from 50 nanograms to 50 micrograms.  
     
     
         10 . A method of  claim 9 , wherein the amount is from about 500 nanograms to about 50 micrograms.  
     
     
         11 . A method of  claim 1 , wherein intraganglionic administration comprises direct injection into the ganglion.  
     
     
         12 . A method of  claim 1 , wherein intraganglionic administration comprises injection into a nerve root.  
     
     
         13 . A method of  claim 1 , further comprising administration of a local anesthetic.  
     
     
         14 . The method of  claim 13 , wherein the local anesthetic is lidocaine, bupivicaine, tetracaine, or ropivicaine.  
     
     
         15 . A method of selectively ablating pain-sensing neurons from a ganglion, said method comprising intrathecal administration of a vanilloid receptor agonist to a dorsal root ganglion.  
     
     
         16 . The method of  claim 15 , wherein the vanilloid receptor agonist is administered to a patient suffering from chronic pain.  
     
     
         17 . The method of  claim 15 , wherein the vanilloid receptor agonist is selected from the group consisting of a resiniferatoxin or a capsaicin.  
     
     
         18 . The method of  claim 15 , wherein the vanilloid receptor agonist is a resiniferatoxin.  
     
     
         19 . The method of  claim 15 , wherein the amount is from 100 nanograms to 500 micrograms.  
     
     
         20 . The method of  claim 15 , wherein the amount is from about 500 nanograms to about 500 micrograms.  
     
     
         21 . The method of  claim 15 , further comprising administration of a local anesthetic.  
     
     
         22 . The method of  claim 15 , wherein the local anesthetic is tetracaine, ropivicaine, or bupivicaine.  
     
     
         23 . A kit for selectively ablating pain sensing neurons from a ganglion selected from the group consisting of a dorsal root ganglion, a trigeminal ganglion, or an autonomic ganglion, said kit comprising a compartment containing a vanilloid receptor agonist in an amount sufficient to ablate the neurons and instructional materials describing how to use the kit.  
     
     
         24 . The kit of  claim 23 , wherein the vanilloid receptor agonist is a resiniferatoxin.  
     
     
         25 . The kit of  claim 23 , wherein the vanilloid receptor agonist is a capsaicin.  
     
     
         26 . The kit of  claim 23 , further comprising a local anesthetic.  
     
     
         27 . The kit of  claim 26 , wherein the local anesthetic is lidocaine or bupivicaine.