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Article
Conolidine: A Novel Plant Extract for Chronic Pain
Anesthesiology and Pain Medicine
  • Amber N Edinoff, Louisiana State University Health Science Center
  • Akash S. Patel, Brigham and Women's Hospital
  • Mitchell W. Baker, University of Maryland School of Medicine
  • Jesse Lawson, Louisiana State University
  • Christopher Wolcott, Louisiana State University
  • Elyse M Cornett, Louisiana State University
  • Kambiz Sadegi, Zabol University of Medical Sciences
  • Adam M. Kaye, University of the Pacific
  • Alan David Kaye, Louisiana State University Health Science Center
ORCiD
Adam M. Kaye: 0000-0002-7224-3322
Document Type
Article
DOI
10.5812/aapm.121438
Publication Date
12-1-2021
Abstract

Pain, the most common symptom reported among patients in the primary care setting, is complex to manage. Opioids are among the most potent analgesics agents for managing pain. Since the mid-1990s, the number of opioid prescriptions for the management of chronic non-cancer pain (CNCP) has increased by more than 400%, and this increased availability has significantly contributed to opioid diversion, overdose, tolerance, dependence, and addiction. Despite the questionable effectiveness of opioids in managing CNCP and their high rates of side effects, the absence of available alternative medications and their clinical limitations and slower onset of action has led to an overreliance on opioids. Conolidine is an indole alkaloid derived from the bark of the tropical flowering shrub Tabernaemontana divaricate used in traditional Chinese, Ayurvedic, and Thai medicine. Conolidine could represent the beginning of a new era of chronic pain management. It is now being investigated for its effects on the atypical chemokine receptor (ACK3). In a rat model, it was found that a competitor molecule binding to ACKR3 resulted in inhibition of ACKR3’s inhibitory activity, causing an overall increase in opiate receptor activity. Although the identification of conolidine as a potential novel analgesic agent provides an additional avenue to address the opioid crisis and manage CNCP, further studies are necessary to understand its mechanism of action and utility and efficacy in managing CNCP.

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International
Citation Information
Amber N Edinoff, Akash S. Patel, Mitchell W. Baker, Jesse Lawson, et al.. "Conolidine: A Novel Plant Extract for Chronic Pain" Anesthesiology and Pain Medicine Vol. 11 Iss. 6 (2021) ISSN: 2228-7531
Available at: http://works.bepress.com/adam-kaye/169/