Chest pain doesn't necessarily come from the heart. An estimated 200,000 Americans each year experience non-cardiac chest pain, which in addition to pain can involve painful swallowing, discomfort and anxiety.
Non-cardiac chest pain can be frightening for patients and result in visits to the emergency room because the painful symptoms, while often originating in the esophagus, can mimic a heart attack. Current treatment — which includes pain modulators such as selective serotonin reuptake inhibitors (SSRI) — has a partial 40 to 50 percent response rate in alleviating symptoms.
New research authored by Temple University Hospital gastroenterologist Ron Schey, MD, FACG, suggests a novel approach to treating non-cardiac chest pain due to esophageal hypersensitivity. The treatment involves a drug called dronabinol, a cannabinoid receptor activator that has traditionally been used to treat nausea and vomiting in HIV patients and for cancer patients undergoing chemotherapy,
In a pilot study involving 13 patients with non-cardiac chest pain, Dr. Schey and his research team found that patients who were given 5 mg of dronabinol twice daily for four weeks fared better than patients who took a placebo, or dummy pill. Those getting dronabinol experienced improved pain tolerance and decreased frequency and intensity of chest pain. In addition, no significant adverse effects were reported.
"This novel study has promising findings in future treatment for these patients," said Dr. Schey, Associate Professor of Medicine at Temple University School of Medicine, who conducted the research while on staff at the University of Iowa Hospitals and Clinic, and analyzed the data at Temple along with Zubair Malik, MD, a first-year fellow in Temple's Division of Gastroenterology.
The pilot study, while encouraging, was very small and not designed to test dronabinol against current therapies for non-cardiac chest pain, so it is difficult to calculate how the drug performs in comparison to existing treatments, Dr. Schey said. He said dronabinol likely helps to diminish pain by activating cannabinoid receptors in the esophagus that decrease sensitivity.
The abstract was presented October 20 in Philadelphia at the Annual Scientific Meeting of the American College of Gastroenterology. The professional organization said it picked the Temple research to be among the "most newsworthy" studies presented at the conference because the findings have an impact on GI patient care.
Dr. Schey joined Temple in 2014; and his research interests include non-cardiac chest pain, GI motility disorders and esophageal disorders.
Dr. Schey said a larger scale study on the effects of dronabinol on non-cardiac chest pain will be initiated in the near future at Temple.
Editor's Note: Neither Dr. Schey nor any member of his immediate family has financial interest in AbbVie, the manufacturer of Marinol®, the brand name of dronabinol.
About Temple Health
Temple University Health System (TUHS) is a $1.4 billion academic health system dedicated to providing access to quality patient care and supporting excellence in medical education and research. The Health System consists of Temple University Hospital (TUH), ranked among the "Best Hospitals" in the region by U.S. News & World Report; TUH-Episcopal Campus; TUH-Northeastern Campus; Fox Chase Cancer Center, an NCI-designated comprehensive cancer center; Jeanes Hospital, a community-based hospital offering medical, surgical and emergency services; Temple Transport Team, a ground and air-ambulance company; and Temple Physicians, Inc., a network of community-based specialty and primary-care physician practices. TUHS is affiliated with Temple University School of Medicine.
Temple University School of Medicine (TUSM), established in 1901, is one of the nation's leading medical schools. Each year, the School of Medicine educates approximately 840 medical students and 140 graduate students. Based on its level of funding from the National Institutes of Health, Temple University School of Medicine is the second-highest ranked medical school in Philadelphia and the third-highest in the Commonwealth of Pennsylvania. According to U.S. News & World Report, TUSM is among the top 10 most applied-to medical schools in the nation.
Temple Health refers to the health, education and research activities carried out by the affiliates of Temple University Health System (TUHS) and by Temple University School of Medicine. TUHS neither provides nor controls the provision of health care. All health care is provided by its member organizations or independent health care providers affiliated with TUHS member organizations. Each TUHS member organization is owned and operated pursuant to its governing documents.
Jeremy Walter | Eurek Alert!
Investigators may unlock mystery of how staph cells dodge the body's immune system
22.09.2017 | Cedars-Sinai Medical Center
Monitoring the heart's mitochondria to predict cardiac arrest?
21.09.2017 | Boston Children's Hospital
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
22.09.2017 | Life Sciences
22.09.2017 | Medical Engineering
22.09.2017 | Physics and Astronomy