ABSTRACT

In recent years, in real clinical practice, complexes containing a combination of uridinomonophosphate and choline have been included in the general therapy regimen of patients suffering from nonspecific back pain and radiculopathy. Is there a need and appropriateness for this? The experts of the National Association have prepared recommendations on topical questions that are regularly asked by practicing physicians regarding the use of a combination of uridine monophosphate and choline. We present to your attention an expert opinion on this issue. 

KEYWORDS: purinergic system, uridine monophosphate, choline, Neurouridine®, pain

For citation: Rachin A.P., Sharov M.N., Rachin S.A., Prokofi eva Y.S., Parsamyan R.R. Application of the Combination of Uridine Monophosphate and Choline in Real Clinical Practice (Expert Recommendations for Practicing Physicians). Comorbidity Neurology. 2024; 1 (1): 35–43. https://doi.org/10.62505/3034-185x-2024-1-35-43 (In Russ.)

*For correspondence: Mikhail N. Sharov, Dr. Sci. (Med.), Professor, Department of Nervous Diseases, Faculty of Stomatology, Russian University of Medicine, Moscow, Russia, e-mail: 6112286@mail.ru.

REFERENCES

1. Burnstock G., Sawynok J. ATP and adenosine receptors and pain. In P. Beaulieu, Lussier D., Porreca F., Dickenson A.H. (Eds.), Pharmacology of pain. Seattle: IASP Press, 2010: 303–326.

2. Burnstock G. Purinergic Mechanisms and Pain. Advances in Pharmacology. 2016; (75): 91–137.

3. Tozaki-Saitoh H., Takeda H., Inoue K. The Role of Microglial Purinergic Receptors in Pain Signaling. Molecules. 2022; 27: 1919. https://doi.org/10.3390/molecules27061919

4. Gerevich Z., Illes P. P2Y receptors and pain transmission. Purinergic Signalling. 2004; 1: 3–10.

5. Kukushkin M.L., Reshetnyak V.K. Purinergic mechanisms of pain and analgesia. Russian Journal of Pain. 2019; 17 (1): 51–56. https://doi.org/10.25731/RASP.2019.01.09 (In Russ.)

6. Lauretti G.C., Omals M., Pereira A.C., et al. Clinical evaluation of the analgesic effect of the cytidine-uridine-hydroxocobalamin complex as a co-adjuvant in the treatment of chronic neuropathic low back pain. Column. 2004; 3 (2): 73–6.

7. Brunschweiger A., Müller C.E. P2 receptors activated by uracil nucleotides — an update. Curr Med Chem. 2006; 13 (3): 289–312.

8. Magni G., Riccio D., Ceruti S. Tackling chronic pain and infl ammation through the purinergic system. Current Medicinal Chemistry. 2018; 25 (32): 3830–3865.

9. Evaldsson C., et al. Anti-infl ammatory effects of exogenous uridine in an animal model of lung infl ammation. Int Immunopharmacol. 2007 Aug; 7 (8): 1025–32.

10. Wattig B., et al. J Enhancement of nerve fi bre regeneration by nucleotides after peripheral nerve crush damage. Electrophysiologic and morphometric investigations. Klin. Med. 1991; 46: 1371.

11. The purinergic system — past, present and future in pain control: expert advice. Neurology today. 2023; 1 (19): 12–13 (In Russ.)

12. Martiáñez T., et al. Purinergic Signal. 2013 Jun; 9 (2): 259–70.

13. Amelin A.V., Afanasiev V.V., Barantsevich E.R., et al. Pyrimidine nucleotides in pain management. Consensus of the international group of specialists. Russian Journal of Pain. 2023; 21 (1): 78–84. https://doi.org/10.17116/pain20232101178 (In Russ.)

14. Caner B., et al. Intraperitoneal administration of CDP-choline or a combination of cytidine plus choline improves nerve regeneration and functional recovery in a rat model of sciatic nerve injury. Neurol Res. 2012; 34 (3): 238–45.

15. Goldberg H., Mibielli M.A., Nunes C.P., et al. A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias. Journal of Pain Research. 2017; 10: 397–404.

16. Rachin A.P., Sharov M.N., Vygovskaya S.N., et al. Experience in the use of a complex uridinemonophosphate drug in the exacerbation of chronic nonspecifi c lower back pain. RMJ. 2017; 24: 1812–1817 (In Russ.)

17. Yakupov E.Z. Adjuvant therapy of pain syndromes: possibilities of using nucleotides. S.S. Korsakov Journal of Neurology and Psychiatry. 2019; 119 (10): 141–145. https://doi.org/10.17116/jnevro2019119101141 (In Russ.)

18. Yakupov E.Z., Troshina Y.V., Kashapova A.O., et al. The results of an open observational study on multimodal effects of the effi cacy and safety of supplement neurouridine in patients with nonspecifi c low back pain (MULTINEURO-1). Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2020; 120 (9): 53–59. https://doi.org/10.17116/jnevro202012009153 (In Russ.)

19. Yakupov E.Z., Troshina Y.V., Gainutdinova R.R., Kashapova A.O. Evaluation of the effi cacy and safety of the neuroprotective complex Neurouridin in patients with back pain. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2021; 121 (6): 46–51. https://doi.org/10.17116/jnevro202112106146 (In Russ.)

20. Инструкция по применению препарата Нейроуридин Н. URL: https://neurouridin.ru/instrucsiya-n.php (дата обращения: 12.12.2024)
21. Abbracchio M.P. The history of the Purine Club: a tribute to Prof. Geoffrey Burnstock Purinergic Signalling. 2021; 17: 127–134.

22. Заключение экспертного совета в рамках 1-го заседания Пуринергического клуба, декабрь 2023. URL: https://painrussia.ru/purineclub/sovet-ekspertov.php (дата обращения: 12.12.2024)

ADDITIONAL INFORMATION
Andrei P. Rachin, Dr. Sci. (Med.), Professor, President of the National Association of Experts in Comorbid Neurology, Moscow, Russia. E-mail:7851377@gmail.com. ORCID: https://orcid.org/0000-0003-4266-0050

Mikhail N. Sharov, Dr. Sci. (Med.), Professor, Department of Nervous Diseases, Faculty of Dentistry, Russian University of Medicine, Moscow, Russia. E-mail: 6112286@mail.ru. ORCID: https://orcid.org/0000-0001-9634-346X

Sergei A. Rachin, Executive Director, National Association of Experts in Comorbid Neurology, Moscow, Russia. E-mail: Rachin.sergei@gmail. com. ORCID: https://orcid.org/0000-0001-9771-4621

Yulia S. Prokofieva, postgraduate student of the Department of Nervous Diseases, Faculty of Dentistry, Russian University of Medicine, Moscow, Russia. E-mail: pryulek@yandex.ru. ORCID: https://orcid.org/0000-0003-4454-7174

Ruzanna R. Parsamyan, Cand. Sci. (Med.), Associate Professor of the Department of Neurology named after. K.N. Tretyakova; Senior Researcher at the Department of Basic Research in Neurocardiology, Research Institute of Cardiology, Saratov State Medical University named after V.I. Razumovsky; Head of Clinic Pain, Saratov, Russia. E-mail: kvl.prr@mail.ru. ORCID: https://orcid.org/0000-0002-6509-5958
 

Author contributions. All authors confirm the compliance of their authorship, according to international ICMJE criteria (all authors made a significant contribution to the development of the concept, research and preparation of the article, read and approved the final version before publication). Rachin S.A., Prokofieva Yu.S., Parsamyan R.R. — searched for suitable literature; Rachin A.P., Sharov M.N. — correcting the text in accordance with the basic requirements.

Funding. This study was supported by any external sources of funding.

Disclosure. The authors declare that they have competing interests.

The content is available under the Creative Commons Attribution 4.0 License.
 ©2024. Andrei P. Rachin, Mikhail N. Sharov, Sergei A. Rachin, Yulia S. Prokofieva, Ruzanna R. Parsamyan