1.NLRP3 inflammasome: a key driver of neuroinflammation and a novel therapeutic target for neuropathic pain
Zana MONTAZERI-KHOSH ; Ahmad EBRAHIMPOUR ; Mahyar HOSSEIN-ZARGARI ; Parsa TAGHIZADEH-TABRIZI ; Mohammad SAFARI-SAHLABADI ; Mohammad Hosein SHEYBANI-ARANI ; Nahid DAVOODIAN
Anesthesia and Pain Medicine 2025;20(4):341-356
Neuropathic pain represents a serious complication arising from a spectrum of disorders that precipitate lesions within the central and peripheral nervous systems. This disabling pain can persist for years, severely diminishing the quality of life of the affected individuals. The treatment options available for neuropathic pain at present have limited efficacy. Moreover, the adverse effects associated with these options restrict their application. The exact etiological mechanisms underlying the pathogenesis of neuropathic pain remain unclear. However, neuroinflammatory processes mediated by the immune system play significant roles in the initiation and progression of neuropathic pain in various models. The nucleotide-binding domain and leucine-rich repeat pyrin-containing protein-3 (NLRP3) inflammasome, a pivotal element of the innate immune system, plays an indispensable role in the pathophysiological mechanisms of central and peripheral neuropathic pain. However, the precise mechanisms facilitating its activation in disparate neuropathic pain conditions remain to be elucidated. Gaining insights into the regulatory mechanisms affecting NLRP3 inflammasome activation in diverse neuropathic pain-associated disorders will aid in developing novel therapeutic avenues. Therefore, this review summarizes the current knowledge on the role of the NLRP3 inflammasome in the pathophysiology of several neuropathic pain-related conditions, such as diabetic neuropathic pain, chemotherapy-induced neuropathic pain, peripheral nerve compression, central nervous system neuropathic pain, radiculopathy, and morphine analgesic tolerance. In addition, this review also discusses the possible use of this inflammasome as a therapeutic target to alleviate the pain-related symptoms of these diseases.
2.Spinal Surgery and Subsequent ESR and WBC Changes Pattern: A Single Center Prospective Study
Akram ZARE ; Mohammadmahdi SABAHI ; Hosein SAFARI ; Arash KIANI ; Meic H. SCHMIDT ; Mahdi ARJIPOUR
Korean Journal of Neurotrauma 2021;17(2):136-147
Objective:
Postoperative inflammation and infections are common complications of spinal surgery and have similar symptoms. However, postoperative infection may lead to a poor outcome and must be differentiated from postoperative inflammation. The objective of this study is determine the changing pattern of postoperative ESR and WBC counts, and investigate the effects of different variables.
Methods:
A total of 61 patients who underwent spinal surgery were enrolled in this prospective study. The erythrocyte sedimentation rate (ESR) and white blood cell (WBC) counts were measured the day before surgery and on 1st, 3rd, 5th, 7th, and 14th postoperative days.
Results:
WBC counts increased on the 1st postoperative day in comparison with the preoperative day (p<0.001), and they gradually decreased until the preoperative value was reached on the 14th postoperative day (p=0.14). The ESR also increased postoperatively, reaching a peak on the 5th postoperative day in comparison with the preoperative day (p<0.001) and gradually decreased thereafter. However, on the 14th postoperative day, the ESR was significantly greater than the preoperative value (p<0.001). In addition, a significant positive correlation was observed between ESR and age, duration of surgery, intraoperative blood loss, and duration of anesthesia.
Conclusion
WBC count continued to rise and was the highest on the 1st postoperative day, after which it gradually decreased and attained normal values on the 14th postoperative day, while the ESR increased on the 1st postoperative day, reached the highest level in patients with and without simultaneous instrumentation on 7th and 5th postoperative days, respectively, and gradually decreased.
3.Health-Related Quality of Life and its Associated Factors in COVID-19 Patients
Morteza ARAB-ZOZANI ; Fatemah HASHEMI ; Hossein SAFARI ; Mahmood YOUSEFI ; Hosein AMERI
Osong Public Health and Research Perspectives 2020;11(5):296-302
Objectives:
Health-related quality of life (HRQoL) is one of the most important outcome measures for patients. The purpose of this study was to evaluate HRQoL and related factors in Coronavirus disease 2019 (COVID-19) patients.
Methods:
A total of 420 COVID-19 patients who had been discharged from hospital were selected using a systematic sampling. The EuroQol 5-dimensional-5 levels (EQ-5D-5L) questionnaire along with medical records of the patients were used to gather the data. The t test and analysis of variance were employed to test the difference between mean EQ-5D-5L scores, and the BetaMix model was used to investigate factors associated with EQ-5D-5L scores.
Results:
The mean score for the patients who completed the EQ-5D-5L questionnaire (n = 409) was 0.6125. The EQ-5D-5L scores were significantly higher in males, patients with younger age , those with a low level of education, the employed, patients who worked in uncrowded workplaces, patients without diabetes, and those who were not admitted to intensive care unit. The BetaMix model showed that gender, age, education, employment status, having diabetes, heart failure, and admission to the intensive care unit were significant independent predictors of the EQ-5D-5L index values.
Conclusion
The mean score for EQ-5D-5L in COVID-19 patients was low in this study. Some of the factors, especially aging and having diabetes, should be considered in the aftercare of patients to improve their HRQoL.

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