PHYSIOLOGICAL REGULATING MEDICINE 1/2008

Physiological Regulating Medicine (PRM) isthe latest integration between Conventio-nal Medicine and Homeopathic Medicine.PRM integrates classic Homeopathy withaninnovative therapeutic concept - the resto-ration of physiological conditions throughmolecules such as hormones, neuropepti-des, interleukins and growth factors in thehomeopathic dilution corresponding to thesame physiological concentration that isfound in the biological environment. Themethod includes the most current knowled-ge on Homeopathy, Homotoxicology, thePsycho-Neuro-Endocrine-Immune (PNEI)axis, and nutrition.Four types of pain can be considered. Thephysiological type is related to the preser-vationof life. Thenociceptive typepresentsas pain of an inflammatory origin, in whichCOX-2 is particularly stimulated by the pro-inflammatory interleukin IL-1ß; this type ofpain is therefore modulated by the levels ofpro-inflammatory vs anti-inflammatory in-terleukins. Neuropathic pain is the result ofdamage, compression, ordysfunctionof theperipheral nerves, or of the Central NervousSystem(CNS); it is a disturbanceof theCNSneurotransmitters. Theaffected neuronsge-nerate false informations that are interpre-ted in the brain as pain. Mixed pain is rela-ted to the pain associated with cancer; inthis case several factors are involved simul-taneously.

- PRM inPainControlTherapy offers a com-plete method with excellent therapeutic re-sults, with formulations that can be injec-ted in acupuncture points for the control ofinflammation-related pain (nociceptive) aswell as neuropathic and mixed pain.

PAIN, INFLAMMA-TION-RELATED PAIN, PHYSIOLOGICALREGULATING MEDICINE, ACUPUNTUREPOINTS, HOMEOPATHY, INTERLEUKINS,PNEI

SUMMARY

KEY WORDS

Urgellés-Lorié L.A.

39

Physiological Regulating Medicine(PRM) is the most recent integration

between Conventional Medicine andHomeopathic Medicine.PRM integrates classic Homeopathyand Homotoxicology with a new thera-peutic concept - the restoration of phys-iological conditions through moleculessuch as hormones, neuropeptides, inter-leukins and growth factors in the home-opathic preparation and dilution corre-sponding to the same physiologicalconcentration that is found in the bio-logical environment.The method includes the most currentknowledge on Homeopathy, Homotoxi-cology, the Psycho-Neuro-Endocrine-Immune (PNEI) axis, and nutrition.

With the phylogenetic development,the macrophage is the first cell that isable to produce neurotransmitters, neu-ropeptides, and hormones, in additionto cytokines; on the other hand, neu-rons can produce neurotransmitters,neuropeptides, cytokines, and growthfactors and express receptors for thesemolecules (1).

There is also a clear anatomical andfunctional integration of these systems,which in fact constitute a macrosystem.Psychoneuroendocrine immunology isa new field of investigation character-ized by very rapid development andincreasing interest among researchgroups, doctors, and medical schools(Seminar at Loyola University Chicago -Stritch School of Medicine, November2007; Symposium at University ofMiami - Miller School of Medicine, June

2008), since numerous molecular phe-nomena have been discovered thatexplain many physiological and patho-logical states whose mechanisms wereunknown (1, 2).It can therefore be understood that theCNS is connected to the neurotransmit-ters, neuropeptides, hormones, and ofcourse the cytokines that together formthe Psycho-Neuro-Endocrine-Immune(PNEI) axis.

PRM has an innovative framework: itcombines the essential experiences ofHomeopathic Medicine with those ofAllopathic Medicine, integrating ele-ments such as Acupuncture andMesotherapy (among others) with mod-ern Physiology, thus achieving a superi-or therapeutic effect.

� For this reason, the results ofAcupuncture in the treatment of paincan be improved when these aspectsare used in combination.

On the other hand, pain and sufferingare two sides of the same coin.When a person is affected by an injury,he/she experiences an unpleasant feel-ing that is a reflection of individual psy-chophysical and environmental factors.The duration of the pain is a very impor-tant factor in the evaluation of psy-chophysical effects: acute pain has arapid onset and is generally associatedwith defined causes. However, if thepain doesn’t comply with the normal orhoped evolution of an acute illness,or the reasonable time period for thehealing of an injury, it then becomes

NOCICEPTIVE PAINVS NEUROPATHIC PAIN– A NEW CLASSIFICATION FOR PAIN CONTROL

THERAPEUTICS

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chronic. Chronic pain – on the contrary– causes the patient’s physical and psy-chological destruction and almostalways accompanies him/her untildeath.

Four categories of pain can be identified(3):

1. physiological2. nociceptive or inflammation-related3. neuropathic4. mixed.

� PHYSIOLOGICAL PAIN

At the physiological level, pain is acuteand it is very important for the preserva-tion of a person’s life. While the loss ofother sensations (vision, hearing) can becompensated for, insensitivity to painwould expose both men and animals tomortal dangers.

� NOCICEPTIVE ORINFLAMMATION-RELATED PAIN

At the nociceptive level, it occurs asperipheral pain that can be somatic orvisceral; it is associated with inflamma-tion.

One strategy for pain relief is aimed tothe periphery level, at the nociceptors,by using drugs that can inhibit the syn-

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PHYSIOLOGICAL REGULATING MEDICINE 1/2008

thesis of pro-inflammatory and proal-gesic prostaglandins. In this respect,non-steroidal anti-inflammatory drugs(NSAIDs) act as the front-line medicinesfor the control of mild to moderateinflammation-related pain, but the sideeffects are often particularly strong.Inflammation is a physiological processin response to a tissue damage.The cellular injury causes the release ofphospholipids (PL) from the cell mem-brane that are transformed into arachi-donic acid (AA) through the action ofA2 phospholipases. AA in the presenceof the cyclooxygenase enzyme (COX)generates prostaglandins (PGs); these inturn are responsible for vasodilatation,increased blood flow, inflammatoryexudates and the sensitization of nerveendings (nociceptors) (FIG. 1), causingthe sensation of pain and other signs ofinflammation such as heat, redness, andswelling involving a functional limita-tion. Cytoprotective PGs participate inthe protection of the gastrointestinalmucosa by inhibiting acid secretion andincreasing the secretion of mucus andbicarbonate, mechanisms responsiblefor keeping the mucosa intact and pre-serving the glomerular filtration rate.

In 1971, Vane found the mechanism ofaction of non-steroidal anti-inflammato-ry drugs (NSAIDs) through the inhibi-tion of COX, whose substrate is AA.In 1972, Lichtemberger et Al. discov-

ered the existence of two isoforms of theCOX enzyme (COX1 and COX2) (4, 5).

Most cells in the body contain COX-1(constitutive) which is expressed in theconstituent form; on the other hand,inflamed tissues express COX-2(inducible) in response to the presenceof pro-inflammatory interleukins.These observations have lead to thehypothesis that COX-2 selectiveinhibitory NSAIDs can have an anti-inflammatory analgesic effect withfewer side effects and less interferencewith COX-1. As a consequence, thegastrointestinal tract, kidney, andplatelet function show a lower inci-dence of typical NSAIDs-relatedinjuries, while the inhibition of COX-2is expressed by a lower production ofPGs in inflamed tissues, thus mediatingthe desired therapeutic effects.This concept was the starting point forresearch in selective COX-2 inhibitors(6, 7).

COX-1(constitutive)

Present

COX-2(inducible)

Not found under physiological

conditions

Isoenzymes

Majority of tissuesMEDIATORS OF PAIN(peripheral)

CYTOKINESENDOTOXINS

PROSTAGLANDINS

Physiological stimulus Inflammatory stimulusCellular membrane

Pain

Inflammation

Arachidonic acidActivation Activation

Protection of thegastric mucosa

HeatRednessSwelling

Stomach Nerve endings Nerve endings Blood capillaries

ANTI-INFLAMMATORY IL

PRO-INFLAMMATORY IL

β-ENDORPHINS

GLUTAMATE

FIG. 3

FIG. 2

FIG. 1

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PHYSIOLOGICAL REGULATING MEDICINE 1/2008

� INNOVATIVE FORMULATIONSFOR PAIN CONTROL

Based on this scientific knowledge, teninjectable medicines for Pain Control*have been formulated; they are pre-pared in a homeopathic form, with theaddition of new active ingredients suchas the anti-pro-inflammatory inter-leukins (Anti IL-1α, Anti IL-1ß) (FIG. 3)and beta-endorphin, in concentrationssimilar to those found in tissues.Of these formulations, nine containbeta-endorphin (all except GUNA-MUSCLE) and 8 contain anti-pro-inflammatory interleukins (Anti IL-1α,Anti IL-1ß) (all except GUNA-MUSCLEand GUNA-NEURAL), so the prepara-tions can modulate nociceptive, neuro-pathic and mixed pain without unde-sired effects. By using acupuncturepoints, a well-known method for itseffectiveness in pain relief, differentneurophysiological mechanisms arebrought into play (17, 18, 19) (FIG. 4).

Finally, if recommendations onacupuncture points are considered inthe treatment of pain, and if the bestindicated Guna Method formulation ischosen, we are provided with a thera-peutic technique that gives excellentresults by exploiting different physiolog-ical mechanisms for the modulation ofpain. The recommendations for treat-ment consist of intradermal, or subcu-taneous injections of 0.5 ml into eachacupuncture point in the affected areaaccording to the technique of homeo-pathic mesotherapy (homeosiniatry)with the following advantages: accord-

ing to personal experience and that ofmany other colleagues over the last 3years, it does not have contraindica-tions, does not cause local reactions,does not cause short- or long-term sideeffects, does not interact with otherpharmaceuticals, and in fact optimizesinteractions with other PRM or homo-toxicologic pharmaceuticals, which canbe used in combination (20, 21, 22,23). For Pain Control, PRM injectableampoules can be administrated alsointra-muscular or orally (indication ofthe Bystander Reaction).

- It is a personal wish that this articlecan be useful not only in identifying theorigin of pain, but in controlling it witha new, innovative, and very effectivemethod. �

References

1. Trillo R.C. et Al. – Dolor y Sistema Inmune. Bo-letín del Dolor – ASPED, Perù, 2001.

2. Bastida D.A. – Neuroendocrine-immunologicalconnections. Rev. Mex. Patol. Clin. 2002;49(2):85-91.

3. Urgellés Lorié, L.A. – Dolor Nociceptivo vs.Neu-ropático. La Medicina Fisiolóica de Regulación:una nueva alternativa.Material de Conferenciasin Puerto Rico, Ecuador, Mexico, 2008.

4. Vane, J.R. – Inhibition of prostaglandin synthe-sis as a mechanism of action for aspirin-likedrugs. Nature New Biol. 231.1971; 232-235.

5. Lichtenberger, L.M., Vane J.R. et Al. – Selectiv-ity of non-steroidal anti-inflammatory drugs asinhibitor of constitutive and inducible cyclooxi-genase. Pro. Natl. Acad. Sci. 1994:90; 11693-11697.

6. Donnelly M.T., Hawkey C.J. – Review article:COX-II inhibitor – a new generation of saferNSAIDs? Aliment Pharmacol Ther, 1997:11;227-236.

7. Urgellés Lorié L.A., L.F. Cifuentes – Celebrex(celecoxib). Analgesico del Milenio. J. de Clinicaen Odontologíá. 17(2) 2002; 105-109.

8. Samad T.A. et Al. – Interleukin-1 beta mediatedinduction of COX-2 in CNS contributes to in-flammatory pain hypersensitivity. Nature. 2001;410: 471-475.

� NEUROPATHIC PAIN

Neuropathic pain is an intense, centraloriginated pain, and is the consequenceof damage, compression, or dysfunctionof the peripheral nerves or of the CNS;it is a disturbance of the neurotransmit-ters in the CNS. The affected neuronsgenerate false messages that are inter-preted as pain in the brain.

It can be caused by:diabetic neuropathy; infection: herpeszoster injury to the CNS or compressionof a peripheral nerve: ischialgia; multi-ple sclerosis; surgical damage; phantomlimb pain.

Treatment is oriented toward the use ofpregabalin, gabapentin, amitriptylineand other new drugs, with the aim ofmodulating pain, especially if associat-ed with diabetic neuropathy andfibromyalgia (10, 11). In these cases,possible strong side effects must betaken into account, contrary to themedicines of Physiological RegulatingMedicine, in which such a risk does notexist.

Ultimately, the sensation of nociceptivepain is proportional to the intensity ofthe stimulus, while in neuropathic pain,a small stimulus can provoke a pain ofhigher intensity.

This type of pain is largely modulatedby levels of glutamate, the most excita-tory neurotransmitter, and by beta-endorphins with a strong analgesiceffect (FIG. 2).

� MIXED PAIN

Various factors are included in thisgroup simultaneously; the most indica-tive example is the pain associated withcancer, which is difficult to control.The use of analgesics alone or in com-bination with opiates has been pro-posed in its treatment (12, 13, 14, 15, 16).In this case, Physiological RegulatingMedicine can also be useful; formula-tions that contain beta-endorphin, apotent endogenous analgesic present inphysiological concentrations, avoid theside effects of other procedures on thesepatients.

Beta-endorphins

“Gate Theory” of Melzack and Wall

Frequency of stimulation

Others

ACUPUNCTURE MECHANISMS

FIG. 4

* Guna-Neck, Guna-Thoracic, Guna-Lumbar, Guna-Shoulder, Guna-Hip, Guna-Handfoot, Guna-Ischial,Guna-Polyarthritis, Guna-Muscle, Guna-Neural,each 2,0 ml (Guna S.p.a. - Milan, Italy).

Urgelles:Art. Colombo 30-10-2008 9:22 Pagina 41

9. Bianchi I. – Th1/Th2 balance diluted and poten-tized Cytokines: the role of Physiological Regu-lating Medicine in immunoregulation. LoyolaUniversity Chicago. Nov. 2007.

10. Kuritzky L., Saraj G. – Current treatments in themanagement of diabetic peripheral neuropaticpain.Pain Medicine News, Nov.5(6).2007:11-20.

11. Gupta K. – Prevalence, diagnosis and manage-ment of Fibromialgia.Medicine News, Nov. 5(6).2007;32-36.

12. Ventafridda V. et Al. – A validation study of theWHO method for Cancer Pain Relief. Cancer,59, 1987;851-856.

13. Ventafridda V. – Continuing care: a major issuein cancer pain management. Pain, 36, 1989;137-143.

14. Urgellés Lorié, L.A. – La Clínica del dolor en on-cología: Un objetivo inmediato.Rev.Cub.Oncol.5 (1-2) 51-64, 1997.

15. Urgellés Lorié L.A. – Dolor y Cáncer. Rev. Se-lecta Médica. Bogotá Colombia. 9(3) 1998; 25-26.

16. Russell K.P. – Three-step analgesic Ladder formanagement of cancer pain. Medicine News,Nov. 5(6). 2007; 81-91.

17. Urgellés Lorié, L.A. – Acupuntura en lasacrolumbalgia.Rev.Hos.Psq. 24(3) 1983; 429.

18. Meizack K., Wall P. – Pain mechanism: a newtheory. Science 150:971-9, 1965.

19. Urgellés Lorié L.A. – Acupuntura para el mane-jo del dolor. Ed. AMOLCA, Venezuela, 2002.

20. Milani L. – Homeomesotherapy for pain man-agement in primary chronic coxarthrosis with ahomeopathic injectable formulation.PRM, 2006;9-18.

21. Milani L. – Inflammation and Physiological Reg-ulating Medicine: New ideas and innovativemedical products. PRM, 1.2007; 19-27.

22. Milani L. – Innovative Treatment concepts inTraumatology, Fibromyalgia, Pain and SportMedicine with PRM. Syllabus. 3rd US NationalTour. November 2007.

23. Milani, L. – Pain Management. Guna InjectableAmpoules. Guna S.p.a., Italy, 2007 (seewww.gunainc.com).

PHYSIOLOGICAL REGULATING MEDICINE 1/2008

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Author’s address

Dr. Luis Urgellés-Lorié, MD, PhD- Specilist in Neurology- Specialist in Neurophysiologydrluisurgelles@ad.com

30 ml / 1.0 fl. oz. bottle

Guna-Arthro+ Guna-Trauma+ Guna-Polyarthritis

Guna-Arthro+ Guna-Flam+ Guna-PolyarthritisGuna-Arthro+ Guna-Matrix+ Guna-Polyarthritis

Guna-Arthro+ Osteobios+ Guna-Polyarthritis

Arthrosis of the small and big joints with clear signs of phlogosis (calor, dolor, rubor, tumor, functio laesa)

Inflammatory diseases of the joints

Arthrosis and patients alreadytreated with corticosteroids

Osteoporosis and osteo-chondrosis

Endocrine arthropathies

PACKAGE SIZE

MOST COMMON COMBINATIONS

Guna-Arthro+ Guna-Fem/Male+ Guna-Polyarthritis

Active ingredients:a-Ketoglutaricum acidum 3X HPUS, a-Lipoicumacidum 3X HPUS, Artery 6X, Ascorbic acid 2X, Barium oxalsuccinate 3X, Bryonia alba 6X, 8X, 12X HPUS, Calcitonin 6X, Cartilago 6X HPUS,Chlorinum 6X HPUS, Cimicifuga racemosa 6X, 8X, 12X HPUS, Colchicum autumnale 6X, 8X, 12X HPUS, Conjunctiva tissue 6X, Dulcamara 6X, 8X, 12X HPUS, Fibroblast growth factor 4C, Funiculus umbilicalis 6X HPUS, Glandula suprarenalis 6X HPUS, Nadidum 3X HPUS,Natrum oxalaceticum 3X HPUS, Nervous growth factor 4C, Parathyroid gland 6X,Placenta totalis 6X HPUS, Quinhydrone 3X, Rhus tox 6X,12X HPUS, Strontium carbonicum 6X, 8X, 12X HPUS, Sulphur 3X HPUS, Vein 6X,

Inactive ingredient:Ethyl alcohol 30%.

For the temporary relief of symptoms due to: Arthrosis, Arthritis, Muscle pain, Articular discomfort.

Adults and Children 6 years and over: 10 drops 3 times a day in a little water. Take 15 minutes beforemeals.

USES

DIRECTION

INGREDIENTS

PHYSIOLOGICAL REGULATING MEDICINEGUNA-ARTHRO

Homeopathic medicine

Urgelles:Art. Colombo 30-10-2008 9:22 Pagina 42