Chemotherapy for pain: reversing inflammatory and neuropathic pain with the anticancer agent mithramycin A

4-Methylesculetin attenuates inflammatory pain via inhibition of Sp1-TRPV1 and inflammation related signaling pathways

BACKGROUND

Discovering lead compounds with anti-inflammatory and analgesic activities from natural products with minimal toxic side effects has been a long-term goal for researchers. 4-Methylesculetin (4-ME), a natural coumarin derivative, has been reported to have anti-inflammatory and antioxidant properties, but its analgesic effect has not yet been studied. This research investigates the analgesic effect and underlying mechanism of 4-ME in peripheral inflammatory pain.

METHODS

Acute or chronic inflammatory pain model was established by injecting formalin or Complete Freund's Adjuvant (CFA) into the right hindpaw of rat, respectively. The mechanical and thermal thresholds were detected by using Von Frey and thermal radiation instrument. Patch-clamp recording was performed to study the electrophysiological properties of ion channel. RT-qPCR, western blot, and immunofluorescence were used to analyze mRNA and protein expressions of relevant signaling pathway molecules.

RESULTS

Intraperitoneal injection of 4-ME could significantly alleviate mechanical and thermal hyperalgesia induced by CFA injection, as well as spontaneous pain induced by formalin injection. In the CFA-induced chronic pain model, 4-ME reduced the levels of IL-6, TNF-α, IL-1β, and inhibited ERK, NF-κB, NLRP3 pathways in dorsal root ganglia (DRG). It downregulated abnormally high expression of TRPV1 caused by CFA injection in DRG, without altering the electrophysiological properties of TRPV1 channel. Further mechanistic studies demonstrated that 4-ME regulated the expression of TRPV1 by inhibiting the transcription factor Sp1. Compared to other coumarin derivatives, 4-ME exhibited a better analgesic effect at low dosage.

CONCLUSION

Our study reveals for the first time that 4-ME could alleviate peripheral inflammatory pain by inhibiting Sp1-TRPV1 pathway, suggests 4-ME as a potential analgesic, and provides a theoretical basis for 4-ME translation into clinical application.

Selenium reduces oxaliplatin induced neuropathic pain: focus on TRPV1

Many drugs preferred for pain relief are insufficient against oxaliplatin (OX) induced neuropathic pain (OX-IN). Studies have shown that such pain mediators as the TRPV1 channel play a critical role in triggering high-sensitivity pain response in the dorsal root ganglia (DRG). TRPV1 activated by oxidative stress increases cytosolic free Ca2+ levels and leads to apoptotic cell damage. The key factors involved in the pathophysiology of OX-IN, which involves many components, are mitochondrial dysfunction and oxidative stress, both triggered by excessive Ca2+ influx across the neuronal membrane. Selenium (Se), an essential trace element, prevents the harmful effects of this oxidative stress through glutathione peroxidase. This study is based on understanding the neuroprotective role of Se, a cofactor for glutathione peroxidase, against TRPV1-mediated oxidative damage, mitochondrial dysfunction and apoptosis in OX-IN using molecular techniques such as patch clamp. The primary target in this study was DRGs as the initial station of OX-induced peripheral pain isolated in adult rats. In addition to the SN (sciatic) neurons isolated from the same animals, in vitro breast cancer cell (MCF-7) was also used to confirm the results. The study was conducted with four groups: control (5% dextrose), OX (4 mg/kg OX twice a week), Se (1.5 mg/kg Se every other day) and finally OX + Se, all of which were administered to the animals intraperitoneally for 4 weeks. The OX (50 μM for 24 h) and Se (200 nM for 2 h) were applied to MCF-7 cells in vitro. Although an excessive increase was observed in Tumour necrosis factor α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6), as well as mitochondrial oxidative stress, apoptosis and TRPV1 channel overactivations in DRG and SN neurons under OX treatment, Se suppressed these negative effects. While OX reduced glutathione peroxidase and significantly increased malondialdehyde level (LP) in DRG neurons, Se reversed this situation. In conclusion, the TRPV1-mediated efficacy of Se in suppressing OX-induced pain symptoms was demonstrated and we concluded that Se should be considered in future therapeutic approaches in the treatment of OX-IN.

Dehydroepiandrosterone ameliorates primary dysmenorrhea by suppressing the SP1/Hsp90ab1/COX-2 signaling pathway

Androgens play a protective role in alleviating chronic pain in women, including pelvic pain; however, their specific role and underlying mechanism in the treatment of primary dysmenorrhea (PD) remain unclear. In this study, clinical data revealed that women with PD exhibited reduced serum testosterone levels, which were inversely correlated with the severity of dysmenorrhea compared to healthy controls. Using a mouse model of PD, we observed significant upregulation of Hsp90ab1 and the PD markers COX-2 in the uterus. Treatment with dehydroepiandrosterone (DHEA), an androgen precursor, suppressed the uterine expression of Hsp90ab1 and COX-2, alleviating pain symptoms. Notably, pharmacological inhibition of Hsp90ab1 with geldanamycin reduced COX-2 expression by inactivating the p-p38 and p-JNK signaling pathways, and effectively mitigated PD. Further analysis identified specificity protein 1 (SP1) as a key driver of Hsp90ab1 transcription through its binding to the promoter region. Inhibition of SP1 using plicamycin reduced Hsp90ab1 expression, alleviated pain, and decreased uterine edema in the mouse model. Conversely, lentiviral overexpression of Hsp90ab1 reversed the therapeutic effects of DHEA, including nociception relief, reduction of uterine edema, and suppression of COX-2 expression. These findings suggest that androgen deficiency triggers SP1-mediated upregulation of Hsp90ab1 and COX-2, forming a critical regulatory loop that exacerbates menstrual cramps. Targeting this pathway represents a promising therapeutic strategy for managing PD.

Implications of TRPM3 and TRPM8 for sensory neuron sensitisation

Sensory neurons serve to receive and transmit a wide range of information about the conditions of the world around us as well as the external and internal state of our body. Sensitisation of these nerve cells, i.e. becoming more sensitive to stimuli or the emergence or intensification of spontaneous activity, for example in the context of inflammation or nerve injury, can lead to chronic diseases such as neuropathic pain. For many of these disorders there are only very limited treatment options and in order to find and establish new therapeutic approaches, research into the exact causes of sensitisation with the elucidation of the underlying mechanisms and the identification of the molecular components is therefore essential. These components include plasma membrane receptors and ion channels that are involved in signal reception and transmission. Members of the transient receptor potential (TRP) channel family are also expressed in sensory neurons and some of them play a crucial role in temperature perception. This review article focuses on the heat-sensitive TRPM3 and the cold-sensitive TRPM8 (and TRPA1) channels and their importance in sensitisation of dorsal root ganglion sensory neurons is discussed based on studies related to inflammation and injury- as well as chemotherapy-induced neuropathy.

Dorsal root ganglion inflammation by oxaliplatin toxicity: DPEP1 as possible target for peripheral neuropathy prevention

BACKGROUND

Peripheral neuropathy (PN) constitutes a dose-limiting side effect of oxaliplatin chemotherapy that often compromises the efficacy of antineoplastic treatments. Sensory neurons damage in dorsal root ganglia (DRG) are the cellular substrate of PN complex molecular origin. Dehydropeptidase-1 (DPEP1) inhibitors have shown to avoid platin-induced nephrotoxicity without compromising its anticancer efficiency. The objective of this study was to describe DPEP1 expression in rat DRG in health and in early stages of oxaliplatin toxicity. To this end, we produced and characterized anti-DPEP1 polyclonal antibodies and used them to define the expression, and cellular and subcellular localization of DPEP1 by immunohistochemical confocal microscopy studies in healthy controls and short term (six days) oxaliplatin treated rats.

RESULTS

DPEP1 is expressed mostly in neurons and in glia, and to a lesser extent in endothelial cells. Rats undergoing oxaliplatin treatment developed allodynia. TNF-𝛼 expression in DRG revealed a pattern of focal and at different intensity levels of neural cell inflammatory damage, accompanied by slight variations in DPEP1 expression in endothelial cells and in nuclei of neurons.

CONCLUSIONS

DPEP1 is expressed in neurons, glia and endothelial cells of DRG. Oxaliplatin caused allodynia in rats and increased TNF-α expression in DRG neurons. The expression of DPEP1 in neurons and other cells of DRG suggest this protein as a novel strategic molecular target in the prevention of oxaliplatin-induced acute neurotoxicity.

Epigenomic landscape of the human dorsal root ganglion: sex differences and transcriptional regulation of nociceptive genes

Gene expression is influenced by chromatin architecture via controlled access of regulatory factors to DNA. To better understand gene regulation in the human dorsal root ganglion (hDRG) we used bulk and spatial transposase-accessible chromatin technology followed by sequencing (ATAC-seq). Using bulk ATAC-seq, we detected that in females diverse differentially accessible chromatin regions (DARs) mapped to the X chromosome and in males to autosomal genes. EGR1/3 and SP1/4 transcription factor binding motifs were abundant within DARs in females, and JUN, FOS and other AP-1 factors in males. To dissect the open chromatin profile in hDRG neurons, we used spatial ATAC-seq. The neuron cluster showed higher chromatin accessibility in GABAergic, glutamatergic, and interferon-related genes in females, and in Ca2+- signaling-related genes in males. Sex differences in transcription factor binding sites in neuron-proximal barcodes were consistent with the trends observed in bulk ATAC-seq data. We validated that EGR1 expression is biased to female hDRG compared to male. Strikingly, XIST, the long-noncoding RNA responsible for X inactivation, hybridization signal was found to be highly dispersed in the female neuronal but not non-neuronal nuclei suggesting weak X inactivation in female hDRG neurons. Our findings point to baseline epigenomic sex differences in the hDRG that likely underlie divergent transcriptional responses that determine mechanistic sex differences in pain.