1
|
Smith AE, Muralidharan A, Smith MT. Prostate cancer induced bone pain: pathobiology, current treatments and pain responses from recent clinical trials. Discov Oncol 2022; 13:108. [PMID: 36258057 PMCID: PMC9579264 DOI: 10.1007/s12672-022-00569-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Metastatic spread of prostate cancer to the skeleton may result in debilitating bone pain. In this review, we address mechanisms underpinning the pathobiology of metastatic prostate cancer induced bone pain (PCIBP) that include sensitization and sprouting of primary afferent sensory nerve fibres in bone. We also review current treatments and pain responses evoked by various treatment modalities in clinical trials in this patient population. METHODS We reviewed the literature using PubMed to identify research on the pathobiology of PCIBP. Additionally, we reviewed clinical trials of various treatment modalities in patients with PCIBP with pain response outcomes published in the past 7 years. RESULTS Recent clinical trials show that radionuclides, given either alone or in combination with chemotherapy, evoked favourable pain responses in many patients and a single fraction of local external beam radiation therapy was as effective as multiple fractions. However, treatment with chemotherapy, small molecule inhibitors and/or immunotherapy agents, produced variable pain responses but pain response was the primary endpoint in only one of these trials. Additionally, there were no published trials of potentially novel analgesic agents in patients with PCIBP. CONCLUSION There is a knowledge gap for clinical trials of chemotherapy, small molecule inhibitors and/or immunotherapy in patients with PCIBP where pain response is the primary endpoint. Also, there are no novel analgesic agents on the horizon for the relief of PCIBP and this is an area of large unmet medical need that warrants concerted research attention.
Collapse
Affiliation(s)
- A. E. Smith
- St Vincent’s Hospital, Darlinghurst, Sydney, NSW Australia
| | - A. Muralidharan
- Neurobiology of Chronic Pain, The Charles Perkins Centre, Faculty of Science, The University of Sydney, Sydney, NSW 2006 Australia
| | - M. T. Smith
- Centre for Integrated Preclinical Drug Development, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, St Lucia Campus, Brisbane, QLD 4072 Australia
| |
Collapse
|
2
|
Li L, Wang J, Geng S, Liu F, Ping L, Gu X, Fan X, Yang M, Liang L, Guo W. Efficacy of adenosylmethionine combined with Si Mo Tang in treatment of neonatal jaundice. Am J Transl Res 2022; 14:3926-3935. [PMID: 35836853 PMCID: PMC9274584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the efficacy of S-adenosylmethionine (SAM-e) combined with Si Mo Tang in the treatment of neonatal jaundice and its effect on liver function, cardiac enzymes, immune function, serum transferrin (TRF) and C-reactive protein (CRP) levels. METHODS The clinical data of 149 infants with neonatal jaundice were collected retrospectively. The infants were grouped according to the treatment methods. All neonates were treated with blue light phototherapy. Besides, group A was treated with SAM-e, group B was treated with Si Mo Tang, and group C was treated with SAM-e combined with Si Mo Tang. The treatment efficacy, serum bilirubin level, neonatal behavioral neurological assessment (NBNA) score, liver function, cardiac enzymes, immune function, serum TRF and CRP level were compared among the three groups before and after treatment. RESULTS The total effective rate of treatment in group C was 96.00%, which was higher than group A (73.47%) and group B (78.00%) (P < 0.05), but no significant difference was observed between groups A and B (P > 0.05). Compared with groups A and B, group C had higher NBNA scores, lower serum bilirubin levels, and lower serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), creatine kinase (CK) and creatine kinase-MB (CK-MB) levels (all P < 0.05); however, there was no statistical differences in NBNA scores, serum bilirubin levels, serum AST and ALT, LDH, CK and CK-MB levels between group A and group B (all P > 0.05). Compared with groups A and B, group C showed higher CD4+, CD4+/CD8+, TRF levels and lower serum CRP levels (P < 0.05), while there was no statistical differences in CD4+, CD4+/CD8+, CD8+, TRF levels and serum CRP levels between group A and group B (all P > 0.05). CONCLUSION SAM-e combined with Si Mo Tang promoted the regression of jaundice, improved liver function, neurodevelopmental conditions and the myocardial enzyme spectrum, reduced the level of inflammation, and improved the immunity of newborns with neonatal jaundice.
Collapse
Affiliation(s)
- Ling Li
- Department of Neonatology, Xingtai People’s HospitalXingtai, Hebei, China
| | - Jingqun Wang
- Department of Neonatology, Xingtai People’s HospitalXingtai, Hebei, China
| | - Shuxia Geng
- Department of Neonatology, Xingtai People’s HospitalXingtai, Hebei, China
| | - Fang Liu
- Department of Neonatology, Bethune International Peace HospitalShijiazhuang, Hebei, China
| | - Lili Ping
- Department of Neonatology, Handan Central HospitalHandan, Hebei, China
| | - Xiaohong Gu
- Department of Neonatology, Zhangjiakou Maternal and Child Health Care HospitalZhangjiakou, Hebei, China
| | - Xueai Fan
- Department of Neonatology, Xingtai Third HospitalXingtai, Hebei, China
| | - Mei Yang
- Department of Neonatology, Baoding First Central HospitalBaoding, Hebei, China
| | - Lixia Liang
- Department of Neonatology, Hengshui Harrison International Peace HospitalHengshui, Hebei, China
| | - Wei Guo
- Department of Neonatology, Xingtai People’s HospitalXingtai, Hebei, China
| |
Collapse
|
3
|
Pineda-Farias JB, Saloman JL, Scheff NN. Animal Models of Cancer-Related Pain: Current Perspectives in Translation. Front Pharmacol 2021; 11:610894. [PMID: 33381048 PMCID: PMC7768910 DOI: 10.3389/fphar.2020.610894] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 10/30/2020] [Indexed: 01/15/2023] Open
Abstract
The incidence of pain in cancer patients during diagnosis and treatment is exceedingly high. Although advances in cancer detection and therapy have improved patient prognosis, cancer and its treatment-associated pain have gained clinical prominence. The biological mechanisms involved in cancer-related pain are multifactorial; different processes for pain may be responsible depending on the type and anatomic location of cancer. Animal models of cancer-related pain have provided mechanistic insights into the development and process of pain under a dynamic molecular environment. However, while cancer-evoked nociceptive responses in animals reflect some of the patients’ symptoms, the current models have failed to address the complexity of interactions within the natural disease state. Although there has been a recent convergence of the investigation of carcinogenesis and pain neurobiology, identification of new targets for novel therapies to treat cancer-related pain requires standardization of methodologies within the cancer pain field as well as across disciplines. Limited success of translation from preclinical studies to the clinic may be due to our poor understanding of the crosstalk between cancer cells and their microenvironment (e.g., sensory neurons, infiltrating immune cells, stromal cells etc.). This relatively new line of inquiry also highlights the broader limitations in translatability and interpretation of basic cancer pain research. The goal of this review is to summarize recent findings in cancer pain based on preclinical animal models, discuss the translational benefit of these discoveries, and propose considerations for future translational models of cancer pain.
Collapse
Affiliation(s)
- Jorge B Pineda-Farias
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Jami L Saloman
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Nicole N Scheff
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.,Hillman Cancer Center, University of Pittsburgh Medicine Center, Pittsburgh, PA, United States
| |
Collapse
|
4
|
de Clauser L, Luiz AP, Santana-Varela S, Wood JN, Sikandar S. Sensitization of Cutaneous Primary Afferents in Bone Cancer Revealed by In Vivo Calcium Imaging. Cancers (Basel) 2020; 12:cancers12123491. [PMID: 33255209 PMCID: PMC7760605 DOI: 10.3390/cancers12123491] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Cancer-induced bone pain severely impairs the quality of life of cancer patients, many of whom suffer from inadequate pain relief. The development of new analgesic therapies depends on the identification of the cells and mechanisms involved in cancer-induced bone pain. Bone marrow innervating sensory neurons have been proposed to contribute to this debilitating disease, but their role remains unexplored. Here we used in vivo calcium imaging to determine the functional role of bone innervating and skin innervating neurons in contributing to pain at an advanced stage of bone cancer. Our results indicate increased excitability of skin innervating neurons, while those innervating bone are unaffected. Our data suggests skin-innervating neurons become hyperexcitable in cancer-induced bone pain and are a potential target for pain relief. Abstract Cancer-induced bone pain (CIBP) is a complex condition, comprising components of inflammatory and neuropathic processes, but changes in the physiological response profiles of bone-innervating and cutaneous afferents remain poorly understood. We used a combination of retrograde labelling and in vivo calcium imaging of bone marrow-innervating dorsal root ganglia (DRG) neurons to determine the contribution of these cells in the maintenance of CIBP. We found a majority of femoral bone afferent cell bodies in L3 dorsal root ganglia (DRG) that also express the sodium channel subtype Nav1.8—a marker of nociceptive neurons—and lack expression of parvalbumin—a marker for proprioceptive primary afferents. Surprisingly, the response properties of bone marrow afferents to both increased intraosseous pressure and acid were unchanged by the presence of cancer. On the other hand, we found increased excitability and polymodality of cutaneous afferents innervating the ipsilateral paw in cancer bearing animals, as well as a behavioural phenotype that suggests changes at the level of the DRG contribute to secondary hypersensitivity. This study demonstrates that cutaneous afferents at distant sites from the tumour bearing tissue contribute to mechanical hypersensitivity, highlighting these cells as targets for analgesia.
Collapse
Affiliation(s)
- Larissa de Clauser
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London WC1E 6BT, UK; (L.d.C.); (A.P.L.); (S.S.-V.); (J.N.W.)
- Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE1 1UL, UK
| | - Ana P. Luiz
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London WC1E 6BT, UK; (L.d.C.); (A.P.L.); (S.S.-V.); (J.N.W.)
| | - Sonia Santana-Varela
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London WC1E 6BT, UK; (L.d.C.); (A.P.L.); (S.S.-V.); (J.N.W.)
| | - John N. Wood
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London WC1E 6BT, UK; (L.d.C.); (A.P.L.); (S.S.-V.); (J.N.W.)
| | - Shafaq Sikandar
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London WC1E 6BT, UK; (L.d.C.); (A.P.L.); (S.S.-V.); (J.N.W.)
- William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London EC1M 6BQ, UK
- Correspondence:
| |
Collapse
|
5
|
Vascular Endothelial Growth Factor A Signaling Promotes Spinal Central Sensitization and Pain-related Behaviors in Female Rats with Bone Cancer. Anesthesiology 2019; 131:1125-1147. [DOI: 10.1097/aln.0000000000002916] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Abstract
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
Background
Cancer pain is a pervasive clinical symptom impairing life quality. Vascular endothelial growth factor A has been well studied in tumor angiogenesis and is recognized as a therapeutic target for anti-cancer treatment. This study tested the hypothesis that vascular endothelial growth factor A and vascular endothelial growth factor receptor 2 contribute to bone cancer pain regulation associated with spinal central sensitization.
Methods
This study was performed on female rats using a metastatic breast cancer bone pain model. Nociceptive behaviors were evaluated by mechanical allodynia, thermal hyperalgesia, spontaneous pain, and CatWalk gait analysis. Expression levels were measured by real-time quantitative polymerase chain reaction, western blot, and immunofluorescence analysis. Excitatory synaptic transmission was detected by whole-cell patch-clamp recordings. The primary outcome was the effect of pharmacologic intervention of spinal vascular endothelial growth factor A/vascular endothelial growth factor receptor 2–signaling on bone cancer pain behaviors.
Results
The mRNA and protein expression of vascular endothelial growth factor A and vascular endothelial growth factor receptor 2 were upregulated in tumor-bearing rats. Spinal blocking vascular endothelial growth factor A or vascular endothelial growth factor receptor 2 significantly attenuated tumor-induced mechanical allodynia (mean ± SD: vascular endothelial growth factor A, 7.6 ± 2.6 g vs. 5.3 ± 3.3 g; vascular endothelial growth factor receptor 2, 7.8 ± 3.0 g vs. 5.2 ± 3.4 g; n = 6; P < 0.0001) and thermal hyperalgesia (mean ± SD: vascular endothelial growth factor A, 9.0 ± 2.4 s vs. 7.4 ± 2.7 s; vascular endothelial growth factor receptor 2, 9.3 ± 2.5 s vs. 7.5 ± 3.1 s; n = 6; P < 0.0001), as well as spontaneous pain and abnormal gaits. Exogenous vascular endothelial growth factor A enhanced excitatory synaptic transmission in a vascular endothelial growth factor receptor 2–dependent manner, and spinal injection of exogenous vascular endothelial growth factor A was sufficient to cause pain hypersensitivity via vascular endothelial growth factor receptor 2–mediated activation of protein kinase C and Src family kinase in naïve rats. Moreover, spinal blocking vascular endothelial growth factor A/vascular endothelial growth factor receptor 2 pathways suppressed protein kinase C-mediated N-methyl-d-aspartate receptor activation and Src family kinase-mediated proinflammatory cytokine production.
Conclusions
Vascular endothelial growth factor A/vascular endothelial growth factor receptor 2 contributes to central sensitization and bone cancer pain via activation of neuronal protein kinase C and microglial Src family kinase pathways in the spinal cord.
Collapse
|
6
|
Almanza A, Segura-Chama P, León-Olea M, Luis E, Garduño-Gutiérrez R, Mercado-Reyes J, Simón-Arceo K, Coffeen U, Hernández-Cruz A, Pellicer F, Mercado F. Cellular Mechanism for Specific Mechanical Antinociception by D2-like Receptor at the Spinal Cord Level. Neuroscience 2019; 417:81-94. [DOI: 10.1016/j.neuroscience.2019.08.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 01/31/2023]
|
7
|
Negus SS. Core Outcome Measures in Preclinical Assessment of Candidate Analgesics. Pharmacol Rev 2019; 71:225-266. [PMID: 30898855 PMCID: PMC6448246 DOI: 10.1124/pr.118.017210] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
All preclinical procedures for analgesic drug discovery involve two components: 1) a “pain stimulus” (the principal independent variable), which is delivered to an experimental subject with the intention of producing a pain state; and 2) a “pain behavior” (the principal dependent variable), which is measured as evidence of that pain state. Candidate analgesics are then evaluated for their effectiveness to reduce the pain behavior, and results are used to prioritize drugs for advancement to clinical testing. This review describes a taxonomy of preclinical procedures organized into an “antinociception matrix” by reference to their types of pain stimulus (noxious, inflammatory, neuropathic, disease related) and pain behavior (unconditioned, classically conditioned, operant conditioned). Particular emphasis is devoted to pain behaviors and the behavioral principals that govern their expression, pharmacological modulation, and preclinical-to-clinical translation. Strengths and weaknesses are compared and contrasted for procedures using each type of behavioral outcome measure, and the following four recommendations are offered to promote strategic use of these procedures for preclinical-to-clinical analgesic drug testing. First, attend to the degree of homology between preclinical and clinical outcome measures, and use preclinical procedures with behavioral outcome measures homologous to clinically relevant outcomes in humans. Second, use combinations of preclinical procedures with complementary strengths and weaknesses to optimize both sensitivity and selectivity of preclinical testing. Third, take advantage of failed clinical translation to identify drugs that can be back-translated preclinically as active negative controls. Finally, increase precision of procedure labels by indicating both the pain stimulus and the pain behavior in naming preclinical procedures.
Collapse
Affiliation(s)
- S Stevens Negus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia
| |
Collapse
|
8
|
Tappe-Theodor A, King T, Morgan MM. Pros and Cons of Clinically Relevant Methods to Assess Pain in Rodents. Neurosci Biobehav Rev 2019; 100:335-343. [PMID: 30885811 DOI: 10.1016/j.neubiorev.2019.03.009] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/14/2019] [Accepted: 03/14/2019] [Indexed: 01/03/2023]
Abstract
The primary objective of preclinical pain research is to improve the treatment of pain. Decades of research using pain-evoked tests has revealed much about mechanisms but failed to deliver new treatments. Evoked pain-tests are often limited because they ignore spontaneous pain and motor or disruptive side effects confound interpretation of results. New tests have been developed to focus more closely on clinical goals such as reducing pathological pain and restoring function. The objective of this review is to describe and discuss several of these tests. We focus on: Grimace Scale, Operant Behavior, Wheel Running, Burrowing, Nesting, Home Cage Monitoring, Gait Analysis and Conditioned Place Preference/ Aversion. A brief description of each method is presented along with an analysis of the advantages and limitations. The pros and cons of each test will help researchers identify the assessment tool most appropriate to meet their particular objective to assess pain in rodents. These tests provide another tool to unravel the mechanisms underlying chronic pain and help overcome the translational gap in drug development.
Collapse
Affiliation(s)
- Anke Tappe-Theodor
- Pharmacology Institute, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.
| | - Tamara King
- Department of Biomedical Sciences, College of Osteopathic Medicine, Center for Excellence in the Neurosciences, University of New England, Biddeford, ME, USA
| | - Michael M Morgan
- Department of Psychology, Washington State University, Vancouver, WA, USA
| |
Collapse
|
9
|
Yamamoto K, Tanaka S, Fuseya S, Ishida T, Zhang H, Kawamata T, Kawamata M. Knockdown of TRPV2 channels in sensory neurons increases limb use and weight bearing but does not affect spontaneous flinching behavior in a mouse model of bone cancer. Mol Pain 2018. [PMCID: PMC6305955 DOI: 10.1177/1744806918819942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Bone cancer pain is a complex pain state involving ongoing pain and movement-related pain, which are thought to be caused by different mechanisms. Transient receptor potential vanilloid subfamily 1 (TRPV1) is involved in ongoing pain but not movement-related pain. The purpose of this study was to investigate the role of transient receptor potential vanilloid subfamily 2 (TRPV2) in bone cancer pain. Proportions of TRPV1- and TRPV2-immunoreactive neurons in lumbar dorsal root ganglia innervating the femurs of male mice were examined by using Fluoro-Gold. Mice were intrathecally injected with small interfering RNA (siRNA) against TRPV2 or scrambled siRNA for three consecutive days from day 14 after sarcoma injection into the left femur. In the mice with bone cancer, the number of spontaneous flinches was quantified for assessment of ongoing pain, and limb use and weight bearing were assessed as indications of movement-related pain. Changes in TRPV2 protein levels in dorsal root ganglion were evaluated by Western blotting. We also examined the effects of intrathecal administration of siRNA against TRPV2 or scrambled siRNA on thermal and mechanical sensitivities in normal mice without tumors. The proportions of TRPV1-immunoreactive and TRPV2-immunoreactive neurons were 21% and 22% of neurons in dorsal root ganglia innervating the femur, respectively. Tumor-bearing mice exhibited an increased number of spontaneous flinches and impaired limb use and weight bearing at day 13 after sarcoma injection. TRPV2 protein level in dorsal root ganglia at day 13 was comparable to that at baseline. siRNA against TRPV2 significantly improved limb use and weight bearing but did not affect the number of spontaneous flinches compared to those in the group treated with scrambled siRNA. siRNA against TRPV2 did not affect thermal or mechanical sensitivity in normal mice. The results suggest that TRPV2 is involved in movement-related pain but not ongoing pain in mice with bone cancer.
Collapse
Affiliation(s)
- Katsumi Yamamoto
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| | - Satoshi Tanaka
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| | - Satoshi Fuseya
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| | - Takashi Ishida
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| | - Hao Zhang
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| | - Tomoyuki Kawamata
- Department of Anesthesiology, Wakayama Medical University, Wakayama City, Japan
| | - Mikito Kawamata
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Nagano, Japan
| |
Collapse
|
10
|
Horváth Á, Borbély É, Bölcskei K, Szentes N, Kiss T, Belák M, Rauch T, Glant T, Zákány R, Juhász T, Karanyicz E, Boldizsár F, Helyes Z, Botz B. Regulatory role of capsaicin-sensitive peptidergic sensory nerves in the proteoglycan-induced autoimmune arthritis model of the mouse. J Neuroinflammation 2018; 15:335. [PMID: 30509328 PMCID: PMC6276168 DOI: 10.1186/s12974-018-1364-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/08/2018] [Indexed: 12/11/2022] Open
Abstract
Objective The regulatory role of capsaicin-sensitive peptidergic sensory nerves has been shown in acute inflammation, but little is known about their involvement in T/B-cell driven autoimmune arthritis. This study integratively characterized the function of these nerve endings in the proteoglycan-induced chronic arthritis (PGIA), a translational model of rheumatoid arthritis. Methods Peptidergic afferents were defunctionalized by resiniferatoxin (RTX) pretreatment in BALB/c mice, PGIA was induced by repeated antigen challenges. Hind paw volume, arthritis severity, grasping ability and the mechanonociceptive threshold were monitored during the 17-week experiment. Myeloperoxidase activity, vascular leakage and bone turnover were evaluated by in vivo optical imaging. Bone morphology was assessed using micro-CT, the intertarsal small joints were processed for histopathological analysis. Results Following desensitization of the capsaicin-sensitive afferents, ankle edema, arthritis severity and mechanical hyperalgesia were markedly diminished. Myeloperoxidase activity was lower in the early, but increased in the late phase, whilst plasma leakage and bone turnover were not altered. Desensitized mice displayed similar bone spurs and erosions, but increased trabecular thickness of the tibia and bony ankylosis of the spine. Intertarsal cartilage thickness was not altered in the model, but desensitization increased this parameter in both the non-arthritic and arthritic groups. Conclusion This is the first integrative in vivo functional and morphological characterization of the PGIA mouse model, wherein peptidergic afferents have an important regulatory function. Their overall effect is proinflammatory by increasing acute inflammation, immune cell activity and pain. Meanwhile, their activation decreases spinal ankylosis, arthritis-induced altered trabecularity, and cartilage thickness in small joints. Electronic supplementary material The online version of this article (10.1186/s12974-018-1364-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ádám Horváth
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Szigeti u. 12, Pécs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Team and Centre for Neuroscience, University of Pécs, Pécs, Hungary.,Department of Pharmacology and Pharmacotherapy, National Brain Research Program 20017-1.2.1-NKP-2017-00002, Chronic Pain Research Group, University of Pécs Medical School, Pécs, Hungary
| | - Éva Borbély
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Szigeti u. 12, Pécs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Team and Centre for Neuroscience, University of Pécs, Pécs, Hungary.,Department of Pharmacology and Pharmacotherapy, National Brain Research Program 20017-1.2.1-NKP-2017-00002, Chronic Pain Research Group, University of Pécs Medical School, Pécs, Hungary
| | - Kata Bölcskei
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Szigeti u. 12, Pécs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Team and Centre for Neuroscience, University of Pécs, Pécs, Hungary.,Department of Pharmacology and Pharmacotherapy, National Brain Research Program 20017-1.2.1-NKP-2017-00002, Chronic Pain Research Group, University of Pécs Medical School, Pécs, Hungary
| | - Nikolett Szentes
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Szigeti u. 12, Pécs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Team and Centre for Neuroscience, University of Pécs, Pécs, Hungary.,Department of Pharmacology and Pharmacotherapy, National Brain Research Program 20017-1.2.1-NKP-2017-00002, Chronic Pain Research Group, University of Pécs Medical School, Pécs, Hungary
| | - Tamás Kiss
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Szigeti u. 12, Pécs, 7624, Hungary.,János Szentágothai Research Centre, Molecular Pharmacology Research Team and Centre for Neuroscience, University of Pécs, Pécs, Hungary.,Department of Pharmacology and Pharmacotherapy, National Brain Research Program 20017-1.2.1-NKP-2017-00002, Chronic Pain Research Group, University of Pécs Medical School, Pécs, Hungary
| | - Mátyás Belák
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Szigeti u. 12, Pécs, 7624, Hungary
| | - Tibor Rauch
- Department of Orthopedic Surgery, Section of Molecular Medicine, Rush University Medical Center, Chicago, USA
| | - Tibor Glant
- Department of Orthopedic Surgery, Section of Molecular Medicine, Rush University Medical Center, Chicago, USA
| | - Róza Zákány
- Department of Anatomy, Histology, and Embryology, University of Debrecen, Debrecen, Hungary
| | - Tamás Juhász
- Department of Anatomy, Histology, and Embryology, University of Debrecen, Debrecen, Hungary
| | - Edina Karanyicz
- Department of Anatomy, Histology, and Embryology, University of Debrecen, Debrecen, Hungary
| | - Ferenc Boldizsár
- Medical School, Department of Immunology, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Szigeti u. 12, Pécs, 7624, Hungary. .,János Szentágothai Research Centre, Molecular Pharmacology Research Team and Centre for Neuroscience, University of Pécs, Pécs, Hungary. .,Department of Pharmacology and Pharmacotherapy, National Brain Research Program 20017-1.2.1-NKP-2017-00002, Chronic Pain Research Group, University of Pécs Medical School, Pécs, Hungary.
| | - Bálint Botz
- János Szentágothai Research Centre, Molecular Pharmacology Research Team and Centre for Neuroscience, University of Pécs, Pécs, Hungary.,Medical School, Department of Radiology, University of Pécs, Pécs, Hungary
| |
Collapse
|
11
|
Abstract
PURPOSE OF REVIEW The goal of this review is to provide a broad overview of the current understanding of mechanisms underlying bone and joint pain. RECENT FINDINGS Bone or joint pathology is generally accompanied by local release of pro-inflammatory cytokines, growth factors, and neurotransmitters that activate and sensitize sensory nerves resulting in an amplified pain signal. Modulation of the pain signal within the spinal cord and brain that result in net increased facilitation is proposed to contribute to the development of chronic pain. Great strides have been made in our understanding of mechanisms underlying bone and joint pain that will guide development of improved therapeutic options for these patients. Continued research is required for improved understanding of mechanistic differences driving different components of bone and/or joint pain such as movement related pain compared to persistent background pain. Advances will guide development of more individualized and comprehensive therapeutic options.
Collapse
Affiliation(s)
- Joshua Havelin
- Center for Excellence in the Neurosciences, University of New England, Biddeford, ME, 04043, USA
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, 04469, USA
| | - Tamara King
- Center for Excellence in the Neurosciences, University of New England, Biddeford, ME, 04043, USA.
- Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, 04469, USA.
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, 11 Hills Beach Rd., Biddeford, ME, 04005, USA.
| |
Collapse
|