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Johnston KJA, Cote AC, Hicks E, Johnson J, Huckins LM. Genetically Regulated Gene Expression in the Brain Associated With Chronic Pain: Relationships With Clinical Traits and Potential for Drug Repurposing. Biol Psychiatry 2024; 95:745-761. [PMID: 37678542 PMCID: PMC10924073 DOI: 10.1016/j.biopsych.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 07/20/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Chronic pain is a common, poorly understood condition. Genetic studies including genome-wide association studies have identified many relevant variants, which have yet to be translated into full understanding of chronic pain. Transcriptome-wide association studies using transcriptomic imputation methods such as S-PrediXcan can help bridge this genotype-phenotype gap. METHODS We carried out transcriptomic imputation using S-PrediXcan to identify genetically regulated gene expression associated with multisite chronic pain in 13 brain tissues and whole blood. Then, we imputed genetically regulated gene expression for over 31,000 Mount Sinai BioMe participants and performed a phenome-wide association study to investigate clinical relationships in chronic pain-associated gene expression changes. RESULTS We identified 95 experiment-wide significant gene-tissue associations (p < 7.97 × 10-7), including 36 unique genes and an additional 134 gene-tissue associations reaching within-tissue significance, including 53 additional unique genes. Of the 89 unique genes in total, 59 were novel for multisite chronic pain and 18 are established drug targets. Chronic pain genetically regulated gene expression for 10 unique genes was significantly associated with cardiac dysrhythmia, metabolic syndrome, disc disorders/dorsopathies, joint/ligament sprain, anemias, and neurologic disorder phecodes. Phenome-wide association study analyses adjusting for mean pain score showed that associations were not driven by mean pain score. CONCLUSIONS We carried out the largest transcriptomic imputation study of any chronic pain trait to date. Results highlight potential causal genes in chronic pain development and tissue and direction of effect. Several gene results were also drug targets. Phenome-wide association study results showed significant associations for phecodes including cardiac dysrhythmia and metabolic syndrome, thereby indicating potential shared mechanisms.
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Affiliation(s)
- Keira J A Johnston
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| | - Alanna C Cote
- Pamela Sklar Division of Psychiatric Genetics, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Emily Hicks
- Pamela Sklar Division of Psychiatric Genetics, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jessica Johnson
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura M Huckins
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
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Frachet S, Danigo A, Labriffe M, Bessaguet F, Quinchard B, Deny N, Baffert KA, Deluche E, Sturtz F, Demiot C, Magy L. Renin-Angiotensin-System Inhibitors for the Prevention of Chemotherapy-Induced Peripheral Neuropathy: OncoToxSRA, a Preliminary Cohort Study. J Clin Med 2022; 11:jcm11102939. [PMID: 35629066 PMCID: PMC9144468 DOI: 10.3390/jcm11102939] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent and dose-limiting adverse side effect of treatment. CIPN affects the oncological prognosis of patients, as well as their quality of life. To date, no specific pharmacological therapy has demonstrated effectiveness in preventing CIPN. Accumulating preclinical evidence suggests that renin-angiotensin system (RAS) inhibitors may have neuroprotective effects. One hundred and twenty patients were included in this observational study and were followed from the beginning of their neurotoxic chemotherapy schedule until their final assessment, at least one month after its cessation. The National Cancer Institute's common toxicity criteria 4.0 (NCI-CTC 4.0) were used to grade the severity of adverse events. Follow-ups also included electrochemical skin conductance and scales for pain, quality of life and disability. Among patients receiving a platinum-based regimen, the mean grade of sensory neuropathy (NCI-CTC 4.0) was significantly lower in the RAS inhibitor group after the end of their anticancer treatment schedule. Because of the observational design of the study, patients in the RAS inhibitor group cumulated comorbidities at risk of developing CIPN. Randomized controlled trials in platinum-based regimens would be worth conducting in the future to confirm the neuroprotective potential of RAS inhibitors during chemotherapy.
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Affiliation(s)
- Simon Frachet
- Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, 87000 Limoges, France;
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (A.D.); (B.Q.); (F.S.); (C.D.)
- Correspondence: ; Tel.: +33-5550-56568
| | - Aurore Danigo
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (A.D.); (B.Q.); (F.S.); (C.D.)
| | - Marc Labriffe
- Department of Pharmacology, Toxicology and Pharmacovigilance, University Hospital of Limoges, 87000 Limoges, France;
- Pharmacology & Transplantation, INSERM U1248, University of Limoges, 87025 Limoges, France
| | - Flavien Bessaguet
- INSERM 1083 CNRS UMR 6015 Mitovasc Laboratory, CarMe Team, University of Angers, 49045 Angers, France;
| | - Bianca Quinchard
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (A.D.); (B.Q.); (F.S.); (C.D.)
| | - Nicolas Deny
- Department of Medical Oncology, University Hospital of Limoges, 87000 Limoges, France; (N.D.); (K.-A.B.); (E.D.)
| | - Kim-Arthur Baffert
- Department of Medical Oncology, University Hospital of Limoges, 87000 Limoges, France; (N.D.); (K.-A.B.); (E.D.)
| | - Elise Deluche
- Department of Medical Oncology, University Hospital of Limoges, 87000 Limoges, France; (N.D.); (K.-A.B.); (E.D.)
| | - Franck Sturtz
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (A.D.); (B.Q.); (F.S.); (C.D.)
- Department of Biochemistry and Molecular Genetics, University Hospital of Limoges, 87000 Limoges, France
| | - Claire Demiot
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (A.D.); (B.Q.); (F.S.); (C.D.)
| | - Laurent Magy
- Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, 87000 Limoges, France;
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (A.D.); (B.Q.); (F.S.); (C.D.)
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Bouchenaki H, Bernard A, Bessaguet F, Frachet S, Richard L, Sturtz F, Magy L, Bourthoumieu S, Demiot C, Danigo A. Neuroprotective Effect of Ramipril Is Mediated by AT2 in a Mouse MODEL of Paclitaxel-Induced Peripheral Neuropathy. Pharmaceutics 2022; 14:pharmaceutics14040848. [PMID: 35456682 PMCID: PMC9030366 DOI: 10.3390/pharmaceutics14040848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 02/06/2023] Open
Abstract
Paclitaxel (PTX)-induced peripheral neuropathy (PIPN) induces numerous symptoms affecting patient quality of life, leading to decreased doses or even to cessation of anticancer therapy. Previous studies have reported that a widely used drug, ramipril, improves neuroprotection in several rodent models of peripheral neuropathy. The protective role of the angiotensin II type 2 receptor (AT2) in the central and peripheral nervous systems is well-established. Here, we evaluate the effects of ramipril in the prevention of PIPN and the involvement of AT2 in this effect. Paclitaxel was administered in wild type or AT2-deficient mice on alternate days for 8 days, at a cumulative dose of 8 mg/kg (2 mg/kg per injection). Ramipril, PD123319 (an AT2 antagonist), or a combination of both were administered one day before PTX administration, and daily for the next twenty days. PTX-administered mice developed mechanical allodynia and showed a loss of sensory nerve fibers. Ramipril prevented the functional and morphological alterations in PTX mice. The preventive effect of ramipril against tactile allodynia was completely absent in AT2-deficient mice and was counteracted by PD123319 administration in wild type mice. Our work highlights the potential of ramipril as a novel preventive treatment for PIPN, and points to the involvement of AT2 in the neuroprotective role of ramipril in PIPN.
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Affiliation(s)
- Hichem Bouchenaki
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
| | - Amandine Bernard
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
| | - Flavien Bessaguet
- INSERM 1083 CNRS UMR 6015 Mitovasc Laboratory, CarMe Team, University of Angers, 49045 Angers, France;
| | - Simon Frachet
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
- Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, 87000 Limoges, France
| | - Laurence Richard
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
- Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, 87000 Limoges, France
| | - Franck Sturtz
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
- Department of Biochemistry and Molecular Genetics, University Hospital of Limoges, 87000 Limoges, France
| | - Laurent Magy
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
- Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, 87000 Limoges, France
| | - Sylvie Bourthoumieu
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
- Department of Cytogenetic, Medical Genetic and Reproduction Biology, University Hospital of Limoges, 87000 Limoges, France
| | - Claire Demiot
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
- Correspondence: ; Tel.: +33-5554-35915
| | - Aurore Danigo
- UR 20218-NeurIT, Faculties of Medicine and Pharmacy, University of Limoges, 87025 Limoges, France; (H.B.); (A.B.); (S.F.); (L.R.); (F.S.); (L.M.); (S.B.); (A.D.)
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Echeverría-Rodríguez O, Godínez-Chaparro B, Gómez-García MV, Mata-Bermúdez A, Del Valle-Mondragón L, Gallardo-Ortíz IA, Villalobos-Molina R. Participation of angiotensin-(1-7) in exercise-induced analgesia in rats with neuropathic pain. Peptides 2021; 146:170670. [PMID: 34634392 DOI: 10.1016/j.peptides.2021.170670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/21/2021] [Accepted: 10/02/2021] [Indexed: 11/29/2022]
Abstract
Exercise reduces neuropathic pain in animals and humans. Recent studies indicate that training exercise favors the synthesis and action of angiotensin-(1-7) (Ang-(1-7)), a vasoactive peptide of the renin-angiotensin system (RAS), in various tissues. Interestingly, Ang-(1-7) also relieves neuropathic pain; however, it remains to be elucidated whether exercise mitigates this type of pain through Ang-(1-7). In this study, we investigated the role of Ang-(1-7) in exercise-induced analgesia in a neuropathic pain model. Male Wistar rats were ligated of lumbar spinal nerves (L5 and L6) or sham-operated. Then, they were subjected to acute (2-h) or chronic (4-week) exercise protocols. Tactile allodynia was evaluated before and after each exercise intervention. Microosmotic pumps were implanted subcutaneously for the release of Ang-(1-7) or A779 (selective Mas receptor (MasR; Ang-(1-7) receptor) antagonist). Plasma levels of Ang II and Ang-(1-7) were quantified by HPLC. Spinal nerve ligation (SNL) produced tactile allodynia. Both acute and chronic exercise reversed this neuropathic behavior. A779 treatment prevented the antiallodynic effect induced by each exercise protocol. SNL increased the plasma Ang II/Ang-(1-7) ratio; however, exercise did not modify it. Acute treatment with Ang-(1-7) via MasR mimicked exercise-mediated antinociception. Collectively, these results suggest that activation of the Ang-(1-7)/MasR axis of the RAS represents a potential novel mechanism by which exercise attenuates neuropathic pain in rats.
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Affiliation(s)
- Omar Echeverría-Rodríguez
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Ciudad de México, Mexico; Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Xochimilco, Coyoacán, Ciudad de México, Mexico.
| | - Beatriz Godínez-Chaparro
- Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Xochimilco, Coyoacán, Ciudad de México, Mexico
| | - María V Gómez-García
- Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Xochimilco, Coyoacán, Ciudad de México, Mexico
| | - Alfonso Mata-Bermúdez
- Departamento de Sistemas Biológicos, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Unidad Xochimilco, Coyoacán, Ciudad de México, Mexico
| | - Leonardo Del Valle-Mondragón
- Departamento de Farmacología, Instituto Nacional de Cardiología "Ignacio Chávez", Tlalpan, Ciudad de México, Mexico
| | - Itzell A Gallardo-Ortíz
- Unidad de Investigación en Biomedicina y Carrera de Enfermería, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, Mexico
| | - Rafael Villalobos-Molina
- Unidad de Investigación en Biomedicina y Carrera de Enfermería, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, Mexico
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Bouchenaki H, Danigo A, Bernard A, Bessaguet F, Richard L, Sturtz F, Balayssac D, Magy L, Demiot C. Ramipril Alleviates Oxaliplatin-Induced Acute Pain Syndrome in Mice. Front Pharmacol 2021; 12:712442. [PMID: 34349658 PMCID: PMC8326755 DOI: 10.3389/fphar.2021.712442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/25/2021] [Indexed: 02/05/2023] Open
Abstract
Oxaliplatin is a key drug for colorectal cancer that causes OXP-induced peripheral neuropathy, a dose-limiting effect characterized by cold and tactile hyperesthesia. The relationship between the sensory nervous system and modulation of the renin-angiotensin system has been described, focusing on pain and neurodegeneration in several animal models. We assessed the effect of the RAS modulator, ramipril, an angiotensin converting-enzyme inhibitor in a mouse model of OXP-induced acute pain syndrome. OXP was administered in Swiss mice at a cumulative dose of 15 mg/kg (3 x 5 mg/kg/3 days, i.p.). RAM was administered i.p. every day from 24 h before the first OXP injection until the end of the experiments. We evaluated OIAS development and treatment effects by sensorimotor tests, intraepidermal nerve fiber and dorsal root ganglia-neuron immunohistochemical analyses, and sciatic nerve ultrastructural analysis. OXP-treated mice showed tactile allodynia and cold hypersensitivity, without motor impairment and evidence of nerve degeneration. RAM prevented cold sensitivity and improved recovery of normal tactile sensitivity in OXP-treated mice. Our finding that RAM alleviates OXP-induced pain is a step towards evaluating its therapeutic potential in patients receiving OXP treatment.
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Affiliation(s)
- Hichem Bouchenaki
- EA 6309 - Myelin Maintenance and Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Aurore Danigo
- EA 6309 - Myelin Maintenance and Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Amandine Bernard
- EA 6309 - Myelin Maintenance and Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Flavien Bessaguet
- EA 6309 - Myelin Maintenance and Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Laurence Richard
- EA 6309 - Myelin Maintenance and Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France.,Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, Limoges, France
| | - Franck Sturtz
- EA 6309 - Myelin Maintenance and Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - David Balayssac
- Neuro-Dol, UMR1107 INSERM, University of Clermont Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Laurent Magy
- EA 6309 - Myelin Maintenance and Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France.,Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, Limoges, France
| | - Claire Demiot
- EA 6309 - Myelin Maintenance and Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
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Alkhudhayri S, Sajini R, Alharbi B, Qabbani J, Al‐Hindi Y, Fairaq A, Yousef A. Investigating the beneficial effect of aliskiren in attenuating neuropathic pain in diabetic Sprague-Dawley rats. Endocrinol Diabetes Metab 2021; 4:e00209. [PMID: 33855212 PMCID: PMC8029555 DOI: 10.1002/edm2.209] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/02/2020] [Accepted: 11/08/2020] [Indexed: 12/28/2022] Open
Abstract
Objectives Worldwide, diabetic neuropathy (DN) is a major complication of diabetes mellitus. The direct renin inhibitor aliskiren is recognized as a treatment for cardiovascular disease in diabetic patients, but little is known about its potential benefits in cases of diabetic neuropathy. Accordingly, we investigated the effects of aliskiren (ALIS) and gliclazide (GLZ) and their combination therapy on peripheral neuropathy in streptozotocin-induced diabetic rats. Methods In total, 112 adult Sprague-Dawley rats were used for this study. Diabetes was induced using streptozotocin (STZ), whereas the control group was treated with an equal volume of citrate buffer. The diabetic rats were divided randomly into six groups according to the proposed treatment regime: diabetic control (DC), gliclazide (GLZ), aliskiren (ALIS), ramipril (RAM), (GLZ + ALIS) and (GLZ + RAM). Behavioural responses to thermal (hot-plate) and mechanical (tail-pinch) pain were evaluated. After eight weeks of daily treatments, the animals were fasted and sacrificed. The blood samples were collected, with the serum separated and subjected to various biochemical and enzyme analyses so as to assess the effect of the treatments on diabetic peripheral neuropathy. Results After 8 weeks, aliskiren alone and in combination with gliclazide therapy had a significant effect (P < .001) in reducing blood glucose levels and showed increased hot-plate and tail-flick latencies compared with the diabetic control group. The threshold of mechanical hyperalgesia was also significantly elevated (P < .001). Conclusions/Interpretations These data suggest that either aliskerin alone or in combination with gliclazide can protect against the development and progression of diabetic neuropathy.
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Affiliation(s)
| | - Rania Sajini
- Faculty of pharmacyUniversity of Umm Al‐QuraMakkahSaudi Arabia
| | | | - Jumana Qabbani
- Faculty of pharmacyUniversity of Umm Al‐QuraMakkahSaudi Arabia
| | - Yosra Al‐Hindi
- Faculty of PharmacyUniversity of Umm Al‐QuraMakkahSaudi Arabia
| | - Arwa Fairaq
- Faculty of PharmacyUniversity of Umm Al‐QuraMakkahSaudi Arabia
| | - Amal Yousef
- Faculty of MedicineCairo UniversityGizaEgypt
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Inhibition of angiotensin converting enzyme induces mechanical allodynia through increasing substance P expression in mice. Neurochem Int 2021; 146:105020. [PMID: 33744374 DOI: 10.1016/j.neuint.2021.105020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/25/2021] [Accepted: 03/10/2021] [Indexed: 11/20/2022]
Abstract
Although emerging evidence shows that angiotensin converting enzyme (ACE) is associated with pain, it is not clear whether inhibition of ACE could affect to nociceptive transmission and which mediators are involved in this process. Here we investigated whether administration of the ACE inhibitors, captopril and enalapril increases the expression of substance P (SP) and whether this increase contributes to the induction of mechanical allodynia in mice. ACE was expressed in the lumbar dorsal root ganglion (DRG) and the superficial dorsal horn (SDH) region of the spinal cord in mice. Either intraperitoneal or intrathecal administration of the ACE inhibitors, captopril and enalapril for 10 days significantly increased the paw withdrawal frequency to innocuous mechanical stimuli and the levels of SP in both the lumbar DRG and the SDH region of the spinal cord dorsal horn. In addition, intraperitoneal administration of the SP receptor (neurokinin-1 receptor) antagonist, L-733,060 suppressed mechanical allodynia that was induced by pretreatment of captopril and enalapril. Intraplantar administration of SP for 3 days induces mechanical allodynia, and this effect was reduced by exogenous ACE administration. These findings demonstrate that inhibition of ACE increases the levels of SP in both the lumbar DRG and spinal cord dorsal horn, ultimately contributing to the induction of mechanical allodynia in mice.
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The Tissue Renin-Angiotensin System and Its Role in the Pathogenesis of Major Human Diseases: Quo Vadis? Cells 2021; 10:cells10030650. [PMID: 33804069 PMCID: PMC7999456 DOI: 10.3390/cells10030650] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/09/2021] [Accepted: 03/13/2021] [Indexed: 01/18/2023] Open
Abstract
Evidence has arisen in recent years suggesting that a tissue renin-angiotensin system (tRAS) is involved in the progression of various human diseases. This system contains two regulatory pathways: a pathological pro-inflammatory pathway containing the Angiotensin Converting Enzyme (ACE)/Angiotensin II (AngII)/Angiotensin II receptor type 1 (AGTR1) axis and a protective anti-inflammatory pathway involving the Angiotensin II receptor type 2 (AGTR2)/ACE2/Ang1–7/MasReceptor axis. Numerous studies reported the positive effects of pathologic tRAS pathway inhibition and protective tRAS pathway stimulation on the treatment of cardiovascular, inflammatory, and autoimmune disease and the progression of neuropathic pain. Cell senescence and aging are known to be related to RAS pathways. Further, this system directly interacts with SARS-CoV 2 and seems to be an important target of interest in the COVID-19 pandemic. This review focuses on the involvement of tRAS in the progression of the mentioned diseases from an interdisciplinary clinical perspective and highlights therapeutic strategies that might be of major clinical importance in the future.
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Sassi KLM, Martins LB, de Miranda AS, Teixeira AL. Renin-Angiotensin-Aldosterone System and Migraine: A Systematic Review of Human Studies. Protein Pept Lett 2020; 27:512-519. [PMID: 31995000 DOI: 10.2174/0929866527666200129160136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/23/2019] [Accepted: 11/17/2019] [Indexed: 12/12/2022]
Abstract
Migraine is a common neurologic condition marked by recurrent episodes of headache. Its pathophysiology is highly complex involving neuronal, inflammatory and vascular mechanisms. The Renin-Angiotensin System (RAS) can modulate all these mechanism, being a potential pharmacological target for migraine treatment. We carried out a systematic review of the studies evaluating the involvement of RAS in patients with migraine. There is evidence from genetic studies exploring the relation between migraine and RAS-related genes and from clinical trials evaluating the efficacy of Angiotensin II Type 1 (AT1) receptor antagonists and angiotensin converting enzyme inhibitors in migraine prophylaxis. RAS seems to play a role in the pathophysiology of migraine, but more direct evidence is still missing.
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Affiliation(s)
- Karina Lúcia Moreira Sassi
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Laís Bhering Martins
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Aline Silva de Miranda
- Department of Morphology, Institute of Biological Sciences, The Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Antonio Lucio Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Hegazy N, Rezq S, Fahmy A. Mechanisms Involved in Superiority of Angiotensin Receptor Blockade over ACE Inhibition in Attenuating Neuropathic Pain Induced in Rats. Neurotherapeutics 2020; 17:1031-1047. [PMID: 32804335 PMCID: PMC7609714 DOI: 10.1007/s13311-020-00912-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although previous reports described the beneficial role of angiotensin-converting enzyme inhibitors (ACE-Is) or AT1 receptor blockers (ARBs) in attenuating neuropathic pain (NP), no study has yet explored the exact underlying mechanisms, as well as the superiority of using centrally versus peripherally acting renin-angiotensin-aldosterone system (RAAS) drugs in NP. We investigated the effects of 14 days of treatment with centrally (telmisartan and ramipril) or peripherally (losartan and enalapril) acting ARBs and ACE-Is, respectively, in attenuating peripheral NP induced by sciatic nerve chronic constriction injury (CCI) in rats. We also compared these with the effects of pregabalin, the standard treatment for NP. Behavioral changes, inflammatory markers (NFкB, TNF-α, COX-2, PGE2, and bradykinin), oxidative stress markers (NADPH oxidase and catalase), STAT3 activation, levels of phosphorylated P38-MAPK, ACE, AT1 receptor (AT1R), and AT2 receptor (AT2R), as well as histopathological features, were assessed in the brainstem and sciatic nerve. CCI resulted in clear pain-related behavior along with increased levels of inflammatory and oxidative stress markers, and STAT3 activity, as well as increased levels of phosphorylated P38-MAPK, ACE, AT1R, and AT2R, along with worsened histopathological findings in both the brainstem and sciatic nerve. ARBs improved both animal behavior and all measured parameters in CCI rats and were more effective than ACE-Is. At the tested doses, centrally acting ARBs or ACE-Is were not superior to the peripherally acting drugs of the same category. These findings suggest that ARBs (centrally or peripherally acting) are an effective treatment modality for NP.
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Affiliation(s)
- Nora Hegazy
- Department of Pharmacology and Toxicology, School of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Samar Rezq
- Department of Pharmacology and Toxicology, School of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, 2500 North State Street, Jackson, 39216, MS, USA.
| | - Ahmed Fahmy
- Department of Pharmacology and Toxicology, School of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
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Tawfik VL, Quarta M, Paine P, Forman TE, Pajarinen J, Takemura Y, Goodman SB, Rando TA, Clark JD. Angiotensin receptor blockade mimics the effect of exercise on recovery after orthopaedic trauma by decreasing pain and improving muscle regeneration. J Physiol 2019; 598:317-329. [PMID: 31784993 DOI: 10.1113/jp278991] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/28/2019] [Indexed: 12/17/2022] Open
Abstract
KEY POINTS Our tibial fracture orthopaedic injury model in mice recapitulates the major manifestations of complex trauma, including nociceptive sensitization, bone fracture, muscle fibrosis and muscle fibre loss. Delayed exercise after complex orthopaedic trauma results in decreased muscle fibrosis and improved pain Losartan, an angiotensin-receptor blocker with anti-fibrotic abilities, recapitulates the effect of exercise on post-injury recovery and may provide an enhanced recovery option for those who are unable to exercise after injury ABSTRACT: Chronic pain and disability after limb injury are major public health problems. Early mobilization after injury improves functional outcomes for patients, although when and how to implement rehabilitation strategies remains a clinical challenge. Additionally, whether the beneficial effects of exercise can be reproduced using pharmacological tools remains unknown and may benefit patients who are unable to exercise as a result of immobilization. We developed a murine model of orthopaedic trauma combining tibia fracture and pin fixation with muscle damage. Behavioural measures included mechanical nociceptive thresholds and distances run on exercise wheels. Bone healing was quantified using microcomputed tomagraphic scanning, and muscle fibre size distribution and fibrosis were followed using immunohistochemistry. We found that the model provided robust mechanical allodynia, fibrosis and a shift to smaller average muscle fibre size lasting up to 5 weeks from injury. We also observed that allowing 'late' (weeks 1-2) rather than 'early' (weeks 0-1) exercise after injury resulted in greater overall running activity and greater reversal of allodynia. In parallel, the late running paradigm was associated with reduced muscle fibrosis, earlier increase in muscle fibre diameter and a short-term benefit in reducing callus volume. Providing the anti-fibrotic angiotensin receptor blocker losartan to mice in drinking water reduced both allodynia and muscle fibrosis. Combining losartan and late exercise provided no additional benefit. We conclude that early healing after orthopaedic trauma must be allowed prior to the initiation of exercise to achieve optimal pain, functional and physiological outcomes and that losartan is a viable candidate for translational studies.
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Affiliation(s)
- Vivianne L Tawfik
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA
| | - Marco Quarta
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Patrick Paine
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | - Thomas E Forman
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA
| | - Jukka Pajarinen
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Yoshinori Takemura
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA.,Department of Anesthesiology, University of Toyama, Toyama, Japan
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Thomas A Rando
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA.,Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA
| | - J David Clark
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA.,Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA
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Haberberger RV, Barry C, Dominguez N, Matusica D. Human Dorsal Root Ganglia. Front Cell Neurosci 2019; 13:271. [PMID: 31293388 PMCID: PMC6598622 DOI: 10.3389/fncel.2019.00271] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/04/2019] [Indexed: 12/14/2022] Open
Abstract
Sensory neurons with cell bodies situated in dorsal root ganglia convey information from external or internal sites of the body such as actual or potential harm, temperature or muscle length to the central nervous system. In recent years, large investigative efforts have worked toward an understanding of different types of DRG neurons at transcriptional, translational, and functional levels. These studies most commonly rely on data obtained from laboratory animals. Human DRG, however, have received far less investigative focus over the last 30 years. Nevertheless, knowledge about human sensory neurons is critical for a translational research approach and future therapeutic development. This review aims to summarize both historical and emerging information about the size and location of human DRG, and highlight advances in the understanding of the neurochemical characteristics of human DRG neurons, in particular nociceptive neurons.
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Affiliation(s)
- Rainer Viktor Haberberger
- Pain and Pulmonary Neurobiology Laboratory, Centre for Neuroscience, Anatomy and Histology, Flinders University, Adelaide, SA, Australia.,Órama Institute, Flinders University, Adelaide, SA, Australia
| | - Christine Barry
- Pain and Pulmonary Neurobiology Laboratory, Centre for Neuroscience, Anatomy and Histology, Flinders University, Adelaide, SA, Australia
| | - Nicholas Dominguez
- Pain and Pulmonary Neurobiology Laboratory, Centre for Neuroscience, Anatomy and Histology, Flinders University, Adelaide, SA, Australia
| | - Dusan Matusica
- Pain and Pulmonary Neurobiology Laboratory, Centre for Neuroscience, Anatomy and Histology, Flinders University, Adelaide, SA, Australia.,Órama Institute, Flinders University, Adelaide, SA, Australia
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Neuroprotective effect of angiotensin II type 2 receptor stimulation in vincristine-induced mechanical allodynia. Pain 2019; 159:2538-2546. [PMID: 30086116 DOI: 10.1097/j.pain.0000000000001361] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Peripheral neuropathy is the major dose-limiting side effect of many currently used chemotherapies, such as vincristine (VCR). We recently demonstrated that candesartan, an angiotensin II type 1 receptor antagonist, was neuroprotective against resiniferatoxin-induced sensory neuropathy, and that this effect is mediated by stimulation of the angiotensin II type 2 receptor (AT2R). Thus, we evaluated the effect of preventive treatment with candesartan and a specific AT2R agonist, C21, on a mouse model of VCR-induced neuropathy. Vincristine was administered daily for 7 days to male Swiss mice. Treatment with candesartan and C21 was started on day 1, before VCR treatment, and continued until day 7. We evaluated the development of VCR-induced neuropathy and the effect of treatment by functional tests, immunohistochemical analyses of intraepidermal nerve fibers and dorsal root ganglia neurons, and ultrastructural analysis of the sciatic nerve. Mice treated with VCR showed high mechanical allodynia but no modifications of motor performance or mechanical/thermal nociception. Treatment with candesartan and C21 completely restored normal tactile sensitivity of VCR-treated mice. Both drugs prevented VCR-induced nonpeptidergic intraepidermal nerve fiber loss. Only C21 displayed neuroprotective effects against VCR-induced loss and enlargement of myelinated nerve fibers in the sciatic nerve. Our finding that candesartan and C21 are protective against VCR-induced neuropathic pain through AT2R stimulation favors evaluation of its therapeutic potential in patients receiving chemotherapy.
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Yezierski RP, Hansson P. Inflammatory and Neuropathic Pain From Bench to Bedside: What Went Wrong? THE JOURNAL OF PAIN 2018; 19:571-588. [DOI: 10.1016/j.jpain.2017.12.261] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 11/29/2017] [Accepted: 12/13/2017] [Indexed: 12/31/2022]
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Bessaguet F, Danigo A, Magy L, Sturtz F, Desmoulière A, Demiot C. Candesartan prevents resiniferatoxin-induced sensory small-fiber neuropathy in mice by promoting angiotensin II-mediated AT2 receptor stimulation. Neuropharmacology 2017; 126:142-150. [PMID: 28882562 DOI: 10.1016/j.neuropharm.2017.08.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/04/2017] [Accepted: 08/31/2017] [Indexed: 12/27/2022]
Abstract
Sensory defects associated with small-fiber neuropathy (SFN) can lead to profound disabilities. The relationship between the sensory nervous system and modulation of the renin-angiotensin system (RAS) has been described and focused on pain and neurodegeneration in several animal models. We have recently developed an experimental model of functional sensory neuropathy showing thermal hypoalgesia and neuropeptide depletion without nerve fiber degeneration. Here, we aimed to determine whether the modulation of angiotensin II (Ang II) activity could prevent sensory neuropathy induced by RTX. Control and RTX mice received ramipril, an Ang II converting enzyme (ACE) inhibitor, (0.5 mg/kg/day) or candesartan, an Ang II type 1 receptor (AT1R) blocker (0.5 mg/kg/day), one day before vehicle or RTX administration, and each day for the next seven days. Ramipril did not have a beneficial effect in RTX mice, whereas candesartan prevented thermal hypoalgesia and reduced neuropeptide depletion in intraepidermal nerve fibers and dorsal root ganglion neurons. The preventive effect of candesartan was not observed in mice deficient for the Ang II type 2 receptor (AT2R) and was counteracted in wild type mice by EMA200, an AT2R antagonist (3 mg/kg/day). Thus, candesartan may promote AT2R activation by blocking AT1R and increasing Ang II production and enhance its mechanisms of neuroprotection in our RTX model. Our finding that candesartan prevents nociception deficits and neuropeptide depletion encourages the evaluation of its therapeutic potential in patients presenting SFN, particularly those who experience chemotherapy-induced SFN.
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Affiliation(s)
- Flavien Bessaguet
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Aurore Danigo
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Laurent Magy
- Department of Neurology, Reference Center for Rare Peripheral Neuropathies, University Hospital of Limoges, Limoges, France
| | - Franck Sturtz
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Alexis Desmoulière
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Claire Demiot
- EA 6309 - Myelin Maintenance & Peripheral Neuropathy, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France.
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de Tommaso M, Kunz M, Valeriani M. Therapeutic approach to pain in neurodegenerative diseases: current evidence and perspectives. Expert Rev Neurother 2016; 17:143-153. [DOI: 10.1080/14737175.2016.1210512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Marina de Tommaso
- Neurophysiopathology of Pain Section, SMBNOS Department, Bari Aldo Moro University, Bari, Italy
| | - Miriam Kunz
- Department of General Practice, Section Gerontology, University Medical Center Groningen, Groningen, The Netherlands
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