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Chodroff L, Bendele M, Valenzuela V, Henry M, Ruparel S. EXPRESS: BDNF Signaling Contributes to Oral Cancer Pain in a Preclinical Orthotopic Rodent Model. Mol Pain 2016; 12:12/0/1744806916666841. [PMID: 27590070 PMCID: PMC5015823 DOI: 10.1177/1744806916666841] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The majority of patients with oral cancer report intense pain that is only partially managed by current analgesics. Thus, there is a strong need to study mechanisms as well as develop novel analgesics for oral cancer pain. Current study employed an orthotopic tongue cancer model with molecular and non-reflexive behavioral assays to determine possible mechanisms of oral cancer pain. Human oral squamous cell carcinoma cells line, HSC2, was injected into the tongue of male athymic mice and tumor growth was observed by day 6. Immunohistological analyses revealed a well-differentiated tumor with a localized immune response and pronounced sensory and sympathetic innervation and vascularization. The tumor expressed TMPRSS2, a protein previously reported with oral squamous cell carcinoma. ATF3 expression in trigeminal ganglia was not altered by tumor growth. Molecular characterization of the model demonstrated altered expression of several pain-related genes, out of which up-regulation of BDNF was most striking. Moreover, BDNF protein expression in trigeminal ganglia neurons was increased and inhibition of BDNF signaling with a tyrosine kinase B antagonist, ANA-12, reversed pain-like behaviors induced by the oral tumor. Oral squamous cell carcinoma tumor growth was also associated with a reduction in feeding, mechanical hypersensitivity in the face, as well as spontaneous pain behaviors as measured by the conditioned place preference test, all of which were reversed by analgesics. Interestingly, injection of HSC2 into the hindpaw did not reproduce this spectrum of pain behaviors; nor did injection of a colonic cancer cell line into the tongue. Taken together, this orthotopic oral cancer pain model reproduces the spectrum of pain reported by oral cancer patients, including higher order cognitive changes, and demonstrates that BDNF signaling constitutes a novel mechanism by which oral squamous cell carcinoma induces pain. Identification of the key role of tyrosine kinase B signaling in oral cancer pain may serve as a novel target for drug development.
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Affiliation(s)
- Leah Chodroff
- University of Texas Health Science Center at San Antonio
| | - Michele Bendele
- University of Texas Health Science Center at San Antonio Cancer Therapy and Research Center
| | | | - Michael Henry
- University of Texas Health Science Center At San Antonio
| | - Shivani Ruparel
- University of Texas Health Science Center at San AntonioUniversity of Texas Health Science Center at San Antonio Cancer Therapy and Research CenterUniversity of Texas Health Science Center at San AntonioUniversity of Texas Health Science Center At San Antonio
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Frutalin reduces acute and neuropathic nociceptive behaviours in rodent models of orofacial pain. Chem Biol Interact 2016; 256:9-15. [DOI: 10.1016/j.cbi.2016.06.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 06/01/2016] [Accepted: 06/10/2016] [Indexed: 02/07/2023]
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Factors Determining Outcome After Trigeminal Nerve Surgery for Neuropathic Pain. J Oral Maxillofac Surg 2016; 74:1323-9. [DOI: 10.1016/j.joms.2016.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 02/10/2016] [Accepted: 02/10/2016] [Indexed: 11/17/2022]
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Hargreaves KM, Ruparel S. Role of Oxidized Lipids and TRP Channels in Orofacial Pain and Inflammation. J Dent Res 2016; 95:1117-23. [PMID: 27307050 DOI: 10.1177/0022034516653751] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Acute or chronic inflammation comprises a highly prevalent type of orofacial pain and is mediated by the generation of endogenous agonists that activate numerous receptors expressed on terminals of trigeminal (TG) nociceptive afferent neurons. One such studied receptor is transient receptor potential vanilloid subtype 1 (TRPV1). TRPV1 is a ligand-gated cation channel that is expressed on a major subclass of nociceptors and is found in many orofacial tissues, including dental pulp. Antagonists to TRPV1 reveal an important role for this channel in mediating hypersensitivity in preclinical models of inflammatory or neuropathic pain. Recent studies have demonstrated that endogenous TRPV1 agonists are generated by oxidation of omega-6 polyunsaturated fatty acids, including both linoleic acid and arachidonic acid. A major mechanism triggering the release of oxidative linoleic acid metabolites (OLAMs) and oxidative arachidonic acid metabolites (OAAMs) is the action of oxidative enzymes. Oxidative enzymes such as cytochrome P450 isozymes are rapidly upregulated in TG neurons after orofacial inflammation and increase the capacity of TG neurons to generate OLAMs. Cytochrome P450 isozymes are also increased in immune cells in irreversibly inflamed human dental pulp, and extracts of this tissue have significantly increased capacity to generate OLAMs. Together, these studies point to a novel pain mechanism involving the enzymatic generation of endogenous OLAM and OAAM agonists of TRPV1. This finding provides a rationale for an entirely new class of analgesics by inhibition of oxidative enzyme activity.
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Affiliation(s)
- K M Hargreaves
- Department of Endodontics, University of Texas Health Science Center at San Antonio, TX, USA
| | - S Ruparel
- Department of Endodontics, University of Texas Health Science Center at San Antonio, TX, USA
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55
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Rozas P, Lazcano P, Piña R, Cho A, Terse A, Pertusa M, Madrid R, Gonzalez-Billault C, Kulkarni AB, Utreras E. Targeted overexpression of tumor necrosis factor-α increases cyclin-dependent kinase 5 activity and TRPV1-dependent Ca2+ influx in trigeminal neurons. Pain 2016; 157:1346-1362. [PMID: 26894912 PMCID: PMC4868804 DOI: 10.1097/j.pain.0000000000000527] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We reported earlier that TNF-α, a proinflammatory cytokine implicated in many inflammatory disorders causing orofacial pain, increases the activity of Cdk5, a key kinase involved in brain development and function and recently found to be involved in pain signaling. To investigate a potential mechanism underlying inflammatory pain in trigeminal ganglia (TGs), we engineered a transgenic mouse model (TNF) that can conditionally overexpresses TNF-α upon genomic recombination by Cre recombinase. TNF mice were bred with Nav1.8-Cre mouse line that expresses the Cre recombinase in sensory neurons to obtain TNF-α:Nav1.8-Cre (TNF-α cTg) mice. Although TNF-α cTg mice appeared normal without any gross phenotype, they displayed a significant increase in TNF-α levels after activation of NFκB signaling in the TG. IL-6 and MCP-1 levels were also increased along with intense immunostaining for Iba1 and GFAP in TG, indicating the presence of infiltrating macrophages and the activation of satellite glial cells. TNF-α cTg mice displayed increased trigeminal Cdk5 activity, and this increase was associated with elevated levels of phospho-T407-TRPV1 and capsaicin-evocated Ca influx in cultured trigeminal neurons. Remarkably, this effect was prevented by roscovitine, an inhibitor of Cdk5, which suggests that TNF-α overexpression induced sensitization of the TRPV1 channel. Furthermore, TNF-α cTg mice displayed more aversive behavior to noxious thermal stimulation (45°C) of the face in an operant pain assessment device as compared with control mice. In summary, TNF-α overexpression in the sensory neurons of TNF-α cTg mice results in inflammatory sensitization and increased Cdk5 activity; therefore, this mouse model would be valuable for investigating the mechanism of TNF-α involved in orofacial pain.
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Affiliation(s)
- Pablo Rozas
- Laboratory of Molecular and Cellular Mechanisms of Pain, Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
- Laboratory of Cellular and Neuronal Dynamics, Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Pablo Lazcano
- Laboratory of Molecular and Cellular Mechanisms of Pain, Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
- Laboratory of Cellular and Neuronal Dynamics, Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Ricardo Piña
- Department of Biology, Faculty of Chemistry and Biology, University of Santiago de Chile, Santiago, Chile
| | - Andrew Cho
- Functional Genomics Section, Laboratory of Cell and Developmental Biology, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - Anita Terse
- Functional Genomics Section, Laboratory of Cell and Developmental Biology, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - Maria Pertusa
- Department of Biology, Faculty of Chemistry and Biology, University of Santiago de Chile, Santiago, Chile
| | - Rodolfo Madrid
- Department of Biology, Faculty of Chemistry and Biology, University of Santiago de Chile, Santiago, Chile
| | - Christian Gonzalez-Billault
- Laboratory of Cellular and Neuronal Dynamics, Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
| | - Ashok B. Kulkarni
- Functional Genomics Section, Laboratory of Cell and Developmental Biology, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - Elias Utreras
- Laboratory of Molecular and Cellular Mechanisms of Pain, Department of Biology, Faculty of Sciences, Universidad de Chile, Santiago, Chile
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Abstract
Pain is a universal experience with profound effects on the physiology, psychology, and sociology of the population. Orofacial pain (OFP) conditions are especially prevalent and can be severely debilitating to a patient's health-related quality of life. Evidence-based clinical trials suggest that pharmacologic therapy may significantly improve patient outcomes either alone or when used as part of a comprehensive treatment plan for OFP. The aim of this article is to provide therapeutic options from a pharmacologic perspective to treat a broad spectrum of OFP. Clinical-based systemic and topical applied pharmaceutical approaches are presented to treat the most common OFP syndromes.
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Affiliation(s)
- Leslie Halpern
- Residency, Oral and Maxillofacial Surgery, Meharry Medical College, 1005 TB Todd Jr. Boulevard, Nashville, TN 37208, USA.
| | - Porchia Willis
- Oral and Maxillofacial Surgery, Meharry Medical College, 1005 TB Todd Jr. Boulevard, Nashville, TN 37208, USA
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Falcão RE, de Souza SA, Camara CA, Quintans JS, Santos PL, Correia MTS, Silva TM, Lima AA, Quintans-Júnior LJ, Guimarães AG. Evaluation of the orofacial antinociceptive profile of the ethyl acetate fraction and its major constituent, rosmarinic acid, from the leaves of Hyptis pectinata on rodents. REVISTA BRASILEIRA DE FARMACOGNOSIA-BRAZILIAN JOURNAL OF PHARMACOGNOSY 2016. [DOI: 10.1016/j.bjp.2015.07.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Smiljic S, Savic S, Stevanovic J, Kostic M. Prevalence and characteristics of orofacial pain in university students. J Oral Sci 2016; 58:7-13. [PMID: 27021534 DOI: 10.2334/josnusd.58.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Sonja Smiljic
- Department of Physiology, Medical Faculty, University of Pristina
| | - Sladjana Savic
- Department of Histology, Medical Faculty, University of Pristina
| | | | - Mirjana Kostic
- Department of Public Health, Medical Faculty, University of Pristina
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Lövgren A, Häggman-Henrikson B, Visscher C, Lobbezoo F, Marklund S, Wänman A. Temporomandibular pain and jaw dysfunction at different ages covering the lifespan - A population based study. Eur J Pain 2015; 20:532-40. [DOI: 10.1002/ejp.755] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2015] [Indexed: 11/09/2022]
Affiliation(s)
- A. Lövgren
- Department of Clinical Oral Physiology; Faculty of Medicine; University of Umeå; Umeå Sweden
| | - B. Häggman-Henrikson
- Department of Clinical Oral Physiology; Faculty of Medicine; University of Umeå; Umeå Sweden
- Department of Orofacial Pain and Jaw function; Faculty of Odontology; Malmö University; Sweden
| | - C.M. Visscher
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; MOVE Research Institute Amsterdam; Amsterdam The Netherlands
| | - F. Lobbezoo
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; MOVE Research Institute Amsterdam; Amsterdam The Netherlands
| | - S. Marklund
- Department of Clinical Oral Physiology; Faculty of Medicine; University of Umeå; Umeå Sweden
| | - A. Wänman
- Department of Clinical Oral Physiology; Faculty of Medicine; University of Umeå; Umeå Sweden
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60
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Abstract
This series of papers aims to provide the dental and medical teams with an update in pain, both acute and chronic orofacial conditions, relevant to dentistry and medicine. Pain is the most common symptom for patients presenting to their dentist, and is increasingly commonly presenting to doctors as well, in general practice and A & E departments. Most of the dental team take for granted their knowledge and ability to manage acute dental pain. However, the education and preparation in managing patients with chronic pain conditions remains poor in many medical and dental schools. Conversely, medics are better educated and exposed to chronic pain during their undergraduate education, however, with regards to orofacial pain education, exposure is diminishing due to decreased exposure to dentistry, ENT, otolaryngology, OMFS and oral surgery. Thus many clinical teams remain disadvantaged when diagnosing and managing orofacial pain. Clinical Relevance: Significant advances that have been made in understanding the pain mechanisms are not to be overlooked and have a huge impact on how we manage patients in pain.
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61
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Branco CA, Fonseca RB, Borges RF, Venezian GC, Magri LV, Mazzetto MO. Perception of the signs and symptoms of temporomandibular disorder in females by using the ProTMDMulti protocol and the visual analog scale before and after acupuncture treatment. Cranio 2015; 34:118-23. [PMID: 25812725 DOI: 10.1179/2151090315y.0000000004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To evaluate the perceptions of patients with TMD in relation to the signs and symptoms before and after acupuncture treatment, according to the ProTMDMulti and the VAS. METHOD 68 patients were divided into groups: muscle TMD treated with acupuncture at local points (MUS-LP), muscle TMD with acupuncture at distant points (MUS-DP), joint and muscle treated with LP (JOI-LP) and joint and muscle treated with DP (JOI-DP). The evaluations were performed at four times: initial, control, final and follow-up. RESULTS The best results were seen in the JOI-LP and the MUS-DP groups, in which the perceptions of the signs and symptoms were statistically lower in the final assessment than in the initial (P<0.05). In all groups, the final and the follow-up evaluations were similar. CONCLUSIONS For TMDs with joint components, the best acupuncture treatment involves local points and for the TMDs with muscle components, points at a distance.
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Affiliation(s)
- Carolina Assaf Branco
- a Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP) , Ribeirão Preto, SP , Brazil
| | | | - Renata Filgueira Borges
- a Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP) , Ribeirão Preto, SP , Brazil
| | - Giovana Cherubini Venezian
- a Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP) , Ribeirão Preto, SP , Brazil
| | - Laís Valencise Magri
- a Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP) , Ribeirão Preto, SP , Brazil
| | - Marcelo Oliveira Mazzetto
- a Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP) , Ribeirão Preto, SP , Brazil
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Gualdani R, Ceruti S, Magni G, Merli D, Di Cesare Mannelli L, Francesconi O, Richichi B, la Marca G, Ghelardini C, Moncelli MR, Nativi C. Lipoic-based TRPA1/TRPV1 antagonist to treat orofacial pain. ACS Chem Neurosci 2015; 6:380-5. [PMID: 25546551 DOI: 10.1021/cn500248u] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Inflammation of the trigeminal nerve is considered one of the most painful conditions known to humankind. The diagnosis is often difficult; moreover, safe and effective pharmacological treatments are lacking. A new molecule, ADM_12, formed by a lipoic and omotaurine residues covalently linked, is here reported. In vitro and in vivo tests showed that ADM_12 is a very attractive original compound presenting (i) a remarkable safety profile; (ii) a high binding constant versus TRPA1; (iii) an intriguing behavior versus TRPV1; and (iv) the ability to significantly and persistently reduce mechanical facial allodynia in rats. Noteworthy, by testing ADM_12, we shed light on the unprecedented involvement of TRPA1 and TRPV1 channels in orofacial pain.
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Affiliation(s)
| | - Stefania Ceruti
- Lab
of Molecular and Cell. Pharm. Purinergic Transmission, Department
of Pharmacological Biomol. Sciences (DiSFeB), University of Milan, 20122 Milan, Italy
| | - Giulia Magni
- Lab
of Molecular and Cell. Pharm. Purinergic Transmission, Department
of Pharmacological Biomol. Sciences (DiSFeB), University of Milan, 20122 Milan, Italy
- Department
of Drug Discovery and Development, Italian Institute of Technology (IIT), 16163 Genova, Italy
| | - Davide Merli
- Lab
of Molecular and Cell. Pharm. Purinergic Transmission, Department
of Pharmacological Biomol. Sciences (DiSFeB), University of Milan, 20122 Milan, Italy
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63
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Zuniga JR, Yates DM, Phillips CL. The Presence of Neuropathic Pain Predicts Postoperative Neuropathic Pain Following Trigeminal Nerve Repair. J Oral Maxillofac Surg 2014; 72:2422-7. [DOI: 10.1016/j.joms.2014.08.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 07/30/2014] [Accepted: 08/03/2014] [Indexed: 11/24/2022]
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64
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Abstract
Headache and facial pain - in particular, temporomandibular disorders (TMDs) - are very prevalent conditions in the general population. TMDs are defined as a collection of symptoms and signs involving masticatory muscles, the temporomandibular joints (TMJs), or both. The pain reported by TMD patients is typically located in the muscles of mastication, in the preauricular area, or in the TMJs. In many cases, headaches and facial pain will occur in the same patient. Much of the research relative to the relationship of these disorders focuses on statistics of association and prevalence data. This review will provide a brief description of the types and classifications of orofacial pains (OFPs), as well as point to relevant research describing the commonalities and potential comorbid nature of these maladies. Finally, several recent papers describing morphologic changes to the brain in headache and TMD individuals will be discussed in an effort to stimulate further research into the potential common pathophysiologic mechanism that may explain the comorbid nature of these disorders.
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65
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Diagnostic role of magnetic resonance imaging in assessing orofacial pain and paresthesia. J Craniofac Surg 2014; 25:1748-51. [PMID: 25148636 DOI: 10.1097/scs.0000000000001000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to compare the efficacy of CT and MRI in evaluating orofacial pain and paresthesia. A total of 96 patients with orofacial pain and/or paresthesia were included in this study. The patients who underwent CT and/or MRI examinations were assessed, and the efficacy of CT and/or MRI examinations in detecting the causative disease of the orofacial pain and paresthesia was evaluated. Seventy (72.9%) of 96 patients underwent CT and/or MRI examinations. Whereas CT examinations detected 2 diseases (4.5%) in 44 tests, 13 diseases (37.1%) were detected in 35 MRI examinations. Seven (53.8%) of 13 diseases, which were detected by MRI, were found in elderly patients. A high percentage of patients, who claimed orofacial pain and paresthesia, have other diseases in their brain, especially in elderly patients, and MRI is more useful than CT for evaluating these patients.
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Michot B, Kayser V, Bastian G, Bourgoin S, Hamon M. Differential pharmacological alleviation of oxaliplatin-induced hyperalgesia/allodynia at cephalic versus extra-cephalic level in rodents. Neuropharmacology 2014; 79:432-43. [DOI: 10.1016/j.neuropharm.2013.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/06/2013] [Accepted: 12/09/2013] [Indexed: 12/21/2022]
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67
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Quintans JS, Costa EV, Tavares JF, Souza TT, Araújo SS, Estevam CS, Barison A, Cabral AG, Silva MS, Serafini MR, Quintans-Júnior LJ. Phytochemical study and antinociceptive effect of the hexanic extract of leaves from Combretum duarteanum and friedelin, a triterpene isolated from the hexanic extract, in orofacial nociceptive protocols. REVISTA BRASILEIRA DE FARMACOGNOSIA-BRAZILIAN JOURNAL OF PHARMACOGNOSY 2014. [DOI: 10.1590/0102-695x20142413347] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Shephard MK, Macgregor EA, Zakrzewska JM. Orofacial pain: a guide for the headache physician. Headache 2013; 54:22-39. [PMID: 24261452 DOI: 10.1111/head.12272] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2013] [Indexed: 12/19/2022]
Abstract
Orofacial pain represents a significant burden in terms of morbidity and health service utilization. It includes very common disorders such as toothache and temporomandibular disorders, as well as rare orofacial pain syndromes. Many orofacial pain conditions have overlapping presentations, and diagnostic uncertainty is frequently encountered in clinical practice. This review provides a clinically orientated overview of common and uncommon orofacial pain presentations and diagnoses, with an emphasis on conditions that may be unfamiliar to the headache physician. A holistic approach to orofacial pain management is important, and the social, cultural, psychological and cognitive context of each patient needs to be considered in the process of diagnostic formulation, as well as in the development of a pain management plan according to the biopsychosocial model. Recognition of psychological comorbidities will assist in diagnosis and management planning.
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Affiliation(s)
- Martina K Shephard
- Oral Medicine Unit, Eastman Dental Hospital, UCLH NHS Foundation Trust, London, UK
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69
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Cavalcante ALC, Siqueira RMP, Araujo JCB, Gondim DV, Ribeiro RA, Quetz JS, Havt A, Lima AAM, Vale ML. Role of NMDA receptors in the trigeminal pathway, and the modulatory effect of magnesium in a model of rat temporomandibular joint arthritis. Eur J Oral Sci 2013; 121:573-83. [DOI: 10.1111/eos.12093] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2013] [Indexed: 01/12/2023]
Affiliation(s)
- André L. C. Cavalcante
- Medical Sciences Post-Graduation Program; Department of Clinical Medicine; Federal University of Ceará; Fortaleza Brazil
| | - Rafaelly M. P. Siqueira
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
| | - Joana C. B. Araujo
- Medical Sciences Post-Graduation Program; Department of Clinical Medicine; Federal University of Ceará; Fortaleza Brazil
| | - Delane V. Gondim
- Department of Morphology; Federal University of Ceará; Fortaleza Brazil
| | - Ronaldo A. Ribeiro
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
| | - Josiane S. Quetz
- Institute of Biomedicine for Brazilian Semi-Arid & Clinical Research Unit; Federal University of Ceara; Fortaleza Brazil
| | - Alexandre Havt
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
- Institute of Biomedicine for Brazilian Semi-Arid & Clinical Research Unit; Federal University of Ceara; Fortaleza Brazil
| | - Aldo A. M. Lima
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
- Institute of Biomedicine for Brazilian Semi-Arid & Clinical Research Unit; Federal University of Ceara; Fortaleza Brazil
| | - Mariana L. Vale
- Medical Sciences Post-Graduation Program; Department of Clinical Medicine; Federal University of Ceará; Fortaleza Brazil
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
- Department of Morphology; Federal University of Ceará; Fortaleza Brazil
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70
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Siqueira-Lima PS, Araújo AAS, Lucchese AM, Quintans JSS, Menezes PP, Alves PB, de Lucca Júnior W, Santos MRV, Bonjardim LR, Quintans-Júnior LJ. β-cyclodextrin complex containing Lippia grata leaf essential oil reduces orofacial nociception in mice - evidence of possible involvement of descending inhibitory pain modulation pathway. Basic Clin Pharmacol Toxicol 2013; 114:188-96. [PMID: 24119304 DOI: 10.1111/bcpt.12145] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 09/01/2013] [Indexed: 12/01/2022]
Abstract
The treatment of orofacial pain remains a major challenge for modern medicine. Thus, we prepared and physicochemically characterized a new β-cyclodextrin complex containing Lippia grata leaf essential oil (β-CD/EO) to investigate their possible antinociceptive activity in animal models of orofacial pain. The results of Differential scanning calorimeter (DSC) and Thermogravimetry/derivative thermogravimetry (TG/DTG) showed that the products prepared by Slurry complexation (SC) method were able to incorporate greater amounts of EO. In the X-ray diffractogram, it was shown that complex between EO and β-CD was formed. Male Swiss mice were pre-treated with β-CD/EO (6, 12 or 24 mg/kg, per os, gavage, p.o.), morphine (5 mg/kg, i.p.) or vehicle (distilled water, p.o.) 1 hr before treatment with formalin (20 μL, 2%), capsaicin (20 μL, 2.5 μg) or glutamate (40 μL, 25 μM) into the right upper lip. Our results demonstrated that p.o. treatment with β-CD/EO was significantly (p < 0.05 or p < 0.001) capable of reducing the nociceptive face-rubbing behaviour in both phases of the formalin test. β-CD/EO-treated mice were also significantly (p < 0.05 or p < 0.001) protected against nociception induced by capsaicin and glutamate. For the action in the central nervous system (CNS), ninety minutes after the treatment, the mice were perfused, the brains collected, crioprotected, cut in a criostate and submitted to an immunofluorescence protocol for Fos protein. The immunofluorescence protocol demonstrated that the β-CD/EO significantly activated (p < 0.05; p < 0.01 or p < 0.001) the motor cortex, the Locus ceruleus, the nucleus raphe magnus and the periaqueductal gray of the CNS. These effects apparently did not alter, in tested doses, the motor coordination of mice in the rota-rod test. Our results proposed that β-CD/EO might present an important draft of drug to the study of new compounds for the treatment of orofacial pain.
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Affiliation(s)
- Pollyana S Siqueira-Lima
- Biotechnology Graduate Program, The State University of Feira de Santana, Feira de Santana, BA, Brazil; Department of Pharmacy, Federal University of Sergipe, Aracaju, SE, Brazil
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71
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Abstract
Orofacial pain refers to pain associated with the soft and hard tissues of the head, face, and neck. It is a common experience in the population that has profound sociologic effects and impact on quality of life. New scientific evidence is constantly providing insight into the cause and pathophysiology of orofacial pain including temporomandibular disorders, cranial neuralgias, persistent idiopathic facial pains, headache, and dental pain. An evidence-based approach to the management of orofacial pain is imperative for the general clinician. This article reviews the basics of pain epidemiology and neurophysiology and sets the stage for in-depth discussions of various painful conditions of the head and neck.
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Affiliation(s)
- Scott S De Rossi
- Department of Oral health and Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA.
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72
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Teodoro FC, Tronco Júnior MF, Zampronio AR, Martini AC, Rae GA, Chichorro JG. Peripheral substance P and neurokinin-1 receptors have a role in inflammatory and neuropathic orofacial pain models. Neuropeptides 2013. [PMID: 23177733 DOI: 10.1016/j.npep.2012.10.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is accumulating evidence that substance P released from peripheral sensory neurons participates in inflammatory and neuropathic pain. In this study it was investigated the ability of substance P to induce orofacial nociception and thermal and mechanical hyperalgesia, as well as the role of NK1 receptors on models of orofacial inflammatory and neuropathic pain. Substance P injected into the upper lip at 1, 10 and 100 μg/50 μL failed to induce nociceptive behavior. Also, substance P (0.1-10 μg/50 μL) injected into the upper lip did not evoke orofacial cold hyperalgesia and when injected at 1 μg/50 μL did not induce mechanical hyperalgesia. However, substance P at this latter dose induced orofacial heat hyperalgesia, which was reduced by the pre-treatment of rats with a non-peptide NK1 receptor antagonist (SR140333B, 3mg/kg). Systemic treatment with SR140333B (3 mg/kg) also reduced carrageenan-induced heat hyperalgesia, but did not exert any influence on carrageenan-induced cold hyperalgesia. Blockade of NK1 receptors with SR140333B also reduced by about 50% both phases of the formalin response evaluated in the orofacial region. Moreover, heat, but not cold or mechanical, hyperalgesia induced by constriction of the infraorbital nerve, a model of trigeminal neuropathic pain, was abolished by pretreatment with SR140333B. Considering that substance P was peripherally injected (i.e. upper lip) and the NK1 antagonist used lacks the ability to cross the blood-brain-barrier, our results demonstrate that the peripheral SP/NK1 system participates in the heat hyperalgesia associated with inflammation or nerve injury and in the persistent pain evoked by formalin in the orofacial region.
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Affiliation(s)
- Fernanda C Teodoro
- Department of Pharmacology, Federal University of Parana, Curitiba, PR, Brazil
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73
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Krzyzanowska A, Avendaño C. Behavioral testing in rodent models of orofacial neuropathic and inflammatory pain. Brain Behav 2012; 2:678-97. [PMID: 23139912 PMCID: PMC3489819 DOI: 10.1002/brb3.85] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 07/10/2012] [Accepted: 07/13/2012] [Indexed: 11/12/2022] Open
Abstract
Orofacial pain conditions are often very debilitating to the patient and difficult to treat. While clinical interest is high, the proportion of studies performed in the orofacial region in laboratory animals is relatively low, compared with other body regions. This is partly due to difficulties in testing freely moving animals and therefore lack of reliable testing methods. Here we present a comprehensive review of the currently used rodent models of inflammatory and neuropathic pain adapted to the orofacial areas, taking into account the difficulties and drawbacks of the existing approaches. We examine the available testing methods and procedures used for assessing the behavioral responses in the face in both mice and rats and provide a summary of some pharmacological agents used in these paradigms to date. The use of these agents in animal models is also compared with outcomes observed in the clinic.
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Affiliation(s)
- Agnieszka Krzyzanowska
- Department of Anatomy, Histology and Neuroscience, Autonoma University of Madrid, Medical School Madrid, Spain
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74
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Sex differences in serotonin enhancement of capsaicin-evoked calcitonin gene-related peptide release from human dental pulp. Pain 2012; 153:2061-2067. [PMID: 22819536 DOI: 10.1016/j.pain.2012.06.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 06/11/2012] [Accepted: 06/18/2012] [Indexed: 12/30/2022]
Abstract
Serotonin (5HT) is a pronociceptive mediator in the periphery, and evidence implicates involvement in trigeminal pain processing. However, the mechanism(s) by which 5HT modulates trigeminal nociceptors remains unclear. Trigeminal pain can be evoked by the transient receptor potential V1 channel (TRPV1), which is expressed by nociceptive trigeminal neurons and induces release of proinflammatory calcitonin gene-related peptide (CGRP). In our preclinical models, 5HT evoked thermal hyperalgesia and enhanced calcium influx and CGRP release from the TRPV1 population of trigeminal nociceptors. Whether this occurs in humans is unknown. As dental pulp is densely innervated by trigeminal nociceptors, routine tooth extractions offer a unique opportunity to examine whether 5HT enhances CGRP release from human nociceptors. Pulpal tissue was collected from 140 extracted molar teeth from men and women, and basal release samples were collected before treatment with saline or 5HT 100μmol/L. CGRP release was then stimulated with the TRPV1 agonist capsaicin 1μmol/L and quantitated by enzyme immunoassay. Additional samples were collected for Western blots to examine 5HT receptor expression. We report that 5HT induced a significant increase in capsaicin-evoked CGRP release, and that this enhancement was observed only in female dental pulp, with no effect of 5HT on male dental pulp. The greatest amount of CGRP release occurred in dental pulp from women in the luteal phase of the menstrual cycle. These results indicate that 5HT enhances capsaicin-evoked CGRP release from human trigeminal nociceptors in a sexually dimorphic manner providing a mechanistic basis for prevalence of trigeminal pain disorders in women.
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75
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Aicher SA, Hermes SM, Whittier KL, Hegarty DM. Descending projections from the rostral ventromedial medulla (RVM) to trigeminal and spinal dorsal horns are morphologically and neurochemically distinct. J Chem Neuroanat 2012; 43:103-11. [PMID: 22119519 PMCID: PMC3319838 DOI: 10.1016/j.jchemneu.2011.11.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 11/08/2011] [Accepted: 11/09/2011] [Indexed: 01/16/2023]
Abstract
Neurons in the rostral ventromedial medulla (RVM) are thought to modulate nociceptive transmission via projections to spinal and trigeminal dorsal horns. The cellular substrate for this descending modulation has been studied with regard to projections to spinal dorsal horn, but studies of the projections to trigeminal dorsal horn have been less complete. In this study, we combined anterograde tracing from RVM with immunocytochemical detection of the GABAergic synthetic enzyme, GAD67, to determine if the RVM sends inhibitory projections to trigeminal dorsal horn. We also examined the neuronal targets of this projection using immunocytochemical detection of NeuN. Finally, we used electron microscopy to verify cellular targets. We compared projections to both trigeminal and spinal dorsal horns. We found that RVM projections to both trigeminal and spinal dorsal horn were directed to postsynaptic profiles in the dorsal horn, including somata and dendrites, and not to primary afferent terminals. We found that RVM projections to spinal dorsal horn were more likely to contact neuronal somata and were more likely to contain GAD67 than projections from RVM to trigeminal dorsal horn. These findings suggest that RVM neurons send predominantly GABAergic projections to spinal dorsal horn and provide direct input to postsynaptic neurons such as interneurons or ascending projection neurons. The RVM projection to trigeminal dorsal horn is more heavily targeted to dendrites and is only modestly GABAergic in nature. These anatomical features may underlie differences between trigeminal and spinal dorsal horns with regard to the degree of inhibition or facilitation evoked by RVM stimulation.
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Affiliation(s)
- Sue A Aicher
- Department of Physiology & Pharmacology, Oregon Health & Science University, Portland, OR 97239-3098, United States.
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