101
|
Irvine KA, Sahbaie P, Ferguson AR, Clark JD. Loss of diffuse noxious inhibitory control after traumatic brain injury in rats: A chronic issue. Exp Neurol 2020; 333:113428. [PMID: 32745472 DOI: 10.1016/j.expneurol.2020.113428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/23/2020] [Accepted: 07/25/2020] [Indexed: 02/07/2023]
Abstract
Chronic pain is one of the most challenging and debilitating symptoms to manage after traumatic brain injury (TBI), yet the underlying mechanisms remain elusive. The disruption of normal endogenous pain control mechanisms has been linked to several forms of chronic pain and may play a role in pain after TBI. We hypothesized therefore that dysfunctional descending noradrenergic and serotonergic pain control circuits may contribute to the loss of diffuse noxious inhibitory control (DNIC), a critical endogenous pain control mechanism, weeks to months after TBI. For these studies, the rat lateral fluid percussion model of mild TBI was used along with a DNIC paradigm involving a capsaicin-conditioning stimulus. We observed sustained failure of the DNIC response up to 180-days post injury. We confirmed, that descending α2 adrenoceptor-mediated noradrenergic signaling was critical for endogenous pain inhibition in uninjured rats. However, augmenting descending noradrenergic signaling using reboxetine, a selective noradrenaline reuptake inhibitor, failed to restore DNIC after TBI. Furthermore, blocking serotonin-mediated descending signaling using selective spinal serotonergic fiber depletion with 5, 7-dihydroxytryptamine was also unsuccessful at restoring endogenous pain modulation after TBI. Unexpectedly, increasing descending serotonergic signaling using the selective serotonin reuptake inhibitor escitalopram and the serotonin-norepinephrine reuptake inhibitor duloxetine restored the DNIC response in TBI rats at both 49- and 180- days post injury. Consistent with these observations, spinal serotonergic fiber depletion with 5, 7-dihydroxytryptamine eliminated the effects of escitalopram. Intact α2 adrenoceptor signaling, however, was not required for the serotonin-mediated restoration of DNIC after TBI. These results suggest that TBI causes maladaptation of descending nociceptive signaling mechanisms and changes in the function of both adrenergic and serotonergic circuits. Such changes could predispose those with TBI to chronic pain.
Collapse
Affiliation(s)
- Karen-Amanda Irvine
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, CA 94305, USA; Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave (E4-220), Palo Alto, CA 94304, USA.
| | - Peyman Sahbaie
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, CA 94305, USA; Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave (E4-220), Palo Alto, CA 94304, USA
| | - Adam R Ferguson
- University of California San Francisco, Brain and Spinal Injury Center, Department Neurosurgery, 1001 Potrero Ave, San Francisco, CA 94110, USA
| | - J David Clark
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, CA 94305, USA; Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave (E4-220), Palo Alto, CA 94304, USA
| |
Collapse
|
102
|
Kaye AD, Granier AL, Garcia AJ, Carlson SF, Fuller MC, Haroldson AR, White SW, Krueger OL, Novitch MB, Cornett EM. Non-Opioid Perioperative Pain Strategies for the Clinician: A Narrative Review. Pain Ther 2020; 9:25-39. [PMID: 31933147 PMCID: PMC7203361 DOI: 10.1007/s40122-019-00146-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Indexed: 12/11/2022] Open
Abstract
Alternative and non-opioid options for pain management are necessary in perioperative patient care. Opioids are no longer touted as cure-all medications, and furthermore, there have been tremendous advances in alternative therapies such as in interventional pain, physical therapy, exercise, and nutritional counseling that have proven benefits to combat pain. The center for disease control now strongly recommends the use of multimodal analgesia and multidisciplinary approaches based on the individual needs of patients: personalized medicine. In this manuscript, the specifics of non-opioid pharmacological and non-pharmacological analgesic approaches will be discussed as well as their possible indications and uses to reduce the need for excessive use of opioids for adequate pain control.
Collapse
Affiliation(s)
- Alan David Kaye
- Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU School of Medicine, Shreveport, LA, USA
- Anesthesiology and Pharmacology, LSU School of Medicine, New Orleans, LA, USA
- Anesthesiology and Pharmacology, Tulane School of Medicine, New Orleans, LA, USA
| | | | - Andrew J Garcia
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | | | | | | | | | | | - Matthew B Novitch
- Department of Anesthesiology, University of Washington, Seattle, WA, USA
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA.
| |
Collapse
|
103
|
Mota CMD, Rodrigues-Santos C, Carolino ROG, Anselmo-Franci JA, Branco LGS. Citral-induced analgesia is associated with increased spinal serotonin, reduced spinal nociceptive signaling, and reduced systemic oxidative stress in arthritis. JOURNAL OF ETHNOPHARMACOLOGY 2020; 250:112486. [PMID: 31846747 DOI: 10.1016/j.jep.2019.112486] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/21/2019] [Accepted: 12/13/2019] [Indexed: 05/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Citral (3,7-dimethyl-2,6-octadienal) is the main component of Cymbopogon citratus (DC) Stapf, an herb with analgesic properties. Arthritic pain is the main unpleasant component of rheumatoid arthritis. The pharmacological approaches used to treat arthritic pain are often accompanied by adjuvant drugs or non-pharmacological treatments, showing a constant need in identifying new efficient analgesic drugs. AIM OF THE STUDY To test the hypothesis that citral, which is a monoterpenoid compound with therapeutic properties, reduces nociception, spinal pro-nociceptive and pro-inflammatory signaling, and systemic oxidative stress in arthritic rats. MATERIALS AND METHODS Complete Freund's adjuvant (CFA) was administrated in the left knee joint of rats. Oral treatment with citral was performed during eight days and mechanical allodynia was monitored during the period of treatment to evaluate the analgesic effect of citral. We assessed the levels of serotonin (5-hydroxytryptamine, 5-HT) in the lumbar dorsal horn of the spinal cord (DHSC) and the profiles of expression of the glycogen synthase kinase-3β (GSK3β), which is a 5-HT-regulated intracellular protein, and of the stress-activated protein kinase (SAPK)/jun N-terminal kinase (JNK) in the DHSC. Plasma levels of superoxide dismutase (SOD) were assessed as an indicator of oxidative stress. RESULTS Administration of CFA induced mechanical allodynia associated with reduced spinal GSK3β phosphorylation, increased spinal SAPK/JNK phosphorylation, and increased plasma SOD levels. Oral administration of citral reversed mechanical allodynia, increased endogenous spinal 5-HT levels, reduced spinal SAPK/JNK phosphorylation, and reduced plasma SOD levels. CONCLUSION Citral shows anti-nociceptive effects in an animal model of arthritic pain by modulating spinal nociceptive signaling.
Collapse
Affiliation(s)
- Clarissa M D Mota
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Caroline Rodrigues-Santos
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ruither O G Carolino
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Janete A Anselmo-Franci
- Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Luiz G S Branco
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil; Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
| |
Collapse
|
104
|
Panahi MH, Mohseni M, Bidhendi Yarandi R, Ramezani Tehrani F. A methodological quality assessment of systematic reviews and meta-analyses of antidepressants effect on low back pain using updated AMSTAR. BMC Med Res Methodol 2020; 20:14. [PMID: 31973739 PMCID: PMC6979288 DOI: 10.1186/s12874-020-0903-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 01/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Antidepressants are prescribed widely to manage low back pain. There are a number of systematic reviews and meta-analyses which have investigated the efficacy of the treatments, while the methodological quality of them has not been assessed yet. This study aims to evaluate the methodological quality of the systematic reviews and meta-analyses investigating the effect of antidepressants on low back pain. METHODS A systematic search was conducted in PubMed, EMBASE, Medline, and Cochrane Library databases up to November 2018. The 16-item Assessment of Multiple Systematic Reviews (AMSTAR2) scale was used to assess the methodological quality of the studies. Systematic reviews and meta-analyses of the Antidepressants treatment effects on low back pain published in English language were included. There was no limitation on the type of Antidepressants drugs, clinical setting, and study population, while non-systematical reviews and qualitative and narrative reviews were excluded. RESULTS A total of 25 systematic reviews and meta-analyses were evaluated; the studies were reported between 1992 and 2017. Obtained results from AMSTAR2 showed that 11 (44%), 9 (36%) and 5 (20%) of the included studies had high, moderate and low qualities, respectively. 13(52%) of studies assessed risk of bias and 2(20%) of meta analyses considered publication bias. Also, 16 (64%) of the included reviews provided a satisfactory explanation for any heterogeneity observed in the results. CONCLUSIONS Although the trend of publishing high quality papers in ADs effect on LBP increased recently, performing more high-quality SRs and MAs in this field with precise subgroups of the type of pains, the class of drugs and their dosages may give clear and more reliable evidence to help clinicians and policymakers.
Collapse
Affiliation(s)
- Mohammad Hossein Panahi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Mohseni
- Neurosurgery Department, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Bidhendi Yarandi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, P.O.Box: 19395-4763, Tehran, Iran.
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Parvane Street, Yaman Street, Velenjak, P.O.Box: 19395-4763, Tehran, Iran
| |
Collapse
|
105
|
Vrekoussis T, Siafaka V, Tsitou A, Tsonis O, Navrozoglou I, Makrigiannakis A, Paschopoulos M. Endometriosis-related chronic pelvic pain: A mini review on pathophysiology and impact on mental health. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2020. [DOI: 10.1177/2284026519895829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Endometriosis-related chronic pelvic pain is a major component of the disease that affects quality of life in women of reproductive age suffering from endometriosis. The present review summarizes current evidence upon pathophysiology and its impact on mental health. It seems that endometriosis-related chronic pelvic pain is the result of chronic stress on the central nervous system as a consequence of chronic pelvic inflammation. Mental health issues may rise as a result of central nervous system derangement and further aggravate pain perception and therefore quality of life. Further properly designed studies are needed in order to elucidate the connection between mental disorders and endometriosis-related chronic pelvic pain.
Collapse
Affiliation(s)
- Thomas Vrekoussis
- Department of Obstetrics and Gynecology, School of Medicine, University of Crete, Heraklion, Greece
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Alexandra Tsitou
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Orestis Tsonis
- Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Iordanis Navrozoglou
- Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Antonis Makrigiannakis
- Department of Obstetrics and Gynecology, School of Medicine, University of Crete, Heraklion, Greece
| | - Minas Paschopoulos
- Department of Obstetrics and Gynecology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| |
Collapse
|
106
|
Pagliusi M, Bonet I, Brandão A, Magalhães S, Tambeli C, Parada C, Sartori C. Therapeutic and Preventive Effect of Voluntary Running Wheel Exercise on Social Defeat Stress (SDS)-induced Depressive-like Behavior and Chronic Pain in Mice. Neuroscience 2020; 428:165-177. [DOI: 10.1016/j.neuroscience.2019.12.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/29/2019] [Accepted: 12/23/2019] [Indexed: 01/21/2023]
|
107
|
Skiöldebrand E, Ley C, Björklund U, Lindahl A, Hansson E. Serotonin-evoked cytosolic Ca 2+ release and opioid receptor expression are upregulated in articular cartilage chondrocytes from osteoarthritic joints in horses. Vet Anim Sci 2019; 8:100078. [PMID: 32734095 PMCID: PMC7386637 DOI: 10.1016/j.vas.2019.100078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 09/11/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis is a pain-associated progressive disease and pain mediators, such as opioid receptors, expressed in articular cartilage could represent novel therapeutic targets. Acute and chronic stages of OA indicate different metabolic abilities of the chondrocytes depending on inflammatory state. This study aimed to investigate the response of healthy and osteoarthritic chondrocytes and their expression and release of pain mediators in response to acute inflammation. Interleukin-1 beta (IL-1β) and lipopolysaccharide (LPS) were used to induce an acute inflammatory response in cultured equine chondrocytes harvested from healthy joints (HC) and osteoarthritic joints (OAC), the latter representing acute exacerbation of a chronic inflammatory state. Intracellular Ca2+ release was determined after exposure to serotonin (5-hydroxytryptamine (5-HT), glutamate or ATP. Protein expression levels of F- and G-actin, representing actin rearrangement, and opioid receptors were investigated. Glutamate concentrations in culture media were measured. Cartilage was immunohistochemically stained for µ (MOR), κ (KOR), and δ (DOR) opioid receptors. Upon exposure to acute inflammatory stimuli, OAC showed increased intracellular Ca2+ release after 5-HT stimulation and increased expression of MOR and KOR. When cells were stimulated by inflammatory mediators, glutamate release was increased in both HC and OAC. Immunostaining for MOR was strong in OA cartilage, whereas KOR was less strongly expressed. DOR was not expressed by cultured HC and OAC and immunostaining of OA cartilage equivocal. We show that chondrocytes in different inflammatory stages react differently to the neurotransmitter 5-HT with respect to intracellular Ca2+ release and expression of peripheral pain mediators. Our findings suggest that opioids and neurotransmitters are important in the progression of equine OA. The inflammatory stage of OA (acute versus chronic) should be taken into consideration when therapeutic strategies are being developed.
Collapse
Affiliation(s)
- Eva Skiöldebrand
- Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden
- Section of Pathology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Cecilia Ley
- Section of Pathology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ulrika Björklund
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Anders Lindahl
- Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden
| | - Elisabeth Hansson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| |
Collapse
|
108
|
Park YS, Sung KW. Selective serotonin reuptake inhibitor escitalopram inhibits 5-HT 3 receptor currents in NCB-20 cells. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2019; 23:509-517. [PMID: 31680773 PMCID: PMC6819908 DOI: 10.4196/kjpp.2019.23.6.509] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 11/15/2022]
Abstract
Escitalopram is one of selective serotonin reuptake inhibitor antidepressants. As an S-enantiomer of citalopram, it shows better therapeutic outcome in depression and anxiety disorder treatment because it has higher selectivity for serotonin reuptake transporter than citalopram. The objective of this study was to determine the direct inhibitory effect of escitalopram on 5-hydroxytryptamine type 3 (5-HT3) receptor currents and study its blocking mechanism to explore additional pharmacological effects of escitalopram through 5-HT3 receptors. Using a whole-cell voltage clamp method, we recorded currents of 5-HT3 receptors when 5-HT was applied alone or co-applied with escitalopram in cultured NCB-20 neuroblastoma cells known to express 5-HT3 receptors. 5-HT induced currents were inhibited by escitalopram in a concentration-dependent manner. EC50 of 5-HT on 5-HT3 receptor currents was increased by escitalopram while the maximal peak amplitude was reduced by escitalopram. The inhibitory effect of escitalopram was voltage independent. Escitalopram worked more effectively when it was co-applied with 5-HT than pre-application of escitalopram. Moreover, escitalopram showed fast association and dissociation to the open state of 5-HT3 receptor channel with accelerating receptor desensitization. Although escitalopram accelerated 5-HT3 receptor desensitization, it did not change the time course of desensitization recovery. These results suggest that escitalopram can inhibit 5-HT3 receptor currents in a non-competitive manner with the mechanism of open channel blocking.
Collapse
Affiliation(s)
- Yong Soo Park
- Department of Anatomy, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Ki-Wug Sung
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| |
Collapse
|
109
|
Lesnak J, Sluka KA. Chronic non-inflammatory muscle pain: central and peripheral mediators. CURRENT OPINION IN PHYSIOLOGY 2019; 11:67-74. [PMID: 31998857 PMCID: PMC6988739 DOI: 10.1016/j.cophys.2019.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Conditions with chronic widespread non-inflammatory muscle pain, such as fibromyalgia, have complex etiologies with numerous proposed mechanisms for their pathophysiology of underlying chronic pain. Advancements in neuroimaging have allowed for the study of brain function and connectivity in humans with these conditions, while development of animal models have allowed for the study of both peripheral and central factors that lead to chronic pain. This article reviews the current literature surrounding the pathophysiology of chronic widespread non-inflammatory muscle pain focusing on both peripheral and central nervous system, as well as immune system, contributions to the development and maintenance of pain. A better understanding of the mechanisms underlying these conditions can allow for improvements in patient education, treatment and outcomes.
Collapse
Affiliation(s)
- Joseph Lesnak
- Department of Physical Therapy and Rehabilitation Science, Pain Research Program, 1-242 MEB, University of Iowa, Iowa City, IA 52252, USA
| | - Kathleen A. Sluka
- Department of Physical Therapy and Rehabilitation Science, Pain Research Program, 1-242 MEB, University of Iowa, Iowa City, IA 52252, USA
| |
Collapse
|
110
|
|
111
|
Moore BR, Islam B, Ward S, Jackson O, Armitage R, Blackburn J, Haider S, McHugh PC. Repurposing of Tranilast for Potential Neuropathic Pain Treatment by Inhibition of Sepiapterin Reductase in the BH 4 Pathway. ACS OMEGA 2019; 4:11960-11972. [PMID: 31460307 PMCID: PMC6682008 DOI: 10.1021/acsomega.9b01228] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/26/2019] [Indexed: 05/08/2023]
Abstract
Tetrahydrobiopterin (BH4) is a cofactor in the production of various signaling molecules including nitric oxide, dopamine, adrenaline, and noradrenaline. BH4 levels are critical for processes associated with cardiovascular function, inflammation, mood, pain, and neurotransmission. Increasing pieces of evidence suggest that BH4 is upregulated in chronic pain. Sepiapterin reductase (SPR) catalyzes both the reversible reduction of sepiapterin to dihydrobiopterin (BH2) and 6-pyruvoyl-tetrahydrobiopterin to BH4 within the BH4 pathway. Therefore, inhibition of SPR by small molecules can be used to control BH4 production and ultimately alleviate chronic pain. Here, we have used various in silico and in vitro experiments to show that tranilast, licensed for use in bronchial asthma, can inhibit sepiapterin reduction by SPR. Docking and molecular dynamics simulations suggest that tranilast can bind to human SPR (hSPR) at the same site as sepiapterin including S157, one of the catalytic triad residues of hSPR. Colorimetric assays revealed that tranilast was nearly twice as potent as the known hSPR inhibitor, N-acetyl serotonin. Tranilast was able to inhibit hSPR activity both intracellularly and extracellularly in live cells. Triple quad mass spectrophotometry of cell lysates showed a proportional decrease of BH4 in cells treated with tranilast. Our results suggest that tranilast can act as a potent hSPR inhibitor and therefore is a valid candidate for drug repurposing in the treatment of chronic pain.
Collapse
Affiliation(s)
- Benjamin
J. R. Moore
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Barira Islam
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Sean Ward
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Olivia Jackson
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Rebecca Armitage
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Jack Blackburn
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
| | - Shozeb Haider
- UCL
School of Pharmacy, 29−39 Brunswick Square, London WC1N 1AX, U.K.
| | - Patrick C. McHugh
- Centre
for Biomarker Research, School of Applied Sciences, Department of Pharmacy,
School of Applied Sciences, Innovative Physical Organic Solutions (IPOS), Department
of Chemical and Biological Sciences, and Department of Chemical Sciences,
School of Applied Sciences, University of
Huddersfield, Queensgate, Huddersfield HD1 3DH, U.K.
- E-mail: . Phone: +(44) 1484 472074. Fax: +(44) 1484 472182
| |
Collapse
|
112
|
Off-label Antidepressant Use for Treatment and Management of Chronic Pain: Evolving Understanding and Comprehensive Review. Curr Pain Headache Rep 2019; 23:66. [DOI: 10.1007/s11916-019-0803-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
113
|
The prevalence and the burden of pain in patients with Huntington disease: a systematic review and meta-analysis. Pain 2019; 160:773-783. [PMID: 30889051 DOI: 10.1097/j.pain.0000000000001472] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
It is remarkable that studies focusing on the prevalence and the burden of pain in patients with Huntington disease (HD) are scarce. This may lead to inadequate recognition of pain and hence lack of treatment, eventually affecting the quality of life. The aim of this review is to investigate the prevalence of pain and its burden in HD by performing a systematic literature search. In February 2018, a systematic search was performed in the electronic databases of Pubmed, Embase, Cinahl, Cochrane, and PsycINFO. Studies focusing on patients with juvenile HD were excluded. All other types of study were included without language restrictions. In total, 2234 articles were identified, 15 of which met the inclusion criteria and provided information on 2578 patients with HD. The sample-weighted prevalence of pain was 41.3% (95% confidence interval: 36%-46%). The pain burden, which was measured with the SF-36, is significantly less compared with that in the general population. The sample-weighted mean score on the SF-36 was 84 (95% confidence interval: 81-86), where a score of 100 represents the lowest symptom burden. The results demonstrate that pain could be an important nonmotor symptom in patients with HD, and there are indications that the pain burden could be diminished because of HD. Larger and high-quality prospective cohort and clinical studies are required to confirm these findings. In the meantime, awareness about pain and its burden in patients with HD is warranted in clinical practice.
Collapse
|
114
|
Marazziti D, Mucci F, Tripodi B, Carbone MG, Muscarella A, Falaschi V, Baroni S. Emotional Blunting, Cognitive Impairment, Bone Fractures, and Bleeding as Possible Side Effects of Long-Term Use of SSRIs. CLINICAL NEUROPSYCHIATRY 2019; 16:75-85. [PMID: 34908941 PMCID: PMC8650205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Selective serotonin (5-HT) reuptake inhibitors (SSRIs) are amongst the most prescribed drugs worldwide not only for psychiatric conditions, but also for medical purposes. Converging data gathered throughout the decades following their development would indicate that SSRIs have a broader side effect profile than previously assumed. Therefore, the aim of the present paper was to to review available literature highlighting less common side effects emerging with their long-term use. METHOD This systematic review, carried out according to PRISMA guidelines, was performed through searching electronic databases of PubMed, Google Scholar, Cochrane Library, Embase, MEDLINE, PsycINFO and Scopus. The keyword used was "SSRIs" combined with the following: "Side effects", or "Emotional blunting or flattening", or "Cognition", or "Neuroimaging", or "Bone", "or "Platelet aggregation", or "Bleeding". RESULTS The most common side effects, besides the classical ones described in the literature are represented by decreased emotional response to both adversive and pleasurable events, some cognitive impairments, bone fractures and prolonged overall bleeding time. CONCLUSIONS After analyzing critically the available findings, it should be noted that only the so-called "emotional blunting" is supported by converging data, while results on cognitive impairment are extremely controversial, given some evidence showing that SSRIs may improve cognition. Similarly, no agreement exists on the detrimental effects of SSRIs on bone metabolism and coagulation.Large, prospective and long-term studies are needed to clarify the possible impact of SSRIs on emotions, cognitive functions, bone fractures and coagulation, as well to detect other possible still neglected side effects.
Collapse
Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Federico Mucci
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Beniamino Tripodi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Manuel Glauco Carbone
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Alessia Muscarella
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Valentina Falaschi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Stefano Baroni
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| |
Collapse
|
115
|
Epigenetics-by-sex interaction for somatization conferred by methylation at the promoter region of SLC6A4 gene. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:125-131. [PMID: 30201454 DOI: 10.1016/j.pnpbp.2018.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/31/2018] [Accepted: 09/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Depression, anxiety and somatoform disorders are all more prevalent in women than in men. However, specific biological mechanisms contributing to such sex differences remain unknown. Serotonergic pathways are involved in mood and behavior regulation and thus have been suggested to be altered in several psychiatric disorders. The serotonin transporter (SERT), encoded by SLC6A4 gene, has received major attention due to its crucial role in serotonergic transmission. METHODS 148 monozygotic twin subjects were assessed for (i) lifetime categorical diagnosis of anxious-depressive disorders, following SCID-I-based DSM-IV criteria, and (ii) current psychiatric symptomatology, from a dimensional approach, by means of the Brief Symptom Inventory (BSI). SLC6A4 gene methylation was analyzed by means of Infinium HumanMethylation450 in a subset of the sample. CpG-specific methylation at the promoter region of SLC6A4 gene was further analyzed by means of pyrosequencing technology in the total sample. RESULTS SLC6A4 methylation was found to be significantly higher in women when compared to men independent of DSM-IV diagnosis. SLC6A4 methylation was further associated with the BSI-derived somatization dimension. CONCLUSIONS Female hypermethylation of a discrete region located within SLC6A4 promoter region could underlie differential SERT expression in women when compared to men and could be one of the causative mechanisms by which women exhibit increased prevalence of somatic symptoms.
Collapse
|
116
|
Changes in brain white matter structure are associated with urine proteins in urologic chronic pelvic pain syndrome (UCPPS): A MAPP Network study. PLoS One 2018; 13:e0206807. [PMID: 30517112 PMCID: PMC6281196 DOI: 10.1371/journal.pone.0206807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 10/21/2018] [Indexed: 12/11/2022] Open
Abstract
The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network has yielded neuroimaging and urinary biomarker findings that highlight unique alterations in brain structure and in urinary proteins related to tissue remodeling and vascular structure in patients with Urological Chronic Pelvic Pain Syndrome (UCPPS). We hypothesized that localized changes in diffusion tensor imaging (DTI) measurements might be associated with corresponding changes in urinary protein levels in UCPPS. To test this hypothesis, we created statistical parameter maps depicting the linear correlation between DTI measurements (fractional anisotropy (FA) and apparent diffusion coefficient (ADC)) and urinary protein quantification (MMP2, MMP9, NGAL, MMP9/NGAL complex, and VEGF) in 30 UCPPS patients from the MAPP Research Network, after accounting for clinical covariates. Results identified a brainstem region that showed a strong correlation between both ADC (R2 = 0.49, P<0.0001) and FA (R2 = 0.39, P = 0.0002) with urinary MMP9 levels as well as a correlation between both ADC (R2 = 0.42, P = 0.0001) and FA (R2 = 0.29, P = 0.0020) and urinary MMP9/NGAL complex. Results also identified significant correlations between FA and urinary MMP9 in white matter adjacent to sensorimotor regions (R2 = 0.30, P = 0.002; R2 = 0.36, P = 0.0005, respectively), as well as a correlation in similar sensorimotor regions when examining ADC and urinary MMP2 levels (R2 = 0.42, P<0.0001) as well as FA and urinary MMP9/NGAL complex (R2 = 0.33, P = 0.0008). A large, diffuse cluster of white matter was identified as having a strong correlation between both ADC (R2 = 0.35, P = 0.0006) and FA (R2 = 0.43, P<0.0001) with urinary NGAL levels. In contrast, no significant association between DTI measurements and VEGF was observed. Results suggest that elevated MMP9 or MMP9/NGAL in UCPPS may be related to degenerative neuronal changes in brainstem nuclei through excitotoxicity, while also facilitating synaptic plasticity in sensorimotor regions.
Collapse
|
117
|
Ferland CE, Teles AR, Ingelmo P, Saran N, Marchand S, Ouellet JA. Blood monoamines as potential biomarkers for conditioned pain modulation efficacy: An exploratory study in paediatrics. Eur J Pain 2018; 23:327-340. [DOI: 10.1002/ejp.1307] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/04/2018] [Accepted: 08/12/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Catherine E. Ferland
- McGill Scoliosis and Spine Group; Montreal Québec Canada
- Shriners Hospitals for Children-Canada; Montreal Québec Canada
- McGill University Health Centre; Montreal Québec Canada
- Alan Edwards Centre for Research on Pain; Montreal Québec Canada
- Department of Anesthesia; McGill University; Montreal Québec Canada
| | - Alisson R. Teles
- McGill Scoliosis and Spine Group; Montreal Québec Canada
- Shriners Hospitals for Children-Canada; Montreal Québec Canada
- McGill University Health Centre; Montreal Québec Canada
- Alan Edwards Centre for Research on Pain; Montreal Québec Canada
- Division of Pediatric Orthopaedics; McGill University; Montreal Québec Canada
| | - Pablo Ingelmo
- McGill University Health Centre; Montreal Québec Canada
- Alan Edwards Centre for Research on Pain; Montreal Québec Canada
- Department of Anesthesia; McGill University; Montreal Québec Canada
| | - Neil Saran
- McGill Scoliosis and Spine Group; Montreal Québec Canada
- Shriners Hospitals for Children-Canada; Montreal Québec Canada
- McGill University Health Centre; Montreal Québec Canada
- Division of Pediatric Orthopaedics; McGill University; Montreal Québec Canada
| | - Serge Marchand
- Department of Surgery; Université de Sherbrooke; Sherbrooke Québec Canada
| | - Jean A. Ouellet
- McGill Scoliosis and Spine Group; Montreal Québec Canada
- Shriners Hospitals for Children-Canada; Montreal Québec Canada
- McGill University Health Centre; Montreal Québec Canada
- Alan Edwards Centre for Research on Pain; Montreal Québec Canada
- Division of Pediatric Orthopaedics; McGill University; Montreal Québec Canada
| |
Collapse
|
118
|
D’Arcy M, Stürmer T, Lund JL. The importance and implications of comparator selection in pharmacoepidemiologic research. CURR EPIDEMIOL REP 2018; 5:272-283. [PMID: 30666285 PMCID: PMC6338470 DOI: 10.1007/s40471-018-0155-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW Pharmacoepidemiologic studies employing large databases are critical to evaluating the effectiveness and safety of drug exposures in large and diverse populations. Because treatment is not randomized, researchers must select a relevant comparison group for the treatment of interest. The comparator group can consist of individuals initiating: (1) a similarly indicated treatment (active comparator), (2) a treatment used for a different indication (inactive comparator) or (3) no particular treatment (non-initiators). Herein we review recent literature and describe considerations and implications of comparator selection in pharmacoepidemiologic studies. RECENT FINDINGS Comparator selection depends on the scientific question and feasibility constraints. Because pharmacoepidemiologic studies rely on the choice to initiate or not initiate a specific treatment, rather than randomization, they are at-risk for confounding related to the comparator choice including: by indication, disease severity and frailty. We describe forms of confounding specific to pharmacoepidemiologic studies and discuss each comparator along with informative examples and a case study. We provide commentary on potential issues relevant to comparator selection in each study, highlighting the importance of understanding the population in whom the treatment is given and how patient characteristics are associated with the outcome. SUMMARY Advanced statistical techniques may be insufficient for reducing confounding in observational studies. Evaluating the extent to which comparator selection may mitigate or induce systematic bias is a critical component of pharmacoepidemiologic studies.
Collapse
Affiliation(s)
- Monica D’Arcy
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer L. Lund
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
119
|
Kaye AD, Kline RJ, Thompson ER, Kaye AJ, Terracciano JA, Siddaiah HB, Urman RD, Cornett EM. Perioperative implications of common and newer psychotropic medications used in clinical practice. Best Pract Res Clin Anaesthesiol 2018; 32:187-202. [PMID: 30322459 DOI: 10.1016/j.bpa.2018.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 06/19/2018] [Indexed: 11/16/2022]
Abstract
Psychotropic medications are widely prescribed by clinicians as both primary therapy for a variety of psychiatric and neurodegenerative diseases and as adjunctive analgesics for use in the perioperative period. It is critical to understand various modes of action, drug-drug interactions, side effects, and clinical implications. Health care providers must understand how these medications interact with anesthetics, as well as other drugs used in perioperative care. We review relevant psychiatric and neurodegenerative diseases, psychotropic medications used to treat them, and how these medications interact with anesthetics and drugs used in perioperative care. We will also discuss emerging psychotropic drugs and the challenges they may create during the perioperative period. Future direction of investigation into the role of these drugs during the perioperative period and implications is also discussed.
Collapse
Affiliation(s)
- Alan D Kaye
- Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 70112, USA.
| | - Ryan J Kline
- Department of Anesthesiology, LSU Health Science Center - New Orleans, 1542 Tulane Avenue, Room 659, New Orleans, LA, 70112, USA.
| | - Elliott R Thompson
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.
| | - Aaron J Kaye
- Medical University of South Carolina, Charleston, SC, 29425, USA.
| | - Justin A Terracciano
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.
| | - Harish B Siddaiah
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.
| | - Richard D Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.
| |
Collapse
|
120
|
Effect of Problem-Solving Therapy Versus Supportive Management in Older Adults with Low Back Pain and Depression While on Antidepressant Pharmacotherapy. Am J Geriatr Psychiatry 2018; 26:765-777. [PMID: 29724663 DOI: 10.1016/j.jagp.2018.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Testing stepped-care approaches that address both depression and low back pain are needed to optimize outcomes in older adults. METHODS This university-based late-life depression research center assessed 227 adults aged ≥ 60 years with chronic low back pain and depression. In Phase 1 participants received 6 weeks of low-dose venlafaxine (≤150 mg/day). Nonresponders were randomized to 10 weeks of high-dose venlafaxine (up to 300 mg/day) plus problem-solving therapy (PST) or high-dose venlafaxine with supportive management. Definition of response was 2 weeks of Patient Health Questionnaire-9 ≤ 5 and ≥30% pain reduction on a numeric rating scale. Function was measured with the Short Physical Performance Battery (SPPB) and Roland Morris Disability Questionnaire (RMDQ). RESULTS Of those who completed Phase 1 (N = 209), 78.5% (N = 164) were nonresponders and 139 proceeded to Phase 2, with 68 randomized to venlafaxine/PST and 71 randomized to venlafaxine/supportive management. Of those in venlafaxine/PST, 41.2% (28/68) responded, and of those in venlafaxine/supportive management, 39.4% (28/71) responded. Cumulative proportion responding over time did not differ across the two arms (hazard ratio: 1.07; 95% confidence interval: 0.63-1.80). We observed clinically significant improvements in physical performance (SPPB) and disability (RMDQ) across both Phase 1 and 2, independent of intervention. Over 12 months of follow-up there was no difference between groups for stability of depression, pain, or disability. CONCLUSION The combination of antidepressant pharmacotherapy and PST was not superior to antidepressant pharmacotherapy and supportive management. Clinically, the rates of response and stability of response over 1 year observed in both groups suggest that these approaches may have clinical utility in these chronically suffering patients.
Collapse
|
121
|
Abstract
BACKGROUND Few studies have reported prescription patterns for headache medication. OBJECTIVE The aim was to present the rates of specific medication prescribed to pediatric patients diagnosed with migraine, tension-type headache (TTH), and new daily persistent headache (NDPH), as well as differences in those prescription patterns by diagnosis, age, and gender. PATIENTS AND METHODS A query using the i2b2 platform yielded 14,591 patients [migraine 10,547 (72.3%); TTH 3200 (21.9%); NDPH 844 (5.8%)] seen over a 3-year period, who were aged 4-17 years at the time of their visit and diagnosed with migraine, TTH, or NDPH. RESULTS Sumatriptan was the most frequently prescribed medication for migraine followed by amitriptyline. The most frequently prescribed medication for both TTH and NDPH was amitriptyline, followed by sumatriptan in TTH and by topiramate in NDPH. Age and gender differences were also found in prescription patterns of each of the diagnoses. The differences in prescription patterns found between the diagnoses, as well as age and gender differences found within the diagnoses, are discussed. CONCLUSIONS A wide range of medications are prescribed to children and adolescents with headache, with most medications prescribed for off-label use. As these medications are not Food and Drug Administration (FDA) approved for use in children and adolescents with headache, there is a need for large scale, randomized controlled trials to assess the efficacy of these medications.
Collapse
|
122
|
Yeo SH, Lim ZJI, Mao J, Yau WP. Effects of Central Nervous System Drugs on Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin Drug Investig 2018; 37:901-928. [PMID: 28756557 DOI: 10.1007/s40261-017-0558-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Pilot trials have suggested that pharmacotherapy may aid stroke recovery. The aim of this study was to systematically review the effects of antidepressants, anti-Alzheimer drugs, anti-Parkinson drugs, central nervous system (CNS) stimulants and piracetam on gross motor function, cognition, disability, dependency and quality of life (QOL) after stroke. METHODS PubMed, EMBASE and the Cochrane Central Register of Controlled Trials databases were searched, and 44 randomized controlled trials that compared outcomes of interest between drug treatment and placebo or no treatment were included. For each study, standardized mean difference (SMD) or mean difference (MD) with 95% confidence interval (CI) were calculated. Meta-analyses were conducted to pool results using either the fixed-effects or random-effects model. RESULTS Selective serotonin reuptake inhibitors (SSRIs) improved gross motor function (SMD 0.54, 95% CI 0.22-0.85; three studies), disability (SMD 0.49, 95% CI 0.32-0.66; 14 studies) and QOL (MD 6.46, 95% CI 4.71-8.22; two studies), but there was insufficient evidence for their use in enhancing global cognition (SMD 0.23, 95% CI -0.01 to 0.46; five studies) and dependency (risk ratio 0.81, 95% CI 0.68-0.97; one fluoxetine study). In particular, gross motor function was improved by fluoxetine (SMD 0.64, 95% CI 0.31-0.98; two studies), while disability was improved by paroxetine (SMD 1.05, 95% CI 0.63-1.46; two studies), citalopram (SMD 0.51, 95% CI 0.08-0.93; two studies) and fluoxetine (SMD 0.41, 95% CI 0.22-0.60; nine studies). There is insufficient evidence for the use of anti-Alzheimer drugs, anti-Parkinson drugs, CNS stimulants and piracetam to promote stroke recovery. CONCLUSIONS Administration of SSRIs may improve gross motor function, reduce disability and enhance QOL for patients recovering from stroke.
Collapse
Affiliation(s)
- See-Hwee Yeo
- Department of Pharmacy, Faculty of Science, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Zheng-Jie Ian Lim
- Department of Pharmacy, Faculty of Science, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Jia Mao
- Department of Pharmacy, Faculty of Science, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Wai-Ping Yau
- Department of Pharmacy, Faculty of Science, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore.
| |
Collapse
|
123
|
Anversa RG, Sousa FSS, Birmann PT, Lima DB, Lenardão EJ, Bruning CA, Savegnago L. Antinociceptive and anti-inflammatory effects of 1,2-bis-(4 methoxyphenylselanyl) styrene in mice: involvement of the serotonergic system. J Pharm Pharmacol 2018; 70:901-909. [PMID: 29582424 DOI: 10.1111/jphp.12907] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/10/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pain is one of the most prevalent, costly and disabling conditions that reduces quality of life. Although there are many analgesics available, there is some concern regarding their efficacy, safety and side effects. Organic selenium compounds are attractive targets of various research groups due to their pharmacological properties. OBJECTIVES The aim of this study was to evaluate the antinociceptive and anti-inflammatory activity of 1,2-bis-(4-methoxyphenylselanyl) styrene (BMOSE) in mice, as well as to investigate the mechanism involved in the antinociceptive effect. METHODS The animals were submitted to the formalin and glutamate tests. The assessment of the possible involvement of the serotonergic system in BMOSE antinociceptive activity was performed using the glutamate test. Also, we investigated the possible toxicity of the compound. KEY FINDINGS 1,2-bis-(4-methoxyphenylselanyl) styrene (0.1-50 mg/kg, i.g.) was efficient in avoiding nociception induced by glutamate and formalin and also reduced paw oedema. The possible involvement of 5-HT3 serotoninergic receptor antagonist ondansetron blocked the antinociceptive effect of BMOSE. The acute toxicity assays did not show any toxicity related to the administration of BMOSE (200 mg/kg). CONCLUSIONS It is possible to conclude that BMOSE has both antinociceptive and anti-inflammatory activity, and the serotoninergic system, more specifically, the 5-HT3 receptor, is involved in the effect.
Collapse
Affiliation(s)
- Roberta Gonçalves Anversa
- Grupo de Pesquisa em Neurobiotecnologia - GPN- Centro de Desenvolvimento Tecnológico, CDTec, Universidade Federal de Pelotas, UFPel, Pelotas, RS, Brazil
| | - Fernanda Severo Sabedra Sousa
- Grupo de Pesquisa em Neurobiotecnologia - GPN-Programa de Pós Graduação em Bioquímica e Bioprospecção, PPGBBio, Universidade Federal de Pelotas, UFPel, Pelotas, RS, Brazil
| | - Paloma Taborda Birmann
- Grupo de Pesquisa em Neurobiotecnologia - GPN-Programa de Pós Graduação em Bioquímica e Bioprospecção, PPGBBio, Universidade Federal de Pelotas, UFPel, Pelotas, RS, Brazil
| | - David Borba Lima
- Laboratório de Síntese Orgânica Limpa- LASOL, Universidade Federal de Pelotas, UFPel, Pelotas, RS, Brazil
| | - Eder João Lenardão
- Laboratório de Síntese Orgânica Limpa- LASOL, Universidade Federal de Pelotas, UFPel, Pelotas, RS, Brazil
| | - César Augusto Bruning
- Grupo de Pesquisa em Neurobiotecnologia - GPN-Programa de Pós Graduação em Bioquímica e Bioprospecção, PPGBBio, Universidade Federal de Pelotas, UFPel, Pelotas, RS, Brazil
| | - Lucielli Savegnago
- Grupo de Pesquisa em Neurobiotecnologia - GPN- Centro de Desenvolvimento Tecnológico, CDTec, Universidade Federal de Pelotas, UFPel, Pelotas, RS, Brazil
| |
Collapse
|
124
|
Within-Person Pain Variability and Mental Health in Older Adults With Osteoarthritis: An Analysis Across 6 European Cohorts. THE JOURNAL OF PAIN 2018; 19:690-698. [PMID: 29496636 DOI: 10.1016/j.jpain.2018.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 01/16/2018] [Accepted: 02/13/2018] [Indexed: 02/03/2023]
Abstract
Pain is a key symptom of osteoarthritis (OA) and has been linked to poor mental health. Pain fluctuates over time within individuals, but a paucity of studies have considered day-to-day fluctuations of joint pain in relation to affective symptoms in older persons with OA. This study investigated the relationship of pain severity as well as within-person pain variability with anxiety and depression symptoms in 832 older adults with OA who participated in the European Project on OSteoArthritis (EPOSA): a 6-country cohort study. Affective symptoms were examined with the Hospital Anxiety and Depression Scale, pain severity was assessed with the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand Osteoarthritis Index, and intraindividual pain variability was measured using pain calendars assessed at baseline, 6, and 12 to 18 months. Age-stratified multiple linear regression analyses adjusted for relevant confounders showed that more pain was associated with more affective symptoms in older-old participants (74.1-85 years). Moreover, older-old participants experienced fewer symptoms of anxiety (ratio = .85, 95% confidence interval [CI], .77-.94), depression (ratio = .90, 95% CI, .82-.98), and total affective symptoms (ratio = .87, 95% CI, .79-.94) if their pain fluctuated more. No such association was evident in younger-old participants (65-74.0 years). These findings imply that stable pain levels are more detrimental to mental health than fluctuating pain levels in older persons. PERSPECTIVE This study showed that more severe and stable joint pain levels were associated with anxiety and depressive symptoms in older persons with OA. These findings emphasize the importance of measuring pain in OA at multiple time points, because joint pain fluctuations may be an indicator for the presence of affective symptoms.
Collapse
|
125
|
Potentiation of morphine-induced antinociception and locomotion by citalopram is accompanied by anxiolytic-like effects. Pharmacol Biochem Behav 2017; 163:83-89. [DOI: 10.1016/j.pbb.2017.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/04/2017] [Accepted: 10/06/2017] [Indexed: 11/30/2022]
|
126
|
Hu X, Dong Y, Jin X, Zhang C, Zhang T, Zhao J, Shi J, Li J. The novel and potent anti-depressive action of triptolide and its influences on hippocampal neuroinflammation in a rat model of depression comorbidity of chronic pain. Brain Behav Immun 2017; 64:180-194. [PMID: 28300618 DOI: 10.1016/j.bbi.2017.03.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 03/02/2017] [Accepted: 03/10/2017] [Indexed: 12/26/2022] Open
Abstract
Chronic pain and depression frequently coexist in clinical setting, and current clinical treatments for this comorbidity have shown limited efficacy. Triptolide (T10), an active component of Tripterygium wilfordii Hook F., has been demonstrated to exert strong analgesic activities in experimental pain models, but whether it possesses anti-depressive actions remains unknown. Using a depression comorbidity of chronic pain rat model induced by spinal nerve ligation (SNL), we investigated the potency of T10 for the treatment of comorbid depression in comparison with a widely used antidepressant, fluoxetine (FLX). Concomitant neuroinflammation changes were also examined in the hippocampus. The results showed that prophylactic and reversal treatments with T10 dose-dependently (30, 100, 300μg/kg) inhibited the depression-like behaviors (DLB) assessed by the forced swim test, sucrose preference test and body weight measurement. The anti-depressive efficacy of T10 at 300μg/kg was significantly stronger than that of FLX at 18mg/kg. T10 at all three doses exhibited more efficient analgesic effects than FLX at 18mg/kg. The combined application of T10 with FLX markedly augmented the effects of T10 or FLX per se, with the facilitating effects of T10 at 30μg/kg being most prominent. In addition, nerve injury caused the activation of microglia and p38 MAPK, the upregulation of IL-1β and TNF-α as well as the downregulation of IL-10 in the hippocampus at postoperative week (POW) 3. These neuroinflammatory responses were reversed by subchronic treatment with T10. Taken together, these results demonstrate that T10 possesses potent anti-depressive function, which is correlated with its immunoregulation in the hippocampus. The combination of a low dose of T10 with FLX may become a more effective medication strategy for the treatment of comorbid depression and chronic pain.
Collapse
Affiliation(s)
- Xiaofan Hu
- Department of Human Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China; Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Yulin Dong
- Department of Human Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China
| | - Xiaohang Jin
- Department of Human Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China
| | - Chunkui Zhang
- Department of Human Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China
| | - Ting Zhang
- Department of Human Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China
| | - Jie Zhao
- Department of Human Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China
| | - Juan Shi
- Department of Human Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China.
| | - Jinlian Li
- Department of Human Anatomy, Histology and Embryology & K. K. Leung Brain Research Centre, Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China.
| |
Collapse
|