1
|
Li DJ, Zhong ZJ, Wang XL, Wei N, Zhao SJ, Shan TT, Liu YP, Yu YQ. Chemokine receptor CXCR2 in primary sensory neurons of trigeminal ganglion mediates orofacial itch. Front Mol Neurosci 2023; 16:1279237. [PMID: 37953876 PMCID: PMC10637378 DOI: 10.3389/fnmol.2023.1279237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Abstract
The CXCR2 chemokine receptor is known to have a significant impact on the initiation and control of inflammatory processes. However, its specific involvement in the sensation of itch is not yet fully understood. In this study, we aimed to elucidate the function of CXCR2 in the trigeminal ganglion (TG) by utilizing orofacial itch models induced by incision, chloroquine (CQ), and histamine. Our results revealed a significant up-regulation of CXCR2 mRNA and protein expressions in the primary sensory neurons of TG in response to itch stimuli. The CXCR2 inhibitor SB225002 resulted in notable decrease in CXCR2 protein expression and reduction in scratch behaviors. Distal infraorbital nerve (DION) microinjection of a specific shRNA virus inhibited CXCR2 expression in TG neurons and reversed itch behaviors. Additionally, the administration of the PI3K inhibitor LY294002 resulted in a decrease in the expressions of p-Akt, Akt, and CXCR2 in TG neurons, thereby mitigating pruritic behaviors. Collectively, we report that CXCR2 in the primary sensory neurons of trigeminal ganglion contributes to orofacial itch through the PI3K/Akt signaling pathway. These observations highlight the potential of molecules involved in the regulation of CXCR2 as viable therapeutic targets for the treatment of itch.
Collapse
Affiliation(s)
- Dong-Jin Li
- College of Life Sciences, Northwest University, Xi’an, China
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Zhen-Juan Zhong
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Xiao-Liang Wang
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Na Wei
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Si-Jia Zhao
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Ting-Ting Shan
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Ya-Ping Liu
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| | - Yao-Qing Yu
- College of Life Sciences, Northwest University, Xi’an, China
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Air Force Medical University, Xi’an, China
- Key Laboratory of Brain Stress and Behavior, People’s Liberation Army, Xi’an, China
| |
Collapse
|
2
|
Kikui S, Miyahara J, Sugiyama H, Kohashi M, Ota K, Danno D, Kashiwaya Y, Takeshima T. A Combination of Indomethacin Farnesyl and Amitriptyline Is Effective for Continuous Interictal Pain with Probable Chronic Paroxysmal Hemicrania. Intern Med 2022; 61:413-417. [PMID: 34176839 PMCID: PMC8866799 DOI: 10.2169/internalmedicine.7511-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 26-year-old woman with a history of migraine reported right-sided, severe stabbing orbital pain with cranial autonomic symptoms (CASs) for approximately 2 years. The attack duration was approximately 30 minutes, with a frequency of twice per day. Taking loxoprofen was ineffective. Six months earlier, moderate pressing continuous interictal pain without CASs had developed. Indomethacin farnesyl completely resolved the attacks but had no effect on the interictal pain. The patient was diagnosed with probable chronic paroxysmal hemicrania in accordance with the International Classification of Headache Disorders (ICHD-3) (third version). Continuous interictal pain gradually disappeared with a combination of indomethacin farnesyl and amitriptyline.
Collapse
Affiliation(s)
- Shoji Kikui
- Department of Neurology, Headache Center, Tominaga Hospital, Japan
| | - Junichi Miyahara
- Department of Neurology, Headache Center, Tominaga Hospital, Japan
| | - Hanako Sugiyama
- Department of Neurology, Headache Center, Tominaga Hospital, Japan
| | - Mutsuo Kohashi
- Department of Neurology, Headache Center, Tominaga Hospital, Japan
| | - Kuniko Ota
- Department of Neurology, Headache Center, Tominaga Hospital, Japan
| | - Daisuke Danno
- Department of Neurology, Headache Center, Tominaga Hospital, Japan
| | | | - Takao Takeshima
- Department of Neurology, Headache Center, Tominaga Hospital, Japan
| |
Collapse
|
3
|
Day M, Abd-Elsayed A, Ashworth B. Algorithms for Management Recommendations. TRIGEMINAL NERVE PAIN 2021:229-242. [DOI: 10.1007/978-3-030-60687-9_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
4
|
Jose A, Prasad RS, Pai A. Trigeminal autonomic cephalalgias: The impersonators. INDIAN JOURNAL OF PAIN 2019. [DOI: 10.4103/ijpn.ijpn_2_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
5
|
Abstract
The primary headaches are composed of multiple entities that cause episodic and chronic head pain in the absence of an underlying pathologic process, disease, or traumatic injury. The most common of these are migraine, tension-type headache, and the trigeminal autonomic cephalalgias. This article reviews the clinical presentation, pathophysiology, and treatment of each to help in differential diagnosis. These headache types share many common signs and symptoms, thus a clear understanding of each helps prevent a delay in diagnosis and inappropriate or ineffective treatment. Many of these patients seek dental care because orofacial pain is a common presenting symptom.
Collapse
Affiliation(s)
- Robert W Mier
- Tufts University School of Dental Medicine, 1 Kneeland Street, Suite 601, Boston, MA 02111, USA.
| | - Shuchi Dhadwal
- Tufts University School of Dental Medicine, 1 Kneeland Street, Suite 601, Boston, MA 02111, USA
| |
Collapse
|
6
|
Sphenopalatine Ganglion Block for the Treatment of Acute Migraine Headache. PAIN RESEARCH AND TREATMENT 2018; 2018:2516953. [PMID: 29862074 PMCID: PMC5971252 DOI: 10.1155/2018/2516953] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 03/28/2018] [Indexed: 01/03/2023]
Abstract
Transnasal sphenopalatine ganglion block is emerging as is an attractive and effective treatment modality for acute migraine headaches, cluster headache, trigeminal neuralgia, and several other conditions. We assessed the efficacy and safety of this treatment using the Sphenocath® device. 55 patients with acute migraine headaches underwent this procedure, receiving 2 ml of 2% lidocaine in each nostril. Pain numeric rating scale (baseline, 15 minutes, 2 hours, and 24 hours) and patient global impression of change (2 hours and 24 hours after treatment) were recorded. The majority of patients became headache-free at 15 minutes, 2 hours, and 24 hours after procedure (70.9%, 78.2%, and 70.4%, resp.). The rate of headache relief (50% or more reduction in headache intensity) was 27.3% at 15 minutes, 20% at 2 hours, and 22.2% at 24 hours. The mean pain numeric rating scale decreased significantly at 15 minutes, 2 hours, and 24 hours, respectively. Most patients rated the results as very good or good. The procedure was well-tolerated with few adverse events. This treatment is emerging as an effective and safe option for management of acute migraine attacks.
Collapse
|
7
|
Hassan S, Lagrata S, Levy A, Matharu M, Zrinzo L. Microvascular decompression or neuromodulation in patients with SUNCT and trigeminal neurovascular conflict? Cephalalgia 2017; 38:393-398. [DOI: 10.1177/0333102417735847] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives To assess the effectiveness of neuromodulation and trigeminal microvascular decompression (MVD) in patients with medically-intractable short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). Methods Two patients with medically refractory SUNCT underwent MVD following beneficial but incomplete response to neuromodulation (occipital nerve stimulation and deep brain stimulation). MRI confirmed neurovascular conflict with the ipsilateral trigeminal nerve in both patients. Results Although neuromodulation provided significant benefit, it did not deliver complete relief from pain and management required numerous postoperative visits with adjustment of medication and stimulation parameters. Conversely, MVD was successful in eliminating symptoms of SUNCT in both patients with no need for further medical treatment or neuromodulation. Conclusion Neuromodulation requires expensive hardware and lifelong follow-up and maintenance. These case reports highlight that microvascular decompression may be preferable to neuromodulation in the subset of SUNCT patients with ipsilateral neurovascular conflict.
Collapse
Affiliation(s)
- Samih Hassan
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Susie Lagrata
- Headache Group, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Andrew Levy
- Headache Group, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Manjit Matharu
- Headache Group, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Ludvic Zrinzo
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, London, UK
| |
Collapse
|
8
|
de Coo I, van Dijk JMC, Metzemaekers JD, Haan J. A Case Report About Cluster-Tic Syndrome Due to Venous Compression of the Trigeminal Nerve. Headache 2016; 57:654-657. [DOI: 10.1111/head.12990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Ilse de Coo
- Department of Neurology; Leiden University Medical Center; Leiden The Netherlands
| | - J. Marc C. van Dijk
- Department of Neurosurgery; University Medical Center Groningen; Groningen The Netherlands
| | | | - Joost Haan
- Department of Neurology; Leiden University Medical Center; Leiden The Netherlands
| |
Collapse
|
9
|
Abstract
Cluster headache (CH), one of the most painful syndromes known to man, is managed with acute and preventive medications. The brief duration and severity of the attacks command the use of rapid-acting pain relievers. Inhalation of oxygen and subcutaneous sumatriptan are the two most effective acute therapeutic options for sufferers of CH. Several preventive medications are available, the most effective of which is verapamil. However, most of these agents are not backed by strong clinical evidence. In some patients, these options can be ineffective, especially in those who develop chronic CH. Surgical procedures for the chronic refractory form of the disorder should then be contemplated, the most promising of which is hypothalamic deep brain stimulation. We hereby review the pathogenesis of CH and the evidence behind the treatment options for this debilitating condition.
Collapse
Affiliation(s)
- Rubesh Gooriah
- Department of Neurology, Hull Royal Infirmary, Kingston upon Hull, UK
| | - Alina Buture
- Department of Neurology, Hull Royal Infirmary, Kingston upon Hull, UK
| | - Fayyaz Ahmed
- Department of Neurology, Hull Royal Infirmary, Kingston upon Hull, UK
| |
Collapse
|
10
|
Charleston L. Do Trigeminal Autonomic Cephalalgias Represent Primary Diagnoses or Points on a Continuum? Curr Pain Headache Rep 2015; 19:22. [DOI: 10.1007/s11916-015-0493-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
11
|
Lambru G, Shanahan P, Matharu M. Exacerbation of SUNCT and SUNA syndromes during intravenous dihydroergotamine treatment: A case series. Cephalalgia 2015; 35:1115-24. [PMID: 25667300 DOI: 10.1177/0333102415570495] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 01/05/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND The management of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and with short-lasting unilateral neuralgiform headache attacks with autonomic symptoms (SUNA) remains challenging in view of the limited understanding of their pathophysiological mechanisms. METHODS An initial observation that patients with both chronic migraine (CM) or cluster headache (CH) and SUNCT/SUNA receiving intravenous dihydroergotamine (IV DHE) had complained of dramatic worsening of the latter led to review of the case notes of patients with CM or CH and co-existent SUNCT/SUNA seen between 2008 and 2013 and who had a trial of IV DHE. RESULTS Twenty-four patients were identified. IV DHE was ineffective for SUNCT/SUNA in 16 patients, while one patient reported a marginal improvement. Five patients reported dramatic worsening of the SUNCT/SUNA. Moreover, two patients developed new-onset SUNA during their first IV DHE infusion. Out of these seven patients, those requiring repeated courses of IV DHE consistently experienced exacerbations of SUNCT/SUNA which were suppressed with IV lidocaine. CONCLUSIONS DHE is an ineffective treatment option for SUNCT and SUNA. Physicians who intend to offer IV DHE to CH or CM patients should warn them that IV DHE could exacerbate and possibly even lead to a de novo onset of SUNCT/SUNA. In view of the reported worsening or new onset of SUNCT/SUNA in patients using dopamine agonists for the treatment of pituitary prolactinomas, we speculate that DHE might worsen or induce SUNCT and SUNA, at least in a sub-group of patients, through a perturbation in the dopaminergic system.
Collapse
Affiliation(s)
| | - Paul Shanahan
- The National Hospital for Neurology and Neurosurgery, London, UK
| | - Manjit Matharu
- Institute of Neurology, UCL, London, UK The National Hospital for Neurology and Neurosurgery, London, UK
| |
Collapse
|
12
|
|