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Santos Passos FR, Pereira EWM, Heimfarth L, Monteiro BS, Barbosa Gomes de Carvalho YM, Siqueira-Lima PS, Melo Coutinho HD, Antunes de Souza Araújo A, Guedes da Silva Almeida JR, Barreto RSS, Picot L, Quintans-Júnior LJ, Quintans JSS. Role of peripheral and central sensitization in the anti-hyperalgesic effect of hecogenin acetate, an acetylated sapogenin, complexed with β-cyclodextrin: Involvement of NFκB and p38 MAPK pathways. Neuropharmacology 2021; 186:108395. [PMID: 33516738 DOI: 10.1016/j.neuropharm.2020.108395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/29/2020] [Accepted: 11/05/2020] [Indexed: 12/30/2022]
Abstract
Neuropathic pain develops due to injury to the somatosensory system, affecting the patient's quality of life. In view of the ineffectiveness of the current pharmacotherapy, substances obtained from natural products (NPs) are a promising alternative. One NP that has been discussed in the literature is hecogenin acetate (HA), a steroidal sapogenin with anti-inflammatory and antinociceptive activity. However, HA has low water solubility, which affects its bioavailability. Thus, the objective of this study was to evaluate the anti-hyperalgesic activity of pure and complexed hecogenin acetate (HA/βCD) in an animal model of chronic neuropathic and inflammatory pain. The inclusion complex was prepared at a molar ratio of 1:2 (HA:βCD) by the lyophilization method. For the induction of chronic inflammatory pain, the mice received an intraplantar injection of CFA (complete Freund's adjuvant), and were evaluated for mechanical hyperalgesia and for the levels of myeloperoxidase (MPO) in the skin of the paw after eight days of treatment. HA and HA/βCD reduced mechanical hyperalgesia in relation to the vehicle group until the fourth and fifth hours, respectively, in the acute evaluation, with a superior effect of the complexed form over the pure form in the second and third hour after treatment (p < 0.001). In the chronic evaluation, HA and HA/βCD reduced hyperalgesia in relation to the vehicle in the eight days of treatment (p < 0.001). Both pure (p < 0.01) and complexed (p < 0.001) forms reduced myeloperoxidase activity in the skin of the animals' paw. Groups of animals subjected to the same pharmacological protocol were submitted to the partial sciatic nerve ligation (PSNL) model and evaluated for mechanical and thermal hyperalgesia, and cold allodynia. HA and HA/βCD reduced mechanical hyperalgesia until the fourth and sixth hours, respectively, and both reduced hyperalgesia in relation to the vehicle in the chronic evaluation (p < 0.001). HA and HA/βCD also reduced thermal hyperalgesia and cold allodynia (p < 0.05 and p < 0.001, respectively). The analysis of the spinal cord of these animals showed a decrease in the levels of the pro-inflammatory cytokines TNF-α, IL-1β and IL-6 and a reduction in the phosphorylation of NFκB and p38MAPK, as well as a decrease in microglioses compared to the vehicle group. In addition, HA/βCD reduced the nociception induced by intraplantar injection of agonist TRPA1 (p < 0.01) and TRPM8 (p < 0.05). Treatment for eight days with HA and HA/βCD showed no signs of gastric or liver damage. HA and HA/βCD were, therefore, shown to have antinociceptive effects in chronic pain models. Based on our exploration of the mechanisms of the action of HA, these effects are likely to be related to inhibited leukocyte migration, interaction with the TRPA1 and TRPM8 receptors, reduced pro-inflammatory cytokines levels, microglial expression and suppression of NF-κB p65 and p38 MAPK pathway signaling. Therefore, HA/βCD has great potential for use in the treatment of chronic pain.
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Affiliation(s)
- Fabiolla Rocha Santos Passos
- Laboratory of Neurosciences and Pharmacological Assays (LANEF- Laboratório de Neurociências e Ensaios Farmacológicos), Department of Physiology, Federal University of Sergipe, São Cristóvão, Brazil; Health Sciences Graduate Program, Brazil
| | - Erik W M Pereira
- Laboratory of Neurosciences and Pharmacological Assays (LANEF- Laboratório de Neurociências e Ensaios Farmacológicos), Department of Physiology, Federal University of Sergipe, São Cristóvão, Brazil; Health Sciences Graduate Program, Brazil
| | - Luana Heimfarth
- Laboratory of Neurosciences and Pharmacological Assays (LANEF- Laboratório de Neurociências e Ensaios Farmacológicos), Department of Physiology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Brenda S Monteiro
- Laboratory of Neurosciences and Pharmacological Assays (LANEF- Laboratório de Neurociências e Ensaios Farmacológicos), Department of Physiology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Yasmim Maria Barbosa Gomes de Carvalho
- Laboratory of Neurosciences and Pharmacological Assays (LANEF- Laboratório de Neurociências e Ensaios Farmacológicos), Department of Physiology, Federal University of Sergipe, São Cristóvão, Brazil
| | | | | | | | | | - Rosana S S Barreto
- Laboratory of Neurosciences and Pharmacological Assays (LANEF- Laboratório de Neurociências e Ensaios Farmacológicos), Department of Physiology, Federal University of Sergipe, São Cristóvão, Brazil
| | - Laurent Picot
- La Rochelle Université, UMRi CNRS 7266 LIENSs, 17042, La Rochelle, France
| | - Lucindo J Quintans-Júnior
- Laboratory of Neurosciences and Pharmacological Assays (LANEF- Laboratório de Neurociências e Ensaios Farmacológicos), Department of Physiology, Federal University of Sergipe, São Cristóvão, Brazil; Health Sciences Graduate Program, Brazil
| | - Jullyana S S Quintans
- Laboratory of Neurosciences and Pharmacological Assays (LANEF- Laboratório de Neurociências e Ensaios Farmacológicos), Department of Physiology, Federal University of Sergipe, São Cristóvão, Brazil; Health Sciences Graduate Program, Brazil.
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Creed SM, Gutridge AM, Argade MD, Hennessy MR, Friesen JB, Pauli GF, van Rijn RM, Riley AP. Isolation and Pharmacological Characterization of Six Opioidergic Picralima nitida Alkaloids. JOURNAL OF NATURAL PRODUCTS 2021; 84:71-80. [PMID: 33326237 PMCID: PMC7932029 DOI: 10.1021/acs.jnatprod.0c01036] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The seeds of the akuamma tree (Picralima nitida) have been used as a traditional treatment for pain and fever. Previous studies have attributed these effects to a series of indole alkaloids found within the seed extracts; however, these pharmacological studies were significantly limited in scope. Herein, an isolation protocol employing pH-zone-refining countercurrent chromatography was developed to provide six of the akuamma alkaloids in high purity and quantities sufficient for more extensive biological evaluation. Five of these alkaloids, akuammine (1), pseudo-akuammigine (3), akuammicine (4), akuammiline (5), and picraline (6), were evaluated against a panel of >40 central nervous system receptors to identify that their primary targets are the opioid receptors. Detailed in vitro investigations revealed 4 to be a potent kappa opioid receptor agonist, and three alkaloids (1-3) were shown to have micromolar activity at the mu opioid receptor. The mu opioid receptor agonists were further evaluated for analgesic properties but demonstrated limited efficacy in assays of thermal nociception. These findings contradict previous reports of the antinociceptive properties of the P. nitida alkaloids and the traditional use of akuamma seeds as analgesics. Nevertheless, their opioid-preferring activity does suggest the akuamma alkaloids provide distinct scaffolds from which novel opioids with unique pharmacologic properties and therapeutic utility can be developed.
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Affiliation(s)
- Simone M Creed
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - Anna M Gutridge
- Department of Medicinal Chemistry and Molecular Pharmacology, College of Pharmacy, Purdue University, West Lafayette, Indiana 47907, United States
| | - Malaika D Argade
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - Madeline R Hennessy
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - J Brent Friesen
- Department of Pharmaceutical Sciences and Pharmacognosy Institute, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - Guido F Pauli
- Department of Pharmaceutical Sciences and Pharmacognosy Institute, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - Richard M van Rijn
- Department of Medicinal Chemistry and Molecular Pharmacology, College of Pharmacy, Purdue Institute for Drug Discovery, Purdue Institute for Integrative Neuroscience, Purdue Interdisciplinary Life Sciences Graduate Program, Purdue University, West Lafayette, Indiana 47907, United States
| | - Andrew P Riley
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
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Ahmed F, Tscharke B, O'Brien JW, Cabot PJ, Hall WD, Mueller JF, Thomas KV. Can wastewater analysis be used as a tool to assess the burden of pain treatment within a population? ENVIRONMENTAL RESEARCH 2020; 188:109769. [PMID: 32535354 DOI: 10.1016/j.envres.2020.109769] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/30/2020] [Accepted: 05/30/2020] [Indexed: 06/11/2023]
Abstract
Pain is a global health priority that is challenging to asses. Here we propose a new approach to estimating the burden of pain treatment in a population using wastewater-based epidemiology (WBE). WBE is able to quantify multiple pharmaceutical compounds in order to estimate consumption by a population. Wastewater samples collected from areas representing whole communities can be analysed to estimate the consumption of drugs used to treat pain, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. The collection and analysis of wastewater can be conducted systematically to estimate the total consumption of NSAIDs and/or opioids in the population of a catchment area and to compare changes over time within the catchment or between different catchment populations. Consumption estimates can be combined by standardising the mass consumed to Defined Daily Doses (DDD) or morphine equivalents in order to assess, the population burden of pain treatment from mild to moderate (for NSAIDs) and for strong and severe pain (for opioids). We propose this method could be used to evaluate the total pain treatment burden between locations and over time. While this concept shows promise, future studies should evaluate the applicability as a tool to measure the burden of pain receiving treatment in a community.
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Affiliation(s)
- Fahad Ahmed
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD, 4102, Australia.
| | - Benjamin Tscharke
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD, 4102, Australia
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD, 4102, Australia
| | - Peter J Cabot
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD, 4102, Australia
| | - Wayne D Hall
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD, 4102, Australia; Centre for Youth Substance Abuse Research, The University of Queensland, Herston, QLD, 4029, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD, 4102, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD, 4102, Australia
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Cabarga L, Batallé G, Pol O. Treatment with slow-releasing hydrogen sulfide donors inhibits the nociceptive and depressive-like behaviours accompanying chronic neuropathic pain: Endogenous antioxidant system activation. J Psychopharmacol 2020; 34:737-749. [PMID: 32312156 DOI: 10.1177/0269881120913154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Therapies to treat chronic neuropathic pain and its associated comorbidities are limited. Recent studies demonstrated that the administration of slow-releasing hydrogen sulfide (H2S) donors inhibited chemotherapy-induced neuropathic pain. However, the antidepressant or anxiolytic effects of these compounds and their mechanisms of action during chronic neuropathic pain have not been evaluated. AIMS To determine whether the administration of two slow-releasing H2S donors, allyl isothiocyanate (A-ITC) and phenyl isothiocyanate (P-ITC), inhibits the nociceptive and emotional disorders associated with chronic neuropathic pain. METHODS In C57BL/6 male mice with neuropathic pain caused by the chronic constriction of the sciatic nerve, we assessed the effects of intraperitoneal administration of A-ITC and P-ITC in (a) the mechanical allodynia, thermal hyperalgesia and thermal allodynia induced by nerve ligation; (b) the anxiety- and depressive-like behaviours linked with neuropathic pain; (c) glial activation and mitogen-activated protein kinases phosphorylation, and (d) expression of the antioxidant enzymes, heme oxygenase 1 (HO-1), NADPH quinone oxidoreductase1, and glutathione S-transferase mu-1 (GSTM1), and alpha-1 (GSTA1), in hippocampus and prefrontal cortex (PFC). RESULTS Both treatments inhibited the allodynia and hyperalgesia, depressive-like behaviours, astroglial activation, and the extracellular signal-regulated kinase 1/2 phosphorylation but were unable to abolish the anxiety-like behaviours accompanying neuropathic pain. A-ITC and P-ITC also augmented the expression of HO-1, GSTM1, and GSTA1 in the hippocampus and/or PFC. CONCLUSIONS The administration of slow-releasing H2S donors might be a promising treatment for the management of chronic neuropathic pain and some associated comorbidities via inhibiting the inflammatory and plasticity changes, and activating the endogenous antioxidant responses.
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Affiliation(s)
- Laura Cabarga
- Grup de Neurofarmacologia Molecular, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain.,Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Gerard Batallé
- Grup de Neurofarmacologia Molecular, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain.,Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
| | - Olga Pol
- Grup de Neurofarmacologia Molecular, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain.,Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Catalunya, Spain
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Rettke H, Naef R, Rufer M, Peng-Keller S. Spiritual Care und chronischer Schmerz: Die Sicht von Fachpersonen. Eine qualitative Untersuchung. ACTA ACUST UNITED AC 2020. [DOI: 10.1515/spircare-2019-0072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Zusammenfassung
Chronischer Schmerz ist ein komplexes Phänomen, das alle Lebensdimensionen betrifft: die psychische, soziale und spirituelle nicht weniger als die physische. Diesem Umstand muss in der Behandlung dieser Patientengruppe Rechnung getragen werden. Wir untersuchten, an welche Voraussetzungen dafür im Deutschschweizer Raum bereits angeknüpft werden kann. An fünf Studienzentren wurden insgesamt 34 Fachpersonen in interprofessionell gemischten Fokusgruppen dazu interviewt, welche spirituellen Anliegen und Bedürfnisse von Patient/-innen mit chronischen Schmerzen sie wahrnehmen und wie diese im Behandlungsprozess berücksichtigt werden können. Eine thematische Analyse zeigte drei Kernthemen: die Relevanz spiritueller Aspekte in der multimodalen Schmerztherapie, handlungsleitende Überzeugungen und die Kompetenz zu Spiritual Care. Die Befragten waren der spirituellen Thematik gegenüber generell aufgeschlossen. Aus ihrer Sicht stellt die Integration spiritueller Anliegen und Bedürfnisse im Behandlungsprozess einen Mehrwert für die Behandlungsqualität in dieser Patientengruppe dar. Dies konsequent umzusetzen, stellt sie jedoch vor teilweise ungelöste Herausforderungen. Hier braucht es Befähigung und institutionelle Unterstützung, um Spiritual Care den entsprechenden Raum zu geben.
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Affiliation(s)
- Horst Rettke
- UniversitätsSpital Zürich – Zentrum Klinische Pflegewissenschaft Zürich Switzerland
| | - Rahel Naef
- Universitätsspital Zürich , Zentrum Klinische Pflegewissenschaft. Switzerland
| | - Michael Rufer
- Psychiatrische Universitätsklinik Zürich . Switzerland
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Zidarov D, Zidarova-Carrié A, Visca R, Miller JM, Brecht K, Viens N, Ahmed S. Core patient-reported outcome domains for routine clinical care in chronic pain management: patients' and healthcare professionals' perspective. Qual Life Res 2020; 29:2007-2020. [PMID: 32125600 DOI: 10.1007/s11136-020-02459-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To identify a core patient-reported outcome (PRO) domain set to be used in routine clinical care in settings offering specialized and supra-specialized multidisciplinary care to individuals with chronic pain (CP). METHODS Two online cross-sectional surveys were administered: one with healthcare professionals (HCPs) and one with individuals with CP. Both surveys included domains of health-related quality of life (HRQoL) from the Patient-Reported Outcomes Measurement Information System (PROMIS) framework. The patients' survey also included the Patient Generated Index (PGI). Areas affected by CP identified in the PGI were mapped to The International Classification of Functioning, Disability and Health (ICF). RESULTS According to HCPs, the five most relevant HRQoL domains to be assessed in routine clinical care were pain interference, pain intensity, physical function, anxiety and depression. The five areas that were the most valued by individuals with CP were recreation and leisure; global mental function; work and employment; household tasks and walking and moving. In total, these represented 74% of all nominated areas. When triangulating both frameworks (ICF/PROMIS) and perspectives (HCPs/patients), 10 core PRO domains were identified: pain interference, pain intensity, physical function, sleep disturbance, anxiety, depression, ability to participate in social roles and activities, fatigue, sleep-related impairments and self-efficacy. CONCLUSIONS This study identified 10 core PRO domains covering the physical, psychological and social consequences of CP on an individual's life from the perspective of individuals with CP and HCPs. The results can help identify appropriate PRO measures to assess the outcomes of multidisciplinary interventions.
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Affiliation(s)
- Diana Zidarov
- Faculty of Medicine, School of Rehabilitation, Université de Montreal, Montreal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montreal, QC, Canada
| | | | - Regina Visca
- McGill Integrated University Health Network (RUIS) Centre of Expertise in Chronic Pain, Montreal, Canada
| | - J Marc Miller
- Clinique d'adaptation à la douleur chronique, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Centre de réadaptation Lucie-Bruneau, Montreal, Canada
| | - Krista Brecht
- Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Natacha Viens
- Direction du soutien de l'autonomie des personnes âgées, Centre intégré universitaire de santé et de services sociaux de l'Ouest-de-l'île-de-Montréal, Montreal, Canada
| | - Sara Ahmed
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montreal, QC, Canada.
- McGill Integrated University Health Network (RUIS) Centre of Expertise in Chronic Pain, Montreal, Canada.
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3654 Prom. Sir William Osler, Montreal, QC, Canada.
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