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Colosimo MM, Nezu CM, Nezu FM, Nezu AM. Social problem solving as a mediator of stress and chronic prostatitis symptomology. PSYCHOL HEALTH MED 2024; 29:448-452. [PMID: 36267040 DOI: 10.1080/13548506.2022.2132410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 08/09/2022] [Indexed: 10/24/2022]
Abstract
Social problem solving (SPS), the process by which individuals attempt to cope with stressful life problems, has previously been found to mediate the relationship between stress and disorder-related symptomatology among several medical patient populations. The present study sought to identify a similar relationship among a sample of 63 men diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Results found that SPS mediated the relationship between two different measures of stress and CP/CPPS symptoms. These results suggest that attempts to foster patients' SPS efficacy may help reduce CP/CPPS-related negative symptoms.
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Affiliation(s)
- Meghan M Colosimo
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | - Christine Maguth Nezu
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
| | | | - Arthur M Nezu
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, USA
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Tay C, Grundy L. Animal models of interstitial cystitis/bladder pain syndrome. Front Physiol 2023; 14:1232017. [PMID: 37731545 PMCID: PMC10507411 DOI: 10.3389/fphys.2023.1232017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/01/2023] [Indexed: 09/22/2023] Open
Abstract
Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic disorder characterized by pelvic and/or bladder pain, along with lower urinary tract symptoms that have a significant impact on an individual's quality of life. The diverse range of symptoms and underlying causes in IC/BPS patients pose a significant challenge for effective disease management and the development of new and effective treatments. To facilitate the development of innovative therapies for IC/BPS, numerous preclinical animal models have been developed, each focusing on distinct pathophysiological components such as localized urothelial permeability or inflammation, psychological stress, autoimmunity, and central sensitization. However, since the precise etiopathophysiology of IC/BPS remains undefined, these animal models have primarily aimed to replicate the key clinical symptoms of bladder hypersensitivity and pain to enhance the translatability of potential therapeutics. Several animal models have now been characterized to mimic the major symptoms of IC/BPS, and significant progress has been made in refining these models to induce chronic symptomatology that more closely resembles the IC/BPS phenotype. Nevertheless, it's important to note that no single model can fully replicate all aspects of the human disease. When selecting an appropriate model for preclinical therapeutic evaluation, consideration must be given to the specific pathology believed to underlie the development of IC/BPS symptoms in a particular patient group, as well as the type and severity of the model, its duration, and the proposed intervention's mechanism of action. Therefore, it is likely that different models will continue to be necessary for preclinical drug development, depending on the unique etiology of IC/BPS being investigated.
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Affiliation(s)
- Cindy Tay
- Neurourology Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
| | - Luke Grundy
- Neurourology Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
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3
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Okui N, Okui MA, Kouno Y, Nakano K. Laser Treatment for Patients With Vulvodynia and Interstitial Cystitis/Bladder Pain Syndrome: A Case Series (The UNICORN-3 Study). Cureus 2023; 15:e41786. [PMID: 37449291 PMCID: PMC10338019 DOI: 10.7759/cureus.41786] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic pain disorder characterized by urgency, frequency of urination, and pelvic pain. Women with IC/BPS often experience sexual dysfunction, vulvodynia, and vaginal health issues. Combined erbium and neodymium yttrium aluminum garnet (YAG) laser treatments targeting the vagina and vulva have shown promise in improving symptoms. Our study aims to investigate the effectiveness of these combined laser treatments in women with IC/BPS and vulvodynia. Methods Women diagnosed with vulvodynia and IC/BPS underwent combined laser treatment using vaginal erbium:YAG laser (VEL) and neodymium:YAG laser (Nd:YAG). Various parameters were evaluated, including the vulvodynia test, numeric rating scale (NRS-11) for pain, interstitial cystitis symptom index and problem index (ICSI and ICPI), pelvic pain and urgency/frequency symptom score (PUF), and mean urination volume/daily urination frequency in a three-day urination diary. Treatment was administered three times, with intervals of one month between each session, and follow-up evaluations were conducted at six and 12 months. All statistical analyses were designed and programmed by the AI chatbot GPT-4 (chatGPT-4). Results Fifteen female patients diagnosed with vulvodynia and IC/BPS were treated with three sessions of VEL + Nd:YAG. Significant improvements were observed in the vulvodynia test, NRS-11 scores, PUF, ICSI scores, ICPI scores, mean urination volume, and daily urination frequency at six and 12 months (p<0.01). Short-term improvements in IC/BPS pain scores correlated with improvements in the vulvodynia test (p=0.007), suggesting a synergistic effect. However, no significant correlations were found at 12 months. Conclusion Combined laser treatments targeting the vagina and vulva showed significant therapeutic effects in women with IC/BPS and vulvodynia. The addition of Nd:YAG to the VEL treatment enhanced outcomes. Short-term improvements in IC/BPS pain scores correlated with improvements in the vulvodynia test, indicating a synergistic effect. Long-term improvements in both vulvodynia and IC/BPS symptoms may occur independently. These findings highlight the importance of comprehensive approaches for treating coexisting vulvodynia and IC/BPS.
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Affiliation(s)
- Nobuo Okui
- Dentistry, Kanagawa Dental University, Kanagawa, JPN
| | | | - Yuko Kouno
- Urology, Dr Okui's Urogynecology and Urology, Yokosuka, JPN
| | - Kaori Nakano
- Urology, Dr Okui's Urogynecology and Urology, Yokosuka, JPN
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Girard BM, Campbell SE, Vizzard MA. Stress-induced symptom exacerbation: Stress increases voiding frequency, somatic sensitivity, and urinary bladder NGF and BDNF expression in mice with subthreshold cyclophosphamide (CYP). FRONTIERS IN UROLOGY 2023; 3:1079790. [PMID: 37811396 PMCID: PMC10558155 DOI: 10.3389/fruro.2023.1079790] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Symptom exacerbation due to stress is prevalent in many disease states, including functional disorders of the urinary bladder (e.g., overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS)); however, the mechanisms underlying the effects of stress on micturition reflex function are unclear. In this study we designed and evaluated a stress-induced symptom exacerbation (SISE) mouse model that demonstrates increased urinary frequency and somatic (pelvic and hindpaw) sensitivity. Cyclophosphamide (CYP) (35 mg/kg; i.p., every 48 hours for a total of 4 doses) or 7 days of repeated variate stress (RVS) did not alter urinary bladder function or somatic sensitivity; however, both CYP alone and RVS alone significantly (p ≤ 0.01) decreased weight gain and increased serum corticosterone. CYP treatment when combined with RVS for 7 days (CYP+RVS) significantly (p ≤ 0.01) increased serum corticosterone, urinary frequency and somatic sensitivity and decreased weight gain. CYP+RVS exposure in mice significantly (p ≤ 0.01) increased (2.6-fold) voiding frequency as we determined using conscious, open-outlet cystometry. CYP+RVS significantly (p ≤ 0.05) increased baseline, threshold, and peak micturition pressures. We also evaluated the expression of NGF, BDNF, CXC chemokines and IL-6 in urinary bladder in CYP alone, RVS alone and CYP+RVS mouse cohorts. Although all treatments or exposures increased urinary bladder NGF, BDNF, CXC and IL-6 content, CYP+RVS produced the largest increase in all inflammatory mediators examined. These results demonstrated that CYP alone or RVS alone creates a change in the inflammatory environment of the urinary bladder but does not result in a change in bladder function or somatic sensitivity until CYP is combined with RVS (CYP+RVS). The SISE model of CYP+RVS will be useful to develop testable hypotheses addressing underlying mechanisms where psychological stress exacerbates symptoms in functional bladder disorders leading to identification of targets and potential treatments.
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Affiliation(s)
- Beatrice M Girard
- The Larner College of Medicine at The University of Vermont, Department of Neurological Sciences, Burlington, VT, 05405
| | - Susan E Campbell
- The Larner College of Medicine at The University of Vermont, Department of Neurological Sciences, Burlington, VT, 05405
| | - Margaret A Vizzard
- The Larner College of Medicine at The University of Vermont, Department of Neurological Sciences, Burlington, VT, 05405
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Ramsay S, Zagorodnyuk V. Role of circadian rhythms and melatonin in bladder function in heath and diseases. Auton Neurosci 2023; 246:103083. [PMID: 36871511 DOI: 10.1016/j.autneu.2023.103083] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023]
Abstract
The circadian system modulates all visceral organ physiological processes including urine storage and voiding. The "master clock" of the circadian system lies within suprachiasmatic nucleus of the hypothalamus while "peripheral clocks" are found in most peripheral tissue and organs, including the urinary bladder. Disruptions of circadian rhythms can cause organ malfunction and disorder or exacerbate pre-existing ones. It has been suggested that nocturia, which develops mostly in the elderly, could be a circadian-related disorder of the bladder. In the bladder, many types of gap junctions and ion channels in the detrusor, urothelium and sensory nerves are likely under strict local peripheral circadian control. The pineal hormone, melatonin, is a circadian rhythm synchroniser capable of controlling a variety of physiological processes in the body. Melatonin predominantly acts via the melatonin 1 and melatonin 2 G-protein coupled receptors expressed in the central nervous system, and many peripheral organs and tissues. Melatonin could be beneficial in the treatment of nocturia and other common bladder disorders. The ameliorating action of melatonin on bladder function is likely due to multiple mechanisms which include central effects on voiding and peripheral effects on the detrusor and bladder afferents. More studies are warranted to determine the precise mechanisms of circadian rhythm coordination of the bladder function and melatonin influences on the bladder in health and diseases.
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Affiliation(s)
- Stewart Ramsay
- Discipline of Human Physiology, Flinders Health & Medical Research Institute, College of Medicine and Public Health, Flinders University, South Australia, Australia
| | - Vladimir Zagorodnyuk
- Discipline of Human Physiology, Flinders Health & Medical Research Institute, College of Medicine and Public Health, Flinders University, South Australia, Australia.
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Pinto AM, Geenen R, Wager TD, Lumley MA, Häuser W, Kosek E, Ablin JN, Amris K, Branco J, Buskila D, Castelhano J, Castelo-Branco M, Crofford LJ, Fitzcharles MA, López-Solà M, Luís M, Marques TR, Mease PJ, Palavra F, Rhudy JL, Uddin LQ, Castilho P, Jacobs JWG, da Silva JAP. Emotion regulation and the salience network: a hypothetical integrative model of fibromyalgia. Nat Rev Rheumatol 2023; 19:44-60. [PMID: 36471023 DOI: 10.1038/s41584-022-00873-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 12/09/2022]
Abstract
Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances and other symptoms, and has a substantial socioeconomic impact. Current biomedical and psychosocial treatments are unsatisfactory for many patients, and treatment progress has been hindered by the lack of a clear understanding of the pathogenesis of fibromyalgia. We present here a model of fibromyalgia that integrates current psychosocial and neurophysiological observations. We propose that an imbalance in emotion regulation, reflected by an overactive 'threat' system and underactive 'soothing' system, might keep the 'salience network' (also known as the midcingulo-insular network) in continuous alert mode, and this hyperactivation, in conjunction with other mechanisms, contributes to fibromyalgia. This proposed integrative model, which we term the Fibromyalgia: Imbalance of Threat and Soothing Systems (FITSS) model, should be viewed as a working hypothesis with limited supporting evidence available. We hope, however, that this model will shed new light on existing psychosocial and biological observations, and inspire future research to address the many gaps in our knowledge about fibromyalgia, ultimately stimulating the development of novel therapeutic interventions.
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Affiliation(s)
- Ana Margarida Pinto
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Coimbra, Portugal
- University of Coimbra, Psychological Medicine Institute, Faculty of Medicine, Coimbra, Portugal
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
- Altrecht Psychosomatic Medicine Eikenboom, Zeist, The Netherlands
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Winfried Häuser
- Department Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Jacob N Ablin
- Internal Medicine H, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Kirstine Amris
- The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Jaime Branco
- Rheumatology Department, Egas Moniz Hospital - Lisboa Ocidental Hospital Centre (CHLO-EPE), Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Chronic Diseases Research Centre (CEDOC), NOVA Medical School, NOVA University Lisbon (NMS/UNL), Lisbon, Portugal
| | - Dan Buskila
- Ben Gurion University of the Negev Beer-Sheba, Beersheba, Israel
| | - João Castelhano
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Coimbra, Portugal
| | - Miguel Castelo-Branco
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Coimbra, Portugal
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mary-Ann Fitzcharles
- Division of Rheumatology, Department of Medicine, McGill University, Montreal, QC, Canada
| | - Marina López-Solà
- Serra Hunter Programme, Department of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mariana Luís
- Rheumatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Tiago Reis Marques
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences (LMS), Hammersmith Hospital, Imperial College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip J Mease
- Swedish Medical Center/Providence St. Joseph Health, Seattle, WA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Filipe Palavra
- Centre for Child Development, Neuropediatric Unit, Paediatric Hospital, Coimbra Hospital and University Centre, Coimbra, Portugal
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, Coimbra, Portugal
| | - Jamie L Rhudy
- Department of Psychology, University of Tulsa, Tulsa, OK, USA
| | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Paula Castilho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Johannes W G Jacobs
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | - José A P da Silva
- University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Coimbra, Portugal.
- Rheumatology Department, Coimbra Hospital and University Centre, Coimbra, Portugal.
- University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, Coimbra, Portugal.
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Wu PY, Menta B, Visk A, Ryals JM, Christianson JA, Wright DE, Chadwick AL. The impact of foot shock-induced stress on pain-related behavior associated with burn injury. Burns 2021; 47:1896-1907. [PMID: 33958242 PMCID: PMC8526636 DOI: 10.1016/j.burns.2021.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 04/05/2021] [Accepted: 04/12/2021] [Indexed: 11/21/2022]
Abstract
Acute pain is prevalent following burn injury and can often transition to chronic pain. Prolonged acute pain is an important risk factor for chronic pain and there is little preclinical research to address this problem. Using a mouse model of second-degree burn, we investigated whether pre-existing stress influences pain(sensitivity) after a burn injury. We introduced a contribution of stress in two different ways: (1) the use of foot-shock as a pre-injury stressor or (2) the use of A/J mice to represent higher pre-existing stress compared to C57Bl/6 mice. C57Bl/6 and A/J mice were exposed to repeated mild foot shock to induce stress for 10 continuous days and mice underwent either burn injury or sham burn injury of the plantar surface of the right hind paw. Assessments of mechanical and thermal sensitivities of the injured and uninjured paw were conducted during the shock protocol and at intervals up to 82-day post-burn injury. In both strains of mice that underwent burn injury, thermal hypersensitivity and mechanical allodynia appeared rapidly in the ipsilateral paw. Mice that were stressed took much longer to recover their hind paw mechanical thresholds to baseline compared to non-stressed mice in both burn and non-burn groups. Analysis of the two mouse strains revealed that the recovery of mechanical thresholds in A/J mice which display higher levels of baseline anxiety was shorter than C57Bl/6 mice. No differences were observed regarding thermal sensitivities between strains. Our results support the view that stress exposure prior to burn injury affects mechanical and thermal thresholds and may be relevant to as a risk factor for the transition from acute to chronic pain. Finally, genetic differences may play a key role in modality-specific recovery following burn injury.
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Affiliation(s)
- Pau Yen Wu
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Blaise Menta
- Department of Biochemistry, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Alexander Visk
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Janelle M Ryals
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Julie A Christianson
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Douglas E Wright
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS 66160, USA; Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS 66160, USA.
| | - Andrea L Chadwick
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Yang MH, Huang JY, Chen SL, Wei JCC. Association of Interstitial Cystitis/Bladder Pain Syndrome with Stress-Related Diseases: A Nationwide Population-Based Study. J Clin Med 2021; 10:jcm10235669. [PMID: 34884371 PMCID: PMC8658298 DOI: 10.3390/jcm10235669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Stress-related diseases (SRDs) are adjustment disorders triggered by stressful life changes. There is a growing body of evidence showing that stress plays an important role in the pathophysiology of IC/BPS. In the present study, we investigated the association between SRDs and a subsequent association of interstitial cystitis/bladder pain syndrome (IC/BPS). Methods: We performed a nested case-control study from the Longitudinal Health Insurance Database (LHID) of Taiwan. The two-year time-varying association between SRDs and IC/BPS was explored to distinguish the short- or long-term effects of these factors. We then conducted multiple conditional logistic regressions to evaluate the adjusted odds ratio (OR) of IC/BPS in patients with a history of SRDs. Results: A total of 1103 IC/BPS patients and 4412 non-IC/BPS patients were analyzed. For all SRDs, the significantly increased risks were obtained in 2 years before IC/BPS diagnosis, and the higher OR was observed within 3 months before the diagnosis of IC/BPS. Multiple conditional logistic regressions showed that patients who had prior medical care for urinary tract infection (OR = 10.95, 95% CI = 9.07 to 13.22), chronic obstructive pulmonary disease (OR = 1.48, 95% CI = 1.13 to 1.93), peptic ulcer (OR = 1.69, 95% CI = 1.37 to 2.09), inflammatory bowel syndrome (OR = 1.66, 95% CI = 1.21 to 2.29), autoimmune diseases (OR = 1.48, 95% CI = 1.11 to 1.97), depression (OR = 1.54, 95% CI = 1.24 to 1.91), sleep disorders (OR = 1.45, 95% CI = 1.19 to 1.78), and allergic rhinitis (OR = 1.29, 95% CI = 1.03 to 1.62) within 2 years had a significant risk of IC/BPS. Conclusions: Our study demonstrates that the health care for SRDs within the previous 2 years is associated with an increased risk of subsequent IC/BPS. The time-varying association provides an important insight that helps us to identify cases with IC/BPS, especially among patients with repeated UTI visits.
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Affiliation(s)
- Min-Hsin Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (M.-H.Y.); (J.-Y.H.)
- Department of Urology, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (M.-H.Y.); (J.-Y.H.)
- Center for Health Data Science, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Sung-Lang Chen
- Department of Urology, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - James Cheng-Chung Wei
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 402, Taiwan
- Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Correspondence: ; Tel.: +886-4-24739595 (ext. #34718)
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Ishida K, Mbanefo EC, Le L, Lamanna O, Pennington LF, Finkel JC, Jardetzky TS, Falcone FH, Hsieh MH. IPSE, a parasite-derived, host immunomodulatory infiltrin protein, alleviates resiniferatoxin-induced bladder pain. Mol Pain 2021; 16:1744806920970099. [PMID: 33342372 PMCID: PMC7756320 DOI: 10.1177/1744806920970099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The transient receptor potential cation channel subfamily V member 1 (TRPV1)
receptor is an important mediator of nociception and its expression is enriched
in nociceptive neurons. TRPV1 signaling has been implicated in bladder pain and
is a potential analgesic target. Resiniferatoxin is the most potent known
agonist of TRPV1. Acute exposure of the rat bladder to resiniferatoxin has been
demonstrated to result in pain-related freezing and licking behaviors that are
alleviated by virally encoded IL-4. The interleukin-4-inducing principle of
Schistosoma mansoni eggs (IPSE) is a powerful inducer of
IL-4 secretion, and is also known to alter host cell transcription through a
nuclear localization sequence-based mechanism. We previously reported that IPSE
ameliorates ifosfamide-induced bladder pain in an IL-4- and nuclear localization
sequence-dependent manner. We hypothesized that pre-administration of IPSE to
resiniferatoxin-challenged mice would dampen pain-related behaviors. IPSE indeed
lessened resiniferatoxin-triggered freezing behaviors in mice. This was a
nuclear localization sequence-dependent phenomenon, since administration of a
nuclear localization sequence mutant version of IPSE abrogated IPSE’s analgesic
effect. In contrast, IPSE’s analgesic effect did not seem IL-4-dependent, since
use of anti-IL-4 antibody in mice given both IPSE and resiniferatoxin did not
significantly affect freezing behaviors. RNA-Seq analysis of resiniferatoxin-
and IPSE-exposed bladders revealed differential expression of TNF/NF-κb-related
signaling pathway genes. In vitro testing of IPSE uptake by
urothelial cells and TRPV1-expressing neuronal cells showed uptake by both cell
types. Thus, IPSE’s nuclear localization sequence-dependent therapeutic effects
on TRPV1-mediated bladder pain may act on TRPV1-expressing neurons and/or may
rely upon urothelial mechanisms.
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Affiliation(s)
- Kenji Ishida
- Division of Urology, Department of Surgery, Children's National Hospital, Washington, DC, USA
| | - Evaristus C Mbanefo
- Division of Urology, Department of Surgery, Children's National Hospital, Washington, DC, USA
| | - Loc Le
- Biomedical Research Institute, Rockville, MD, USA
| | - Olivia Lamanna
- Division of Urology, Department of Surgery, Children's National Hospital, Washington, DC, USA
| | - Luke F Pennington
- Department of Structural Biology, Stanford University, Stanford, CA, USA
| | - Julia C Finkel
- Department of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, Washington, DC, USA
| | | | - Franco H Falcone
- Institute of Parasitology, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Michael H Hsieh
- Division of Urology, Department of Surgery, Children's National Hospital, Washington, DC, USA
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Therapeutic Drug Monitoring of Antidepressants for the Treatment of Chronic Musculoskeletal Pain With and Without Depression. Ther Drug Monit 2020; 42:893-901. [PMID: 32569061 DOI: 10.1097/ftd.0000000000000783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Antidepressants are recommended for the treatment of chronic musculoskeletal pain; however, target serum concentrations based on therapeutic drug monitoring (TDM) have not been established. Therefore, the authors analyzed routine care TDM data of antidepressants in patients with chronic pain with and without depression in terms of treatment outcomes in an interdisciplinary multimodal pain treatment (IMPT) program. METHODS Patients with chronic musculoskeletal pain and TDM for amitriptyline (n = 45) or duloxetine (n = 30) were retrospectively included. The German pain questionnaire for pain intensity and the Depression Anxiety Stress scale were applied at T0 and at the end of the IMPT program (T1). A relief of pain intensity score ≥2 was considered as a positive outcome. Comorbid depression was diagnosed based on ICD-10 criteria. Serum concentrations of antidepressants were measured for routine clinical care TDM. RESULTS After IMPT, stress improved in all subgroups, and depressive symptoms improved only in the duloxetine group. Overall, 40% and 27% of patients in the amitriptyline and duloxetine subgroup, respectively, were responders in terms of maximum pain score relief. Responders with comorbid depression were treated with a dose that led to a 1.7-fold higher serum concentration of the active moiety of amitriptyline (amitriptyline + nortriptyline) compared with nonresponders. Similarly, a 2.3-fold higher serum concentration was observed in depressed responders than in nondepressed responders (at minimum 131.5 ng/mL). CONCLUSIONS Dosing of antidepressants for chronic pain relief should specifically take comorbid depression into account. TDM may provide better outcomes of pain relief in an IMPT setting in patients with comorbid depression.
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Maddern J, Grundy L, Castro J, Brierley SM. Pain in Endometriosis. Front Cell Neurosci 2020; 14:590823. [PMID: 33132854 PMCID: PMC7573391 DOI: 10.3389/fncel.2020.590823] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/15/2020] [Indexed: 12/15/2022] Open
Abstract
Endometriosis is a chronic and debilitating condition affecting ∼10% of women. Endometriosis is characterized by infertility and chronic pelvic pain, yet treatment options remain limited. In many respects this is related to an underlying lack of knowledge of the etiology and mechanisms contributing to endometriosis-induced pain. Whilst many studies focus on retrograde menstruation, and the formation and development of lesions in the pathogenesis of endometriosis, the mechanisms underlying the associated pain remain poorly described. Here we review the recent clinical and experimental evidence of the mechanisms contributing to chronic pain in endometriosis. This includes the roles of inflammation, neurogenic inflammation, neuroangiogenesis, peripheral sensitization and central sensitization. As endometriosis patients are also known to have co-morbidities such as irritable bowel syndrome and overactive bladder syndrome, we highlight how common nerve pathways innervating the colon, bladder and female reproductive tract can contribute to co-morbidity via cross-organ sensitization.
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Affiliation(s)
- Jessica Maddern
- Visceral Pain Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Luke Grundy
- Visceral Pain Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Joel Castro
- Visceral Pain Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Stuart M. Brierley
- Visceral Pain Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Discipline of Medicine, University of Adelaide, North Terrace Campus, Adelaide, SA, Australia
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12
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Intrabladder PAC1 Receptor Antagonist, PACAP(6-38), Reduces Urinary Bladder Frequency and Pelvic Sensitivity in Mice Exposed to Repeated Variate Stress (RVS). J Mol Neurosci 2020; 71:1575-1588. [PMID: 32613552 DOI: 10.1007/s12031-020-01649-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/22/2020] [Indexed: 12/18/2022]
Abstract
Stress causes symptom exacerbation in functional disorders of the urinary bladder. However, the potential mediators and underlying mechanisms of stress effects on micturition reflex function are unknown. We have characterized PACAP (Adcyap1) and PAC1 receptor (Adcyap1r1) signaling in stress-induced urinary bladder dysfunction in mice. We determined PACAP and PAC1 transcripts and protein expressions in the urinary bladder and lumbosacral dorsal root ganglia (DRG) and spinal cord in repeated variate stress (RVS) or control mouse (handling only) groups. RVS in mice significantly (p ≤ 0.01) increased serum corticosterone and urinary bladder NGF content and decreased weight gain. PACAP and PAC1 mRNA and protein were differentially regulated in lower urinary tract tissues with changes observed in lumbosacral DRG and spinal cord but not in urinary bladder. RVS exposure in mice significantly (p ≤ 0.01) increased (2.5-fold) voiding frequency as determined using conscious cystometry. Intrabladder administration of the PAC1 receptor antagonist, PACAP(6-38) (300 nM), significantly (p ≤ 0.01) increased infused volume (1.5-2.7-fold) to elicit a micturition event and increased the intercontraction interval (i.e., decreased voiding frequency) in mice exposed to RVS and in control mice, but changes were smaller in magnitude in control mice. We also evaluated the effect of PAC1 blockade at the level of the urinary bladder on pelvic sensitivity in RVS or control mouse groups using von Frey filament testing. Intrabladder administration of PACAP(6-38) (300 nM) significantly (p ≤ 0.01) reduced pelvic sensitivity following RVS. PACAP/receptor signaling in the CNS and PNS contributes to increased voiding frequency and pelvic sensitivity following RVS and may represent a potential target for therapeutic intervention.
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13
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Phelps CE, Navratilova E, Dickenson AH, Porreca F, Bannister K. Kappa opioid signaling in the right central amygdala causes hind paw specific loss of diffuse noxious inhibitory controls in experimental neuropathic pain. Pain 2020; 160:1614-1621. [PMID: 30870321 DOI: 10.1097/j.pain.0000000000001553] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Diffuse noxious inhibitory controls (DNICs) is a pain-inhibits-pain phenomenon demonstrated in humans and animals. Diffuse noxious inhibitory control is diminished in many chronic pain states, including neuropathic pain. The efficiency of DNIC has been suggested to prospectively predict both the likelihood of pain chronification and treatment response. Little is known as to why DNIC is dysfunctional in neuropathic pain. Here, we evaluated DNIC in the rat L5/L6 spinal nerve ligation (SNL) model of chronic pain using both behavioral and electrophysiological outcomes. For behavior, nociceptive thresholds were determined using response to noxious paw pressure on both hind paws as the test stimulus before, and after, injection of a conditioning stimulus of capsaicin into the left forepaw. Functionally, the spike firing of spinal wide-dynamic-range neuronal activity was evaluated before and during noxious ear pinch, while stimulating the ipsilateral paw with von Frey hairs of increased bending force. In both assays, the DNIC response was significantly diminished in the ipsilateral (ie, injured) paw of SNL animals. However, behavioral loss of DNIC was not observed on the contralateral (ie, uninjured) paw. Systemic application of nor-binaltorphimine, a kappa opioid antagonist, did not ameliorate SNL-induced hyperalgesia but reversed loss of the behavioral DNIC response. Microinjection of nor-binaltorphimine into the right central amygdala (RCeA) of SNL rats did not affect baseline thresholds but restored DNIC both behaviorally and electrophysiologically. Cumulatively, these data suggest that net enhanced descending facilitations may be mediated by kappa opioid receptor signaling from the right central amygdala to promote diminished DNIC after neuropathy.
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Affiliation(s)
- Caroline E Phelps
- Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, United States
| | - Edita Navratilova
- Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, United States
| | - Anthony H Dickenson
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Frank Porreca
- Department of Pharmacology, Arizona Health Sciences Center, University of Arizona, Tucson, AZ, United States
| | - Kirsty Bannister
- Department of Pharmacology and Therapeutics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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14
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Abdal Dayem A, Kim K, Lee SB, Kim A, Cho SG. Application of Adult and Pluripotent Stem Cells in Interstitial Cystitis/Bladder Pain Syndrome Therapy: Methods and Perspectives. J Clin Med 2020; 9:jcm9030766. [PMID: 32178321 PMCID: PMC7141265 DOI: 10.3390/jcm9030766] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 12/11/2022] Open
Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a multifactorial, chronic disease without definite etiology characterized by bladder-related pelvic pain. IC/BPS is associated with pain that negatively affects the quality of life. There are various therapeutic approaches against IC/BPS. However, no efficient therapeutic agent against IC/BPS has been discovered yet. Urothelium dysfunction is one of the key factors of IC/BPS-related pathogenicity. Stem cells, including adult stem cells (ASCs) and pluripotent stem cells (PSCs), such as embryonic stem cells (ESCs) and induced PSCs (iPSCs), possess the abilities of self-renewal, proliferation, and differentiation into various cell types, including urothelial and other bladder cells. Therefore, stem cells are considered robust candidates for bladder regeneration. This review provides a brief overview of the etiology, pathophysiology, diagnosis, and treatment of IC/BPS as well as a summary of ASCs and PSCs. The potential of ASCs and PSCs in bladder regeneration via differentiation into bladder cells or direct transplantation into the bladder and the possible applications in IC/BPS therapy are described in detail. A better understanding of current studies on stem cells and bladder regeneration will allow further improvement in the approaches of stem cell applications for highly efficient IC/BPS therapy.
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Affiliation(s)
- Ahmed Abdal Dayem
- Department of Stem Cell & Regenerative Biotechnology and Incurable Disease Animal Model and Stem Cell Institute (IDASI), Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea; (A.A.D.); (K.K.); (S.B.L.)
| | - Kyeongseok Kim
- Department of Stem Cell & Regenerative Biotechnology and Incurable Disease Animal Model and Stem Cell Institute (IDASI), Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea; (A.A.D.); (K.K.); (S.B.L.)
| | - Soo Bin Lee
- Department of Stem Cell & Regenerative Biotechnology and Incurable Disease Animal Model and Stem Cell Institute (IDASI), Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea; (A.A.D.); (K.K.); (S.B.L.)
| | - Aram Kim
- Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05029, Korea
- Correspondence: (A.K.); (S.-G.C.); Tel.: +82-2-2030-7675 (A.K.); +82-2-450-4207 (S.-G.C.); Fax: +82-2-2030-7748 (A.K.); +82-2-450-4207 (S.-G.C.)
| | - Ssang-Goo Cho
- Department of Stem Cell & Regenerative Biotechnology and Incurable Disease Animal Model and Stem Cell Institute (IDASI), Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea; (A.A.D.); (K.K.); (S.B.L.)
- Correspondence: (A.K.); (S.-G.C.); Tel.: +82-2-2030-7675 (A.K.); +82-2-450-4207 (S.-G.C.); Fax: +82-2-2030-7748 (A.K.); +82-2-450-4207 (S.-G.C.)
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15
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Arnold LM, Bennett RM, Crofford LJ, Dean LE, Clauw DJ, Goldenberg DL, Fitzcharles MA, Paiva ES, Staud R, Sarzi-Puttini P, Buskila D, Macfarlane GJ. AAPT Diagnostic Criteria for Fibromyalgia. THE JOURNAL OF PAIN 2019; 20:611-628. [DOI: 10.1016/j.jpain.2018.10.008] [Citation(s) in RCA: 148] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/28/2018] [Accepted: 10/15/2018] [Indexed: 01/08/2023]
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16
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Birder LA. Pathophysiology of interstitial cystitis. Int J Urol 2019; 26 Suppl 1:12-15. [DOI: 10.1111/iju.13985] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/18/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Lori A Birder
- Departments of Medicine and Pharmacology and Chemical Biology University of Pittsburgh Pittsburgh Pennsylvania USA
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17
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Abstract
Most of us live blissfully unaware of the orchestrated function that our internal organs conduct. When this peace is interrupted, it is often by routine sensations of hunger and urge. However, for >20% of the global population, chronic visceral pain is an unpleasant and often excruciating reminder of the existence of our internal organs. In many cases, there is no obvious underlying pathological cause of the pain. Accordingly, chronic visceral pain is debilitating, reduces the quality of life of sufferers, and has large concomitant socioeconomic costs. In this review, we highlight key mechanisms underlying chronic abdominal and pelvic pain associated with functional and inflammatory disorders of the gastrointestinal and urinary tracts. This includes how the colon and bladder are innervated by specialized subclasses of spinal afferents, how these afferents become sensitized in highly dynamic signaling environments, and the subsequent development of neuroplasticity within visceral pain pathways. We also highlight key contributing factors, including alterations in commensal bacteria, altered mucosal permeability, epithelial interactions with afferent nerves, alterations in immune or stress responses, and cross talk between these two adjacent organs.
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Affiliation(s)
- Luke Grundy
- Visceral Pain Research Group, College of Medicine and Public Health, Centre for Neuroscience, Flinders University, Bedford Park, South Australia 5042, Australia; .,Centre for Nutrition and Gastrointestinal Diseases, University of Adelaide, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia 5000, Australia
| | - Andelain Erickson
- Visceral Pain Research Group, College of Medicine and Public Health, Centre for Neuroscience, Flinders University, Bedford Park, South Australia 5042, Australia; .,Centre for Nutrition and Gastrointestinal Diseases, University of Adelaide, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia 5000, Australia
| | - Stuart M Brierley
- Visceral Pain Research Group, College of Medicine and Public Health, Centre for Neuroscience, Flinders University, Bedford Park, South Australia 5042, Australia; .,Centre for Nutrition and Gastrointestinal Diseases, University of Adelaide, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia 5000, Australia
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18
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Grundy L, Caldwell A, Brierley SM. Mechanisms Underlying Overactive Bladder and Interstitial Cystitis/Painful Bladder Syndrome. Front Neurosci 2018; 12:931. [PMID: 30618560 PMCID: PMC6299241 DOI: 10.3389/fnins.2018.00931] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/27/2018] [Indexed: 12/18/2022] Open
Abstract
The bladder is innervated by extrinsic afferents that project into the dorsal horn of the spinal cord, providing sensory input to the micturition centers within the central nervous system. Under normal conditions, the continuous activation of these neurons during bladder distension goes mostly unnoticed. However, for patients with chronic urological disorders such as overactive bladder syndrome (OAB) and interstitial cystitis/painful bladder syndrome (IC/PBS), exaggerated bladder sensation and altered bladder function are common debilitating symptoms. Whilst considered to be separate pathological entities, there is now significant clinical and pre-clinical evidence that both OAB and IC/PBS are related to structural, synaptic, or intrinsic changes in the complex signaling pathways that mediate bladder sensation. This review discusses how urothelial dysfunction, bladder permeability, inflammation, and cross-organ sensitisation between visceral organs can regulate this neuroplasticity. Furthermore, we discuss how the emotional affective component of pain processing, involving dysregulation of the HPA axis and maladaptation to stress, anxiety and depression, can exacerbate aberrant bladder sensation and urological dysfunction. This review reveals the complex nature of urological disorders, highlighting numerous interconnected mechanisms in their pathogenesis. To find appropriate therapeutic treatments for these disorders, it is first essential to understand the mechanisms responsible, incorporating research from every level of the sensory pathway, from bladder to brain.
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Affiliation(s)
- Luke Grundy
- Visceral Pain Research Group, Centre for Neuroscience, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Centre for Nutrition and Gastrointestinal Diseases, Discipline of Medicine, South Australian Health and Medical Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Ashlee Caldwell
- Visceral Pain Research Group, Centre for Neuroscience, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Centre for Nutrition and Gastrointestinal Diseases, Discipline of Medicine, South Australian Health and Medical Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Stuart M. Brierley
- Visceral Pain Research Group, Centre for Neuroscience, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Centre for Nutrition and Gastrointestinal Diseases, Discipline of Medicine, South Australian Health and Medical Research Institute, The University of Adelaide, Adelaide, SA, Australia
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19
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Affiliation(s)
- Steven E. Harte
- Department of Anesthesiology Chronic Pain and Fatigue Research Center University of Michigan Ann Arbor Michigan
| | - Richard E. Harris
- Department of Anesthesiology Chronic Pain and Fatigue Research Center University of Michigan Ann Arbor Michigan
| | - Daniel J. Clauw
- Department of Anesthesiology Chronic Pain and Fatigue Research Center University of Michigan Ann Arbor Michigan
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20
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Rau M, Bärlocher C, Knechtle B. [Successful Antibiotic Treatment of Lumbar Pain]. PRAXIS 2018; 107:535-544. [PMID: 29690840 DOI: 10.1024/1661-8157/a002965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Zusammenfassung. Wir berichten über einen 74-jährigen Mann, der plötzlich einschiessende und in der Folge zur Bettlägrigkeit führende lumbale Schmerzen spürte. Ein MRT zeigte die Progredienz einer bereits bekannten Spinalkanalstenose L2/3 mit aktivierten Osteochondrosen und Spondylarthrosen. Eine Facettengelenksinfiltration brachte keine Schmerzlinderung, ebenso wenig wie die Durchführung eines Sakralblocks. Bei persistierenden Schmerzen wurde die lumbale Operation geplant, vorgängig zur Operation bei Status nach Myokardinfarkt musste eine Koronar-CT durchgeführt werden. Bei Niereninsuffizienz war die Bestimmung des Kreatinins notwendig. Bei der Blutabnahme wurde zudem das CRP bestimmt, das erhöht war. Bei Verdacht auf das Vorliegen einer Prostatitis aufgrund des erhöhten PSA-Wertes wurde eine antibiotische Behandlung begonnen. Zwei Tage nach Beginn der Antibiose zeigte sich die Schmerzlinderung, und die Operation konnte abgesagt werden.
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Affiliation(s)
- Monika Rau
- 1 Medbase St. Gallen, Am Vadianplatz, St. Gallen
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21
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Pankey T, Kelly PJ, Ramaswamy M. Stress Reduction Through a Brief Writing Intervention With Women in Jail. JOURNAL OF CORRECTIONAL HEALTH CARE 2018; 22:240-6. [PMID: 27302709 DOI: 10.1177/1078345816654230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the feasibility/acceptability of writing as a stress reduction strategy with incarcerated women. METHODS The authors implemented a writing intervention in which six women wrote on topics of their choosing for 20 minutes on 5 consecutive days. Feasibility was assessed with investigator field notes; daily post-writing evaluations assessed intervention acceptability. The study also assessed the continuation of writing at 1-month postintervention and acceptability of instruments for evaluation of future interventions. RESULTS Implementation barriers were minimal; participants voiced enthusiasm about the program and continued to write 3 to 4 days per week in the month postintervention. No problems were encountered in the completion of evaluation instruments. CONCLUSION Writing is a feasible, reproducible stress relief intervention for incarcerated women.
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Affiliation(s)
- Tyson Pankey
- Department of Counseling Psychology, School of Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Patricia J Kelly
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Megha Ramaswamy
- Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA
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22
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Pierce AN, Eller-Smith OC, Christianson JA. Voluntary wheel running attenuates urinary bladder hypersensitivity and dysfunction following neonatal maternal separation in female mice. Neurourol Urodyn 2018; 37:1623-1632. [PMID: 29464752 DOI: 10.1002/nau.23530] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/28/2018] [Indexed: 01/08/2023]
Abstract
AIMS Patients with interstitial cystitis/painful bladder syndrome (IC/PBS) commonly suffer from widespread pain and mood disorder, which has been attributed to improper functioning of the hypothalamic-pituitary-adrenal (HPA) axis. Voluntary exercise has been shown to improve HPA axis function, therefore we are determining whether voluntary wheel running can attenuate urological pain and dysfunction following neonatal maternal separation (NMS) in female mice. METHODS Mice underwent NMS for 3 h/day from postnatal Day 1-21, were caged with free access to running wheels at 4 weeks of age, and assessed 4 weeks later for bladder sensitivity, micturition, reward behavior, mast cell degranulation, and HPA axis-related in vitro analysis. RESULTS Increased bladder sensitivity, void frequency, and mast cell degranulation was observed in adult sedentary (-Sed) NMS mice, compared to naïve-Sed controls. Sucrose preference was increased in NMS-Sed mice and corticotropin-releasing factor receptor 1 (CRF1 ) and glucocorticoid receptor mRNA levels were significantly reduced in the hippocampus. Exercise normalized bladder sensitivity, micturition output, and increased brain-derived neurotrophic factor (BDNF) mRNA levels in the hippocampus of NMS mice. Mast cell degranulation was also normalized in NMS bladders following exercise. CONCLUSIONS Voluntary exercise normalized behavioral outcomes resulting from NMS in female mice, increased hippocampal BDNF mRNA levels, and decreased mast cell degranulation in the bladder. Together these results provide novel insight into the efficacy of voluntary exercise to attenuate comorbid outcomes resulting from exposure to early life stress.
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Affiliation(s)
- Angela N Pierce
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Olivia C Eller-Smith
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Julie A Christianson
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas
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23
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Fuentes IM, Christianson JA. The Influence of Early Life Experience on Visceral Pain. Front Syst Neurosci 2018; 12:2. [PMID: 29434541 PMCID: PMC5790786 DOI: 10.3389/fnsys.2018.00002] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/12/2018] [Indexed: 12/12/2022] Open
Abstract
Pain is the most reported and troublesome symptom of nearly all functional disorders affecting the genitourinary and gastrointestinal organs. Patients with irritable bowel syndrome (IBS), interstitial cystitis/painful bladder syndrome (IC/PBS), vulvodynia, and/or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS; collectively termed chronic pelvic pain syndromes) report pain severe enough to impact quality of life and often suffer from symptoms of or are diagnosed with more than one of these syndromes. This increased comorbidity between chronic pelvic pain syndromes, and with pain disorders of disparate body regions, as well as with mood disorders, can be influenced by disruptions in the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the response to stress and influences the perception of pain. Experiencing trauma, neglect, or abuse in early life can permanently affect the functioning of the HPA axis. As such, a significant proportion of patients suffering from comorbid chronic pelvic pain syndromes report a history of early life stress or trauma. Here we will report on how these early life experiences influence chronic pelvic pain in patients. We will also discuss various rodent models that have been developed to study this phenomenon to understand the mechanisms underlying HPA axis dysfunction, as well as potential underlying mechanisms connecting these syndromes to one another.
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Affiliation(s)
- Isabella M Fuentes
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Julie A Christianson
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
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24
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The water avoidance stress induces bladder pain due to a prolonged alpha1A adrenoceptor stimulation. Naunyn Schmiedebergs Arch Pharmacol 2017; 390:839-844. [PMID: 28569366 DOI: 10.1007/s00210-017-1384-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/17/2017] [Indexed: 10/19/2022]
Abstract
Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) remains an elusive disease with the cause for the pain unclear. BPS/IC patients present increased sympathetic activity and high levels of urinary noradrenaline. At the experimental level, it has been shown that chronic adrenergic stimulation produces pain and bladder changes through an alpha 1A adrenoceptor mediated mechanism. Water avoidance stress (WAS) in rodents reproduces signs of nociception and bladder changes seen in BPS/IC patients. In this study, we explore the possible role of alpha 1A adrenoceptor in bladder pain and morphological changes. WAS was induced in a group of female Wistar rats. A separate WAS group received 0.2 mg/kg day silodosin (WAS + S). Lower abdominal pain was determined by performing sensitivity to Von Frey filaments. Bladder reflex activity was determined by cystometry in anaesthetised animals. Urine was collected for noradrenaline quantification by HPLC. Bladders were harvested and stained with Haematoxylin-eosin (to analyse urothelial morphology and to determine the disruption of surface umbrella cells) or with Toluidine Blue 0.1% to analyse mast cell infiltration. WAS increased urinary noradrenaline level and bladder frequency and decreased mechanical pain threshold, which was reversed by silodosin. WAS induced lymphocytic and mast cells infiltration in the mucosa and mild urothelial disruption, which was absent in WAS + S group. Alpha 1A adrenoceptor stimulation has an important role in the appearance of bladder pain in rats. Since BPS/IC patients present high levels of noradrenaline, alpha 1A stimulation may be an additional trigger for bladder dysfunction presented by these patients. Further studies will determine the clinical relevance of this finding in the treatment of BPS/IC patients.
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25
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Carey ET, Till SR, As-Sanie S. Pharmacological Management of Chronic Pelvic Pain in Women. Drugs 2017; 77:285-301. [DOI: 10.1007/s40265-016-0687-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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26
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Leue C, Kruimel J, Vrijens D, Masclee A, van Os J, van Koeveringe G. Functional urological disorders: a sensitized defence response in the bladder-gut-brain axis. Nat Rev Urol 2016; 14:153-163. [PMID: 27922040 DOI: 10.1038/nrurol.2016.227] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Functional urological and gastrointestinal disorders are interrelated and characterized by a chronic course and considerable treatment resistance. Urological disorders associated with a sizeable functional effect include overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Poor treatment outcomes might be attributable to untreated underlying psychological and psychiatric disorders, as the co-occurrence of functional urological and gastrointestinal disorders with mood and anxiety disorders is common. The hypothetical bladder-gut-brain axis (BGBA) is a useful framework under which this interaction can be studied, suggesting that functional disorders represent a sensitized response to earlier threats such as childhood adversity or previous traumatic events, resulting in perceived emotional and bodily distress - the symptoms of functional disorders. Psychological and physical stress pathways might contribute to such alarm falsification, and neuroticism could be a risk factor for the co-occurrence of functional disorders and affective conditions. Additionally, physical threat - either from external sources or internal sources such as infection - might contribute to alarm falsification by influencing body-brain crosstalk on homeostasis and, therefore, affecting mood, cognition, and behaviour. Multidisciplinary research and an integrated care approach is, therefore, required to further elucidate and remediate functional urological and gastrointestinal polymorphic phenotypes.
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Affiliation(s)
- Carsten Leue
- Department of Psychiatry and Psychology, Maastricht University Medical Center (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Pelvic Care Centre (PCC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Neuro-intervention Centre (NIC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Joanna Kruimel
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Pelvic Care Centre (PCC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Neuro-intervention Centre (NIC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Desiree Vrijens
- Department of Urology, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Pelvic Care Centre (PCC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Neuro-intervention Centre (NIC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Adrian Masclee
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Pelvic Care Centre (PCC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Neuro-intervention Centre (NIC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Center (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Neuro-intervention Centre (NIC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Pelvic Care Centre (PCC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.,Neuro-intervention Centre (NIC) Maastricht, Maastricht University Medical Centre (MUMC), P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
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Fang Z, Xu K. Interstitial Cystitis/Bladder Pain Syndrome: a Review and an Update. CURRENT BLADDER DYSFUNCTION REPORTS 2016. [DOI: 10.1007/s11884-016-0387-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Ortego G, Villafañe JH, Doménech-García V, Berjano P, Bertozzi L, Herrero P. Is there a relationship between psychological stress or anxiety and chronic nonspecific neck-arm pain in adults? A systematic review and meta-analysis. J Psychosom Res 2016; 90:70-81. [PMID: 27772562 DOI: 10.1016/j.jpsychores.2016.09.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/28/2016] [Accepted: 09/08/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To systematically review and analyze the research evidence linking stress or anxiety to chronic nonspecific neck-arm pain (NSNAP) in adults. SUBJECTS AND METHODS Data were obtained from Pubmed, Scopus, PsycInfo, Web of Science, Physiotherapy Evidence Database (PEDro) and The Cochrane library database from their inception to July 2015. Two authors independently conducted the searches, extracted data, and completed methodological quality assessments. The methodological quality of the cohort and case-control studies was evaluated using the Newcastle-Ottawa scale, whilst the quality of the Randomized Controlled Trial (RCT) was evaluated using the PEDro scale. RESULTS Twenty-eight studies involving 39,166 participants met the inclusion criteria. Four studies, including 5 pair-wise comparisons, were included in the meta-analysis: Three were cohort studies and 1 was a cross-sectional study. The meta-analysis outcome demonstrated a relationship between chronic NSNAP and psychological stress. The estimate odds ratio for all studies combined was 2.33 (95% CI, 1.04-5.18; p=0.039). A high heterogeneity of the findings appeared (Q=28.94, I2=86% p=0.00). CONCLUSION This study shows that there is a strong relationship between stress and chronic NSNAP. Despite this finding, we cannot support that stress is a risk factor for chronic NSNAP due to the low quality of the results according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). It was not possible to make a quantitative analysis comparing the relationship between anxiety and chronic NSNAP. However, according to the qualitative analysis there is a strong relationship between anxiety and chronic NSNAP.
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Affiliation(s)
- Gorka Ortego
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov A23 km 299, 50830, Villanueva de Gállego Zaragoza, Spain.
| | | | - Victor Doménech-García
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov A23 km 299, 50830, Villanueva de Gállego Zaragoza, Spain
| | | | | | - Pablo Herrero
- iPhysio Research Group, Universidad San Jorge, Campus Universitario, Autov A23 km 299, 50830, Villanueva de Gállego Zaragoza, Spain
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Boccia ML. How Do Early Life Experiences Modulate Sexual Function, Stress, and Pain? The Role of Serotonin in Sexual Function. CURRENT SEXUAL HEALTH REPORTS 2016. [DOI: 10.1007/s11930-016-0077-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Fuentes IM, Walker NK, Pierce AN, Holt BR, Di Silvestro ER, Christianson JA. Neonatal maternal separation increases susceptibility to experimental colitis and acute stress exposure in male mice. IBRO Rep 2016; 1:10-18. [PMID: 28164167 PMCID: PMC5289700 DOI: 10.1016/j.ibror.2016.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Experiencing early life stress can result in maladjusted stress response via dysregulation of the hypothalamic-pituitary-adrenal axis and serves as a risk factor for developing chronic pelvic pain disorders. We investigated whether neonatal maternal separation (NMS) would increase susceptibility to experimental colitis or exposure to acute or chronic stress. Male mice underwent NMS from postnatal day 1-21 and as adults were assessed for open field behavior, hindpaw sensitivity, and visceromotor response (VMR) to colorectal distension (CRD). VMR was also measured before and after treatment with intracolonic trinitrobenzene sulfonic acid (TNBS) or exposure to acute or chronic water avoidance stress (WAS). Myeloperoxidase (MPO) activity, proinflammatory gene and corticotropin-releasing factor (CRF) receptor expression were measured in distal colon. Baseline VMR was not affected by NMS, but undergoing CRD increased anxiety-like behaviors and mechanical hindpaw sensitivity of NMS mice. Treatment with TNBS dose-dependently decreased body weight and survival only in NMS mice. Following TNBS treatment, IL-6 and artemin mRNA levels were decreased in the distal colon of NMS mice, despite increased MPO activity. A single WAS exposure increased VMR during CRD in NMS mice and increased IL-6 mRNA and CRF2 protein levels in the distal colon of naïve mice, whereas CRF2 protein levels were heightened in NMS colon both at baseline and post-WAS exposure. Taken together, these results suggest that NMS in mice disrupts inflammatory- and stress-induced gene expression in the colon, potentially contributing towards an exaggerated response to specific stressors later in life.
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Affiliation(s)
- Isabella M Fuentes
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160
| | - Natalie K Walker
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160
| | - Angela N Pierce
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160
| | - Briana R Holt
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160
| | - Elizabeth R Di Silvestro
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160
| | - Julie A Christianson
- Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160
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31
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Cao DY, Bai G, Ji Y, Karpowicz JM, Traub RJ. EXPRESS: Histone hyperacetylation modulates spinal type II metabotropic glutamate receptor alleviating stress-induced visceral hypersensitivity in female rats. Mol Pain 2016; 12:1744806916660722. [PMID: 27385724 PMCID: PMC4956148 DOI: 10.1177/1744806916660722] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/13/2016] [Accepted: 06/27/2016] [Indexed: 12/14/2022] Open
Abstract
Stress is often a trigger to exacerbate chronic pain including visceral hypersensitivity associated with irritable bowel syndrome, a female predominant functional bowel disorder. Epigenetic mechanisms that mediate stress responses are a potential target to interfere with visceral pain. The purpose of this study was to examine the effect of a histone deacetylase inhibitor, suberoylanilide hydroxamic acid, on visceral hypersensitivity induced by a subchronic stressor in female rats and to investigate the involvement of spinal glutamate receptors. Three daily sessions of forced swim induced visceral hypersensitivity. Intrathecal suberoylanilide hydroxamic acid prevented or reversed the stress-induced visceral hypersensitivity, increased spinal histone 3 acetylation and increased mGluR2 and mGluR3 expression. Chromatin immunoprecipitation (ChIP) analysis revealed enrichment of H3K9Ac and H3K18Ac at several promoter Grm2 and Grm3 regions. The mGluR2/3 antagonist LY341495 reversed the inhibitory effect of suberoylanilide hydroxamic acid on the stress-induced visceral hypersensitivity. In surprising contrast, stress and/or suberoylanilide hydroxamic acid had no effect on spinal NMDA receptor expression or function. These data reveal histone modification modulates mGluR2/3 expression in the spinal cord to attenuate stressinduced visceral hypersensitivity. HDAC inhibitors may provide a potential approach to relieve visceral hypersensitivity associated with irritable bowel syndrome.
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Affiliation(s)
| | - Guang Bai
- University of Maryland School of Dentistry
| | - Yaping Ji
- University of Maryland School of Dentistry
| | - Jane M Karpowicz
- University of Maryland School of DentistryUniversity of Maryland School of DentistryUniversity of Maryland School of Dentistry
| | - Richard J Traub
- University of Maryland School of DentistryUniversity of Maryland School of DentistryUniversity of Maryland School of Dentistry
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