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Bajic JE, Howarth GS, Mashtoub S, Whittaker AL, Bobrovskaya L, Hutchinson MR. Neuroimmunological complications arising from chemotherapy-induced gut toxicity and opioid exposure in female dark agouti rats. J Neurosci Res 2022; 100:237-250. [PMID: 34510524 DOI: 10.1002/jnr.24959] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 12/19/2022]
Abstract
Cancer patients may experience symptom clusters, including chemotherapy-induced (CI) gut toxicity (CIGT) and cognitive impairment. Analgesic selection for pain associated with CIGT is difficult as opioids induce glial reactivity and unwanted side effects. This study quantified central glial reactivity and proinflammatory effects in rats with CIGT using three mechanistically different analgesics. Regional adaptations were indicative of immune-to-brain signaling routes. Utilizing a 5-fluorouracil-induced GT (5IGT) rat model and analgesic intervention (carprofen (CAR), buprenorphine (BUP), and tramadol (TRAM)), spinal and brain neuroimmune modulation was examined via microglial, astrocyte, and proinflammatory (cluster of differentiation molecule 11b; CD11b, glial fibrillary associated protein; GFAP, and interleukin-1 beta; IL1β) reactivity marker expression changes by western blot analysis. 5IGT significantly increased thoracic GFAP (p < 0.05) and IL-1β (p < 0.0001) expression, CAR and BUP ameliorated these effects. BUP and TRAM with 5-FU synergistically increased hippocampal GFAP expression. CAR administered with 5IGT significantly elevated hippocampal and thoracic CD11b expression levels (p < 0.05). The neuroimmune responses observed in this study suggest activation of peripheral-to-central immune signaling pathways. We speculate that the opioid-induced hippocampal changes inferred a humorally mediated mechanism, whereas thoracic neuroimmune modifications indicated activation of an indirect neural route. Although TRAM ameliorated 5IGT-intestinal inflammation, this opioid presents complications relating to bodyweight and regional glial dysregulation (neuroinflammation) and may not be optimal in the management of pain associated with 5IGT. The chemotherapy-induced gut-derived neuroimmune consequences observed suggest a potential mechanistic contribution to central components of the cancer symptom cluster experience, while the opioid-related glial changes have implications for optimal pain management in this setting warranting further investigation.
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Affiliation(s)
- Juliana Esma Bajic
- Discipline of Physiology, Adelaide Medical School, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia
- Australian Research Council Centre of Excellence for Nanoscale Biophotonics, The University of Adelaide, Adelaide, SA, Australia
| | - Gordon Stanley Howarth
- Discipline of Physiology, Adelaide Medical School, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
- Gastroenterology Department, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - Suzanne Mashtoub
- Discipline of Physiology, Adelaide Medical School, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia
- Gastroenterology Department, Women's and Children's Hospital, North Adelaide, SA, Australia
- School of Medicine, University of Western Australia, Fiona Stanley Hospital, Murdoch, WA, Australia
| | | | - Larisa Bobrovskaya
- Health and Biomedical Innovation, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Mark Rowland Hutchinson
- Discipline of Physiology, Adelaide Medical School, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia
- Australian Research Council Centre of Excellence for Nanoscale Biophotonics, The University of Adelaide, Adelaide, SA, Australia
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Espinosa-Juárez JV, Jaramillo-Morales OA, Déciga-Campos M, Moreno-Rocha LA, López-Muñoz FJ. Sigma-1 receptor antagonist (BD-1063) potentiates the antinociceptive effect of quercetin in neuropathic pain induced by chronic constriction injury. Drug Dev Res 2021; 82:267-277. [PMID: 33051885 DOI: 10.1002/ddr.21750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/20/2020] [Accepted: 10/02/2020] [Indexed: 12/23/2022]
Abstract
Neuropathic pain is characterized by the presence of hyperalgesia and allodynia. Pharmacological treatments include the use of antiepileptics such as pregabalin or gabapentin, as well as antidepressants; however, given the role of the sigma-1 receptor in the generation and maintenance of pain, it has been suggested that sigma-1 receptor antagonists may be effective. There are also other alternatives that have been explored, such as the use of flavonoids such as quercetin. Due to the relevance of drug combinations in therapeutics, the objective of this work was to evaluate the effect of the combination of BD-1063 with quercetin in a chronic sciatic nerve constriction model using the "Surface of Synergistic Interaction" analysis method. The combination had preferable additive or synergistic effects, with BD-1063 (17.8 mg/kg) + QUER (5.6 mg/kg) showing the best antinociceptive effects. The required doses were also lower than those used individually to obtain the same level of effect. Our results provide the first evidence that the combination of a sigma-1 receptor antagonist and the flavonoid quercetin may be useful in the treatment of nociceptive behaviors associated with neuropathic pain, suggesting a new therapeutic alternative for this type of pain.
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Affiliation(s)
- Josué Vidal Espinosa-Juárez
- Escuela de Ciencias Químicas sede Ocozocoautla, Universidad Autónoma de Chiapas, Ocozocoautla de Espinosa, Chiapas, Mexico
| | - Osmar Antonio Jaramillo-Morales
- Departamento de Enfermería y Obstetricia. División de Ciencias de la Vida, Campus Irapuato-Salamanca, Universidad de Guanajuato. Carretera Irapuato-Silao km. 9, El copal, complejo 2 de la DICIVA, Irapuato, Guanajuato, Mexico
| | - Myrna Déciga-Campos
- Sección de Estudios de Posgrado e Investigación de la Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, Mexico
| | - Luis Alfonso Moreno-Rocha
- Departamento Sistemas Biológicos, Universidad Autónoma Metropolitana, Unidad Xochimilco, México City, Mexico
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Analysis of Animal Well-Being When Supplementing Drinking Water with Tramadol or Metamizole during Chronic Pancreatitis. Animals (Basel) 2020; 10:ani10122306. [PMID: 33291366 PMCID: PMC7762076 DOI: 10.3390/ani10122306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Pain management during in vivo experiments can considerably improve the wellbeing of animals. However, often it is not clear, which drugs are best for the animals and how to apply these drugs without causing stress. In this study, we evaluated mice when metamizole or tramadol was provided via drinking water. Neither of these two drugs reduced the amount of consumed water or body weight in healthy mice or influenced their natural behavior, such as nest building or burrowing activity. Both analgesics were then given to mice suffering from chronic pancreatitis. Mice drinking tramadol supplemented water, at some time-points, experienced less loss in body weight and consumed more water than mice drinking metamizole. However, no major differences in other methods measuring wellbeing of mice was observed. In conclusion, both analgesics can be used during chronic pancreatitis, but tramadol seems to be moderately advantageous when compared to metamizole. Abstract Pain management during in vivo experiments is an animal welfare concern and is in many countries also legally required. In this study, we evaluated C57Bl/6J mice when 3 g/L metamizole or 1 g/L tramadol was provided via drinking water, before and during cerulein-induced chronic pancreatitis. Supplementation of drinking water with metamizole or tramadol did not significantly reduce the amount of consumed water. In order to evaluate the wellbeing of mice, a distress score, burrowing activity, nesting behavior, and body weight was assessed. Before induction of pancreatitis, neither tramadol nor metamizole influenced these readout parameters. Chronic pancreatitis caused a significantly increased distress score, decreased burrowing activity and a reduction in body weight. Mice drinking tramadol-supplemented water experienced less loss in body weight and consumed more water than mice drinking metamizole, at a few time-points during chronic pancreatitis. Pancreatic atrophy, a characteristic feature of chronic pancreatitis was not differentially influenced by either analgesic. In conclusion, both analgesics can be used during 33 days of chronic pancreatitis, but tramadol seems to be moderately advantageous when compared to metamizole.
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Carrillo-Calzadilla PE, López-Muñoz FJ, Moreno-Rocha LA, Medina-López JR, Cortés-Arroyo AR, Domínguez-Ramírez AM. Pharmacokinetics and pharmacodynamics of metamizol in co-administration with morphine under acute and chronic treatments in arthritic rats. J Pharm Pharmacol 2017; 69:642-651. [DOI: 10.1111/jphp.12702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 01/12/2017] [Indexed: 12/01/2022]
Abstract
Abstract
Objective
To investigate the relationship between metamizol pharmacokinetics and the antinociceptive effect produced after subcutaneous administration of metamizol (177.8 mg/kg) alone or in combination with morphine (3.2 mg/kg), under acute and chronic treatments.
Methods
Antinociception was assessed using the pain-induced functional impairment model in rat (PIFIR). Serial blood samples were collected from the same animals to study the pharmacokinetics of metamizol.
Key findings
The co-administration of the drugs in single dose, confirmed the potentiation of their individual antinociceptive effects. When the drugs were administered alone following the chronic schedule, a pronounced tolerance development to their antinociceptive effects was found, whereas it was significantly attenuated when they were administered together. Metamizol pharmacokinetics was unaltered by the presence of morphine. Plasma concentrations of 4-methylaminoantipyrine, an active metabolite markedly decreased under chronic administration.
Conclusions
The mechanism involved in the potentiation of the antinociceptive effect produced by the combination, cannot be explained by the interaction of morphine on metamizol pharmacokinetics. Other pharmacokinetic interactions along with known pharmacodynamic interactions in which metamizol active metabolites contribute, should be considered. The frequency of administration enhances tolerance development and induces metamizol elimination process.
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Affiliation(s)
| | | | - Luis Alfonso Moreno-Rocha
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana Unidad Xochimilco, México City, México
| | - José Raúl Medina-López
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana Unidad Xochimilco, México City, México
| | - Alma Rosa Cortés-Arroyo
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana Unidad Xochimilco, México City, México
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Ruiz-Pérez D, Benito J, Largo C, Polo G, Canfrán S, Gómez de Segura IA. Metamizole (dipyrone) effects on sevoflurane requirements and postoperative hyperalgesia in rats. Lab Anim 2016; 51:365-375. [PMID: 27694319 DOI: 10.1177/0023677216671553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Unlike non-steroidal anti-inflammatory drugs (NSAIDs), metamizole has poor anti-inflammatory effects; and is suitable for models where analgesia, but not anti-inflammatory effects, is desirable. Like opioids, these drugs produce perioperative analgesia while reducing anaesthetic requirements, but it remains unclear whether they may develop tolerance or hyperalgesia, and thus decrease in analgesic efficacy. The aim was to determine whether tolerance or hyperalgesia to metamizole occurred in rats, and whether the sevoflurane minimum alveolar concentration (MAC) was affected. In a randomized, prospective, controlled study, male Wistar rats ( n = 8 per group) were administered metamizole (300 mg/kg, day 4). Previously, the following treatments were provided: daily metamizole for four days (0-3), morphine (10 mg/kg; positive control, day 0 only) or saline (negative control). The main outcome measures were mechanical (MNT) and warm thermal (WNT) nociceptive quantitative sensory thresholds. The baseline sevoflurane MAC and the reduction produced by the treatments were also determined. The mean (SD) baseline MAC [2.4(0.2)%vol] was decreased by morphine and metamizole by 45(11)% and 33(7)% ( P = 0.000, both), respectively. Baseline MNT [35.4(4.5) g] and WNT [13.2(2.4) s] were decreased by morphine and metamizole: MNT reduction of 22(6)% ( P = 0.000) and 22(7)% ( P = 0.001), respectively and WNT reduction of 34(14)% ( P = 0.000) and 24(13)% ( P = 0.001). The baseline MAC on day 4 was neither modified by treatments nor the MAC reduction produced by metamizole (days 0 and 4; P > 0.05). In conclusion, repeated metamizole administration may produce hyperalgesia, although it may not modify its anaesthetic sparing effect. The clinical relevance of this effect in painful research models requiring prolonged analgesic therapy warrants further investigation.
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Affiliation(s)
- Daniel Ruiz-Pérez
- 1 Comparative Pain Research Group, Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain.,2 Experimental Surgery Unit, La Paz University Hospital, Madrid, Spain
| | - Javier Benito
- 1 Comparative Pain Research Group, Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Carlota Largo
- 2 Experimental Surgery Unit, La Paz University Hospital, Madrid, Spain
| | - Gonzalo Polo
- 1 Comparative Pain Research Group, Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Susana Canfrán
- 1 Comparative Pain Research Group, Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Ignacio Alvarez Gómez de Segura
- 1 Comparative Pain Research Group, Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
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Espinosa-Juárez JV, Jaramillo-Morales OA, Corona-Ramos JN, Medina-López JR, López-Muñoz FJ. Antinociceptive Interactions Between Meloxicam and Gabapentin in Neuropathic Pain Depend on the Ratio used in Combination in Rats. Drug Dev Res 2016; 77:134-42. [DOI: 10.1002/ddr.21300] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/29/2016] [Indexed: 01/08/2023]
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Moreno-Rocha LA, López-Muñoz FJ, Medina-López JR, Domínguez-Ramírez AM. Effect of tramadol on metamizol pharmacokinetics and pharmacodynamics after single and repeated administrations in arthritic rats. Saudi Pharm J 2015; 24:674-684. [PMID: 27829810 PMCID: PMC5094430 DOI: 10.1016/j.jsps.2015.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/09/2015] [Indexed: 11/29/2022] Open
Abstract
Combined administration of certain doses of opioid compounds with a non-steroidal anti-inflammatory drug can produce additive or supra-additive effects while reducing unwanted effects. We have recently reported that co-administration of metamizol with tramadol produces antinociceptive effect potentiation, after acute treatment. However, none information about the effect produced by the combination after chronic or repeated dose administration exists. The aims of this study were to investigate whether the antinociceptive synergism produced by the combination of metamizol and tramadol (177.8 + 17.8 mg/kg, s.c. respectively) is maintained after repeated treatment and whether the effects observed are primarily due to pharmacodynamic interactions or may be related to pharmacokinetics changes. Administration of metamizol plus tramadol acute treatment significantly enhanced the antinociceptive effect of the drugs given alone (P < 0.05). Nevertheless, this effect decreased about 53% after the chronic treatment (3 doses per day, for 4 days). No pharmacokinetic interaction between metamizol and tramadol was found under acute treatment (P > 0.05). The mechanism involved in the synergism of the antinociceptive effect observed with the combination of metamizol and tramadol in single dose cannot be attributed to a pharmacokinetic interaction, and other pharmacodynamic interactions have to be considered. On the other hand, when metamizol and tramadol were co-administered under repeated administrations, a pharmacokinetic interaction and tolerance development occurred. Differences found in metamizol active metabolites’ pharmacokinetics (P < 0.05) were related to the development of tolerance produced by the combination after repeated doses. This work shows an additional preclinical support for the combination therapy. The clinical utility of this combination in a suitable dose range should be evaluated in future studies.
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Affiliation(s)
- Luis Alfonso Moreno-Rocha
- Departamento Sistemas Biológicos, Universidad Autónoma Metropolitana, Unidad Xochimilco, Calzada del Hueso 1100, Colonia Villa Quietud, México, D.F. C.P. 04960, Mexico
| | - Francisco Javier López-Muñoz
- Departamento de Farmacobiología, Centro de Investigación y Estudios Avanzados, Sede Sur, Calzada de los Tenorios 235, Colonia Granjas Coapa, México, D.F. C.P. 14330, Mexico
| | - José Raúl Medina-López
- Departamento Sistemas Biológicos, Universidad Autónoma Metropolitana, Unidad Xochimilco, Calzada del Hueso 1100, Colonia Villa Quietud, México, D.F. C.P. 04960, Mexico
| | - Adriana Miriam Domínguez-Ramírez
- Departamento Sistemas Biológicos, Universidad Autónoma Metropolitana, Unidad Xochimilco, Calzada del Hueso 1100, Colonia Villa Quietud, México, D.F. C.P. 04960, Mexico
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