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Soliman N, Denk F. Practical approaches to improving translatability and reproducibility in preclinical pain research. Brain Behav Immun 2024; 115:38-42. [PMID: 37793487 DOI: 10.1016/j.bbi.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/21/2023] [Accepted: 09/30/2023] [Indexed: 10/06/2023] Open
Abstract
Pain research continues to face the challenge of poor translatability of pre-clinical studies. In this short primer, we are summarizing the possible causes, with an emphasis on practical and constructive solutions. In particular, we stress the importance of increased heterogeneity in animal studies; formal or informal pre-registration to combat publication bias; and increased statistical training in order to help pre-clinical scientists appreciate the usefulness of available experimental design and reporting guidelines.
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Affiliation(s)
- Nadia Soliman
- Pain Research, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Franziska Denk
- Wolfson Centre for Age-related Diseases, King's College London, Guy's Campus, London, SE1 1UL, United Kingdom.
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MacDonald DI, Jayabalan M, Seaman J, Nickolls A, Chesler A. Pain persists in mice lacking both Substance P and CGRPα signaling. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.15.567208. [PMID: 38076807 PMCID: PMC10705526 DOI: 10.1101/2023.11.15.567208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
The neuropeptides Substance P and CGRPα have long been thought important for pain sensation. Both peptides and their receptors are expressed at high levels in pain-responsive neurons from the periphery to the brain making them attractive therapeutic targets. However, drugs targeting these pathways individually did not relieve pain in clinical trials. Since Substance P and CGRPα are extensively co-expressed we hypothesized that their simultaneous inhibition would be required for effective analgesia. We therefore generated Tac1 and Calca double knockout (DKO) mice and assessed their behavior using a wide range of pain-relevant assays. As expected, Substance P and CGRPα peptides were undetectable throughout the nervous system of DKO mice. To our surprise, these animals displayed largely intact responses to mechanical, thermal, chemical, and visceral pain stimuli, as well as itch. Moreover, chronic inflammatory pain and neurogenic inflammation were unaffected by loss of the two peptides. Finally, neuropathic pain evoked by nerve injury or chemotherapy treatment was also preserved in peptide-deficient mice. Thus, our results demonstrate that even in combination, Substance P and CGRPα are not required for the transmission of acute and chronic pain.
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Affiliation(s)
- Donald Iain MacDonald
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, United States
| | - Monessha Jayabalan
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, United States
| | - Jonathan Seaman
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, United States
| | - Alec Nickolls
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, United States
| | - Alexander Chesler
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, United States
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, United States
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Xiong J, Wang Z, Bai J, Cheng K, Liu Q, Ni J. Calcitonin gene-related peptide: a potential protective agent in cerebral ischemia-reperfusion injury. Front Neurosci 2023; 17:1184766. [PMID: 37529236 PMCID: PMC10387546 DOI: 10.3389/fnins.2023.1184766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/29/2023] [Indexed: 08/03/2023] Open
Abstract
Ischemic stroke is the most common type of cerebrovascular disease with high disability and mortality rates, which severely burdens patients, their families, and society. At present, thrombolytic therapy is mainly used for the treatment of ischemic strokes. Even though it can achieve a good effect, thrombolytic recanalization can cause reperfusion injury. Calcitonin gene-related peptide (CGRP) is a neuropeptide that plays a neuroprotective role in the process of ischemia-reperfusion injury. By combining with its specific receptors, CGRP can induce vasodilation of local cerebral ischemia by directly activating the cAMP-PKA pathway in vascular smooth muscle cells and by indirectly activating the NO-cGMP pathway in an endothelial cell-dependent manner,thus rapidly increasing ischemic local blood flow together with reperfusion. CGRP, as a key effector molecule of neurogenic inflammation, can reduce the activation of microglia, downregulates Th1 classical inflammation, and reduce the production of TNF-α, IL-2, and IFN-γ and the innate immune response of macrophages, leading to the reduction of inflammatory factors. CGRP can reduce the overexpression of the aquaporin-4 (AQP-4) protein and its mRNA in the cerebral ischemic junction, and play a role in reducing cerebral edema. CGRP can protect endothelial cells from angiotensin II by reducing the production of oxidants and protecting antioxidant defense. Furthermore, CGRP-upregulated eNOS can further induce VEGF expression, which then promotes the survival and angiogenesis of vascular endothelial cells. CGRP can also reduce apoptosis by promoting the expression of Bcl-2 and inhibiting the expression of caspase-3. These effects suggest that CGRP can reduce brain injury and repair damaged nerve function. In this review, we focused on the role of CGRP in cerebral ischemia-reperfusion injury.
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Affiliation(s)
- Jie Xiong
- Department of Rehabilitation, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Zhiyong Wang
- Department of Rehabilitation, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Junhui Bai
- Department of Rehabilitation, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Keling Cheng
- Department of Rehabilitation, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Qicai Liu
- Department of Reproductive Medicine Centre, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jun Ni
- Department of Rehabilitation, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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Chaliha DR, Vaccarezza M, Corti E, Takechi R, Dhaliwal SS, Drummond P, Visser E, Chen FK, Charng J, Lam V, Mamo JC. L-arginine and aged garlic extract for the prevention of migraine: a study protocol for a randomised, double-blind, placebo-controlled, phase-II trial (LARGE trial). BMC Neurol 2023; 23:122. [PMID: 36973718 PMCID: PMC10041759 DOI: 10.1186/s12883-023-03149-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
Background Migraine is a common and distressing neurological condition characterised by recurrent throbbing headaches, nausea and heightened sensitivity to light and sound. Accumulating evidence suggests that cerebral arteries dilate during migraine, causing distal microvessels to constrict, which could activate nociceptors and cause onset of headache pain. If so, preventing or attenuating chronic microvascular constriction, and promoting a dilatory phenotype, may reduce frequency and/or severity of migraines. The primary aim of the L-Arginine and Aged Garlic Extract (LARGE) trial is to investigate whether oral treatment with dietary nutraceuticals, L-arginine and aged garlic extract (AGE), both systemic vasodilatory agents, will alleviate migraine frequency, duration and severity in adults with chronic frequent episodic migraines. Methods The study is a randomised double-blind placebo-controlled phase-II single-site clinical trial conducted in Perth, Australia. The target sample is to recruit 240 participants diagnosed with chronic frequent episodic migraines between 18 and 80 years of age. Participants will be randomised to one of four treatment groups for 14 weeks (placebo induction for 2 weeks, followed by 12 weeks on one of the respective treatment arms): placebo, L-arginine, AGE, or a combination of L-arginine and AGE. The doses of L-arginine and AGE are 1.5 g and 1 g daily, respectively. The primary outcome is to assess migraine response using change in migraine frequency and intensity between baseline and 12 weeks. Secondary outcomes include the impact of L-arginine and/or AGE on photosensitivity, retinal vessel changes, and blood biomarker concentrations of vascular tone, following a 12-week intervention. Discussion The protocol describes the oral administration of 2 nutraceutical-based interventions as possible prophylactic treatments for chronic frequent episodic migraines, with potential for direct clinical translation of outcomes. Potential limitations of the study include the fixed-dose design of each treatment arm and that in vivo neuroimaging methods, such as magnetic resonance imaging (MRI), will not be conducted to determine putative cerebro-vasodilatory changes to coincide with the outcome measures. Dose-response studies may be indicated. Trial registration The trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry ACTRN12621001476820 (Universal Trial Number: U1111-1268-1117) on 04/08/2021. This is protocol version 1, submitted on 25/11/2022. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-023-03149-y.
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Affiliation(s)
- Devahuti R. Chaliha
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Mauro Vaccarezza
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Emily Corti
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Ryusuke Takechi
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - Satvinder S. Dhaliwal
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.4280.e0000 0001 2180 6431Duke-NUS Medical School, National University of Singapore, Queenstown, Singapore
- grid.11875.3a0000 0001 2294 3534Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
- grid.443365.30000 0004 0388 6484Singapore University of Social Sciences, 463 Clementi Road, Clementi, 599494 Singapore
| | - Peter Drummond
- grid.1025.60000 0004 0436 6763College of Science, Health, Engineering and Education (SHEE), Murdoch University, Murdoch, WA Australia
| | - Eric Visser
- grid.266886.40000 0004 0402 6494School of Medicine, University of Notre Dame, Fremantle, Australia
| | - Fred K. Chen
- grid.1012.20000 0004 1936 7910Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, WA Australia
- grid.1008.90000 0001 2179 088XOphthalmology, Department of Surgery, The University of Melbourne, East Melbourne, VIC Melbourne, Australia
| | - Jason Charng
- grid.1012.20000 0004 1936 7910Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, WA Australia
- grid.1012.20000 0004 1936 7910Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA Australia
| | - Virginie Lam
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - John C.L. Mamo
- grid.1032.00000 0004 0375 4078Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Australia
- grid.1032.00000 0004 0375 4078School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
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Sharav Y, Haviv Y, Benoliel R. Orofacial Migraine or Neurovascular Orofacial Pain from Pathogenesis to Treatment. Int J Mol Sci 2023; 24:2456. [PMID: 36768779 PMCID: PMC9917018 DOI: 10.3390/ijms24032456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/21/2023] [Accepted: 01/25/2023] [Indexed: 01/28/2023] Open
Abstract
The purpose of the present study is to examine possible differences between orofacial migraine (OFM) and neurovascular orofacial pain (NVOP). Facial presentations of primary headache are comparable to primary headache disorders; but occurring in the V2 or V3 dermatomes of the trigeminal nerve. These were classified and recently published in the International Classification of Orofacial Pain, 1st edition (ICOP). A category in this classification is "orofacial pains resembling presentations of primary headaches," which encompasses OFM and NVOP. The differences between NVOP and OFM are subtle, and their response to therapy may be similar. While classified under two separate entities, they contain many features in common, suggesting a possible overlap between the two. Consequently, their separation into two entities warrants further investigations. We describe OFM and NVOP, and their pathophysiology is discussed. The similarities and segregating clinical signs and symptoms are analyzed, and the possibility of unifying the two entities is debated.
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Affiliation(s)
- Yair Sharav
- Department of Oral Medicine, Sedation & Maxillofacial Imaging, School of Dental Medicine, Hebrew University-Hadassah, Jerusalem 91010, Israel
| | - Yaron Haviv
- Department of Oral Medicine, Sedation & Maxillofacial Imaging, School of Dental Medicine, Hebrew University-Hadassah, Jerusalem 91010, Israel
| | - Rafael Benoliel
- Unit for Oral Medicine, Department of Oral and Maxillofacial Surgery Division of ENT, Head & Neck and Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center-Ichilov, Tel Aviv 61060, Israel
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