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Olin S, Schildt J, Lane M, Odunayo A, Springer C, Call D, Jones S, Geiser D, Millis D, Drum M. The effects of hyperbaric oxygen therapy on snake-bite-associated wounds in dogs. J Vet Emerg Crit Care (San Antonio) 2024; 34:211-221. [PMID: 38761038 DOI: 10.1111/vec.13383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 05/20/2024]
Abstract
OBJECTIVE To assess the effect of hyperbaric oxygen therapy (HBOT) on Crotalinae envenomation-induced wound swelling and severity and pain in dogs, and to describe the safety and complications of HBOT. DESIGN Prospective, randomized, controlled, blinded study (2017-2021). SETTING University teaching hospital, private veterinary practice. ANIMALS Thirty-six client-owned dogs presenting within 24 hours of a confirmed or suspected naturally occurring Crotalinae snake bite injury were enrolled between 2017 and 2021. INTERVENTIONS In addition to the standard of care treatment, dogs received 2 interventions with either HBOT (n = 19) or control (n = 16) within 24 hours of hospital admission. Dogs receiving HBOT were pressurized over 15 minutes (1 psi/min), maintained at a target pressure of 2 atmosphere absolute (ATA) for 30 minutes, and decompressed over 15 minutes. Control dogs received 1 ATA for 1 hour. Local wound swelling, wound severity score, and pain score were assessed at admission, before and after each intervention, and at hospital discharge. MEASUREMENTS AND MAIN RESULTS There was no significant difference in wound swelling (P = 0.414), severity score (P = 1.000), or pain score (P = 0.689) between HBOT and control groups. Pain decreased significantly over time regardless of the study intervention (P < 0.001). There were no major adverse effects associated with either study intervention. CONCLUSIONS HBOT did not significantly alter the short-term recovery from Crotalinae envenomation in this study population. However, the study might be underpowered to detect a significant treatment effect.
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Affiliation(s)
- Shelly Olin
- Department of Small Animal Clinical Science, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Julie Schildt
- Department of Small Animal Clinical Science, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | | | - Adesola Odunayo
- Department of Small Animal Clinical Science, University of Florida, Gainesville, Florida, USA
| | - Cary Springer
- Research Computing Support, Office of Information Technology, University of Tennessee, Knoxville, Tennessee, USA
| | - Dana Call
- Neel Veterinary Hospital, Oklahoma City, Oklahoma, USA
| | - Selene Jones
- Allergy Skin and Ear Clinic for Pets, Livonia, Michigan, USA
| | - Dennis Geiser
- Hospital Administration, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Daryl Millis
- Department of Small Animal Clinical Science, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
| | - Marti Drum
- Department of Small Animal Clinical Science, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA
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Cao C, Li Q, Zhang X, Varrassi G, Wang H. Effectiveness of Hyperbaric Oxygen for Fibromyalgia: A Meta-Analysis of Randomized Controlled Trials. Clin Pract 2023; 13:583-595. [PMID: 37218804 DOI: 10.3390/clinpract13030053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Hyperbaric oxygen therapy (HBOT) has been reported as an emerging treatment regimen for fibromyalgia syndrome (FMS), with a paucity of solid evidence. Accordingly, a systematic review and meta-analysis were performed to address the effectiveness of HBOT on FMS. METHODS We searched the Cochrane Database, EMBASE, Medline, PubMed, Clinicaltrials.gov, and PsycINFO, and the reference sections of original studies and systematic reviews from inception to May 2022. Randomized controlled trials (RCTs) on the treatment of FMS with HBOT were included. Outcome measures included pain, Fibromyalgia Impact Questionnaire (FIQ), Tender Points Count (TPC), and side effects. RESULTS Four RCTs, with 163 participants, were included for analysis. Pooled results showed that HBOT could benefit FMS with significant improvement at the end of treatment, including FIQ (SMD = -1.57, 95% CI -2.34 to -0.80) and TPC (SMD = -2.50, 95% CI -3.96 to -1.05). However, there was no significant effect on pain (SMD = -1.68, 95% CI, -4.47 to 1.11). Meanwhile, HBOT significantly increased the incidence of side effects (RR = 24.97, 95% CI 3.75 to 166.47). CONCLUSIONS Collectively, emerging evidence from RCTs indicates that HBOT can benefit FMS patients in FIQ and TPC throughout the observation time phrases. Although HBOT has some side effects, it does not cause serious adverse consequences.
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Affiliation(s)
- Chunfeng Cao
- Department of Orthopedics, The Yongchuan Hospital of Chongqing Medical University, 439# Xuanhua Road, Yongchuan, Chongqing 402160, China
| | - Qianlu Li
- Department of Neurology, The Yongchuan Hospital of Chongqing Medical University, 439# Xuanhua Road, Yongchuan, Chongqing 402160, China
| | - Xinran Zhang
- Department of Orthopedics, The Yongchuan Hospital of Chongqing Medical University, 439# Xuanhua Road, Yongchuan, Chongqing 402160, China
| | - Giustino Varrassi
- Department of Research, Polo Procacci Foundation, Via Tacito 7, 00193 Roma, Italy
| | - Haiqiang Wang
- Institute of Integrative Medicine, Shaanxi University of Chinese Medicine, Xixian Avenue, Xixian District, Xi'an 712046, China
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Chen X, You J, Ma H, Zhou M, Huang C. Efficacy and safety of hyperbaric oxygen therapy for fibromyalgia: a systematic review and meta-analysis. BMJ Open 2023; 13:e062322. [PMID: 36690401 PMCID: PMC9872467 DOI: 10.1136/bmjopen-2022-062322] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To investigate the efficacy and safety of hyperbaric oxygen therapy (HBOT) for fibromyalgia (FM). DESIGN A systematic review and meta-analysis. DATA SOURCES PubMed, EMBASE, Cochrane Library, Web of Science, VIP (China Science and Technology Journal Database), CNKI (China National Knowledge Infrastructure) and WanFang database were searched from from inception to 22 October 2022. ELIGIBILITY CRITERIA We included clinical trials (randomised controlled and non-randomised controlled trials) of HBOT for FM. DATA EXTRACTION AND SYNTHESIS Two researchers independently screened the literature, extracted data and evaluated the quality of the included studies, with disagreements resolved by a third researcher. The Cochrane Collaboration checklists and the Methodological Index for Non-randomised Studies were used to assess the risk of bias. Meta-analysis was performed by RevMan V.5.4.1 software. Random effect models were used for meta-analysis. RESULTS Nine studies were included in this review, with a total of 288 patients. For pain assessment, we combined the results of the Visual Analogue Scale and Widespread Pain Index. The results showed that HBOT could relieve the pain of FM patients compared with the control intervention (standardised mean difference=-1.56, 95% CI (-2.18 to -0.93), p<0.001, I 2=51%). Most included studies reported that HBOT ameliorated tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM. Adverse events occurred in 44 of 185 patients (23.8%). Twelve patients (6.5%) withdrew because of adverse reactions. No serious adverse events or complications were observed. CONCLUSIONS HBOT might have a positive effect in improving pain, tender points, fatigue, multidimensional function, patient global and sleep disturbance in FM, with reversible side effects. Low pressure (less than 2.0 atmospheric absolute) may be beneficial to reduce adverse events in FM. Further studies should be carried out to evaluate the optimal protocol of HBOT in FM. PROSPERO REGISTRATION NUMBER CRD42021282920.
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Affiliation(s)
- Xinxin Chen
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jiuhong You
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Hui Ma
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Mei Zhou
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Cheng Huang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Levitan DM, Hitt M, Geiser DR, Lyman R. Rationale for hyperbaric oxygen therapy in traumatic injury and wound care in small animal veterinary practice. J Small Anim Pract 2021; 62:719-729. [PMID: 34018618 PMCID: PMC8519146 DOI: 10.1111/jsap.13356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/25/2021] [Accepted: 04/18/2021] [Indexed: 12/30/2022]
Abstract
Hyperbaric oxygen therapy is in wide use in human medicine around the world. Although hyperbaric oxygen therapy is available for veterinary use, it is still significantly underutilised. The physical principles, gas laws and physiologic mechanisms by which hyperbaric oxygen therapy is therapeutic, especially in traumatic injuries and complicated wound care, are discussed. Then, considerations are offered for the implementation of hyperbaric oxygen therapy in veterinary practices. Finally, a review of clinical indications for veterinary practices, including a presentation of select literature, is provided. Applying hyperbaric oxygen therapy in an earlier and more consistent manner could improve short- and long-term outcomes in complicated wounds. The authors also hope this information may stimulate interest in the design of future, prospective studies for the various clinical situations described.
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Affiliation(s)
- D. M. Levitan
- College of Veterinary MedicineLong Island UniversityBrookvilleNY11548USA
| | - M. Hitt
- Atlantic Veterinary Internal Medicine and OncologyAnnapolisMD21401USA
| | - D. R. Geiser
- College of Veterinary MedicineUniversity of TennesseeKnoxvilleTN37996USA
| | - R. Lyman
- Animal Emergency and Referral CenterFort PierceFL34982USA
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Abstract
Chemotherapeutic agents can cause peripheral neuropathy, a deleterious side effect of cancer treatment. Hyperbaric oxygen (HBO2) treatment has shown great potential for decreasing pain in numerous clinical pain conditions and in preclinical studies. This study was designed to test whether HBO2 might also be useful for treating chemotherapy-induced peripheral neuropathy. Male and female Sprague-Dawley rats were injected with 1 mg/kg paclitaxel or vehicle every other day for 7 days to induce allodynia, followed by either one single, or four daily 60-min exposures to HBO2 or room air. Mechanical and cold allodynia as well as locomotor behavior and body weight were assessed intermittently for several weeks. Estrous cycling was also tracked in female rats. Paclitaxel caused pronounced mechanical allodynia in both sexes that was completely reversed by either one or four treatments of HBO2. Females in all treatment groups showed greater cold acetone scores than males, and acetone scores were not reliably reduced by HBO2 treatment. Neither paclitaxel nor HBO2 treatment altered locomotor behavior or estrous cycling. We conclude that HBO2 treatment was highly effective at reducing mechanical allodynia in paclitaxel-treated rats without affecting weight gain, locomotion, or estrous cycling, suggesting that HBO2 may be effective for treating chemotherapy-induced neuropathic pain without producing significant side effects.
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Wahl AM, Bidstrup D, Smidt-Nielsen IG, Werner MU, Hyldegaard O, Rotbøll-Nielsen P. A single session of hyperbaric oxygen therapy demonstrates acute and long-lasting neuroplasticity effects in humans: a replicated, randomized controlled clinical trial. J Pain Res 2019; 12:2337-2348. [PMID: 31534358 PMCID: PMC6682324 DOI: 10.2147/jpr.s198359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 04/24/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose Animal studies have demonstrated anti-inflammatory, and anti-nociceptive properties of hyperbaric oxygen therapy (HBOT). However, physiological data are scarce in humans. In a recent experimental study, the authors used the burn injury (BI) model observing a decrease in secondary hyperalgesia areas (SHA) in the HBOT-group compared to a control-group. Surprisingly, a long-lasting neuroplasticity effect mitigating the BI-induced SHA-response was seen in the HBOT-preconditioned group. The objective of the present study, therefore, was to confirm our previous findings using an examiner-blinded, block-randomized, controlled, crossover study design. Patients and methods Nineteen healthy subjects attended two BI-sessions with an inter-session interval of ≥28 days. The BIs were induced on the lower legs by a contact thermode (12.5 cm2, 47C°, 420 s). The subjects were block-randomized to receive HBOT (2.4 ATA, 100% O2, 90 min) or ambient conditions ([AC]; 1 ATA, 21% O2), dividing cohorts equally into two sequence allocations: HBOT-AC or AC-HBOT. All sensory assessments performed during baseline, BI, and post-intervention phases were at homologous time points irrespective of sequence allocation. The primary outcome was SHA, comparing interventions and sequence allocations. Results Data are mean (95% CI). During HBOT-sessions a mitigating effect on SHA was demonstrated compared to AC-sessions, ie, 18.8 (10.5–27.0) cm2 vs 32.0 (20.1–43.9) cm2 (P=0.021), respectively. In subjects allocated to the sequence AC-HBOT a significantly larger mean difference in SHA in the AC-session vs the HBOT-session was seen 25.0 (5.4–44.7) cm2 (P=0.019). In subjects allocated to the reverse sequence, HBOT-AC, no difference in SHA between sessions was observed (P=0.55), confirming a preconditioning, long-lasting (≥28 days) effect of HBOT. Conclusion Our data demonstrate that a single HBOT-session compared to control is associated with both acute and long-lasting mitigating effects on BI-induced SHA, confirming central anti-inflammatory, neuroplasticity effects of hyperbaric oxygen therapy.
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Affiliation(s)
- Anna M Wahl
- Hyperbaric Unit, Department of Anesthesia, Head and Orthopedic Center, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark
| | - Daniel Bidstrup
- Hyperbaric Unit, Department of Anesthesia, Head and Orthopedic Center, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark
| | - Isabel G Smidt-Nielsen
- Hyperbaric Unit, Department of Anesthesia, Head and Orthopedic Center, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark
| | - Mads U Werner
- Multidisciplinary Pain Center, Neuroscience Center, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark
| | - Ole Hyldegaard
- Hyperbaric Unit, Department of Anesthesia, Head and Orthopedic Center, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Per Rotbøll-Nielsen
- Multidisciplinary Pain Center, Neuroscience Center, Rigshospitalet, Copenhagen University Hospitals, Copenhagen, Denmark
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7
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Cohen B, Ahuja S, Schacham YN, Chelnick D, Mao G, Ali-Sakr Esa W, Maheshwari K, Sessler DI, Turan A. Intraoperative Hyperoxia Does Not Reduce Postoperative Pain: Subanalysis of an Alternating Cohort Trial. Anesth Analg 2019; 128:1160-1166. [PMID: 31094783 DOI: 10.1213/ane.0000000000004002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Postoperative pain is common and promotes opioid use. Surgical wounds are hypoxic because normal perfusion is impaired. Local wound ischemia and acidosis promote incisional pain. Some evidence suggests that improving oxygen supply to surgical wounds might reduce pain. We therefore tested the hypothesis that supplemental (80% inspired) intraoperative oxygen reduces postoperative pain and opioid consumption. METHODS We conducted a post hoc analysis of a large, single-center alternating cohort trial allocating surgical patients having general anesthesia for colorectal surgery to either 30% or 80% intraoperative oxygen concentration in 2-week blocks for a total of 39 months. Irrespective of allocation, patients were given sufficient oxygen to maintain saturation ≥95%. Patients who had regional anesthesia or nerve blocks were excluded. The primary outcome was pain and opioid consumption during the initial 2 postoperative hours, analyzed jointly. The secondary outcome was pain and opioid consumption over the subsequent 24 postoperative hours. Subgroup analyses of the primary outcome were conducted for open versus laparoscopic procedures and for patients with versus without chronic pain. RESULTS A total of 4702 cases were eligible for analysis: 2415 were assigned to 80% oxygen and 2287 to 30% oxygen. The groups were well balanced on potential confounding factors. Average pain scores and opioid consumption were similar between the groups (mean difference in pain scores, -0.01 [97.5% CI, -0.16 to 0.14; P = .45], median difference in opioid consumption, 0.0 [97.5% CI, 0 to 0] mg morphine equivalents; P = .82). There were also no significant differences in the secondary outcome or subgroup analyses. CONCLUSIONS Supplemental intraoperative oxygen does not reduce acute postoperative pain or reduce opioid consumption.
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Affiliation(s)
- Barak Cohen
- From the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
- Division of Anesthesia, Critical Care and Pain Management, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Sanchit Ahuja
- From the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
| | - Yehoshua N Schacham
- From the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
- Internal Medicine C, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - David Chelnick
- From the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
| | | | | | - Kamal Maheshwari
- From the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
- General Anesthesia, Cleveland Clinic, Cleveland, Ohio
| | - Daniel I Sessler
- From the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
| | - Alparslan Turan
- From the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio
- General Anesthesia, Cleveland Clinic, Cleveland, Ohio
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Zhang Y, Brewer AL, Nelson JT, Smith PT, Shirachi DY, Quock RM. Hyperbaric oxygen produces a nitric oxide synthase-regulated anti-allodynic effect in rats with paclitaxel-induced neuropathic pain. Brain Res 2019; 1711:41-47. [PMID: 30629945 DOI: 10.1016/j.brainres.2019.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 12/17/2018] [Accepted: 01/06/2019] [Indexed: 12/21/2022]
Abstract
Research has demonstrated that hyperbaric oxygen (HBO2) treatment produced relief of both acute and chronic pain in patients and animal models. However, the mechanism of HBO2 antinociceptive effect is still elusive. Based on our earlier findings that implicate NO in the acute antinociceptive effect of HBO2, the purpose of this study was to ascertain whether HBO2-induced antinociception in a chronic neuropathic pain model is likewise dependent on NO. Neuropathic pain was induced in male Sprague Dawley rats by four injections of paclitaxel (1.0 mg/kg, i.p.). Twenty-four hours after the last paclitaxel injection, rats were treated for one day or four consecutive days with 60-min HBO2 at 3.5 atmospheres absolute (ATA). Two days before HBO2 treatment, some groups of rats were implanted with Alzet® osmotic minipumps that continuously infused a selective inhibitor of neuronal NO synthase (nNOS) into the lateral cerebral ventricle for 7 days. Mechanical and cold allodynia were assessed every other day, using electronic von Frey and acetone assays, respectively. Rats in the paclitaxel control group exhibited a mechanical or cold allodynia that was significantly reversed by one HBO2 treatment for mechanical allodynia and four HBO2 treatments for cold allodynic. In rats treated with the nNOS inhibitor, the effects of HBO2 were nullified in the mechanical allodynia test but unaffected in the cold allodynia test. In summary, these results demonstrate that the antiallodynic effect of HBO2 in two different pain tests is dependent on NO in the CNS.
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Affiliation(s)
- Yangmiao Zhang
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman 99164, WA, USA
| | - Abigail L Brewer
- Department of Psychology, Washington State University, Pullman 99164, WA, USA
| | - Jordan T Nelson
- Department of Psychology, Washington State University, Pullman 99164, WA, USA
| | - Paxton T Smith
- Department of Psychology, Washington State University, Pullman 99164, WA, USA
| | - Donald Y Shirachi
- Department of Physiology and Pharmacology, Thomas J. Long School of Pharmacy and Health Sciences, University of Pacific, Stockton, CA 95211, USA
| | - Raymond M Quock
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman 99164, WA, USA; Department of Psychology, Washington State University, Pullman 99164, WA, USA; Translational Addiction Research Center, Washington State University, Pullman 99164, WA, USA.
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Buhler AVK, Tachibana S, Zhang Y, Quock RM. nNOS immunoreactivity co-localizes with GABAergic and cholinergic neurons, and associates with β-endorphinergic and met-enkephalinergic opioidergic fibers in rostral ventromedial medulla and A5 of the mouse. Brain Res 2018; 1698:170-178. [PMID: 30081038 DOI: 10.1016/j.brainres.2018.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 05/24/2018] [Accepted: 08/02/2018] [Indexed: 11/26/2022]
Abstract
The present study examined the co-expression of neuronal nitric oxide synthase (nNOS) in the rostral ventromedial medulla (RVM) and A5 regions of the mouse brainstem within several neurochemical populations involved in nociceptive modulation. Double immunohistochemical methods showed that nNOS+ neurons do not co-localize with serotonergic neurons within any of these regions. Within the RVM, the nuclei raphe magnus and gigantocellularis contain a population of nNOS+/GAD67+ neurons, and within the paragigantocellularis lateralis, there is a smaller population of nNOS+/CHAT+ neurons. Further, nNOS+ neurons overlap the region of expression of β-endorphinergic and met-enkephalinergic fibers within the RVM. No co-labeling was found within the A5 for any of these populations. These findings suggest that pain-modulatory serotonergic neurons within the brainstem do not directly produce nitric oxide (NO). Rather, NO-producing neurons within the RVM belong to GABAergic and cholinergic cell populations, and are in a position to modulate or be modulated by local opioidergic neurons.
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Affiliation(s)
- Amber V K Buhler
- School of Pharmacy, Pacific University Oregon, 222 SE 8th Ave, Hillsboro, OR 97123, United States.
| | - Sean Tachibana
- School of Pharmacy, Pacific University Oregon, 222 SE 8th Ave, Hillsboro, OR 97123, United States
| | - Yangmiao Zhang
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA 99164, United States
| | - Raymond M Quock
- Department of Psychology, Washington State University, Pullman, WA 99164, United States
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10
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Brewer AL, Liu S, Buhler AV, Shirachi DY, Quock RM. Role of spinal GABA receptors in the acute antinociceptive response of mice to hyperbaric oxygen. Brain Res 2018; 1699:107-116. [PMID: 30077648 DOI: 10.1016/j.brainres.2018.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/15/2018] [Accepted: 08/02/2018] [Indexed: 02/01/2023]
Abstract
New pain treatments are in demand due to the pervasive nature of pain conditions. Hyperbaric oxygen (HBO2) has shown potential in treating pain in both clinical and preclinical settings, although the mechanism of this effect is still unknown. The aim of this study was to investigate whether the major inhibitory neurotransmitter γ-aminobutyric acid (GABA) is involved in HBO2-induced antinociception in the central nervous system (CNS). To accomplish this goal, pharmacological interactions between GABA drugs and HBO2 were investigated using the behavioral acetic acid abdominal constriction test. Western blotting was used to quantify protein changes that might occur as a result of the interactions. GABAA but not GABAB receptor antagonists dose-dependently reduced HBO2 antinociception, while antagonism of the GABA reuptake transporter enhanced this effect. Western blot results showed an interaction between the pain stimulus and HBO2 on expression of the phosphorylated β3 subunit of the GABAA receptor at S408/409 in homogenates of the lumbar but not thoracic spinal cord. A significant interaction was also found in neuronal nitric oxide synthase (nNOS) expression in the lumbar but not thoracic spinal cord. These findings support the notion that GABA may be involved in HBO2-induced antinociception at the GABAA receptor but indicate that more study will be needed to understand the intricacies of this interaction.
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Affiliation(s)
- Abigail L Brewer
- Department of Psychology, Washington State University, Pullman, WA 99164, USA
| | - Shulin Liu
- Department of Aviation Medicine, Naval Medicine Research Institute, Second Military Medical University, Shanghai 200433, China
| | - Amber V Buhler
- School of Pharmacy, Pacific University Oregon, Hillsboro, OR 97123, USA
| | - Donald Y Shirachi
- Department of Physiology and Pharmacology, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA
| | - Raymond M Quock
- Department of Psychology, Washington State University, Pullman, WA 99164, USA; Translational Addiction Research Center, Washington State University, Pullman, WA 99164, USA.
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Ding Y, Yao P, Hong T, Han Z, Zhao B, Chen W, Zhou G. Early hyperbaric oxygen effects on neuropathic pain and nitric oxide synthase isoforms in CCI rats. Oncotarget 2018; 9:7513-7521. [PMID: 29484128 PMCID: PMC5800920 DOI: 10.18632/oncotarget.23867] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 12/24/2017] [Indexed: 12/20/2022] Open
Abstract
Neuropathic pain is pain caused by injury or dysfunction in the central and/or peripheral nervous system. Neuropathic pain has a high incidence with a complex mechanism, but effective treatment remains elusive. Hyperbaric oxygen (HBO) therapy has been widely used in the treatment of a variety of neurological diseases. The current study used a rat model of neuropathic pain induced by chronic constriction injury (CCI) of the sciatic nerve. We observed the effects of early use of 2.5 absolute atmosphere (ATA) HBO on neuropathic pain-related behaviors and the expression of nitric oxide synthase (NOS) isoforms in the spinal dorsal horn. In the CCI group, mechanical withdrawal threshold (MWT) was decreased, Thermal withdrawal latency (TWL) was shortened, and mRNA and protein levels of iNOS and nNOS were significantly increased compared to the sham group. MWT was increased, TWL was enhanced, and iNOS and nNOS levels were significantly decreased in the HBO group compared to the CCI group. There was no change in eNOS levels across all groups. HBO treatment at early stages can improve hyperalgesia.
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Affiliation(s)
- Yuanyuan Ding
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Peng Yao
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tao Hong
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhenkai Han
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Baisong Zhao
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Weimin Chen
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guangyu Zhou
- Department of Nephrology, Shengjing Hospital of China Medical University, Shenyang, China
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Ding Y, Yao P, Hong T, Han Z, Zhao B, Chen W. The NO-cGMP-PKG signal transduction pathway is involved in the analgesic effect of early hyperbaric oxygen treatment of neuropathic pain. J Headache Pain 2017; 18:51. [PMID: 28470432 PMCID: PMC5415449 DOI: 10.1186/s10194-017-0760-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 04/22/2017] [Indexed: 01/02/2023] Open
Abstract
Background Hyperbaric oxygen (HBO) has the potential to relieve neuropathic pain. The purpose of this study was to determine whether the NO-cGMP-PKG signaling pathway is involved in the analgesic effects of early hyperbaric oxygen treatment of neuropathic pain in rats. Methods Rats were randomly grouped for establishment of chronic constriction injury (CCI) models. Intrathecal catheters were inserted and 2.5ATA HBO therapy was administered from day 1 post-surgery for 60 minutes daily, continuously for 5 days; menstruum NS, DMSO, NO synthase(NOS) nonspecific inhibitor (L-NAME), soluble guanylyl cyclase(sGC) inhibitor (ODQ) and protein kinase G(PKG) inhibitor (KT5823) were administered intrathecally 30 minutes prior to HBO therapy. Pain-related behaviors in rats were observed at specific time points. Western blot and real-time RT-PCR were used to observe the expressions of PKG1 mRNA and protein in the spinal dorsal horn. Results Compared with the CCI group, HBO could significantly relieve mechanical and thermal hyperalgesia in rats. After intrathecal administration of L-NAME, ODQ and KT5823, effects of HBO on relieving hyperalgesia in rats were reversed (P < 0.05 vs. HBO), and expression of PKG1 mRNA and protein decreased in the spinal dorsal horn of the animals (P < 0.05 vs. HBO). Conclusions Early HBO therapy could significantly improve symptoms of hyperalgesia of neuropathic pain in rats, possibly via activation of the NO-cGMP-PKG signaling transduction pathway.
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Affiliation(s)
- Yuanyuan Ding
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Peng Yao
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
| | - Tao Hong
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Zhenkai Han
- Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Baisong Zhao
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Weimin Chen
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
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13
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Nicoara D, Zhang Y, Nelson JT, Brewer AL, Maharaj P, DeWald SN, Shirachi DY, Quock RM. Hyperbaric oxygen treatment suppresses withdrawal signs in morphine-dependent mice. Brain Res 2016; 1648:434-437. [PMID: 27534375 DOI: 10.1016/j.brainres.2016.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 07/22/2016] [Accepted: 08/13/2016] [Indexed: 01/29/2023]
Abstract
Hyperbaric oxygen (HBO2) therapy reportedly reduces opiate withdrawal in human subjects. The purpose of this research was to determine whether HBO2 treatment could suppress physical signs of withdrawal in opiate-dependent mice. Male NIH Swiss mice were injected s.c. with morphine sulfate twice a day for 4 days, the daily dose gradually increasing from 50mg/kg on day 1 to 125mg/kg on day 4. On day 5, withdrawal was precipitated by i.p. injection of 5.0mg/kg naloxone. Mice were observed for physical withdrawal signs, including jumping, forepaw tremor, wet-dog shakes, rearing and defecation for 30min. Sixty min prior to the naloxone injection, different groups of mice received either a 30-min or 60-min HBO2 treatment at 3.5atm absolute. HBO2 treatment significantly reduced naloxone-precipitated jumping, forepaw tremor, wet-dog shakes, rearing and defecation. Based on these experimental findings, we concluded that treatment with HBO2 can suppress physical signs of withdrawal syndrome in morphine-dependent mice.
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Affiliation(s)
- Daniel Nicoara
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Yangmiao Zhang
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Jordan T Nelson
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Abigail L Brewer
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Prianka Maharaj
- Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
| | - Shea N DeWald
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Donald Y Shirachi
- Department of Physiology and Pharmacology, University of the Pacific Thomas J. Long School of Pharmacy and Health Sciences, Stockton, CA, USA
| | - Raymond M Quock
- Department of Psychology, Washington State University, Pullman, WA, USA; Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA; Translational Addiction Research Center, Washington State University, Pullman, WA, USA.
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14
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Successful Treatment of Lower Limb Complex Regional Pain Syndrome following Three Weeks of Hyperbaric Oxygen Therapy. Pain Res Manag 2016; 2016:3458371. [PMID: 27445607 PMCID: PMC4904619 DOI: 10.1155/2016/3458371] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/08/2015] [Indexed: 02/07/2023]
Abstract
Hyperbaric oxygen therapy (HBOT) is a treatment that delivers 100% oxygen at increased atmospheric pressures. The efficacy of HBOT for treating pain has been described in various animal pain models and may have clinical efficacy in the treatment of human chronic pain syndromes. We present our experience with posttraumatic Complex Regional Pain Syndrome (CRPS) type 2 in a patient who underwent 15 sessions of HBOT. A 41-year-old male with one-year history of CRPS of left foot followed by left ankle fracture demonstrated less pain, decreased swelling, less allodynia, and improvement in skin color and range of motion of the lower limb after 3 weeks of HBOT. Patient was back to work for the first time in over a year. HBOT may be considered as a valuable therapeutic tool in the treatment of long-standing CRPS.
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15
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RASMUSSEN VM, BORGEN AE, JANSEN EC, ROTBØLL NIELSEN PH, WERNER MU. Hyperbaric oxygen therapy attenuates central sensitization induced by a thermal injury in humans. Acta Anaesthesiol Scand 2015; 59:749-62. [PMID: 25735985 DOI: 10.1111/aas.12492] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 01/16/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hyperbaric oxygen (HBO2 ) treatment has in animal experiments demonstrated antinociceptive effects. It was hypothesized that these effects would attenuate secondary hyperalgesia areas (SHAs), an expression of central sensitization, after a first-degree thermal injury in humans. METHODS Seventeen healthy volunteers were examined during two sessions using a randomized crossover design. Volunteers were studied during control conditions (ambient pressure, FI O2 = 0.21) and during HBO2 (2.4 standard atmosphere, FI O2 = 1.0, 90 min) conditions in a pressure chamber. Quantitative sensory testing, including assessment of SHAs was performed. RESULTS A statistically significant overall attenuation of SHAs was seen during the HBO2 sessions compared with the control-sessions (P = 0.011). In the eight volunteers starting with the HBO2 session, no difference in SHAs compared with control was demonstrated. However, in the nine volunteers starting with the control session, a statistical significant attenuation of SHAs was demonstrated in the HBO2 session (P = 0.004). CONCLUSIONS The results indicate that HBO2 therapy in humans attenuates central sensitization induced by a thermal skin injury, compared with control. These new and original findings in humans corroborate animal experimental data. The thermal injury model may give impetus to future human neurophysiological studies exploring the central effects of hyperbaric oxygen treatment.
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Affiliation(s)
- V. M. RASMUSSEN
- Multidisciplinary Pain Center, Neuroscience Center; Rigshospitalet; Copenhagen University Hospitals; Copenhagen Denmark
| | - A. E. BORGEN
- Hyperbaric Unit; Department of Anaesthesia; Head and Orthopedic Center; Rigshospitalet; Copenhagen University Hospitals; Copenhagen Denmark
| | - E. C. JANSEN
- Hyperbaric Unit; Department of Anaesthesia; Head and Orthopedic Center; Rigshospitalet; Copenhagen University Hospitals; Copenhagen Denmark
| | - P. H. ROTBØLL NIELSEN
- Multidisciplinary Pain Center, Neuroscience Center; Rigshospitalet; Copenhagen University Hospitals; Copenhagen Denmark
| | - M. U. WERNER
- Multidisciplinary Pain Center, Neuroscience Center; Rigshospitalet; Copenhagen University Hospitals; Copenhagen Denmark
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16
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Efrati S, Golan H, Bechor Y, Faran Y, Daphna-Tekoah S, Sekler G, Fishlev G, Ablin JN, Bergan J, Volkov O, Friedman M, Ben-Jacob E, Buskila D. Hyperbaric oxygen therapy can diminish fibromyalgia syndrome--prospective clinical trial. PLoS One 2015; 10:e0127012. [PMID: 26010952 PMCID: PMC4444341 DOI: 10.1371/journal.pone.0127012] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 04/08/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Fibromyalgia Syndrome (FMS) is a persistent and debilitating disorder estimated to impair the quality of life of 2-4% of the population, with 9:1 female-to-male incidence ratio. FMS is an important representative example of central nervous system sensitization and is associated with abnormal brain activity. Key symptoms include chronic widespread pain, allodynia and diffuse tenderness, along with fatigue and sleep disturbance. The syndrome is still elusive and refractory. The goal of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on symptoms and brain activity in FMS. METHODS AND FINDINGS A prospective, active control, crossover clinical trial. Patients were randomly assigned to treated and crossover groups: The treated group patients were evaluated at baseline and after HBOT. Patients in the crossover-control group were evaluated three times: baseline, after a control period of no treatment, and after HBOT. Evaluations consisted of physical examination, including tender point count and pain threshold, extensive evaluation of quality of life, and single photon emission computed tomography (SPECT) imaging for evaluation of brain activity. The HBOT protocol comprised 40 sessions, 5 days/week, 90 minutes, 100% oxygen at 2ATA. Sixty female patients were included, aged 21-67 years and diagnosed with FMS at least 2 years earlier. HBOT in both groups led to significant amelioration of all FMS symptoms, with significant improvement in life quality. Analysis of SPECT imaging revealed rectification of the abnormal brain activity: decrease of the hyperactivity mainly in the posterior region and elevation of the reduced activity mainly in frontal areas. No improvement in any of the parameters was observed following the control period. CONCLUSIONS The study provides evidence that HBOT can improve the symptoms and life quality of FMS patients. Moreover, it shows that HBOT can induce neuroplasticity and significantly rectify abnormal brain activity in pain related areas of FMS patients. TRIAL REGISTRATION ClinicalTrials.gov NCT01827683.
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Affiliation(s)
- Shai Efrati
- Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel
- The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
- * E-mail: (SE); (EBJ)
| | - Haim Golan
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Nuclear Medicine institute, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Yair Bechor
- The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Yifat Faran
- School of Social Work, Ashkelon Academic College, Ashkelon, Israel
| | - Shir Daphna-Tekoah
- School of Social Work, Ashkelon Academic College, Ashkelon, Israel
- Social Work Department, Kaplan Medical Center, Rehovot, Israel
| | - Gal Sekler
- School of Physics and Astronomy, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Gregori Fishlev
- The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jacob N. Ablin
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Institute of Rheumatology, Tel Aviv Sourasky medical center Israel, Tel- Aviv, Israel
| | - Jacob Bergan
- The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Olga Volkov
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Nuclear Medicine institute, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Mony Friedman
- The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eshel Ben-Jacob
- Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
- School of Physics and Astronomy, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Center for Theoretical Biological Physics, Rice University, Houston, Texas, United States of America
- * E-mail: (SE); (EBJ)
| | - Dan Buskila
- Department of Medicine H, Soroka Medical Center, BGU University of the Negev, Beer Sheva, Israel
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17
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Lim TKY, Shi XQ, Johnson JM, Rone MB, Antel JP, David S, Zhang J. Peripheral nerve injury induces persistent vascular dysfunction and endoneurial hypoxia, contributing to the genesis of neuropathic pain. J Neurosci 2015; 35:3346-59. [PMID: 25716835 PMCID: PMC6605560 DOI: 10.1523/jneurosci.4040-14.2015] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 01/09/2015] [Accepted: 01/12/2015] [Indexed: 12/22/2022] Open
Abstract
Nerve injury is associated with microvascular disturbance; however, the role of the vascular system has not been well characterized in the context of neuropathic pain. Furthermore, ischemia is thought to play a role in a number of neuropathic pain conditions, and yet the role of hypoxia has also not been characterized in neuropathic pain conditions. In this study, we observed the presence of persistent endoneurial hypoxia in a mouse model of traumatic peripheral nerve injury, causing painful mononeuropathy. We attribute the ongoing hypoxia to microvascular dysfunction, endoneurial fibrosis, and increased metabolic requirements within the injured nerve. Increased lactate levels were observed in injured nerves, as well as increased oxygen consumption and extracellular acidification rates, suggesting that anaerobic glycolysis is required to maintain cellular ATP levels. Hypoxia causes a reduction in levels of the Na(+)/K(+) ATPase ion transporter in both cultured primary dorsal root ganglion neurons and injured peripheral nerve. A reduction of Na(+)/K(+) ATPase ion transporter levels likely contributes to the hyperexcitability of injured nerves. Physiological antagonism of hypoxia with hyperbaric oxygen alleviated mechanical allodynia in nerve-injured animals. These results suggest that hypoxia and the Na(+)/K(+) ATPase ion transporter may be a novel mechanistic target for the treatment of neuropathic pain. In addition, the findings support the possibility of using hypoxia activated pro-drugs to localize treatments for neuropathic pain and nerve injury to injured nerves.
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Affiliation(s)
- Tony K Y Lim
- Neurology and Neurosurgery, Alan Edwards Centre for Research on Pain, and
| | - Xiang Q Shi
- Alan Edwards Centre for Research on Pain, and
| | | | | | | | - Samuel David
- Neurology and Neurosurgery, Centre for Research in Neuroscience, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada, H3G 1A4
| | - Ji Zhang
- Neurology and Neurosurgery, Alan Edwards Centre for Research on Pain, and Faculty of Dentistry, McGill University, Montreal Quebec, Canada H3A 0G4, and
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18
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Liu S, Shirachi DY, Quock RM. The acute antinociceptive effect of hyperbaric oxygen is not accompanied by an increase in markers of oxidative stress. Life Sci 2014; 98:44-8. [PMID: 24418003 PMCID: PMC3943864 DOI: 10.1016/j.lfs.2013.12.207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 12/18/2013] [Accepted: 12/26/2013] [Indexed: 10/25/2022]
Abstract
AIMS Exposure to hyperbaric oxygen (HBO2) causes an antinociceptive response in mice. However, breathing oxygen (O2) at an elevated pressure can potentially cause oxygen toxicity. The aim of this study was to identify the determinants of HBO2 antinociception and the toxicity profile of HBO2. MAIN METHODS Male NIH Swiss mice were assessed for acute antinociceptive responsiveness under room air or 100% O2 at 1.0 or 3.5 atmospheres absolute (ATA), using the acetic acid-induced abdominal constriction test. For the oxygen toxicity test, mice were exposed to 3.5 ATA oxygen for 11min, 60min, and 60min daily for 2days (120min) or 60min daily for 4days (240min), then assessed by analyzing the levels of two oxidative stress markers, MDA (malondialdehyde) and protein carbonyl in brain, spinal cord and lung. KEY FINDINGS Only the combination of 100% O2 and 3.5 ATA caused significant antinociception. The antinociceptive effect of 100% O2 was pressure-dependent up to 3.5 ATA. In the oxygen toxicity test, mice exposed to HBO2 for different time intervals had levels of brain, spinal cord and lung MDA and protein carbonyl that were comparable to that of control animals exposed to room air. SIGNIFICANCE Treatment with 100% O2 evokes a pressure-dependent antinociceptive effect. Since there was no significant increase in levels of the oxidative stress markers in the tested tissues, it is concluded that HBO2 at 3.5 ATA produces antinociception in the absence of oxidative stress in mice.
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Affiliation(s)
- Shulin Liu
- Department of Diving Medicine, Second Military Medical University, Shanghai, China; Department of Psychology, Washington State University, Pullman, WA 99164, USA
| | - Donald Y Shirachi
- Department of Physiology and Pharmacology, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA
| | - Raymond M Quock
- Department of Psychology, Washington State University, Pullman, WA 99164, USA; Translational Addiction Research Center, Washington State University, Pullman, WA 99164, USA.
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19
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Zhang Y, Stolz P, Shirachi D, Quock R. Reduced antinociceptive responsiveness to hyperbaric oxygen in opioid-tolerant mice. Eur J Pain 2014; 18:1032-9. [DOI: 10.1002/j.1532-2149.2013.00448.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2013] [Indexed: 12/12/2022]
Affiliation(s)
- Y. Zhang
- Department of Integrative Physiology and Neuroscience and Graduate Program in Neuroscience, College of Veterinary Medicine; Washington State University; Pullman USA
| | - P.A. Stolz
- Department of Psychology; Washington State University; Pullman USA
| | - D.Y. Shirachi
- Department of Physiology and Pharmacology, Thomas J. Long School of Pharmacy and Health Sciences; University of the Pacific; Stockton USA
| | - R.M. Quock
- Department of Integrative Physiology and Neuroscience and Graduate Program in Neuroscience, College of Veterinary Medicine; Washington State University; Pullman USA
- Department of Psychology; Washington State University; Pullman USA
- Translational Addiction Research Center; Washington State University; Pullman USA
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20
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Zhao BS, Meng LX, Ding YY, Cao YY. Hyperbaric oxygen treatment produces an antinociceptive response phase and inhibits astrocyte activation and inflammatory response in a rat model of neuropathic pain. J Mol Neurosci 2014; 53:251-61. [PMID: 24390961 DOI: 10.1007/s12031-013-0213-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 12/15/2013] [Indexed: 10/25/2022]
Abstract
Hyperbaric oxygen (HBO) treatment has been proven to be a promising candidate for protection of the nervous system after acute injury in animal models of neuropathic pain. The purposes of this study were to examine the antinociceptive response phase induced by HBO treatment in a model of neuropathic pain and to determine the dependence of the treatment's mechanism of alleviating neuropathic pain on the inhibition of spinal astrocyte activation. Neuropathic pain was induced in rats by chronic constriction injury of the sciatic nerve. Mechanical threshold and thermal latency were tested preoperatively and for 1 week postoperatively, four times daily at fixed time points. Methane dicarboxylic aldehyde (MDA) and superoxide dismutase (SOD) parameters were used as indices of oxidative stress response and tested before and after the treatment. The inflammatory cytokines interleukin (IL)-1β and IL-10 were assayed in the sciatic nerve were with enzyme-linked immunoassay. Glial fibrillary acidic protein activation in the spinal cord was evaluated immunohistochemically. The rats exhibited temporary allodynia immediately after HBO treatment completion. This transient allodynia was closely associated with changes in MDA and SOD levels. A single HBO treatment caused a short-acting antinociceptive response phase. Repetitive HBO treatment led to a long-acting antinociceptive response phase and inhibited astrocyte activation. These results indicated that HBO treatment played a dual role in the aggravation and alleviation of neuropathic pain, though the aggravated pain effect (transient allodynia) was far less pronounced than the antinociceptive phase. Astrocyte inhibition and anti-inflammation may contribute to the antinociceptive effect of HBO treatment after nerve injury.
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Affiliation(s)
- Bai-Song Zhao
- Department of Anesthesiology, China Medical University, Shengjing Hospital, 110004, Shenyang, China,
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21
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Heeman JH, Zhang Y, Shirachi DY, Quock RM. Involvement of spinal cord opioid mechanisms in the acute antinociceptive effect of hyperbaric oxygen in mice. Brain Res 2013; 1540:42-7. [PMID: 24113418 PMCID: PMC3867933 DOI: 10.1016/j.brainres.2013.09.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/21/2013] [Accepted: 09/30/2013] [Indexed: 10/26/2022]
Abstract
Earlier research has demonstrated that treatment with hyperbaric oxygen (HBO2) can elicit an antinociceptive response in models of acute pain. We have demonstrated that this antinociceptive effect is centrally-mediated and is dependent on opioid receptors. The purpose of the present study was to examine the role of endogenous opioid peptides and opioid receptors specifically in the spinal cord in the acute antinociceptive effect of HBO2 in mice. Male NIH Swiss mice were exposed to HBO2 (100% oxygen at 3.5atm absolute) for 11min and their antinociceptive responsiveness was determined using the glacial acetic acid-induced abdominal constriction test. HBO2-induced antinociception was sensitive to antagonism by intrathecal (i.t.) pretreatment with the κ- and μ-selective opioid antagonists norbinaltorphimine and β-funaltrexamine, respectively, but not the δ-selective antagonist naltrindole. The antinociceptive effect of HBO2 was also significantly attenuated by i.t. pretreatment with a rabbit antiserum against rat dynorphin1-13 but not antisera against β-endorphin or methionine-enkephalin. Based on these experimental findings, the acute antinociceptive effect of HBO2 appears to involve neuronal release of dynorphin and activation of κ- and μ-opioid receptors in the spinal cord.
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Affiliation(s)
- Jacqueline H. Heeman
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
| | - Yangmiao Zhang
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
- Graduate Program in Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
| | - Donald Y. Shirachi
- Department of Physiology and Pharmacology, University of the Pacific, Stockton, CA, USA
| | - Raymond M. Quock
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
- Graduate Program in Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
- Translational Addiction Research Center, Washington State University, Pullman, WA, USA
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22
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Gibbons CR, Liu S, Zhang Y, Sayre CL, Levitch B, Moehlmann S, Shirachi DY, Quock RM. Involvement of brain opioid receptors in the anti-allodynic effect of hyperbaric oxygen in rats with sciatic nerve crush-induced neuropathic pain. Brain Res 2013; 1537:111-6. [PMID: 23998986 PMCID: PMC3827781 DOI: 10.1016/j.brainres.2013.08.050] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 08/21/2013] [Accepted: 08/25/2013] [Indexed: 01/03/2023]
Abstract
Earlier research has demonstrated that hyperbaric oxygen (HBO2) can produce an antinociceptive effect in models of acute pain. Recent studies have revealed that HBO2 can produce pain relief in animal models of chronic pain as well. The purpose of the present investigation was to ascertain whether HBO2 treatment might suppress allodynia in rats with neuropathic pain and whether this effect might be blocked by the opioid antagonist naltrexone (NTX). Male Sprague Dawley rats were subjected to a sciatic nerve crush under anesthesia and mechanical thresholds were assessed using an electronic von Frey anesthesiometer. The time course of the HBO2-induced anti-allodynic effect in different treatment groups was plotted, and the area-under-the-curve (AUC) was determined for each group. Seven days after the nerve crush procedure, rats were treated with HBO2 at 3.5 atm absolute (ATA) for 60 min and exhibited an anti-allodynic effect, compared to nerve crush-only control rats. Twenty-four hours before HBO2 treatment, another group of rats was implanted with Alzet(®) osmotic minipumps that continuously released NTX into the lateral cerebral ventricle for 7 days. These NTX-infused, HBO2-treated rats exhibited an allodynic response comparable to that exhibited by rats receiving nerve crush only. Analysis of the AUC data showed that HBO2 significantly reduced the nerve crush-induced allodynia; this anti-allodynic effect of HBO2 was reversed by NTX. These results implicate opioid receptors in the pain relief induced by HBO2.
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Affiliation(s)
- Carlee R. Gibbons
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
| | - Shulin Liu
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
- Department of Diving Medicine, Second Military Medical University, Shanghai, China
| | - Yangmiao Zhang
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
| | - Casey L. Sayre
- Faculty of Pharmacy, University of Manitoba, Winnipeg, MB, Canada
| | - Briana Levitch
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
| | - Sarah Moehlmann
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
| | - Donald Y. Shirachi
- Department of Physiology and Pharmacology, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA, USA
| | - Raymond M. Quock
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA, USA
- Translational Addiction Research Center, Washington State University, Pullman, WA, USA
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23
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Repetitive hyperbaric oxygen treatment attenuates complete Freund's adjuvant-induced pain and reduces glia-mediated neuroinflammation in the spinal cord. THE JOURNAL OF PAIN 2013; 14:747-58. [PMID: 23680474 DOI: 10.1016/j.jpain.2013.02.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 01/14/2013] [Accepted: 02/05/2013] [Indexed: 12/23/2022]
Abstract
UNLABELLED Hyperbaric oxygen (HBO) therapy is reported to attenuate pain in both clinical pain conditions and animal pain models, but the underlying mechanism remains to be investigated. Here, we show that 7 daily 60-minute HBO (100% oxygen, 2 atmosphere absolute) treatments effectively and persistently inhibited heat hyperalgesia, mechanical allodynia, and paw edema induced by peripheral injection of complete Freund's adjuvant (CFA). Five daily 60-minute HBO treatments also produced a prolonged reversal effect of the ongoing inflammatory pain. Furthermore, such an HBO treatment reduced CFA-induced activation of glial cells, phosphorylation of mitogen-activated protein kinases, and production of a variety of proinflammatory cytokines (tumor necrosis factor alpha [TNF-α], interleukin-1 beta [IL-1β], and interleukin-6 [IL-6]) and chemokines (monocyte chemoattractant protein-1 [MCP-1], keratinocyte-derived chemokine [KC], and IFN-gamma-inducible protein 10 [IP-10]) in the spinal cord. HBO treatment also decreased lipopolysaccharide-induced mRNA expression of these cytokines and chemokines in primary cultures of astrocytes and microglia. In addition, the mRNA expressions of IL-1β, IL-6, MCP-1, KC, and IP-10 in the inflamed paw skin were decreased by HBO. Taken together, these data suggest that HBO treatment is an effective therapy for inflammatory pain in animals. The inhibition of the neuroinflammation that is mediated by glial cells and inflammatory mediators may, at least in part, contribute to the antinociceptive effect of HBO therapy. PERSPECTIVE Our results suggest that repetitive HBO treatment attenuates CFA-induced pain and reduces glial activation and inflammatory mediators' production. These findings provide evidence of the antinociception effect of HBO on inflammatory pain and characterize some of the underlying mechanisms.
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Effect of hyperbaric oxygenation on intervertebral disc degeneration: an in vivo study with sprague-dawley rats. Spine (Phila Pa 1976) 2013; 38:E137-42. [PMID: 23138406 DOI: 10.1097/brs.0b013e31827bf6bf] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN An in vivo study was conducted to test the effect of hyperbaric oxygenation (HBO) on intervertebral disc degeneration in Sprague-Dawley rats. OBJECTIVE To observe the changes in intervertebral disc height and levels of glycosaminoglycan, collagen, interleukin-1β (IL-1β), prostaglandin E2 (PGE2), and inducible nitric oxide synthase (iNOS) in degenerated intervertebral discs after HBO therapy. SUMMARY OF BACKGROUND DATA Although the involvement of IL-1β, PGE-2, NO, and low O2 concentration has been demonstrated in intervertebral disc degeneration, the actual mechanism is not clear. It has been reported that HBO influences changes in IL-1β, PGE-2, NO, and O2 concentration. Previously, a study demonstrated an in vitro positive effect of HBO on the human nucleus pulposus. Thus, an in vivo study in animals was necessary. METHODS Twelve Sprague-Dawley rats were each injected with chondroitinase ABC in 2 proximal intervertebral discs of the tail. After treating with 100% oxygen at 2.5 atmospheres 2 hours per days for 10 days, the change in disc height was determined by radiography. The amounts of PGE-2, iNOS, glycosaminoglycan, and total collagen in the intervertebral disc were quantified by enzyme-linked immunosorbent assay. Tissue morphology and the distribution of glycosaminoglycan, IL-1β, and iNOS in the intervertebral disc were assessed by histology and immunohistochemistry. The area of IL-1β in the intervertebral discs was quantified using image analysis software. RESULTS HBO therapy stopped the decrease in intervertebral disc height, caused an increase in the amount of glycosaminoglycan, and inhibited IL-1β, PGE-2, and iNOS production. CONCLUSION HBO provides a potential treatment modality for intervertebral disc degeneration.
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Carlile EL, Shirachi DY, Quock RM. An anxiolytic-like effect of hyperbaric oxygen in the mouse light/dark exploration test. Life Sci 2012; 90:267-71. [PMID: 22154905 DOI: 10.1016/j.lfs.2011.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 11/11/2011] [Accepted: 11/17/2011] [Indexed: 11/28/2022]
Abstract
AIMS We studied whether hyperbaric oxygen (HBO(2)) treatment, which is known to increase production of nitric oxide (NO) in the brain, might also produce an NO-dependent anxiolytic-like behavioral response. MAIN METHODS Male NIH Swiss mice (20-25g) were subjected to a 60-min HBO(2) treatment at different absolute atmospheres, and anxiety was assessed using the light/dark exploration test at different time intervals following the cessation of HBO(2) treatment. To ascertain the underlying mechanism of action, other groups of mice were pretreated with the NO synthase inhibitor N(G)-monomethyl-l-arginine acetate, the NO scavenger 2-(4-carboxyphenyl)-4,5-dihydro-4,4,5,5-tetramethyl-1H-imidazolyl-1-oxy-3-oxide (carboxy-PTIO), the soluble guanylyl cyclase-inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ) or the benzodiazepine antagonist flumazenil to determine their influence on the HBO(2)-induced anxiolytic-like effect. KEY FINDINGS A 60-min HBO(2) treatment at 3.0 absolute atmospheres increased the time spent by mice in the light compartment that lasted up to 90 min following the end of HBO(2) treatment. This anxiolytic effect of HBO(2) was significantly reduced by pretreatment with L-NMMA, carboxy-PTIO, ODQ and flumazenil. SIGNIFICANCE Based on these findings, we conclude that a 60-min HBO(2) treatment is capable of inducing an anxiolytic effect that possibly involves NO, cyclic GMP and the benzodiazepine binding site.
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Affiliation(s)
- Edina L Carlile
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA 99164, USA
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Abstract
This paper is the thirty-third consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2010 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration (Section 16); and immunological responses (Section 17).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, USA.
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Effect of hyperbaric oxygenation on intervertebral disc degeneration: an in vitro study with human lumbar nucleus pulposus. Spine (Phila Pa 1976) 2011; 36:1925-31. [PMID: 21289555 DOI: 10.1097/brs.0b013e3181feebde] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN An in vitro study with degenerated human lumbar intervertebral disc specimens cultured under hyperbaric oxygenation (HBO). OBJECTIVE To observe the changes in interleukin (IL)-1β, prostaglandin (PG)-E2, nitric oxide (NO), cell growth, and apoptosis of the human nucleus pulposus cell (NPC) after HBO. SUMMARY OF BACKGROUND DATA Intervertebral disc degeneration has been demonstrated as related to IL-1β, PG-E2, NO, and O2 concentration but the actual mechanism is not clear. HBO also has also been reported in the literature to influence changes in IL-1β, prostaglandin E2, NO, and O2 concentration. However, the direct effect of HBO on the disc cells has not been previously reported. METHODS We collected 12 human lumbar degenerated disc specimens and evaluated the effects of HBO on the cultured NPCs. The amounts of IL-1β, PG-E2, and NO in the conditioned medium were quantified by enzyme-linked immunosorbent assay and high performance liquid chromatography. Cell growth was measured by increase in cell number. Cell viability and proteoglycan content were evaluated by histologic study using safranin O staining. In situ analysis of apoptosis was performed using Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. RESULTS Our data indicated that HBO treatment inhibited IL-1β, PG-E2, and NO production but increased cell number and matrix synthesis of cultured NPCs. TUNEL staining showed that HBO treatment suppressed the apoptosis of cultured NPCs. CONCLUSION HBO provides a potential treatment modality for disc degeneration.
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Quock LP, Zhang Y, Chung E, Ohgami Y, Shirachi DY, Quock RM. The acute antinociceptive effect of HBO₂ is mediated by a NO-cyclic GMP-PKG-KATP channel pathway in mice. Brain Res 2010; 1368:102-7. [PMID: 20977894 DOI: 10.1016/j.brainres.2010.10.079] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 10/16/2010] [Accepted: 10/20/2010] [Indexed: 10/18/2022]
Abstract
Previous research has found that hyperbaric oxygen (HBO(2)) produces an acute antinociceptive effect that is dependent on nitric oxide (NO). The present study was undertaken to determine whether HBO(2)-induced acute antinociception might involve a NO-cyclic GMP-protein kinase G-ATP-sensitive potassium (K(ATP)) channel pathway. Male NIH Swiss mice were subjected to a 5-min HBO(2) treatment (100% oxygen at 3.5 absolute atmospheres) and antinociception was assessed over the next 6 min still under HBO(2) using the acetic acid abdominal constriction test. Pretreatment with 2-(4-carboxyphenyl)-4,5-dihydro-4,4,5,5-tetramethyl-1H-imidazolyl-1-oxy-3-oxide (carboxy-PTIO, an NO scavenger), 1H-[1,2,4]-oxadiazolo-[4,3-a]quinoxalin-1-one) (a soluble guanylyl cyclase-inhibitor, Rp-8-(4-chlorophenylthio)-guanosine-3',5'-cyclic monophosphorothioate (a protein kinase G-inhibitor) or glibenclamide (an ATP-sensitive potassium channel-inhibitor) all led to antagonism of the HBO(2)-induced acute antinociception in a dose-dependent manner. These findings suggest that HBO(2)-induced acute antinociception might be due to activation of a NO-cyclic GMP-protein kinase G-K(ATP) channel pathway.
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Affiliation(s)
- Lindsay P Quock
- Department of Pharmaceutical Sciences, College of Pharmacy, Washington State University, Pullman, WA 99164-6534, USA
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