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Chen X, Cheng Z, Xu J, Wang Q, Zhao Z, Jiang Q. Causal effects of educational attainment on temporomandibular disorders and the mediating pathways: A Mendelian randomization study. J Oral Rehabil 2024; 51:817-826. [PMID: 38205584 DOI: 10.1111/joor.13654] [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: 10/17/2023] [Revised: 12/19/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND As one of the most important indicators of socioeconomic status, educational attainment (EA) exhibits a strong association with temporomandibular disorders (TMDs). Despite this link, there is a lack of evidence regarding the causal role of EA in either facilitating or preventing TMDs. OBJECTIVE This study aimed to investigate the causal effect of education on TMDs and explore potential mediating pathways. METHODS Utilizing summary statistics from genome-wide association studies on years of schooling (N = 766 345) and TMDs (N = 211 023), we conducted Mendelian randomization (MR) to assess the overall effect of education. Additionally, a two-step MR approach was employed to evaluate 30 potential mediators and calculate the mediation proportions in the association. Comprehensive sensitivity analyses were used to verify the robustness, heterogeneity, and pleiotropy. RESULTS Univariable MR analyses revealed a causal effect of lower EA on an increased risk of TMDs (OR: 0.53, 95% CI: 0.43-0.66, p < .001). Five out of 30 modifiable factors were identified as causal mediators in the associations of EA with TMDs, including feeling nervous (mediation proportion: 11.6%), feeling tense (10.2%), depression (9.6%), feeling worry (7.6%) and daily smoking (8.9%). Meanwhile, no pleiotropy was detected in the analyses (p > .05). CONCLUSION Our findings supported that higher EA has a protective effect on the onset of TMDs, with partial mediation by psychological disorders and daily smoking. Interventions on these factors thus have the potential of substantially reducing the burden of TMDs attributed to low education.
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Affiliation(s)
- Xin Chen
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
| | - Zheng Cheng
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
| | - Junyu Xu
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
| | - Qianyi Wang
- Department of Cardiology, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
| | - Zhibai Zhao
- Department of Oral Mucosal Diseases, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
| | - Qianglin Jiang
- Department of Oral and Maxillofacial Surgery, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China
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Shao J, Fei Y, Xiao J, Wang L, Zou S, Yang J. The role of miRNA-144-3p/Oprk1/KOR in nicotine dependence and nicotine withdrawal in male rats. Nicotine Tob Res 2023; 25:1856-1864. [PMID: 37455648 PMCID: PMC10664084 DOI: 10.1093/ntr/ntad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/31/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION The kappa-opioid receptor (KOR) has been implicated in mediating the behavioral and biochemical effects associated with nicotine reward and withdrawal; however, its underlying mechanisms remain to be further explored. METHODS Adult male Sprague-Dawley rats were used to establish a nicotine dependence and withdrawal model by injecting nicotine (3 mg/kg/day, s.c.) or vehicle for 14 days, followed by the termination of nicotine for 7 days. Body weight gain, pain behaviors, and withdrawal scores were assessed in succession. MicroRNA (miRNA) sequencing was performed, and quantitative real-time PCR was used to detect the expression of candidate miRNAs and Oprk1. Western blotting was performed to examine KOR protein expression of KOR. Luciferase assay was conducted to validate the relationship of certain miRNAs/Oprk1. RESULTS The behavioral results showed that nicotine dependence and withdrawal induced behavioral changes. Biochemical analyses demonstrated that miR-144-3p expression decreased and Oprk1/KOR expression increased in the prefrontal cortex, nucleus accumben, and hippocampus. Further investigation suggested that miR-144-3p exerted an inhibitory effect on Oprk1 expression in PC12 cells. CONCLUSIONS This study revealed that miR-144-3p/Oprk1/KOR might be a potential pathway underlying the adverse effects induced by nicotine dependence and withdrawal, and might provide a novel therapeutic target for smoking cessation. IMPLICATIONS This study demonstrates an impact of nicotine dependence and nicotine withdrawal on behavioral outcomes and the expressions of miR-144-3p/Oprk1/KOR in male rats. These findings have important translational implications given the continued use of nicotine and the difficulty in smoking cessation worldwide, which can be applied to alleviated the adverse effects induced by nicotine dependence and withdrawal, thus assist smokers to quit smoking.
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Affiliation(s)
- Jiali Shao
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
| | - Yanxia Fei
- Department of Anesthesiology, Women’s Hospital, School of Medicine Zhejiang University, Zhejiang, China
| | - Ji Xiao
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
| | - Lijuan Wang
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
| | - Shuangfa Zou
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
| | - Jinfeng Yang
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
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Gomez M, Jeudy J, Petit A, Brunet J, Saint-Cast Y, Rabarin F, Cesari B, Raimbeau G, Bigorre N. Acute pain after digital crushing and nicotine intoxication. Cigarettes are always a false friend. A prospective study. Orthop Traumatol Surg Res 2023; 109:103425. [PMID: 36183973 DOI: 10.1016/j.otsr.2022.103425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/27/2021] [Accepted: 09/28/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Nicotine addiction is a public health problem. Our hypothesis was that the degree of nicotine dependence is positively correlated with the perceived intensity of acute pain. MATERIALS AND METHODS A single-center prospective comparative observational study was conducted from 2019 to 2021. Patients included presented distal phalanx extra-articular trauma of less than 24hours' progression. We compared a group of smokers with a group of non-smokers. A Digital Pain Scale (DPS) was assessed at time of trauma, at first consultation, and once a day until the fifth day post-trauma. A Fagerström test was performed. The primary endpoints were the correlation between dependence and DPS and the correlation between the amount of tobacco consumed and DPS. The secondary endpoints were analgesic consumption according to Fagerström, DPS and tobacco consumption. RESULTS Sixty-seven patients were included: 26 smokers, 41 non-smokers. No significant correlation was found between dependence level or amount of tobacco used and DPS. Consumption of level II analgesics was significantly 2-fold higher in the smoking group on the second, third and fifth day: respectively, 2.15 tablets versus 1.22 (p=0.02), 1.27 versus 0.49 (p=0.01), and 0.69 versus 0.20 (p=0.04). CONCLUSION Patients who smoke are exposed to more frequent and more intense pain and consume more palliative painkillers. LEVEL OF EVIDENCE IIB; exposed vs. non-exposed cohort.
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Affiliation(s)
- Mathurin Gomez
- Département de chirurgie osseuse, centre hospitalier universitaire (CHU) d'Angers, 4, rue Larrey, 49000 Angers, France.
| | - Jérôme Jeudy
- Centre de la main, 47, rue de la Foucaudière, 49000 Trélazé, France
| | - Alexandre Petit
- Centre de la main, 47, rue de la Foucaudière, 49000 Trélazé, France
| | - Jérôme Brunet
- Centre de la main, 47, rue de la Foucaudière, 49000 Trélazé, France
| | - Yann Saint-Cast
- Centre de la main, 47, rue de la Foucaudière, 49000 Trélazé, France
| | - Fabrice Rabarin
- Centre de la main, 47, rue de la Foucaudière, 49000 Trélazé, France
| | - Bruno Cesari
- Centre de la main, 47, rue de la Foucaudière, 49000 Trélazé, France
| | - Guy Raimbeau
- Centre de la main, 47, rue de la Foucaudière, 49000 Trélazé, France
| | - Nicolas Bigorre
- Centre de la main, 47, rue de la Foucaudière, 49000 Trélazé, France
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Borgonetti V, Roberts AJ, Bajo M, Galeotti N, Roberto M. Chronic alcohol induced mechanical allodynia by promoting neuroinflammation: A mouse model of alcohol-evoked neuropathic pain. Br J Pharmacol 2023; 180:2377-2392. [PMID: 37050867 PMCID: PMC10898491 DOI: 10.1111/bph.16091] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND AND PURPOSE Chronic pain is considered a key factor contributing to alcohol use disorder (AUD). The mechanisms responsible for chronic pain associated with chronic alcohol consumption are unknown. We evaluated the development of chronic pain in a mouse model of alcohol dependence and investigate the role of neuroinflammation. EXPERIMENTAL APPROACH The chronic-intermittent ethanol two-bottle choice CIE-2BC paradigm generates three groups: alcohol-dependent with escalating alcohol intake, nondependent (moderate drinking) and alcohol-naïve control male and female mice. We measured mechanical allodynia during withdrawal and after the last voluntary drinking. Immunoblotting was used to evaluate the protein levels of IBA-1, CSFR, IL-6, p38 and ERK2/1 in spinal cord tissue of dependent and non-dependent animals. KEY RESULTS We found significant escalation of drinking in the dependent group in male and female compared with the non-dependent group. The dependent group developed mechanical allodynia during 72 h of withdrawal, which was completely reversed after voluntary drinking. We observed an increased pain hypersensitivity compared with the naïve in 50% of non-dependent group. Increased IBA-1 and CSFR expression was observed in spinal cord tissue of both hypersensitivity-abstinence related and neuropathy-alcohol mice, and increased IL-6 expression and ERK1/2 activation in mice with hypersensitivity-related to abstinence, but not in mice with alcohol-evoked neuropathic pain. CONCLUSIONS AND IMPLICATIONS The CIE-2BC model induces two distinct pain conditions specific to the type of ethanol exposure: abstinence-related hypersensitivity in dependent mice and alcohol-evoked neuropathic pain in about a half of the non-dependent mice.
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Affiliation(s)
- Vittoria Borgonetti
- Department of Neuroscience, Psychology, Drug Research, and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Viale G. Pieraccini 6, Florence, 50139, Italy
- Department of Molecular Medicine and Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Amanda J. Roberts
- Animal Models Core, The Scripps Research Institute, 10550 N. Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Michal Bajo
- Department of Molecular Medicine and Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Nicoletta Galeotti
- Department of Neuroscience, Psychology, Drug Research, and Child Health (NEUROFARBA), Section of Pharmacology, University of Florence, Viale G. Pieraccini 6, Florence, 50139, Italy
| | - Marisa Roberto
- Department of Molecular Medicine and Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd, La Jolla, CA 92037, USA
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Rahmadi M, Nurhan AD, Rahmawati RIA, Damayanti TF, Purwanto DA, Khotib J. Epigallocatechin Gallate Ameliorates Nicotine Withdrawal Conditions-Induced Somatic and Affective Behavior Changes in Mice and Its Molecular Mechanism. Behav Neurol 2023; 2023:5581893. [PMID: 37346971 PMCID: PMC10281828 DOI: 10.1155/2023/5581893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/10/2023] [Accepted: 05/20/2023] [Indexed: 06/23/2023] Open
Abstract
In nicotine withdrawal (NW) conditions, molecular changes, such as increasing corticotropin-releasing factor (CRF) in the amygdala, and melanocortin signaling in the hypothalamus, can occur in the brain, leading to increased feeding behavior and body weight as somatic changes as well as high anxiety-like behavior as an affective changes. Therefore, this research aimed to investigate the effect of epigallocatechin gallate (EGCG), the largest component in green tea, on CRF, pro-opiomelanocortin (POMC), and melanocortin four receptor gene expression in the brain under NW conditions. The 24 Balb/c male mice used were randomly divided into four groups. The doses used included normal saline 1.0 mL/kg as a control group, and nicotine 3.35 mg/kg that was administered subcutaneously three times a day. After NW conditions, EGCG 50 mg/kg was administered intraperitoneally two times a day. Behavior evaluation was performed to measure somatic and affective changes, and the animal was sacrificed for molecular analysis. The results showed that NW conditions significantly increased food intake, body weight, and anxiety-like behavior compared with the normal group. Meanwhile, EGCG significantly decreased food intake, body weight, and anxiety-like behavior compared with NW conditions in mice without EGCG. The polymerase chain reaction results also showed that EGCG decreased the CRF mRNA expression in the amygdala and increased the POMC. This indicated that EGCG improved somatic and affective behavior in NW conditions by decreasing CRF mRNA expression in the amygdala and increasing POMC mRNA expression in the hypothalamus.
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Affiliation(s)
- Mahardian Rahmadi
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Biomedical Pharmacy Research Group, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Ahmad D. Nurhan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Biomedical Pharmacy Research Group, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Retno I. A. Rahmawati
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Theresia F. Damayanti
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Djoko A. Purwanto
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Pharmaceutical Analysis Research Group, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Junaidi Khotib
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Biomaterial Translational Research Group, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
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Bartík P, Šagát P, Pyšná J, Pyšný L, Suchý J, Trubák Z, Petrů D. The Effect of High Nicotine Dose on Maximum Anaerobic Performance and Perceived Pain in Healthy Non-Smoking Athletes: Crossover Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1009. [PMID: 36673765 PMCID: PMC9859273 DOI: 10.3390/ijerph20021009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
Background: In recent years, there has been intensive discussion about the positive effect of nicotine usage on enhancing sports performance. It is frequently applied through a non-burned tobacco form before physical activity. Nicotine is under the World Anti-Doping Agency (WADA) 2021 monitoring program. Therefore, study results that reveal either positive or negative effects are expected. This is the pilot study that reports the effect of 8 mg dose of nicotine on performance and perceived pain. Material and Methods: This research aimed to explore the oral intake effect of a high-nicotine dose (8 mg) on the maximum anaerobic performance and other selected physical performance parameters in healthy, well-trained adult athletes (n = 15, age 30.7 ± 3.6, BMI 25.3 ± 1.7). The cross-sectional study protocol included the oral administration of either sublingual nicotine or placebo tablets before the anaerobic load assessed by a standardized 30 s Wingate test of the lower limbs. Afterward, the Borg subjective perception of pain (CR 10) and Borg rating of perceived exertion (RPE) were evaluated. Wilcoxon signed-rank test was used for the analysis of data with a 0.05 level of significance. Results: The results revealed that oral administration of an 8 mg nicotine dose does not significantly improve any of the physical performance parameters monitored. We only reported the statistically significant positive effect in RPE (p = 0.03). Conclusion: Lower perception of pain intensity that we reported after nicotine application might be an important factor that affects performance. However, we did not report any improvement in physical performance parameters.
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Affiliation(s)
- Peter Bartík
- Health and Physical Education Department, Prince Sultan University, Riyadh 11586, Saudi Arabia
| | - Peter Šagát
- Health and Physical Education Department, Prince Sultan University, Riyadh 11586, Saudi Arabia
| | - Jana Pyšná
- Department of Physical Education and Sport, Faculty of Education, J. E. Purkyne University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Ladislav Pyšný
- Department of Physical Education and Sport, Faculty of Education, J. E. Purkyne University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Jiří Suchý
- Department of Physical Education, Faculty of Education, Charles University, 116 39 Prague, Czech Republic
| | - Zdeněk Trubák
- Department of Physical Education and Sport, Faculty of Education, J. E. Purkyne University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
| | - Dominika Petrů
- Department of Physical Education and Sport, Faculty of Education, J. E. Purkyne University in Ústí nad Labem, 400 96 Ústí nad Labem, Czech Republic
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Iida H, Yamaguchi S, Goyagi T, Sugiyama Y, Taniguchi C, Matsubara T, Yamada N, Yonekura H, Iida M. Consensus statement on smoking cessation in patients with pain. J Anesth 2022; 36:671-687. [PMID: 36069935 PMCID: PMC9666296 DOI: 10.1007/s00540-022-03097-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/13/2022] [Indexed: 11/30/2022]
Abstract
Smoking is closely associated with the development of various cancers and tobacco-related illnesses such as cardiovascular and respiratory disorders. However, data are scarce on the relationship between smoking and both acute and chronic pain. In addition to nicotine, tobacco smoke contains more than 4000 different compounds. Although nicotine is not the sole cause of smoking-induced diseases, it plays a critical role in pain-related pathophysiology. Despite the acute analgesic effects of nicotine, long-term exposure leads to tolerance and increased pain sensitivity due to nicotinic acetylcholine receptor desensitization and neuronal plastic changes. The purpose of smoking cessation interventions in smoking patients with pain is primarily not only to reduce their pain and associated limitations in activities of daily living, but also to improve the outcomes of underlying pain-causing conditions and reduce the risks of tobacco-related disorders. This statement aims to summarize the available evidence on the impact of smoking on pain and to inform medical professionals of the significance of smoking cessation in patients with pain.
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Affiliation(s)
- Hiroki Iida
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan. .,Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, Gifu, Japan. .,Anesthesiology and Pain Relief Center, Central Japan International Medical Center, 1-1 Kenkonomachi, Minokamo, Gifu, 505-8510, Japan.
| | - Shigeki Yamaguchi
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Anesthesiology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Toru Goyagi
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Anesthesiology, Akita University Hospital, Akita, Japan
| | - Yoko Sugiyama
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Woman Doctor Active Support in Perioperative Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.,Anesthesiology and Pain Relief Center, Central Japan International Medical Center, 1-1 Kenkonomachi, Minokamo, Gifu, 505-8510, Japan
| | - Chie Taniguchi
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,College of Nursing, Aichi Medical University, Nagakute, Japan
| | - Takako Matsubara
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe , Japan
| | - Naoto Yamada
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Anesthesiology, Iwate Medical University Hospital, Iwate, Japan
| | - Hiroshi Yonekura
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Anesthesiology and Pain Medicine, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Mami Iida
- Working Group on the Role of Smoking Cessation in Pain Relief, The Japan Society of Pain Clinicians (JSPC), Tokyo, Japan.,Department of Internal Medicine, Gifu Prefectural General Medical Center, Gifu, Japan
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Mechanism of Electroacupuncture Analgesia on Nicotine Withdrawal-Induced Hyperalgesia in a Rat Model. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7975803. [PMID: 36072415 PMCID: PMC9444398 DOI: 10.1155/2022/7975803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/06/2022] [Indexed: 11/18/2022]
Abstract
Purpose This study aimed to investigate the analgesic effect and mechanism of electroacupuncture (EA) in nicotine withdrawal-induced hyperalgesia rats. Methods Behavioral testing was conducted twice a week for 7 weeks during nicotine administration using von Frey filaments. Electroacupuncture at the bilateral “Zusanli” and “Taichong” points was applied daily for 3 days during nicotine withdrawal. Western blot analysis and immunohistology were used to determine expression levels of pain-related factors in the spinal cord and midbrain periaqueductal gray (PAG). Results Behavioral tests showed that electroacupuncture had a significant analgesic effect on nicotine withdrawal-induced hyperalgesic rats. Western blot results demonstrated that, in hyperalgesic rats, the expressions of nicotinic acetylcholine receptors (subunits: nAChR α7, α4, or β2) decreased in the spinal cord, nAChR α7, and β2 decreased in PAG. The proinflammatory factor cyclooxygenase 2 (COX2) and the activated microglia (ionized calcium-binding adaptor molecule 1, Iba1 positive cells) increased in the spinal cord and PAG compared to controls. After electroacupuncture treatment, nAChR α7 and nAChR β2 expressions increased significantly, and COX2 and Iba1 expressions decreased in the spinal cord. Compared with the nonelectroacupuncture nicotine withdrawal group, electroacupuncture stimulation increased the expression of nAChR α7 and nAChR α4 in the PAG of rats with electroacupuncture. Immunohistochemical results confirmed that electroacupuncture reversed nicotine withdrawal-induced changes in nAChR α7 positive neurons and Iba1-positive microglia in the dorsal horn of the spinal cord. Conclusion Electroacupuncture treatment has an analgesic effect on nicotine withdrawal-induced pain in nicotine-dependent rats. The mechanism of analgesia of the electroacupuncture treatment relates to the increased expression of nAChR α7 and nAChR β2 proteins in the spinal cord, nAChR α7 in the PAG, and decreased expression of Iba1 and COX2 protein in the spinal cord.
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9
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Taniguchi C, Narisada A, Tanaka H, Iida H, Iida M, Mori R, Nakayama A, Suzuki K. Smoking cessation after cancer diagnosis reduces the risk of severe cancer pain: A longitudinal cohort study. PLoS One 2022; 17:e0272779. [PMID: 35944029 PMCID: PMC9362951 DOI: 10.1371/journal.pone.0272779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Whether abstinence from smoking among cancer patients reduces cancer pain is still unclear. Opioids can act as a surrogate index for evaluating the incidence of severe cancer pain in countries where opioid abuse is infrequent. This study aimed to investigate whether changed smoking behavior after cancer diagnosis influences the incidence of severe cancer pain as determined by strong opioid use. Methods Using a large Japanese insurance claims database (n = 4,797,329), we selected 794,702 insured employees whose annual health checkup data could be confirmed ≥6 times between January 2009 and December 2018. We selected 591 study subjects from 3,256 employees who were diagnosed with cancer pain and had health checkup data at the year of cancer pain diagnosis. Results A significantly greater proportion of patients who continued smoking after cancer diagnosis (“current smoker”, n = 133) received strong opioids (36.8%) compared with patients who had never smoked or had stopped before cancer diagnosis (“non-smoker”, n = 383, 20.6%; p<0.05) but also compared with patients who had quit smoking after cancer diagnosis (“abstainer:”, n = 75, 24.0%; p<0.05). In multivariable Cox proportional hazards regression analysis, abstainers had a significantly lower risk of receiving strong opioids than current smokers (hazard ratio: 0.57, 95% CI: 0.328 to 0.997). These findings were consistent across multiple sensitivity analyses. Conclusion Our study demonstrated that patients who quit smoking after cancer diagnosis have a lower risk of severe cancer pain. This information adds clinical incentives for improving quality of life among those who smoked at the time of cancer diagnosis.
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Affiliation(s)
- Chie Taniguchi
- College of Nursing, Aichi Medical University, Nagakute, Aichi, Japan
- * E-mail:
| | - Akihiko Narisada
- Institute for Occupational Health Science, Aichi Medical University, Nagakute, Aichi, Japan
| | - Hideo Tanaka
- Public Health Center of Neyagawa City, Neyagawa, Osaka, Japan
- Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Hiroki Iida
- Department of Anesthesiology and Pain Medicine, Central Japan International Medical Center, Minokamo, Gifu, Japan
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center, Gifu, Gifu, Japan
| | - Rina Mori
- College of Nursing, Aichi Medical University, Nagakute, Aichi, Japan
| | - Ayako Nakayama
- College of Nursing, Aichi Medical University, Nagakute, Aichi, Japan
| | - Kohta Suzuki
- Institute for Occupational Health Science, Aichi Medical University, Nagakute, Aichi, Japan
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
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10
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Iida H, Kai T, Kuri M, Tanabe K, Nakagawa M, Yamashita C, Yonekura H, Iida M, Fukuda I. A practical guide for perioperative smoking cessation. J Anesth 2022; 36:583-605. [PMID: 35913572 DOI: 10.1007/s00540-022-03080-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/24/2022] [Indexed: 12/15/2022]
Abstract
The perioperative management of patients who are smokers presents anesthesiologists with various challenges related to respiratory, circulatory, and other clinical problems. Regarding 30-day postoperative outcomes, smokers have higher risks of mortality and complications than non-smokers, including death, pneumonia, unplanned tracheal intubation, mechanical ventilation, cardiac arrest, myocardial infarction, and stroke. Given the benefits of smoking cessation and the adverse effects of smoking on perioperative patient management, patients should quit smoking long before surgery. However, anesthesiologists cannot address these issues alone. The Japanese Society of Anesthesiologists established guidelines in 2015 (published in a medical journal in 2017) to enlighten surgical staff members and patients regarding perioperative tobacco cessation. The primary objective of perioperative smoking cessation is to reduce the risks of adverse cardiovascular and respiratory events, wound infection, and other perioperative complications. Perioperative preparations constitute a powerful teachable moment, a "golden opportunity" for smoking cessation to achieve improved primary disease outcomes and prevent the occurrence of tobacco-related conditions. This review updates the aforementioned guidelines as a practical guide to cover the nuts and bolts of perioperative smoking cessation. Its goal is to assist surgeons, anesthesiologists, and other medical professionals and to increase patients' awareness of smoking risks before elective surgery.
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Affiliation(s)
- Hiroki Iida
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan. .,Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, Gifu, Japan. .,Anesthesiology and Pain Relief Center, Central Japan International Medical Center, 1-1 Kenkonomachi, Minokamo, Gifu, 505-8510, Japan.
| | - Tetsuya Kai
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan.,Department of Anesthesiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Michioki Kuri
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan.,Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kumiko Tanabe
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan.,Department of Anesthesiology and Pain Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Masashi Nakagawa
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan.,Department of Intensive Care Medicine, Tokyo Women's Medical University, Shinjuku, Japan
| | - Chizuru Yamashita
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan.,Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroshi Yonekura
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan.,Department of Anesthesiology and Pain Medicine, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Mami Iida
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan.,Department of Internal Medicine, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Ikuo Fukuda
- Japanese Society of Anesthesiologists Perioperative Smoking Cessation Working Group, Kobe, Japan.,Cardiovascular Center, Suita Tokushukai Hospital, Suita, Japan
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11
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Robinson CL, Kim RS, Li M, Ruan QZ, Surapaneni S, Jones M, Pak DJ, Southerland W. The Impact of Smoking on the Development and Severity of Chronic Pain. Curr Pain Headache Rep 2022; 26:575-581. [PMID: 35731364 DOI: 10.1007/s11916-022-01060-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to examine the impact of smoking and its role on the development of chronic pain and provide a critical review of recent literature. RECENT FINDINGS Recent studies demonstrate the bidirectional and dependent relationship between smoking and chronic pain. Those who are in pain have a more difficult time in the cessation of smoking as well as an increased sensitivity to pain during abstinence, lower confidence, and higher relapse rates. The fear of pain and the anxiety and depression that abstinence causes results in a grim outcome for long-term cessation. The dependent nature between chronic pain and smoking is affected by numerous variables. Providers should consider a multiprong approach to treating chronic pain and targeting smoking cessation treatment by providing motivational therapy, nicotine replacement, and medication therapies to prevent relapse, and providing those who are more likely to relapse with a higher level of care.
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Affiliation(s)
- Christopher L Robinson
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
| | - Rosa S Kim
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA
| | - Michael Li
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Qing Zhao Ruan
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Sindhuja Surapaneni
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Mark Jones
- Department of Anesthesia, Weill Cornell Medical College, New York, NY, USA
| | - Daniel J Pak
- Department of Anesthesia, Weill Cornell Medical College, New York, NY, USA
| | - Warren Southerland
- Department of Anesthesia, The Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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12
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Wang SJ, Zhang YP, Candiotti KA. Effects of electroacupuncture on pain sensation in a rat model of hyperalgesia with nicotine dependence. Neural Regen Res 2021; 17:905-910. [PMID: 34472492 PMCID: PMC8530145 DOI: 10.4103/1673-5374.322477] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Tobacco smoking is considered to be one of the main risk factors in the development of chronic pain. Long-term chronic exposure to nicotine and other forms of tobacco have been shown to be associated with an increased incidence of pain. Studies have shown that acupuncture can help smokers to reduce their desire to smoke, reduce their withdrawal symptoms, and avoid a relapse after treatment. However, little has been reported about the effects of acupuncture on pain sensitivity caused by long-term smoking. Models of hyperalgesia were established in rats exposed to nicotine for 6 weeks. After 6 weeks of continuous nicotine exposure, electroacupuncture at bilateral acupoints Zusanli (ST36) and Taichong (LR3) was performed 20 minutes per day for 6 days at a continuous wave with a frequency of 2 Hz and a stimulus intensity of 1 mA. The results revealed that electroacupuncture treatment increased the mechanical response threshold of hind paw of nicotine-dependent rats with hyperalgesia and up-regulated the protein expression of pain-related factors μ-opioid receptor, β-endorphin and glutamic acid decarboxylase 65 in the spinal cord and midbrain periaqueductal gray and the protein expression of glutamic acid decarboxylase 67 in the spinal cord. These findings suggest that electroacupuncture treatment has positive analgesic effects on pain sensitivity caused by long-term chronic nicotine exposure. One possible mechanism for the improved analgesia is that electroacupuncture increases the expression of pain-related factors in the spinal cord and midbrain periaqueductal gray. This study was approved by Institutional Animal Care and Use Committee (IACUC) of the University of Miami (#18-167) on December 12, 2018.
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Affiliation(s)
- Shu-Ju Wang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, Hubei Province, China
| | - Yan-Ping Zhang
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Keith A Candiotti
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL, USA
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13
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Balayssac D. [Relation between tobacco smoking and pain: A narrative review of the scientific literature]. Rev Mal Respir 2021; 38:269-277. [PMID: 33648775 DOI: 10.1016/j.rmr.2021.02.005] [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: 08/03/2020] [Accepted: 09/20/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Tobacco smoking and pain have an intimate, complex, two-way interaction. The purpose of this narrative review of the literature is to present what is currently understood about the relationship. STATE OF KNOWLEDGE Tobacco smoking (and the associated chronic exposure to nicotine) has been defined as a risk factor for chronic pain, involving nociceptive sensitisation. For people who smoke, pain will be both a motivational factor for tobacco consumption and a barrier to tobacco use cessation. Conversely, nicotine (acute exposure) has clearly demonstrated analgesic properties, mediated in particular by activation of nicotinic acetylcholine receptors. PERSPECTIVES The management of pain in people who smoke is still largely unaddressed, and further studies will be needed to develop effective strategies for tobacco use cessation in this context. Nicotine and modulators of nicotinic acetylcholine receptors represent innovative strategies for the discovery of new analgesics. CONCLUSIONS The effects of smoking on pain, chronic nociceptive sensitisation and acute analgesia, serve to maintain tobacco consumption via negative reinforcement. A holistic therapeutic strategy is necessary to maximise the likelihood of successful smoking cessation.
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Affiliation(s)
- D Balayssac
- Université Clermont Auvergne, Inserm U1107 Neuro-Dol, Laboratoire de toxicologie, CHU Clermont-Ferrand, Direction de la recherche clinique et de l'innovation, 63000 Clermont-Ferrand, France.
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14
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Zhang Y, Sevilla A, Weller R, Wang S, Gitlin MC, Candiotti KA. The role of α7-nicotinic acetylcholine receptor in a rat model of chronic nicotine-induced mechanical hypersensitivity. Neurosci Lett 2020; 743:135566. [PMID: 33352289 DOI: 10.1016/j.neulet.2020.135566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/19/2022]
Abstract
Smokers have a higher incidence of chronic pain than non-smokers, but the neural mechanism is not yet fully understood. Nicotine is the main component of tobacco and acts as an agonist for nicotinic cholinergic receptors (nAChRs) in the nervous system. This study was approved by the IACUC of UM. The effects of chronic nicotine administration on mechanical sensitivity were studied using a rat model. The changes in the expression levels of the α7 isoform of nAChR (α7-nAChR), inflammatory cytokines TNFα and COX-2, as well as the density of neuro-immune cells (astrocytes and microglia) were measured concurrently. The results indicate that long-term nicotine administration induces hypersensitivity to mechanical stimuli, as demonstrated by a significant reduction in the pain perception threshold. In response to nicotine, the expression levels of α7-nAChR increased in the periaqueductal gray matter (PAG) and decreased in the spinal cord. Acute administration of the selective α7-nAChR agonist CDP-Choline reversed this hypersensitivity. Chronic nicotine administration led to an increase of microglial cells in the dorsal horn of the spinal cord and increased expression levels of the cytokines TNFα and COX-2. This study suggests that decreased α7-nAChR expression in the spinal cord, as a result of long-term exposure to nicotine, may be causatively linked to chronic pain. Simultaneously, the increase of neuro-immune factors in the spinal cord is also a potential factor leading to chronic pain.
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Affiliation(s)
- Yanping Zhang
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA.
| | - Alec Sevilla
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA
| | - Robert Weller
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA
| | - Shuju Wang
- Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Melvin C Gitlin
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA
| | - Keith A Candiotti
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, USA.
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15
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Nicotine induces P2X4 receptor, interleukin-1 beta, and brain-derived neurotrophic factor expression in BV2 microglia cells. Neuroreport 2020; 31:1249-1255. [PMID: 33165201 DOI: 10.1097/wnr.0000000000001546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Upregulation of P2X4 receptor (P2X4R), brain-derived neurotrophic factor (BDNF), and interleukin-1 beta (IL-1β) in activated microglia is associated with hyperalgesia. This study investigated whether nicotine increases pain hypersensitivity by altering the expression of these molecules in microglia. We also examined the role of interferon regulatory factor 8 (IRF8) in this process. METHODS Experiments were performed in BV2 microglial cells. IRF8 was knocked down or overexpressed using lentiviruses harboring a short hairpin RNA targeting IRF8 or an IRF8 overexpression construct, respectively. P2X4R, BDNF, and IL-1β mRNA and protein levels were evaluated by real-time PCR and western blotting, respectively, and BDNF and IL-1β secretion was assessed by ELISA. RESULTS Chronic nicotine exposure enhanced the expression of P2X4R, BDNF, and IL-1β in BV2 cells, and stimulated the release of BDNF and IL-1β in the presence of ATP. IRF8 was found to mediate the nicotine-induced increases in BDNF and IL-1β mRNA and P2X4R protein levels in BV2 cells. CONCLUSION Nicotine may increase pain hypersensitivity by promoting the expression of P2X4R, BDNF, and IL-1β through modulation of IRF8 levels in microglial cells.
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16
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Guo L, Zhang Y, Wang J, Qi Y, Zhang Z. IRF8 is crucial for the nicotine withdrawal-induced hyperalgesia in mice. Transl Neurosci 2020; 11:283-293. [PMID: 33335768 PMCID: PMC7712045 DOI: 10.1515/tnsci-2020-0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 11/15/2022] Open
Abstract
Background Interferon regulatory factor 8 (IRF8) is involved in the pathogenesis of neuropathic pain. However, whether and how IRF8 can regulate the nicotine withdrawal (NTW)-induced hyperalgesia has not been clarified. Methods C57BL/6 mice were randomized and injected subcutaneously with saline (Control) or nicotine (3 mg/kg) three times per day for 7 consecutive days, followed by injection with mecamylamine to induce NTW. Their paw withdrawal latencies (PWLs) were measured, and the relative levels of IRF8 expression in the spinal cord tissues were determined longitudinally by western blot. The numbers of IRF8+ cells in the spinal cord tissues were examined. In addition, the NTW mice were randomized and infused intrathecally with vehicle saline (NS), control lentivirus or lentivirus for the expression of IRF8-specific shRNA for three days. Their PWLs, microglia activation, IRF8 and P2X4R and BDNF expression in the spinal cord tissues were determined. Results In comparison with the Control mice, the NTW significantly decreased the PWLs but increased the relative levels of IRF8 expression and the numbers of IRF8+ cells in the spinal cord tissues of mice. IRF8-silencing significantly mitigated the NTW-decreased PWLs and attenuated the NTW-enhanced microglia activation and P2X4R and BDNF expression in the spinal cord tissues of mice. Conclusions Spinal IRF8 is crucial for the NTW-induced hyperalgesia by enhancing microglia activation and spinal P2X4R and BDNF expression in mice. The IRF8/P2X4R/BDNF axis may be potential therapeutic targets for postoperative pain of smokers.
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Affiliation(s)
- Lina Guo
- Department of Anesthesiology, Liaocheng People's Hospital, Cheeloo College of Medicine, Shandong University, Liaocheng, 252000, Shandong, China.,Department of Anesthesiology, Liaocheng People's Hospital, No. 67 of Dongchang West Road, Liaocheng, 252000, Shandong, China
| | - Yang Zhang
- Department of Anesthesiology, Liaocheng People's Hospital, No. 67 of Dongchang West Road, Liaocheng, 252000, Shandong, China
| | - Jinping Wang
- Department of Anesthesiology, Liaocheng People's Hospital, No. 67 of Dongchang West Road, Liaocheng, 252000, Shandong, China
| | - Yingying Qi
- Department of Anesthesiology, Liaocheng People's Hospital, No. 67 of Dongchang West Road, Liaocheng, 252000, Shandong, China
| | - Zongwang Zhang
- Department of Anesthesiology, Liaocheng People's Hospital, Cheeloo College of Medicine, Shandong University, Liaocheng, 252000, Shandong, China.,Department of Anesthesiology, Liaocheng People's Hospital, No. 67 of Dongchang West Road, Liaocheng, 252000, Shandong, China
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