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Kayama T, Tamura A, Xiaoying T, Tsutsui KI, Kitajo K, Sasaki T. Transformer-based classification of visceral pain-related local field potential patterns in the brain. Sci Rep 2024; 14:24372. [PMID: 39420022 DOI: 10.1038/s41598-024-75616-6] [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: 07/03/2024] [Accepted: 10/07/2024] [Indexed: 10/19/2024] Open
Abstract
Neuronal ensemble activity entrained by local field potential (LFP) patterns underlies a variety of brain functions, including emotion, cognition, and pain perception. Recent advances in machine learning approaches may enable more effective methods for analyzing LFP patterns across multiple brain areas than conventional time-frequency analysis. In this study, we tested the performance of two machine learning algorithms, AlexNet and the Transformer models, to classify LFP patterns in eight pain-related brain regions before and during acetic acid-induced visceral pain behaviors. Over short time windows lasting several seconds, applying AlexNet to LFP power datasets, but not to raw time-series LFP traces from multiple brain areas, successfully achieved superior classification performance compared with simple LFP power analysis. Furthermore, applying the Transformer directly to the raw LFP traces achieved significantly superior classification performance than AlexNet when using LFP power datasets. These results demonstrate the utility of the Transformer in the analysis of neurophysiological signals, and pave the way for its future applications in the decoding of more complex neuronal activity patterns.
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Affiliation(s)
- Tasuku Kayama
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-Ku, Sendai, 980-8578, Japan
| | - Atsushi Tamura
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-Ku, Sendai, 980-8578, Japan
| | - Tuo Xiaoying
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-Ku, Sendai, 980-8578, Japan
| | - Ken-Ichiro Tsutsui
- Laboratory of Systems Neuroscience, Graduate School of Life Sciences, Tohoku University, Sendai, 980-8577, Japan
| | - Keiichi Kitajo
- Division of Neural Dynamics, National Institute for Physiological Sciences, 38 Nishigonaka, Myodaiji, Okazaki, 444-8585, Aichi, Japan
- Physiological Sciences Program, Department of Advanced Studies, Graduate University for Advanced Studies (SOKENDAI), 38 Nishigonaka, Myodaiji, Okazaki, 444-8585, Aichi, Japan
| | - Takuya Sasaki
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-Ku, Sendai, 980-8578, Japan.
- Department of Neuropharmacology, Tohoku University School of Medicine, 4-1 Seiryo-machi, Aoba-Ku, Sendai, 980-8575, Japan.
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Methorst R, Jongbloed MRM, Noordam R, DeRuiter MC. Exploring Sex Differences in Pain Manifestation of Coronary Artery Disease through Mendelian Randomization. J Cardiovasc Dev Dis 2024; 11:264. [PMID: 39330322 PMCID: PMC11432350 DOI: 10.3390/jcdd11090264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/12/2024] [Accepted: 08/26/2024] [Indexed: 09/28/2024] Open
Abstract
Pain manifestation following coronary artery disease (CAD) disease differs between men and women. Here, we aimed to provide evidence favoring possible differences in pain manifestation between men and women following CAD using Mendelian randomization (MR). We used summary-level data from sex-stratified genome-wide association studies on CAD and self-reported and clinically diagnosed chest, neck and shoulder, back, and facial pain using data from the UK Biobank cohort (N > 450,000) followed by two-sample MR (sensitivity) analyses. We identified 32 and 19 independent genetic variants associated with CAD for men and women, respectively, as instrumental variables. Genetically influenced CAD was associated with a higher risk of self-reported chest pain in both men (OR: 1.27, CI: 1.2-1.33) and women (OR: 1.44, CI: 1.20-1.73), with similar results for clinically diagnosed chest pain (men OR: 1.22, CI: 1.17-1.26; women OR: 1.31, CI: 1.18-1.46). In addition, in women only, genetically influenced CAD was associated with a higher risk of back pain (OR: 1.35, CI: 1.03-1.66) and neck and shoulder pain (OR: 1.22, CI: 0.91-1.63) (p-values for interaction with men: 0.030 and 0.041, respectively). Sensitivity analysis did not indicate the results were biased by directional pleiotropy. We found evidence, based on genetic predisposition for CAD, for different pain manifestations of CAD in men and women. While CAD was associated with chest pain in both sexes, we only found evidence for a higher risk of back pain and neck and shoulder pain in women, supporting common notions that women may present more often with uncharacteristic anginal symptoms.
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Affiliation(s)
- Ruben Methorst
- Department of Anatomy and Embryology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
| | - Monique R M Jongbloed
- Department of Anatomy and Embryology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
| | - Marco C DeRuiter
- Department of Anatomy and Embryology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands
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3
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Ishibashi N, Nanjo T, Tao S. Photobiomodulation improves acute restraint stress-induced visceral hyperalgesia in rats. Lasers Med Sci 2024; 39:143. [PMID: 38806837 PMCID: PMC11133191 DOI: 10.1007/s10103-024-04091-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/18/2024] [Indexed: 05/30/2024]
Abstract
The purpose of this study is to explore the potential application of photobiomodulation to irritable bowel syndrome. We established the following experimental groups: the Non-Stress + Sham group, which consisted of rats that were not restrained and were only subjected to sham irradiation; the Stress + Sham group, which underwent 1 hour of restraint stress followed by sham irradiation; and the Stress + Laser group, which was subjected to restraint stress and percutaneous laser irradiation bilaterally on the L6 dorsal root ganglia for 5 minutes each. The experiment was conducted twice, with three and two laser conditions examined. Following laser irradiation, a barostat catheter was inserted into the rat's colon. After a 30-minute acclimatization period, the catheter was inflated to a pressure of 60 mmHg, and the number of abdominal muscle contractions was measured over a 5-minute period. The results showed that photobiomodulation significantly suppressed the number of abdominal muscle contractions at average powers of 460, 70, and 18 mW. However, no significant suppression was observed at average powers of 1 W and 3.5 mW. This study suggests that photobiomodulation can alleviate visceral hyperalgesia induced by restraint stress, indicating its potential applicability to irritable bowel syndrome.
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Affiliation(s)
- Naoya Ishibashi
- Bio-medical Engineering Group, Drug Discovery Laboratory, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2, Asahigaoka, Hino-shi, Tokyo, 191-8512, Japan.
| | - Takuya Nanjo
- Bio-medical Engineering Group, Drug Discovery Laboratory, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2, Asahigaoka, Hino-shi, Tokyo, 191-8512, Japan
| | - Shinichi Tao
- Bio-medical Engineering Group, Drug Discovery Laboratory, Teijin Institute for Bio-medical Research, Teijin Pharma Ltd., 4-3-2, Asahigaoka, Hino-shi, Tokyo, 191-8512, Japan
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Gupta M, Patil AS, Chitneni A, Schatman ME, Kalia H, Deer TR, Sayed D, Soin A, Baranidharan G, Staats P, Kapural L, Attaluri PA, Verrills P, Diwan S, Levin D, Halder N, Abd-Elsayed AA. Chronic Abdominal Discomfort Syndrome (CADS): Defining and Discussing a Novel Diagnosis. J Pain Res 2024; 17:975-979. [PMID: 38496342 PMCID: PMC10943270 DOI: 10.2147/jpr.s450008] [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: 11/29/2023] [Accepted: 02/27/2024] [Indexed: 03/19/2024] Open
Abstract
In this article, we propose a new diagnostic paradigm known as Chronic Abdominal Discomfort Syndrome (CADS). Patient's presentation centers around chronic abdominal pain not explained by acute pathology with or without accompanying dyspepsia, bloating, nausea and vomiting among other symptoms. The pathophysiology is noted to be neurogenic, possibly stemming from visceral sympathetic nerves or abdominal wall afferent nerves. Diagnosis is supported by signs or symptoms traversing clinical, diagnostic and functional criteria. Included is a tool which can assist clinicians in diagnosing patients with CADS per those domains. We hope to facilitate primary care physicians' and gastroenterologists' utilization of our criteria to provide guidance for selecting which patients may benefit from further interventions or evaluation by a pain physician. The pain physician may then offer interventions to provide the patient with relief.
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Affiliation(s)
- Mayank Gupta
- Kansas Pain Management & Neuroscience Research Center, LLC, Overland Park, KS, USA
| | - Anand S Patil
- St. Luke’s Rehabilitation Medical Center, Spokane, WA, USA
| | | | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care & Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Hemant Kalia
- Rochester Regional Health System, Rochester, NY, USA
| | - Timothy R Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | - Dawood Sayed
- The University of Kansas Health System, Kansas City, KS, USA
| | - Amol Soin
- The Ohio Pain Clinic, Dayton, OH, USA
| | | | - Peter Staats
- National Spine & Pain Centers, Frederick, MD, USA
| | | | | | | | | | - Danielle Levin
- Department of Anesthesiology, Perioperative Care & Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Alaa A Abd-Elsayed
- UW Health Pain Services, University of Wisconsin-Madison, Madison, WI, USA
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Penuela L, DBrass TJ, Tubog TD. Use of Transversus Abdominis Plane Block in Hysterectomy: A Systematic Review. J Perianesth Nurs 2023; 38:331-338. [PMID: 36055904 DOI: 10.1016/j.jopan.2022.06.017] [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: 03/03/2022] [Revised: 06/08/2022] [Accepted: 06/15/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine the effectiveness of transversus abdominis plane (TAP) block in hysterectomy. DESIGN Systematic review METHODS: This review followed the guidelines of the PRISMA statement. PubMed, CINAHL, the Cochrane Collaboration, Google Scholar, and other gray literature databases were searched for eligible studies. The evidence level and quality ratings were assessed using the guidelines proposed by the Johns Hopkins Nursing Evidence-Based Practice Model. FINDINGS Six randomized controlled trials and three systematic reviews with meta-analysis consisting of 2,164 patients were analyzed. The use of TAP block reduced the pain scores in the early part of the postoperative period with diminishing effect late in the postoperative phase. In addition, TAP block lowered the overall opioid consumption, reduced the incidence of PONV, and prolonged the time for rescue medication. All studies included in the review were categorized as Level I and rated Grade A implying strong confidence in the true effects of TAP block in all outcome measures in the review. CONCLUSIONS The addition of TAP block for pain control in hysterectomy patients can improve postoperative pain management. This review found that TAP block has opioid-sparing effects and is safe and effective in reducing pain scores postoperatively in hysterectomy patients.
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König AN, Linkohr B, Peters A, Ladwig K, Laxy M, Schwettmann L. Relating the visceral factor of pain to domain‐specific risk attitudes. JOURNAL OF BEHAVIORAL DECISION MAKING 2023. [DOI: 10.1002/bdm.2323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Affiliation(s)
- Adriana N. König
- Munich School of Management and Munich Center of Health Sciences Ludwig‐Maximilians‐Universität München Munich Germany
- Department Environmental Health Helmholtz Zentrum München Neuherberg Germany
| | - Birgit Linkohr
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health (GmbH) Neuherberg Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health (GmbH) Neuherberg Germany
- Institute for Medical Information Processing, Biometry and Epidemiology Ludwig‐Maximilians‐Universität München Munich Germany
- German Centre for Diabetes Research (DZD) Neuherberg Germany
| | - Karl‐Heinz Ladwig
- Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health (GmbH) Neuherberg Germany
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar Technische Universität München (TUM) Munich Germany
| | - Michael Laxy
- Department Environmental Health Helmholtz Zentrum München Neuherberg Germany
- German Centre for Diabetes Research (DZD) Neuherberg Germany
- Department of Sport and Health Sciences Technische Universität München Munich Germany
| | - Lars Schwettmann
- Department Environmental Health Helmholtz Zentrum München Neuherberg Germany
- Department of Health Services Research, School of Medicine and Health Sciences Carl von Ossietzky University of Oldenburg Oldenburg Germany
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Qi L, Lin SH, Ma Q. Spinal VGLUT3 lineage neurons drive visceral mechanical allodynia but not sensitized visceromotor reflexes. Neuron 2023; 111:669-681.e5. [PMID: 36584681 DOI: 10.1016/j.neuron.2022.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 09/08/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022]
Abstract
Visceral pain is among the most prevalent and bothersome forms of chronic pain, but their transmission in the spinal cord is still poorly understood. Here, we conducted focal colorectal distention (fCRD) to drive both visceromotor responses (VMRs) and aversion. We first found that spinal CCK neurons were necessary for noxious fCRD to drive both VMRs and aversion under naive conditions. We next showed that spinal VGLUT3 neurons mediate visceral allodynia, whose ablation caused loss of aversion evoked by low-intensity fCRD in mice with gastrointestinal (GI) inflammation or spinal circuit disinhibition. Importantly, these neurons were dispensable for driving sensitized VMRs under both inflammatory and central disinhibition conditions. Anatomically, a subset of VGLUT3 neurons projected to parabrachial nuclei, whose photoactivation sufficiently generated aversion in mice with GI inflammation, without influencing VMRs. Our studies suggest the presence of different spinal substrates that transmit nociceptive versus affective dimensions of visceral sensory information.
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Affiliation(s)
- Lu Qi
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Shing-Hong Lin
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA
| | - Qiufu Ma
- Dana-Farber Cancer Institute and Department of Neurobiology, Harvard Medical School, Boston, MA 02115, USA.
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Singh S, Bolckmans R, Ratnatunga K, Gorissen K, Jones O, Lindsey I, Cunningham C. Pelvic pain is a common prolapse symptom and improvement after ventral mesh rectopexy is more frequent than deterioration or de novo pain. Colorectal Dis 2023; 25:118-127. [PMID: 36050626 DOI: 10.1111/codi.16321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/29/2022] [Accepted: 08/14/2022] [Indexed: 02/02/2023]
Abstract
AIM The aim of this work was to assess the relationship between pelvic pain and rectal prolapse both before prolapse surgery and in the long term after ventral mesh rectopexy (VMR). METHOD Patients undergoing VMR between 2004 and 2017 were contacted. Outcomes including the severity of pelvic pain were recorded using a numeric rating scale. RESULTS Four hundred and seventy eight of the 749 patients (64%) were successfully contacted. Of these, 39% reported pre-existing pelvic pain prior to VMR (group A) and 61% were pain free (group B). The median follow-up time was 8.0 years (interquartile range 5.0-10.0 years). Symptoms of obstructed defaecation were significantly more common (p = 0.002) in group A (91/187, 49%) than in group B (101/291, 35%). In contrast, faecal incontinence was more common (p = 0.007) in group B (75/291, 26%) than in group A (29/187, 15%). In group A, 76% showed improvement in pelvic pain after VMR: 61% were pain free and 39% had partial improvement in their pre-existing pelvic pain. Patients with persistent pelvic pain were younger (p = 0.01) and more likely to have revisional surgery after VMR (p = 0.0003), but there was no relation to the indication for surgery (p = 0.59). In group B, 15% reported de novo pelvic pain after VMR, and this was more common in women under 50 years old (p = 0.001), when obstructed defaecation was the indication (p = 0.03), in mesh erosion (p = <0.05) and when associated with revisional surgery (p = 0.005). CONCLUSION Pelvic pain is common (39%) in patients undergoing prolapse surgery, and VMR improves this pain in most patients (76%). However, a significant number of patients fail to improve (12%), experience worsening of pain (12%) or develop de novo pelvic pain (15%).
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Affiliation(s)
- Sandeep Singh
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Roel Bolckmans
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Keshara Ratnatunga
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kim Gorissen
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Oliver Jones
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ian Lindsey
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Chris Cunningham
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Peach CJ, Edgington-Mitchell LE, Bunnett NW, Schmidt BL. Protease-activated receptors in health and disease. Physiol Rev 2023; 103:717-785. [PMID: 35901239 PMCID: PMC9662810 DOI: 10.1152/physrev.00044.2021] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 07/08/2022] [Accepted: 07/10/2022] [Indexed: 11/22/2022] Open
Abstract
Proteases are signaling molecules that specifically control cellular functions by cleaving protease-activated receptors (PARs). The four known PARs are members of the large family of G protein-coupled receptors. These transmembrane receptors control most physiological and pathological processes and are the target of a large proportion of therapeutic drugs. Signaling proteases include enzymes from the circulation; from immune, inflammatory epithelial, and cancer cells; as well as from commensal and pathogenic bacteria. Advances in our understanding of the structure and function of PARs provide insights into how diverse proteases activate these receptors to regulate physiological and pathological processes in most tissues and organ systems. The realization that proteases and PARs are key mediators of disease, coupled with advances in understanding the atomic level structure of PARs and their mechanisms of signaling in subcellular microdomains, has spurred the development of antagonists, some of which have advanced to the clinic. Herein we review the discovery, structure, and function of this receptor system, highlight the contribution of PARs to homeostatic control, and discuss the potential of PAR antagonists for the treatment of major diseases.
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Affiliation(s)
- Chloe J Peach
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, New York
- Department of Neuroscience and Physiology and Neuroscience Institute, Grossman School of Medicine, New York University, New York, New York
| | - Laura E Edgington-Mitchell
- Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, Victoria, Australia
- Bluestone Center for Clinical Research, Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, New York
| | - Nigel W Bunnett
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, New York
- Department of Neuroscience and Physiology and Neuroscience Institute, Grossman School of Medicine, New York University, New York, New York
| | - Brian L Schmidt
- Department of Molecular Pathobiology, College of Dentistry, New York University, New York, New York
- Bluestone Center for Clinical Research, Department of Oral and Maxillofacial Surgery, New York University College of Dentistry, New York, New York
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Nishida K, Matsumura S, Kobayashi T. Involvement of Brn3a-positive spinal dorsal horn neurons in the transmission of visceral pain in inflammatory bowel disease model mice. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:979038. [PMID: 36570085 PMCID: PMC9768036 DOI: 10.3389/fpain.2022.979038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022]
Abstract
The spinal dorsal horn plays a crucial role in the transmission and processing of somatosensory information. Although spinal neural circuits that process several distinct types of somatic sensations have been studied extensively, those responsible for visceral pain transmission remain poorly understood. In the present study, we analyzed dextran sodium sulfate (DSS)-induced inflammatory bowel disease (IBD) mouse models to characterize the spinal dorsal horn neurons involved in visceral pain transmission. Immunostaining for c-fos, a marker of neuronal activity, demonstrated that numerous c-fos-positive cells were found bilaterally in the lumbosacral spinal dorsal horn, and their distribution was particularly abundant in the shallow dorsal horn. Characterization of these neurons by several molecular markers revealed that the percentage of the Pit1-Oct1-Unc86 domain (POU domain)-containing transcription factor Brn3a-positive neurons among the c-fos-positive neurons in the shallow dorsal horn was 30%-40% in DSS-treated mice, which was significantly higher than that in the somatic pain model mice. We further demonstrated by neuronal tracing that, within the shallow dorsal horn, Brn3a-positive neurons were more highly represented in spino-solitary projection neurons than in spino-parabrachial projection neurons. These results raise the possibility that Brn3a-positive spinal dorsal horn neurons make a large contribution to visceral pain transmission, part of which is mediated through the spino-solitary pathway.
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Mao M, Zhou Y, Jiao Y, Yin S, Cheung C, Yu W, Gao P, Yang L. Bibliometric and visual analysis of research on the links between the gut microbiota and pain from 2002 to 2021. Front Med (Lausanne) 2022; 9:975376. [PMID: 36457577 PMCID: PMC9705792 DOI: 10.3389/fmed.2022.975376] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/25/2022] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND AND AIMS The gut microbiota is involved in the regulation of pain, which is proved by plenty of evidence. Although a substantial quantity of research on the link between the gut microbiota and pain has emerged, no study has focused on the bibliometric analysis of this topic. We aim to present a bibliometric review of publications over the past 20 years and predict research hot spots. METHODS Relevant publications between 2002 and 2021 were extracted from the Science Citation Index-Expanded (SCI-EXPANDED) of the Web of Science Core Collection (WoSCC) database on April 22, 2022. CiteSpace (version 5.8 R3c), VOSviewer, the Online Analysis Platform of Literature Metrology, and the R package bibliometrix were used to analyze and visualize. RESULTS A total of 233 articles have been published between 2002 and 2021. The number of publication outputs increased rapidly since 2016. The collaboration network revealed that the USA, Baylor College of Medicine, and Vassilia Theodorou were the most influential country, institute, and scholar, respectively. Alimentary pharmacology and therapeutics and Gut were the most co-cited journal and Neurogastroenterology and Motility was the most productive journal. Visceral sensitivity, fibromyalgia, gastrointestinal, chronic pain, stress, gut microbiome, LGG, brain-gut axis, SLAB51, and sequencing were the top 10 clusters in co-occurrence cluster analysis. Keyword burst detection indicated that the brain-gut axis and short-chain fatty acid were the current research hot spots. CONCLUSION Research on the links between the gut microbiota and pain has increased rapidly since 2016. The current research focused on the brain-gut axis and short-chain fatty acid. Accordingly, the SCFAs-mediated mechanism of pain regulation will be a research direction of great importance on the links between the gut microbiota and pain. This study provided instructive assistance to direct future research efforts on the links between the gut microbiota and pain.
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Affiliation(s)
- Menghan Mao
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanyu Zhou
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingfu Jiao
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Suqing Yin
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chiwai Cheung
- Department of Anesthesiology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Weifeng Yu
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Po Gao
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liqun Yang
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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12
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López‐Estévez S, López‐Torrellardona JM, Parera M, Martínez V. Long-lasting visceral hypersensitivity in a model of DSS-induced colitis in rats. Neurogastroenterol Motil 2022; 34:e14441. [PMID: 36239298 PMCID: PMC9787759 DOI: 10.1111/nmo.14441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 05/31/2022] [Accepted: 07/18/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Persistent visceral hypersensitivity is a key component of functional and inflammatory gastrointestinal diseases. Current animal models fail to fully reproduce the characteristics of visceral pain in humans, particularly as it relates to persistent hypersensitivity. This work explores the validity of DSS-induced colitis in rats as a model to mimic chronic intestinal hypersensitivity. METHODS Exposure to DSS (5% for 7 days) was used to induce colitis in rats. Thereafter, changes in viscerosensitivity (visceromotor responses to colorectal distension-CRD), the presence of somatic referred pain (mechanosensitivity of the hind paws, von Frey test) and the expression (qRT-PCR) of sensory-related markers (colon, lumbosacral DRGs, and lumbosacral spinal cord) were assessed at different times during the 35 days period after colitis induction. RESULTS Following colitis, a sustained increase in visceromotor responses to CRD were observed, indicative of the presence of visceral hypersensitivity. Responses in animals without colitis remained stable over time. In colitic animals, somatic referred hypersensitivity was also detected. DSS-induced colitis was associated to a differential expression of sensory-related markers (with both pro- and anti-nociceptive action) in the colon, lumbosacral DRGs and lumbosacral spinal cord; indicating the presence of peripheral and central sensitization. CONCLUSIONS AND INFERENCES DSS-induced colitis in rats is associated to the generation of a long-lasting state of visceral (colonic) hypersensitivity, despite clinical colitis resolution. This model reproduces the changes in intestinal sensitivity characteristics of inflammatory and functional gastrointestinal disorders in humans and can be used in the characterization of new pharmacological treatments against visceral pain.
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Affiliation(s)
- Sergio López‐Estévez
- Department of Cell Biology, Physiology and ImmunologyUniversitat Autònoma de BarcelonaBarcelonaSpain
- Neuroscience InstituteUniversitat Autònoma de BarcelonaBarcelonaSpain
| | | | - Marc Parera
- Department of Cell Biology, Physiology and ImmunologyUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Vicente Martínez
- Department of Cell Biology, Physiology and ImmunologyUniversitat Autònoma de BarcelonaBarcelonaSpain
- Neuroscience InstituteUniversitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)Instituto de Salud Carlos IIIMadridSpain
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13
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Caron JP, Kreher MA, Mickle AM, Wu S, Przkora R, Estores IM, Sibille KT. Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain across the Clinical Spectrum. Nutrients 2022; 14:nu14122536. [PMID: 35745266 PMCID: PMC9228511 DOI: 10.3390/nu14122536] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
Dietary behavior can have a consequential and wide-ranging influence on human health. Intermittent fasting, which involves intermittent restriction in energy intake, has been shown to have beneficial cellular, physiological, and system-wide effects in animal and human studies. Despite the potential utility in preventing, slowing, and reversing disease processes, the clinical application of intermittent fasting remains limited. The health benefits associated with the simple implementation of a 12 to 16 h fast suggest a promising role in the treatment of chronic pain. A literature review was completed to characterize the physiologic benefits of intermittent fasting and to relate the evidence to the mechanisms underlying chronic pain. Research on different fasting regimens is outlined and an overview of research demonstrating the benefits of intermittent fasting across diverse health conditions is provided. Data on the physiologic effects of intermittent fasting are summarized. The physiology of different pain states is reviewed and the possible implications for intermittent fasting in the treatment of chronic pain through non-invasive management, prehabilitation, and rehabilitation following injury and invasive procedures are presented. Evidence indicates the potential utility of intermittent fasting in the comprehensive management of chronic pain and warrants further investigation.
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Affiliation(s)
- Jesse P. Caron
- Pain TRAIL—Translational Research in Assessment & Intervention Lab, Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32607, USA; (J.P.C.); (M.A.K.); (A.M.M.); (S.W.); (R.P.); (I.M.E.)
| | - Margaret Ann Kreher
- Pain TRAIL—Translational Research in Assessment & Intervention Lab, Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32607, USA; (J.P.C.); (M.A.K.); (A.M.M.); (S.W.); (R.P.); (I.M.E.)
| | - Angela M. Mickle
- Pain TRAIL—Translational Research in Assessment & Intervention Lab, Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32607, USA; (J.P.C.); (M.A.K.); (A.M.M.); (S.W.); (R.P.); (I.M.E.)
| | - Stanley Wu
- Pain TRAIL—Translational Research in Assessment & Intervention Lab, Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32607, USA; (J.P.C.); (M.A.K.); (A.M.M.); (S.W.); (R.P.); (I.M.E.)
| | - Rene Przkora
- Pain TRAIL—Translational Research in Assessment & Intervention Lab, Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32607, USA; (J.P.C.); (M.A.K.); (A.M.M.); (S.W.); (R.P.); (I.M.E.)
- Department of Anesthesiology, Division of Pain Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Irene M. Estores
- Pain TRAIL—Translational Research in Assessment & Intervention Lab, Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32607, USA; (J.P.C.); (M.A.K.); (A.M.M.); (S.W.); (R.P.); (I.M.E.)
| | - Kimberly T. Sibille
- Pain TRAIL—Translational Research in Assessment & Intervention Lab, Department of Physical Medicine & Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32607, USA; (J.P.C.); (M.A.K.); (A.M.M.); (S.W.); (R.P.); (I.M.E.)
- Department of Anesthesiology, Division of Pain Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA
- Correspondence:
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14
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Shobeiri P, Kalantari A, Teixeira AL, Rezaei N. Shedding light on biological sex differences and microbiota-gut-brain axis: a comprehensive review of its roles in neuropsychiatric disorders. Biol Sex Differ 2022; 13:12. [PMID: 35337376 PMCID: PMC8949832 DOI: 10.1186/s13293-022-00422-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/14/2022] [Indexed: 12/15/2022] Open
Abstract
Women and men are suggested to have differences in vulnerability to neuropsychiatric disorders, including major depressive disorder (MDD), generalized anxiety disorder (GAD), schizophrenia, eating disorders, including anorexia nervosa, and bulimia nervosa, neurodevelopmental disorders, such as autism spectrum disorder (ASD), and neurodegenerative disorders including Alzheimer’s disease, Parkinson’s disease. Genetic factors and sex hormones are apparently the main mediators of these differences. Recent evidence uncovers that reciprocal interactions between sex-related features (e.g., sex hormones and sex differences in the brain) and gut microbiota could play a role in the development of neuropsychiatric disorders via influencing the gut–brain axis. It is increasingly evident that sex–microbiota–brain interactions take part in the occurrence of neurologic and psychiatric disorders. Accordingly, integrating the existing evidence might help to enlighten the fundamental roles of these interactions in the pathogenesis of neuropsychiatric disorders. In addition, an increased understanding of the biological sex differences on the microbiota–brain may lead to advances in the treatment of neuropsychiatric disorders and increase the potential for precision medicine. This review discusses the effects of sex differences on the brain and gut microbiota and the putative underlying mechanisms of action. Additionally, we discuss the consequences of interactions between sex differences and gut microbiota on the emergence of particular neuropsychiatric disorders. The human microbiome is a unique set of organisms affecting health via the gut–brain axis. Neuropsychiatric disorders, eating disorders, neurodevelopmental disorders, and neurodegenerative disorders are regulated by the microbiota–gut–brain axis in a sex-specific manner. Understanding the role of the microbiota–gut–brain axis and its sex differences in various diseases can lead to better therapeutic methods.
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Affiliation(s)
- Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, 14194, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran
| | - Amirali Kalantari
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, 14194, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran. .,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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15
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Kim DJ, Mirmina J, Narine S, Wachtel J, Carbajal JM, Fox H, Cáceda R. Altered physical pain processing in different psychiatric conditions. Neurosci Biobehav Rev 2021; 133:104510. [PMID: 34952034 DOI: 10.1016/j.neubiorev.2021.12.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/07/2021] [Accepted: 12/19/2021] [Indexed: 01/07/2023]
Abstract
Several reports indicate either increased or decreased pain sensitivity associated with psychiatric disorders. Chronic pain is highly prevalent in many of these conditions. We reviewed the literature regarding experimental pain sensitivity in patients with major depression, bipolar disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder, panic disorder, obsessive-compulsive disorder and schizophrenia. Electronic searches were performed to identify studies comparing experimental pain in patients with these conditions and controls. Across 31 depression studies, reduced pain threshold was noted except for ischemic stimuli, where increased pain tolerance and elevated sensitivity to ischemic pain was observed. A more pervasive pattern of low pain sensitivity was found across 20 schizophrenia studies. The majority of PTSD studies (n = 20) showed no significant differences compared with controls. The limited number of bipolar disorder (n = 4) and anxiety (n = 9) studies precluded identification of clear trends. Wide data variability was observed. Awareness of psychiatric patients' pain perception abnormalities is needed for active screening and addressing physical comorbidities, in order to enhance quality of life, life expectancy and mental health.
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Affiliation(s)
- Diane J Kim
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Julianne Mirmina
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Serah Narine
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Jonathan Wachtel
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Jessica M Carbajal
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Helen Fox
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA
| | - Ricardo Cáceda
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, New York, USA; Psychiatry Service, Northport Veterans Affairs Medical Center, Northport, New York, USA.
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16
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Sadik O, Schaffer D, Land W, Xue H, Yazgan I, Kafesçilere AK, Sungur M. A Bayesian Network Concept for Pain Assessment (Preprint). JMIR BIOMEDICAL ENGINEERING 2021. [DOI: 10.2196/35711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Parker R, Bedwell GJ, Hodkinson P, Lourens A, Setshedi M. Managing acute abdominal pain in the emergency centre: Lessons from a patient's experience. Afr J Emerg Med 2021; 11:483-486. [PMID: 34815928 PMCID: PMC8593562 DOI: 10.1016/j.afjem.2021.06.006] [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: 03/15/2021] [Revised: 05/31/2021] [Accepted: 06/26/2021] [Indexed: 11/22/2022] Open
Abstract
Pain is one of the most common reasons people present to the emergency centre with 7-10% of presentations being due to acute abdominal pain. However, pain is also often neglected by clinicians in emergency centres. The well validated South African Triage Score (SATS) incorporates pain assessment in the prioritising of patients with the aim of guiding clinicians. Based on the SATS, severe pain (a score of ≥8 out of 10) should prompt the clinician to initiate treatment within 10 min of presentation, as unmanaged pain has multiple negative consequences, including poor outcomes of the acute incident with delayed healing and increased risk of developing chronic pain. In this commentary, we present a patient's experience when attending an emergency centre for acute abdominal pain, describe relevant pain mechanisms and highlight the stages where clinical management could have been optimised.
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Affiliation(s)
- Romy Parker
- Dept of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Gill J Bedwell
- Dept of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Peter Hodkinson
- Division of Emergency Medicine, Dept of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Andrit Lourens
- Division of Emergency Medicine, Dept of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Paramedic Science, School of Nursing, Midwifery and Health, Faculty of Health and Life Sciences Coventry University, Coventry, United Kingdom
| | - Mashiko Setshedi
- Division of Gastroenterology, Dept of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
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18
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da Silva JF, Binda NS, Pereira EMR, de Lavor MSL, Vieira LB, de Souza AH, Rigo FK, Ferrer HT, de Castro CJ, Ferreira J, Gomez MV. Analgesic effects of Phα1β toxin: a review of mechanisms of action involving pain pathways. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210001. [PMID: 34868281 PMCID: PMC8610172 DOI: 10.1590/1678-9199-jvatitd-2021-0001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 03/26/2021] [Indexed: 01/01/2023] Open
Abstract
Phα1β is a neurotoxin purified from spider venom that acts as a high-voltage-activated (HVA) calcium channel blocker. This spider peptide has shown a high selectivity for N-type HVA calcium channels (NVACC) and an analgesic effect in several animal models of pain. Its activity was associated with a reduction in calcium transients, glutamate release, and reactive oxygen species production from the spinal cord tissue and dorsal ganglia root (DRG) in rats and mice. It has been reported that intrathecal (i.t.) administration of Phα1β to treat chronic pain reverted opioid tolerance with a safer profile than ω-conotoxin MVIIA, a highly selective NVACC blocker. Following a recent development of recombinant Phα1β (CTK 01512-2), a new molecular target, TRPA1, the structural arrangement of disulphide bridges, and an effect on glial plasticity have been identified. CTK 01512-2 reproduced the antinociceptive effects of the native toxin not only after the intrathecal but also after the intravenous administration. Herein, we review the Phα1β antinociceptive activity in the most relevant pain models and its mechanisms of action, highlighting the impact of CTK 01512-2 synthesis and its potential for multimodal analgesia.
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Affiliation(s)
- Juliana Figueira da Silva
- Laboratory of Pharmacology, Department of Pharmacy, Federal
University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Nancy Scardua Binda
- Laboratory of Pharmacology, Department of Pharmacy, Federal
University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Elizete Maria Rita Pereira
- Graduate Program in Health Sciences, Institute of Education and
Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | | | - Luciene Bruno Vieira
- Department of Pharmacology, Institute of Biological Sciences (ICB),
Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Alessandra Hubner de Souza
- Graduate Program in Health Sciences, Institute of Education and
Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Flávia Karine Rigo
- Graduate Program in Health Sciences, University of the Extreme South
of Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Hèlia Tenza Ferrer
- Center of Technology in Molecular Medicine, School of Medicine,
Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Célio José de Castro
- Graduate Program in Health Sciences, Institute of Education and
Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Juliano Ferreira
- Department of Pharmacology, Federal University of Santa Catarina,
Florianópolis, SC, Brazil
| | - Marcus Vinicius Gomez
- Graduate Program in Health Sciences, Institute of Education and
Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
- Center of Technology in Molecular Medicine, School of Medicine,
Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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19
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Stucky CL, Mikesell AR. Cutaneous pain in disorders affecting peripheral nerves. Neurosci Lett 2021; 765:136233. [PMID: 34506882 PMCID: PMC8579816 DOI: 10.1016/j.neulet.2021.136233] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 08/16/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023]
Abstract
Our ability to quickly detect and respond to harmful environmental stimuli is vital for our safety and survival. This inherent acute pain detection is a "gift" because it both protects our body from harm and allows healing of damaged tissues [1]. Damage to tissues from trauma or disease can result in distorted or amplified nociceptor signaling and sensitization of the spinal cord and brain (Central Nervous System; CNS) pathways to normal input from light touch mechanoreceptors. Together, these processes can result in nagging to unbearable chronic pain and extreme sensitivity to light skin touch (allodynia). Unlike acute protective pain, chronic pain and allodynia serve no useful purpose and can severely reduce the quality of life of an affected person. Chronic pain can arise from impairment to peripheral neurons, a phenomenon called "peripheral neuropathic pain." Peripheral neuropathic pain can be caused by many insults that directly affect peripheral sensory neurons, including mechanical trauma, metabolic imbalance (e.g., diabetes), autoimmune diseases, chemotherapeutic agents, viral infections (e.g., shingles). These insults cause "acquired" neuropathies such as small-fiber neuropathies, diabetic neuropathy, chemotherapy-induced peripheral neuropathy, and post herpetic neuralgia. Peripheral neuropathic pain can also be caused by genetic factors and result in hereditary neuropathies that include Charcot-Marie-Tooth disease, rare channelopathies and Fabry disease. Many acquired and hereditary neuropathies affect the skin, our largest organ and protector of nearly our entire body. Here we review how cutaneous nociception (pain perceived from the skin) is altered following diseases that affect peripheral nerves that innervate the skin. We provide an overview of how noxious stimuli are detected and encoded by molecular transducers on subtypes of cutaneous afferent endings and conveyed to the CNS. Next, we discuss several acquired and hereditary diseases and disorders that cause painful or insensate (lack of sensation) cutaneous peripheral neuropathies, the symptoms and percepts patients experience, and how cutaneous afferents and other peripheral cell types are altered in function in these disorders. We highlight exciting new research areas that implicate non-neuronal skin cells, particularly keratinocytes, in cutaneous nociception and peripheral neuropathies. Finally, we conclude with ideas for innovative new directions, areas of unmet need, and potential opportunities for novel cutaneous therapeutics that may avoid CNS side effects, as well as ideas for improved translation of mechanisms identified in preclinical models to patients.
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Affiliation(s)
- Cheryl L Stucky
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States.
| | - Alexander R Mikesell
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States
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20
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Ferraro S, Klugah-Brown B, Tench CR, Yao S, Nigri A, Demichelis G, Pinardi C, Bruzzone MG, Becker B. Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain-Meta-analytic evidence from neuroimaging studies. Hum Brain Mapp 2021; 43:998-1010. [PMID: 34734458 PMCID: PMC8764475 DOI: 10.1002/hbm.25702] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/10/2021] [Accepted: 10/19/2021] [Indexed: 12/27/2022] Open
Abstract
Neurobiological pain models propose that chronic pain is accompanied by neurofunctional changes that mediate pain processing dysfunctions. In contrast, meta‐analyses of neuroimaging studies in chronic pain conditions have not revealed convergent evidence for robust alterations during experimental pain induction. Against this background, the present neuroimaging meta‐analysis combined three different meta‐analytic approaches with stringent study selection criteria for case–control functional magnetic resonance imaging experiments during acute pain processing with a focus on chronic pain disorders. Convergent neurofunctional dysregulations in chronic pain patients were observed in the left anterior insula cortex. Seed‐based resting‐state functional connectivity based on a large publicly available dataset combined with a meta‐analytic task‐based approach identified the anterior insular region as a key node of an extended bilateral insula‐fronto‐cingular network, resembling the salience network. Moreover, the meta‐analytic decoding showed that this region presents a high probability to be specifically activated during pain‐related processes, although we cannot exclude an involvement in autonomic processes. Together, the present findings indicate that dysregulated left anterior insular activity represents a robust neurofunctional maladaptation and potential treatment target in chronic pain disorders.
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Affiliation(s)
- Stefania Ferraro
- The Clinical Hospital of the Chengdu Brain Science Institute, School of Life Science and Technology, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China.,Neuroradiology Department, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Benjamin Klugah-Brown
- The Clinical Hospital of the Chengdu Brain Science Institute, School of Life Science and Technology, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Christopher R Tench
- Division of Clinical Neurosciences, Clinical Neurology, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Shuxia Yao
- The Clinical Hospital of the Chengdu Brain Science Institute, School of Life Science and Technology, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Anna Nigri
- Neuroradiology Department, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Greta Demichelis
- Neuroradiology Department, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pinardi
- Neuroradiology Department, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Grazia Bruzzone
- Neuroradiology Department, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Benjamin Becker
- The Clinical Hospital of the Chengdu Brain Science Institute, School of Life Science and Technology, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
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21
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Tramullas M, Collins JM, Fitzgerald P, Dinan TG, O' Mahony SM, Cryan JF. Estrous cycle and ovariectomy-induced changes in visceral pain are microbiota-dependent. iScience 2021; 24:102850. [PMID: 34381975 PMCID: PMC8333168 DOI: 10.1016/j.isci.2021.102850] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/07/2021] [Accepted: 07/09/2021] [Indexed: 12/11/2022] Open
Abstract
Visceral hypersensitivity (VH) is a hallmark of many functional gastrointestinal disorders including irritable bowel syndrome and is categorized by a dull, diffuse sensation of abdominal pain. Recently, the gut microbiota has been implicated in VH in male mice, but the effects in females have yet to be explored fully. To this end, we now show that somewhat surprisingly, female germ-free mice have similar visceral pain responses to colorectal distension (CRD) as their conventional controls. However, we show that although sensitivity to CRD is estrous cycle stage-dependent in conventional mice, it is not in germ-free mice. Further, ovariectomy (OVX) induced VH in conventional but not germ-free mice, and induced weight gain regardless of microbiota status. Finally, we show that estrogen-replacement ameliorated OVX-induced VH. Taken together, this study provides evidence for a major role of female sex hormones and the gut microbiota in sensation of visceral pain in females.
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Affiliation(s)
| | - James M Collins
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | - Timothy G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Behavioural Science, University College Cork, Cork, Ireland
| | - Siobhain M O' Mahony
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
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22
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West C, McVey Neufeld KA. Animal models of visceral pain and the role of the microbiome. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2021; 10:100064. [PMID: 34151049 PMCID: PMC8190503 DOI: 10.1016/j.ynpai.2021.100064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 05/16/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023]
Abstract
Visceral pain refers to pain arising from the internal organs and is distinctly different from the expression and mechanisms of somatic pain. Diseases and disorders with increased visceral pain are associated with significantly reduced quality of life and incur large financial costs due to medical visits and lost work productivity. In spite of the notable burden of illness associated with those disorders involving increased visceral pain, and some knowledge regarding etiology, few successful therapeutics have emerged, and thus increased attention to animal models of visceral hypersensitivity is warranted in order to elucidate new treatment opportunities. Altered microbiota-gut-brain (MGB) axis communication is central to the comorbid gastrointestinal/psychiatric diseases of which increased visceral (intestinal) sensitivity is a hallmark. This has led to a particular focus on intestinal microbiome disruption and its potential role in the etiology of heightened visceral pain. Here we provide a review of studies examining models of heightened visceral pain due to altered bidirectional communication of the MGB axis, many of which are conducted on a background of stress exposure. We discuss work in which the intestinal microbiota has either been directly manipulated (as with germ-free, antibiotic, and fecal microbial transplantation studies) or indirectly affected through early life or adult stress, inflammation, and infection. Animal models of visceral pain alterations with accompanying changes to the intestinal microbiome have the highest face and construct validity to the human condition and are the focus of the current review.
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Affiliation(s)
- Christine West
- McMaster Brain-Body Institute at St Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Karen-Anne McVey Neufeld
- McMaster Brain-Body Institute at St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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23
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Ray K, Hamed M, Imsirovic A, Swaminathan C, Sajid MS. Intraperitoneal local anaesthesia for post-operative pain management in patients undergoing laparoscopic colorectal surgery: a systematic review and meta-analysis. Minerva Surg 2021; 77:57-64. [PMID: 34047532 DOI: 10.23736/s2724-5691.21.08789-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Intraperitoneal instillation of local anaesthetic agents has been reported as an effective adjunct to pain management and early functional recovery in colorectal surgery. Laparoscopic colorectal resection (LCR) is considered as the gold standard approach to resect benign and malignant lesions of the colon and rectum due to the advantages of reduced pain score, quicker recovery, and shorter hospitalization. The objective of this study is to systematically analyze the published RCTs evaluating the effectiveness of intraperitoneal local anesthetic (IPLA) instillation versus standard analgesia in patients undergoing LCR. EVIDENCE ANALYSIS Electronic databases such as Embase, Medline, PubMed, PubMed Central and the Cochrane library pertaining to the use of IPLA infiltration after LCR were systematically reviewed using the principles of meta-analysis. EVIDENCE SYNTHESIS Five RCTs on 292 patients undergoing LCR were either given IPLA or standard post-operative analgesia. In the random-effects model analysis using the statistical software Review Manager, statistically 2-4 hours pain score (Standardized mean difference (SMD), -1.72; 95% CI, -2.62, -0.81; z = 3.71; P = 0.0002) was significantly ower in the IPLA group. The 12 hours post-operative pain score (P = 0.23) was also lower in the IPLA group but failed to reach the statistical significance. Opioid analgesia requirement was lower in the IPLA group (SMD -7.60; 95% CI, -11.21, -3.90; z = 4.12; P = 0.0001) but the time to flatus, length of stay and the frequency of nausea/vomiting were statistically similar in both groups. CONCLUSIONS IPLA instillation is an effective modality to reduce the post-operative pain score and lower the opioid analgesic requirements in patients undergoing LCR without influencing the time to first flatus, length of stay, and post-operative nausea/vomiting.
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Affiliation(s)
- Kausik Ray
- Department of Gastrointestinal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK -
| | - Moaz Hamed
- Department of Gastrointestinal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Anja Imsirovic
- Department of Gastrointestinal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Christie Swaminathan
- Department of Gastrointestinal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Muhammad S Sajid
- Department of Gastrointestinal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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Mutlu H, Ertas K, Kokulu K, Sert ET, Diri MA, Gul M. An effective treatment option for pain caused by urolithiasis: A randomised-controlled trial of local active warming with heat-patch. Int J Clin Pract 2021; 75:e13969. [PMID: 33368937 DOI: 10.1111/ijcp.13969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/21/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND There is growing interest in physical medicine treatment options for renal colic. In this study, we aimed to determine whether or not heat-patch treatment with no drug was effective in relieving renal colic. METHODS For this purpose, patients who were diagnosed with renal colic in the emergency department were randomised to have either heat-patch or sham treatment. The Visual Analogue Scale (VAS) scores of renal colic, body temperature (Btemp), and sub-patch skin temperature (Stemp) values were measured at 0, 15, 30, 45, and 60 minutes. In addition, the salvage treatment needs of the groups were compared. RESULTS The average age of the study group was 30.5 ± 8.3 years and that of the sham group was 31.0 ± 8.2 years (P = .75). According to the baseline VAS score of the patients, 15, 30, 45, and 60 minutes VAS scores significantly decreased in the heat-patch group (P < .001). The Btemp values did not differ significantly between the heat-patch and sham groups. In addition, no statistically significant difference was found between the two groups in terms of Stemp values at 0 and 15 minutes (P = .39 and P = .10, respectively). However, there was a significant difference in the heat-patch group in terms of Stemp values at 30, 45, and 60 minutes compared with the sham group (P < .001). The salvage treatment rates for the heat-patch and sham groups were 11.5% and 31.4%, respectively (P = .01). CONCLUSION As non-pharmaceutical treatment, the heat-patch has been shown to be a possible candidate for pain relief in patients with urolithiasis. Further research should concentrate on multicentre and large scale randomised studies.
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Affiliation(s)
- Huseyin Mutlu
- Department of Emergency Medicine, Aksaray University School of Medicine, Aksaray, Turkey
| | - Kasim Ertas
- Department of Urology, Van Yüzüncü Yil University School of Medicine, Van, Turkey
| | - Kamil Kokulu
- Department of Emergency Medicine, Aksaray University School of Medicine, Aksaray, Turkey
| | - Ekrem Taha Sert
- Department of Emergency Medicine, Aksaray University School of Medicine, Aksaray, Turkey
| | - Mehmet Akif Diri
- Department of Urology, Aksaray University School of Medicine, Konya, Turkey
| | - Murat Gul
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
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25
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Kania BF, Wrońska D, Bracha U. Pain, Pathophysiological Mechanisms, and New Therapeutic Options for Alternative Analgesic Agents in Sheep: A Review and Investigation. Animals (Basel) 2021; 11:ani11030909. [PMID: 33810059 PMCID: PMC8004948 DOI: 10.3390/ani11030909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/14/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary The purpose of this review is to provide current data on the definition and types of pain, describe its neuropharmacological and pathological mechanisms, and present a comparative analysis of the results obtained after intracerebroventricular (ICV) infusion of voltage-gated calcium channel inhibitors (VGCCIs) such as diltiazem, nifedipine, and verapamil, cholecystokinin receptor antagonists (PD, proglumide), and glutamatergic receptor antagonists (L-AP3, DL-AP3) during experimental distension of the duodenal and/or descending colonic wall. This method was used as a model for suppressing pain in sheep based on viscero-visceral inhibitory reflex, measured by the inhibition of behavioral symptoms of stress, degree of reticulo-ruminal motility, and changes in plasma cortisol and catecholamine concentration. After ICV infusion, all tested substances suppressed, to varying degrees, the viscero-visceral inhibitory reflex, tachycardia, hyperventilation, bleating, and gnashing of the teeth, whereas they increased the levels of cortisol and plasma catecholamines in sheep. These substances could be potential non-narcotic agents for the treatment of visceral intestinal pain (intestinal colic) in sheep, but clinical confirmation of the substances’ efficacy for treating intestinal colic is needed. Abstract Relief from suffering is the guiding principle of medical and veterinary ethics. Medical care for animals should be carried out to meet all welfare conditions. The need for pain management is demonstrated by recent monographs devoting attention to this urgent ethical need. Little data, however, are available on the prevention and attenuation of pain in sheep. After administration of narcotic analgesics used for severe visceral pain, sheep react with a state of excitement. Therefore, it was decided to experimentally investigate the usefulness of potential non-narcotic drugs to relieve pain in sheep with intestinal colic caused by 10 min of mechanical distension of their duodenal and/or descending colonic wall. The results indicate the potential usefulness of VGCCIs (diltiazem, nifedipine, verapamil), cholecystokinin receptor antagonists (PD, proglumide), and metabotropic glutaminergic receptor antagonists (mGluRAs), such as L-AP3, DL-AP3. As a premedication, these substances prevented the occurrence of symptoms of acute intestinal pain including atony of reticulo-rumen, tachycardia, hyperventilation, moaning, gnashing of teeth, hypercortisolemia, and catecholaminemia; hence, these substances are considered potential agents in the treatment of sheep visceral pain.
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Affiliation(s)
- Bogdan Feliks Kania
- University Center of Veterinary Medicine Jagiellonian University-Agricultural University, Hugon Kołłątaj Agricultural University in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
- Correspondence: or ; Tel.: +48-12-429-75-47; Fax: +48-12-662-40-19
| | - Danuta Wrońska
- Department of Animal Physiology and Endocrinology, Animal Breeding and Biology Faculty, Hugon Kołłątaj Agricultural University in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland;
| | - Urszula Bracha
- Center of Experimental and Innovative Medicine, Hugon Kołłątaj Agricultural University in Krakow, ul. Rędzina 1C, 30-248 Krakow, Poland;
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26
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A splenic cyst causing a viscerosomatic reflex in the thoracic spine. A case report. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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27
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Wilmes L, Collins JM, O'Riordan KJ, O'Mahony SM, Cryan JF, Clarke G. Of bowels, brain and behavior: A role for the gut microbiota in psychiatric comorbidities in irritable bowel syndrome. Neurogastroenterol Motil 2021; 33:e14095. [PMID: 33580895 DOI: 10.1111/nmo.14095] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The gastrointestinal microbiota has emerged as a key regulator of gut-brain axis signalling with important implications for neurogastroenterology. There is continuous bidirectional communication between the gut and the brain facilitated by neuronal, endocrine, metabolic, and immune pathways. The microbiota influences these signalling pathways via several mechanisms. Studies have shown compositional and functional alterations in the gut microbiota in stress-related psychiatric disorders. Gut microbiota reconfigurations are also a feature of irritable bowel syndrome (IBS), a gut-brain axis disorder sharing high levels of psychiatric comorbidity including both anxiety and depression. It remains unclear how the gut microbiota alterations in IBS align with both core symptoms and these psychiatric comorbidities. METHODS In this review, we highlight common and disparate features of these microbial signatures as well as the associated gut-brain axis signalling pathways. Studies suggest that patients with either IBS, depression or anxiety, alone or comorbid, present with alterations in gut microbiota composition and harbor immune, endocrine, and serotonergic system alterations relevant to the common pathophysiology of these comorbid conditions. KEY RESULTS Research has illustrated the utility of fecal microbiota transplantation in animal models, expanding the evidence base for a potential causal role of disorder-specific gut microbiota compositions in symptom set expression. Moreover, an exciting study by Constante and colleagues in this issue highlights the possibility of counteracting this microbiota-associated aberrant behavioral phenotype with a probiotic yeast, Saccharomyces boulardii CNCM I-745. CONCLUSIONS AND INFERENCES Such data highlights the potential for therapeutic targeting of the gut microbiota as a valuable strategy for the management of comorbid psychiatric symptoms in IBS.
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Affiliation(s)
- Lars Wilmes
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.,Department of Psychiatry and Behavioural Science, University College Cork, Cork, Ireland
| | - James M Collins
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | - Siobhain M O'Mahony
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Gerard Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Behavioural Science, University College Cork, Cork, Ireland
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Kaski SW, White AN, Gross JD, Siderovski DP. Potential for Kappa-Opioid Receptor Agonists to Engineer Nonaddictive Analgesics: A Narrative Review. Anesth Analg 2021; 132:406-419. [PMID: 33332902 DOI: 10.1213/ane.0000000000005309] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A serious adverse effect of prescription opioid analgesics is addiction, both to these analgesics and to illicit drugs like heroin that also activate the µ-opioid receptor (MOR). Opioid use disorder (OUD) and opioid overdose deaths represent a current American health crisis, and the prescription of opioid analgesics has contributed significantly to this crisis. While prescription opioids are highly effective analgesics, there currently exists no facile way to use them for extended periods without the risk of addiction. If addiction caused by MOR-targeting analgesics could be blocked by blending in a new "antiaddiction" ingredient that does not diminish analgesia and does not introduce its own therapeutically limiting side effects, then continued clinical use of prescription opioids for treating pain could be maintained (or even enhanced) instead of curtailed. In this narrative review, we contextualize this hypothesis, first with a brief overview of the current American opioid addiction crisis. The neurobiology of 2 key receptors in OUD development, MOR and the κ-opioid receptor (KOR), is then discussed to highlight the neuroanatomical features and circuitry in which signal transduction from these receptors lie in opposition-creating opportunities for pharmacological intervention in curtailing the addictive potential of MOR agonism. Prior findings with mixed MOR/KOR agonists are considered before exploring new potential avenues such as biased KOR agonists. New preclinical data are highlighted, demonstrating that the G protein-biased KOR agonist nalfurafine reduces the rewarding properties of MOR-targeting analgesics and enhances MOR-targeting analgesic-induced antinociception. Finally, we discuss the recent discovery that a regulator of G protein signaling (namely, RGS12) is a key component of signaling bias at KOR, presenting another drug discovery target toward identifying a single agent or adjuvant to be added to traditional opioid analgesics that could reduce or eliminate the addictive potential of the latter drug.
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Affiliation(s)
- Shane W Kaski
- From the Departments of Neuroscience and Behavioral Medicine & Psychiatry, West Virginia University, Morgantown, West Virginia
| | - Allison N White
- From the Departments of Neuroscience and Behavioral Medicine & Psychiatry, West Virginia University, Morgantown, West Virginia
| | - Joshua D Gross
- Department of Cell Biology, Duke University Medical Center, Durham, North Carolina
| | - David P Siderovski
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas
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29
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Yuan T, Greenwood-Van Meerveld B. Abdominal and Pelvic Pain: Current Challenges and Future Opportunities. FRONTIERS IN PAIN RESEARCH 2021; 2:634804. [PMID: 35295470 PMCID: PMC8915637 DOI: 10.3389/fpain.2021.634804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/04/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Tian Yuan
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Beverley Greenwood-Van Meerveld
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- VA Health Care System, Oklahoma City, OK, United States
- *Correspondence: Beverley Greenwood-Van Meerveld
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30
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Zhao Y, Siri S, Feng B, Pierce DM. Computational Modeling of Mouse Colorectum Capturing Longitudinal and Through-thickness Biomechanical Heterogeneity. J Mech Behav Biomed Mater 2021; 113:104127. [PMID: 33125950 PMCID: PMC8053306 DOI: 10.1016/j.jmbbm.2020.104127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 09/03/2020] [Accepted: 10/01/2020] [Indexed: 12/19/2022]
Abstract
Mechanotransduction, the encoding of local mechanical stresses and strains at sensory endings into neural action potentials at the viscera, plays a critical role in evoking visceral pain, e.g., in the distal colon and rectum (colorectum). The wall of the colorectum is structurally heterogeneous, including two major composites: the inner consists of muscular and submucosal layers, and the outer consists of circular muscular, intermuscular, longitudinal muscular, and serosal layers. In fact the colorectum presents biomechanical heterogenity across both the longitudinal and through-thickness directions thus highlighting the differential roles of sensory nerve endings within different regions of the colorectum in visceral mechanotransduction. We determined constitutive models and model parameters for individual layers of the colorectum from three longitudinal locations (colonic, intermediate, and distal) using nonlinear optimization to fit our experimental results from biaxial extension tests on layer-separated colorectal tissues (mouse model, 7×7 mm2, Siri et al., Am. J. Physiol. Gastrointest. Liver Physiol. 316, G473-G481 and 317, G349-G358), and quantified the thicknesses of the layers. In this study we also quantified the residual stretches stemming from separating colorectal specimens into inner and outer composites and we completed new pressure-diameter mechanical testing to provide an additional validation case. We implemented the constitutive equations and created two-layered, 3-D finite element models using FEBio (University of Utah), and incorporated the residual stretches. We validated the modeling framework by comparing FE-predicted results for both biaxial extension testing of bulk specimens of colorectum and pressure-diameter testing of bulk segments against corresponding experimental results independent of those used in our model fitting. We present the first theoretical framework to simulate the biomechanics of distal colorectum, including both longitudinal and through-thickness heterogeneity, based on constitutive modeling of biaxial extension tests of colon tissues from mice. Our constitutive models and modeling framework facilitate analyses of both fundamental questions (e.g., the impact of organ/tissue biomechanics on mechanotransduction of the sensory nerve endings, structure-function relationships, and growth and remodeling in health and disease) and specific applications (e.g., device design, minimally invasive surgery, and biomedical research).
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Affiliation(s)
- Y Zhao
- Department of Mechanical Engineering, University of Connecticut, Storrs, CT, USA; Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - S Siri
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - B Feng
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - D M Pierce
- Department of Mechanical Engineering, University of Connecticut, Storrs, CT, USA; Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA.
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31
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Romero-Morelos P, Ruvalcaba-Paredes E, Garciadiego-Cázares D, Pérez-Santos M, Reyes-Long S, Alfaro-Rodriguez A, Salcedo M, Mancilla-Ramírez J, Bandala C. Neurophysiological Mechanisms Related to Pain Management in Bone Tumors. Curr Neuropharmacol 2021; 19:308-319. [PMID: 33176655 PMCID: PMC8033964 DOI: 10.2174/1570159x18666201111112748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 08/24/2020] [Accepted: 10/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Primary and metastatic bone tumor incidence has increased in the previous years. Pain is a common symptom and is one of the most important related factors to the decrease of quality of life in patients with bone tumor. Different pain management strategies are not completely effective and many patients afflicted by cancer pain cannot be controlled properly. In this sense, we need to elucidate the neurophysiology of cancer-induced pain, contemplating other components such as inflammation, neuropathies and cognitive components regarding bone tumors, and thus pave the way for novel therapeutic approaches in this field. AIM This study aims to identify the neurophysiology of the mechanisms related to pain management in bone tumors. METHODS Advanced searches were performed in scientific databases: PubMed, ProQuest, EBSCO, and the Science Citation index to get information about the neurophysiology mechanisms related to pain management in bone tumors. RESULTS The central and peripheral mechanisms that promote bone cancer pain are poorly understood. Studies have shown that bone cancer could be related to neurochemicals produced by tumor and inflammatory cells, coupled with peripheral sensitization due to nerve compression and injury caused by tumor growth. The activity of mesolimbic dopaminergic neurons, substance P, cysteine/ glutamate antiporter, and other neurochemical dynamics brings us putative strategies to suggest better and efficient treatments against pain in cancer patients. CONCLUSION Cancer-induced bone pain could include neuropathic and inflammatory pain, but with different modifications to the periphery tissue, nerves and neurochemical changes in different neurological levels. In this sense, we explore opportunity areas in pharmacological and nonpharmacological pain management, according to pain-involved mechanisms in this study.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Cindy Bandala
- Address correspondence to this author at the Departament of Neurosciences, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Calzada México-Xochimilco 289, Col. Arenal de Guadalupe, Del. Tlalpan, 14389 Ciudad de México, México; Tel: (+52) (55) 5999 1000, ext. 19303; E-mail:
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Van Oudenhove L, Kragel PA, Dupont P, Ly HG, Pazmany E, Enzlin P, Rubio A, Delon-Martin C, Bonaz B, Aziz Q, Tack J, Fukudo S, Kano M, Wager TD. Common and distinct neural representations of aversive somatic and visceral stimulation in healthy individuals. Nat Commun 2020; 11:5939. [PMID: 33230131 PMCID: PMC7684294 DOI: 10.1038/s41467-020-19688-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022] Open
Abstract
Different pain types may be encoded in different brain circuits. Here, we examine similarities and differences in brain processing of visceral and somatic pain. We analyze data from seven fMRI studies (N = 165) and five types of pain and discomfort (esophageal, gastric, and rectal distension, cutaneous thermal stimulation, and vulvar pressure) to establish and validate generalizable pain representations. We first evaluate an established multivariate brain measure, the Neurologic Pain Signature (NPS), as a common nociceptive pain system across pain types. Then, we develop a multivariate classifier to distinguish visceral from somatic pain. The NPS responds robustly in 98% of participants across pain types, correlates with perceived intensity of visceral pain and discomfort, and shows specificity to pain when compared with cognitive and affective conditions from twelve additional studies (N = 180). Pre-defined signatures for non-pain negative affect do not respond to visceral pain. The visceral versus the somatic classifier reliably distinguishes somatic (thermal) from visceral (rectal) stimulation in both cross-validation and independent cohorts. Other pain types reflect mixtures of somatic and visceral patterns. These results validate the NPS as measuring a common core nociceptive pain system across pain types, and provide a new classifier for visceral versus somatic pain.
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Affiliation(s)
- Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism, and Ageing, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Cognitive and Affective Neuroscience Lab, Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Philip A Kragel
- Department of Psychology and Neuroscience and the Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Patrick Dupont
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Huynh Giao Ly
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism, and Ageing, KU Leuven, Leuven, Belgium
| | - Els Pazmany
- Interfaculty Institute for Family and Sexuality Studies, Department of Neurosciences, University of Leuven, Leuven, Belgium
| | - Paul Enzlin
- Interfaculty Institute for Family and Sexuality Studies, Department of Neurosciences, University of Leuven, Leuven, Belgium
| | - Amandine Rubio
- Grenoble Institute of Neuroscience, University of Grenoble Alpes, Grenoble, France
| | - Chantal Delon-Martin
- Grenoble Institute of Neuroscience, University of Grenoble Alpes, Grenoble, France
| | - Bruno Bonaz
- Grenoble Institute of Neuroscience, University of Grenoble Alpes, Grenoble, France
| | - Qasim Aziz
- Barts and The London School of Medicine and Dentistry, Wingate Institute of Neurogastroenterology, Centre for Neuroscience and Trauma, Blizzard Institute, Queen Mary University of London, London, UK
| | - Jan Tack
- Gastrointestinal Motility and Sensitivity Research Group, Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism, and Ageing, KU Leuven, Leuven, Belgium
| | - Shin Fukudo
- Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Michiko Kano
- Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Frontier Research Institute for Interdisciplinary Sciences (FRIS), Tohoku University, Sendai, Japan
| | - Tor D Wager
- Cognitive and Affective Neuroscience Lab, Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA.
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Franco de la-Torre L, Alonso-Castro ÁJ, Zapata-Morales JR, Rivas-Carrillo JD, Vidaurrazaga-Lugo J, Partida-Castellanos EM, Granados-Soto V, Isiordia-Espinoza MA. Antinociception and less gastric injury with the dexketoprofen-tapentadol combination in mice. Fundam Clin Pharmacol 2020; 35:371-378. [PMID: 33150641 DOI: 10.1111/fcp.12625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/17/2020] [Accepted: 11/02/2020] [Indexed: 01/11/2023]
Abstract
The purpose of this study was to evaluate the antinociceptive interaction between dexketoprofen and tapentadol in three different dose ratios, as well as the ulcerogenic activity of this combination. Dose-response curves were carried out for dexketoprofen, tapentadol, and dexketoprofen-tapentadol combinations in the acetic acid-induced writhing test in mice. On the other hand, the gastric damage of all treatments was assessed after the surgical extraction of the stomachs. Intraperitoneal administration of dexketoprofen and tapentadol induced a dose-dependent antinociceptive effect, reaching a maximal effect of about 58% and 99%, respectively. Isobolographic analysis and the interaction index showed that the three proportions produced an analgesic potentiation (synergistic interaction). Interestingly, the 1:1 and 1:3 ratios of the drugs combination produced minor gastric injury in comparison with the 3:1 proportion. Our data suggest that all proportions of the dexketoprofen-tapentadol combination produced a synergistic interaction in the acetic acid-induced visceral pain model in mice with a low incidence of gastric injury.
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Affiliation(s)
- Lorenzo Franco de la-Torre
- Instituto de Investigación en Ciencias Médicas, Cuerpo Académico Terapéutica y Biología Molecular (UDG-CA-973), Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos, Mexico
| | - Ángel Josabad Alonso-Castro
- Departamento de Farmacia, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Mexico
| | - Juan Ramón Zapata-Morales
- Departamento de Farmacia, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Mexico
| | - Jorge David Rivas-Carrillo
- Centro de Investigación Científica y Experimentación Animal, Laboratorio de Ingeniería de Tejidos y Trasplantes, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - José Vidaurrazaga-Lugo
- Instituto de Investigación en Ciencias Médicas, Cuerpo Académico Terapéutica y Biología Molecular (UDG-CA-973), Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos, Mexico
| | - Elsa Maria Partida-Castellanos
- Instituto de Investigación en Ciencias Médicas, Cuerpo Académico Terapéutica y Biología Molecular (UDG-CA-973), Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos, Mexico
| | - Vinicio Granados-Soto
- Neurobiology of Pain Laboratory, Departamento de Farmacobiología, Cinvestav, Mexico City, México
| | - Mario Alberto Isiordia-Espinoza
- Instituto de Investigación en Ciencias Médicas, Cuerpo Académico Terapéutica y Biología Molecular (UDG-CA-973), Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos, Mexico
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Regmi B, Shah MK. Possible implications of animal models for the assessment of visceral pain. Animal Model Exp Med 2020; 3:215-228. [PMID: 33024943 PMCID: PMC7529330 DOI: 10.1002/ame2.12130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 07/06/2020] [Indexed: 12/22/2022] Open
Abstract
Acute pain, provoked generally after the activation of peripheral nociceptors, is an adaptive sensory function that alerts the individual to avoid noxious stimuli. However, uncontrolled acute pain has a maladaptive role in sensory activity leading to development of a chronic pain state which persists even after the damage is resolved, or in some cases, in the absence of an initial local acute injury. Huge numbers of people suffer from visceral pain at least once during their life span, leading to substantial health care costs. Although studies reporting on the mechanism of visceral pain are accumulating, it is still not precisely understood. Therefore, this review aims to elucidate the mechanism of visceral pain through an evaluation of different animal models and their application to develop novel therapeutic approaches for treating visceral pain. To assess the nociceptive responses in viscera, several visceral pain models such as inflammatory, traction, stress and genetic models utilizing different methods of measurement have been devised. Among them, the inflammatory and traction models are widely used for studying the visceral pain mechanism of different disease conditions and post-operative surgery in humans and animals. A hapten, 2,4,6-trinitrobenzene sulfonic acid (TNBS), has been extensively used as an inflammatory agent to induce visceral pain. The traction model seems to cause a strong pain stimulation and autonomic reaction and could thus be the most appropriate model for studying the underlying visceral pain mechanism and for probing the therapeutic efficacies of various anesthetic and analgesics for the treatment of visceral pain and hyperalgesia.
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Affiliation(s)
- Bharata Regmi
- Department of Surgery and Pharmacology Agriculture and Forestry University (AFU) Rampur Chitwan Nepal
| | - Manoj K Shah
- Department of Surgery and Pharmacology Agriculture and Forestry University (AFU) Rampur Chitwan Nepal
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How I Treat Acute and Persistent Sickle Cell Pain. Mediterr J Hematol Infect Dis 2020; 12:e2020064. [PMID: 32952975 PMCID: PMC7485466 DOI: 10.4084/mjhid.2020.064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/13/2020] [Indexed: 01/07/2023] Open
Abstract
Sickle pain is the hallmark of sickle cell disease (SCD). It could be acute, persistent/relapsing, chronic, or neuropathic. Although there is a general consensus that pain is a major manifestation of SCD, there is a controversy as to the types of pain and their interrelationship between acute, chronic, relapsing, persistent, etc. This report first reviews the general approach to the management of acute vaso-occlusive crisis (VOC) pain, including education, counseling, pharmacotherapy, non-pharmacotherapy, and fluid therapy. This is followed by the presentation of five patients that represent typical issues that are commonly encountered in the management of patients with SCD. These issues are: individualized treatment of pain, bilaterality of pain, use of illicit drugs, tolerance to opioids, opioid-induced hyperalgesia, and withdrawal syndrome. The clinical aspects and management of each of these issues are described. Moreover, such complications as tolerance and withdrawal may persist after discharge and may be mistaken as chronic pain rather than resolving, persistent or relapsing pain.
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Benson S, Rebernik L, Pastoors D, Brinkhoff A, Wegner A, Elsenbruch S, Engler H. Impact of acute inflammation on the extinction of aversive gut memories. Brain Behav Immun 2020; 88:294-301. [PMID: 32531428 DOI: 10.1016/j.bbi.2020.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/27/2020] [Accepted: 06/06/2020] [Indexed: 01/25/2023] Open
Abstract
Impaired extinction of pain-related fear memories can lead to persistent or resurging fear of pain, contributing to the development and maintenance of chronic pain conditions. The mechanisms underlying maladaptive pain-related learning and memory processes remain incompletely understood, particularly in the context of interoceptive, visceral pain. Inflammation is known to interfere with learning and memory, but its effects on the extinction of pain-related fear memories have never been tested. In a randomized, double-blind, placebo-controlled study, we assessed the impact of experimental acute inflammation on the extinction and reinstatement of conditioned visceral pain-related fear. Forty healthy male volunteers underwent differential fear conditioning with visceral pain as clinically relevant unconditioned stimulus (US). Participants then received an intravenous injection of either 0.8 ng/kg lipopolysaccharide (LPS) as inflammatory stimulus or physiological saline as placebo, and extinction training was conducted at the peak of the inflammatory response. Extinction recall and reinstatement test were performed after overnight consolidation. Results showed that visceral pain represents an effective US, eliciting pronounced conditioned pain-related fear responses. Repeated unreinforced presentation of the pain-predictive cue during extinction training resulted in full extinction of the conditioned behavioral response. However, unexpected re-exposure to the US during reinstatement test resulted in return of fear. Despite pronounced LPS-induced effects on inflammatory markers, cortisol, and negative affect, we did not find evidence that acute inflammation resulted in altered fear extinction. The findings support the notion that visceral pain-related fear learning establishes a robust aversive memory trace that remains preserved during inhibitory learning, leaving a latent vulnerability for the return of fear. Inflammation during inhibitory learning did neither weaken nor further amplify this aversive memory trace, suggesting that it is rather resistant to acute inflammation-induced effects, at least in healthy individuals with no additional vulnerability factors.
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Affiliation(s)
- Sven Benson
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Laura Rebernik
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Daniel Pastoors
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Alexandra Brinkhoff
- Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Alexander Wegner
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Germany; Department of Orthopaedics, Trauma and Reconstructive Surgery, Marienhospital Mülheim an der Ruhr, Germany
| | - Sigrid Elsenbruch
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Germany; Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Germany.
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Chandan JS, Keerthy D, Zemedikun DT, Okoth K, Gokhale KM, Raza K, Bandyopadhyay S, Taylor J, Nirantharakumar K. The association between exposure to childhood maltreatment and the subsequent development of functional somatic and visceral pain syndromes. EClinicalMedicine 2020; 23:100392. [PMID: 32637892 PMCID: PMC7329705 DOI: 10.1016/j.eclinm.2020.100392] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Childhood maltreatment is a global public health issue linked to a vast mortality and morbidity burden. This study builds on current literature to explore the risk of developing central sensitivity syndromes (CSS) (consisting of somatic and visceral pain syndromes) subsequent to childhood maltreatment exposure. METHODS A retrospective population based open cohort study using the UK primary care database, 'The Health Improvement Network,' between 1st January 1995-31st December 2018. 80,657 adult patients who had experienced childhood maltreatment or maltreatment related concerns (exposed patients) were matched to 161,314 unexposed patients by age and sex. Outcomes of interest were the development of CSS: either somatic (Fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, chronic lower back pain, chronic headache, myofascial pain syndrome and restless leg syndrome) or visceral (Interstitial cystitis, vulvodynia, chronic prostatitis and irritable bowel syndrome) in nature. Effect sizes are presented as adjusted incidence rate ratios (aIRR) with confidence intervals (CI). Models were adjusted for the following covariates at cohort entry: age, sex, deprivation, anxiety, depression and serious mental ill health. RESULTS The average age at cohort entry was 23.4 years and the median follow was 2.2 years. There was an increased risk of developing fibromyalgia (aIRR 2.06; 95% CI 1.71-2.48), chronic fatigue syndrome (1.47; 1.08-2.00), chronic lower back pain (1.99; 1.68-2.35), restless leg syndrome (1.82; 1.41-2.35) and irritable bowel syndrome (1.15; 1.08-1.22) when compared to the unexposed group, whereas no statistical association was seen with the development of temporomandibular joint disorder (1.00; 0.88-1.13), chronic headache (1.04; 0.59-1.86), interstitial cystitis (1.19; 0.51-2.74), vulvodynia (0.65; 0.34-1.26), chronic prostatitis (0.34; 0.07-1.77) and myofascial pain syndrome (0.88; 0.36-2.14). Outcome numbers were low, most likely, due to the rarity of visceral conditions (aside from irritable bowel syndrome). The association between a history of childhood maltreatment and CSS were mainly observed in somatic CSS. INTERPRETATION The debilitating effects of CSS carry a substantial physical, psychological and economic burden to both the individuals who are diagnosed with them and the health services who serve them. Primary prevention approaches targeting childhood maltreatment as well as secondary preventative approaches should be considered to minimise the associated burden of CSS.
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Affiliation(s)
- Joht Singh Chandan
- Warwick Medical School, University of Warwick, Coventry CV47HL, United Kingdom
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Deepiksana Keerthy
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Dawit Tefra Zemedikun
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Kelvin Okoth
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Krishna Margadhamane Gokhale
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Karim Raza
- Arthritis Research, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Siddhartha Bandyopadhyay
- Centre of Crime, Justice and Policing, The Department of Economics, University of Birmingham, B152TT, United Kingdom
| | - Julie Taylor
- Child Protection, School of Nursing, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
- Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, United Kingdom
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
- Midlands Health Data Research UK, University of Birmingham B152TT, United Kingdom
- Corresponding author at: Institute of Applied Health Research, College of Medical and Dental sciences, University of Birmingham, B152TT
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Temporal Summation in Chronic Pelvic Pain. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 42:556-560. [DOI: 10.1016/j.jogc.2019.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 01/09/2023]
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Tlacomulco-Flores LL, Déciga-Campos M, González-Trujano ME, Carballo-Villalobos AI, Pellicer F. Antinociceptive effects of Salvia divinorum and bioactive salvinorins in experimental pain models in mice. JOURNAL OF ETHNOPHARMACOLOGY 2020; 248:112276. [PMID: 31593812 DOI: 10.1016/j.jep.2019.112276] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 05/29/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Salvia divinorum Epling & Játiva is a Mexican plant used not only in rituals but also in traditional medicine for pain relief. One of the most known bioactive compounds is salvinorin A, which acts centrally in kappa-type opioid receptors. AIM OF THE STUDY Despite its traditional use as a medicinal plant, there is not enough scientific investigation to reinforce its potential as analgesic. In this study, Salvia divinorum antinociceptive activity was evaluated in experimental models of nociceptive pain; the writhing test and formalin-induced licking behavior in mice. MATERIAL AND METHODS Different Salvia divinorum extracts were prepared by maceration at room temperature in increased polarity (hexane, ethyl acetate and methanol). The ethyl acetate extract (EAEx) was chosen in order to be fractioned and to obtain a mixture of salvinorins. The antinociceptive effect of EAEx (3, 10, 30, and 100 mg/kg, i.p.) was compared with that of tramadol (a partial opioid agonist analgesic drug, 30 mg/kg, i.p.) and the mixture of salvinorins (30 mg/kg, i.p.). In addition, a participation of opioids (naloxone, NX 1 and/or 3 mg/kg, i.p.) and serotonin 5-HT1A receptors (WAY100635, 0.32 mg/kg, i.p.) was investigated as possible inhibitory neurotransmission involved. RESULTS As a result, the EAEx produced significant and dose-dependent antinociceptive effect concerning salvinorins constituents. This effect was blocked in the presence of NX and WAY100635 in the abdominal test, but only by NX in the formalin-induced licking behavior. Whereas, the effect of salvinorins mixture involved opioids and serotonin 5-HT1A receptors. CONCLUSION Data provide evidence of the potential of this species, where salvinorin A is in part responsible bioactive constituent involving participation of the opioids and/or 5-HT1A serotonin receptors depending on the kind of pain model explored.
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Affiliation(s)
- Lorenzo Leonel Tlacomulco-Flores
- Laboratorio de Neurofarmacología de Productos Naturales, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente", Av. México-Xochimilco 101, Col. Sn Lorenzo Huipulco, 14370, Ciudad de México, Mexico; Sección de Estudios de Posgrado e Investigación de la Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón S/n Col, Casco de Santo Tomás, 11340, Ciudad de México, Mexico
| | - Myrna Déciga-Campos
- Sección de Estudios de Posgrado e Investigación de la Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón S/n Col, Casco de Santo Tomás, 11340, Ciudad de México, Mexico
| | - María Eva González-Trujano
- Laboratorio de Neurofarmacología de Productos Naturales, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente", Av. México-Xochimilco 101, Col. Sn Lorenzo Huipulco, 14370, Ciudad de México, Mexico.
| | - Azucena Ibeth Carballo-Villalobos
- Departamento de Química Inorgánica y Nuclear, Facultad de Química, Universidad Nacional Autónoma de México. Conjunto E. Circuito de la Investigación Científica, Ciudad Universitaria, 04510, Ciudad de México, Mexico
| | - Francisco Pellicer
- Laboratorio de Neurofarmacología de Productos Naturales, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente", Av. México-Xochimilco 101, Col. Sn Lorenzo Huipulco, 14370, Ciudad de México, Mexico
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Sun LH, Zhang WX, Xu Q, Wu H, Jiao CC, Chen XZ. Estrogen modulation of visceral pain. J Zhejiang Univ Sci B 2020; 20:628-636. [PMID: 31273960 DOI: 10.1631/jzus.b1800582] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
It is commonly accepted that females and males differ in their experience of pain. Gender differences have been found in the prevalence and severity of pain in both clinical and animal studies. Sex-related hormones are found to be involved in pain transmission and have critical effects on visceral pain sensitivity. Studies have pointed out the idea that serum estrogen is closely related to visceral nociceptive sensitivity. This review aims to summarize the literature relating to the role of estrogen in modulating visceral pain with emphasis on deciphering the potential central and peripheral mechanisms.
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Affiliation(s)
- Li-Hong Sun
- Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Wen-Xin Zhang
- Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Qi Xu
- Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Hui Wu
- Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Cui-Cui Jiao
- Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Xin-Zhong Chen
- Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
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Ruiz J, Feigenbaum L, Best TM. The Thoracic Spine in the Overhead Athlete. Curr Sports Med Rep 2020; 19:11-16. [PMID: 31913918 DOI: 10.1249/jsr.0000000000000671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Overhead athletes are susceptible to many injuries, particularly in the shoulder and lumbar spine. Due to the heterogeneity of these two regional injuries, it is difficult to pinpoint the exact origin. A potential contributing factor that should be thoroughly evaluated is the thoracic spine. It can be challenging to quantify exactly how much thoracic spine mobility or lack thereof plays a role toward injury. Despite this, when examining mechanics of an overhead athlete, if neuromuscular control of the thorax is impaired, adjacent motion segments often take the brunt of the required movements. This article addresses the need to incorporate the thoracic spine when analyzing the entire kinetic chain. Clinical pearls regarding thoracic neuromuscular control and rehabilitation were explored, as well as a review of recent literature. Further investigation of thoracic spine therapeutic interventions should be considered when treating overhead athletes.
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Affiliation(s)
- Jeffrey Ruiz
- Department of Physical Therapy and Athletics, Miller School of Medicine, University of Miami, Coral Gables, FL
| | - Luis Feigenbaum
- Department of Physical Therapy and Athletics, Miller School of Medicine, University of Miami, Coral Gables, FL
| | - Thomas M Best
- Division of Sports Medicine, Department of Orthopedics, Miller School of Medicine, University of Miami Sports Medicine Institute, Coral Gables, FL
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Lu Y, Xu HM, Han Y, Zhang YL. Analgesic effect of resveratrol on colitis-induced visceral pain via inhibition of TRAF6/NF-κB signaling pathway in the spinal cord. Brain Res 2019; 1724:146464. [DOI: 10.1016/j.brainres.2019.146464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 08/08/2019] [Accepted: 09/15/2019] [Indexed: 12/15/2022]
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Lan J, Zheng J, Feng J, Peng W. Nrf2 mediates the antinociceptive activity of dexmedetomidine in an acute inflammatory visceral pain rat model by activating the NF-κB sensor. Cell Biochem Funct 2019; 38:97-105. [PMID: 31773760 DOI: 10.1002/cbf.3456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/24/2019] [Accepted: 10/21/2019] [Indexed: 12/13/2022]
Abstract
Dexmedetomidine (DEX) is a highly selective α2 adrenoceptor agonist. In this study, we evaluated the antalgic effect of DEX on acetic acid-induced acute inflammatory visceral pain (AIVP) in rats. Additionally, we evaluated the role of Nrf2 signalling in antinociception. We administered acetic acid to male Sprague Dawley rats that were treated with DEX or saline. Twenty rats were randomly classified into the following groups: normal, model, vehicle, or DEX group. Both q-RT PCR and enzyme-linked immunosorbent assay data suggested that interleukin 1β (IL-1β), tumour necrosis factor α, and IL-6 were upregulated in the spinal cord. Western blotting and q-RT PCR analyses were performed to detect the protein and mRNA expression levels of Nrf2, Keap1, and HO-1 in the spinal cord. The DEX group exhibited a significant downregulation in Nrf2/Keap1/HO-1 signal activation compared with the model group. Furthermore, we used the Nrf2-/- knockout AIVP rat model to determine the role of Nrf2 in the antinociceptive effect of DEX. We observed that the Nrf2 knockout blocked the Keap1/Nrf2/HO-1 signal transduction and partially abated the antinociceptive and the anti-inflammatory effects of DEX. Moreover, our data also indicated that DEX treatment decreased the activation and expression of nuclear factor (NF)-κB. However, Nrf2 silencing restored the expression of NF-κB and its phosphorylated form to physiological levels. In summary, our results suggested that Nrf2 signalling plays an important role in the antinociceptive effect of DEX in the AIVP rat model and that Nrf2 exerts its function by enhancing the activation of the NF-κB sensor. SIGNIFICANCE OF THE STUDY: Currently, using the behavioural parameters is not adequate for the diagnosis of AIVP, and there are no studies that have investigated the role and the mechanism of DEX in ameliorating visceral pain. In this study, we demonstrated that acetic acid stimulation in rats induces AIVP. Additionally, the administration of DEX inhibited the acute inflammation response and decreased the visceromotor reaction (behavioural) to algesia. Further, DEX inhibited the Keap1/Nrf2 pathway, which was activated by acetic acid treatment. We suggest that suppressing the inflammatory response could partially regulate the antinociceptive effect of DEX through Nrf2-mediated NF-κB activation associated with AIVP.
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Affiliation(s)
- Jiangli Lan
- Department of Anesthesiology, Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital, Nanning, China
| | - Jianqiu Zheng
- Department of Anesthesiology, Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital, Nanning, China
| | - Jifeng Feng
- Department of Anesthesiology, Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital, Nanning, China
| | - Wei Peng
- Department of Anesthesiology, Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital, Nanning, China
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Alabi AO, Ajayi AM, Omorogbe O, Umukoro S. Anti-nociceptive and anti-inflammatory effects of an aqueous extract of blended leaves of Ocimum gratissimum and Psidium guajava. CLINICAL PHYTOSCIENCE 2019. [DOI: 10.1186/s40816-019-0130-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To investigate the antinociceptive and anti-inflammatory activities of aqueous extract of a blended mixture of dried leaves of Ocimum gratissimum and Psidium guajava, a traditional analgesic drug polyherbal (TADP) used as a remedy for pain-related conditions.
Methods
Antinociceptive activity of TADP (100, 200 and 400 mg/kg) was evaluated in the hot plate test and acetic acid-induced nociception in mice while the anti-inflammatory was evaluated in carrageenan-induced paw oedema in rats. Levels of nitrite, myeloperoxidase, glutathione and malondialdehyde were assayed in carrageenan-induced paw tissue.
Results
TADP (200 and 400 mg/kg) significantly prolong the latency time in the hot-plate test. TADP (100–400 mg/kg) produced a dose-dependent significant inhibition of the acetic-acid induced abdominal constriction. The antinociceptive activity of TADP in the presence of naloxone and atropine was not reversed whereas yohimbine and glibenclamide significantly reversed it. TADP (100, 200 and 400 mg/kg) significantly reduced the swelling in the carrageenan-induced oedema model and also produced a reduction in the nitrite and myeloperoxidase level. TADP (400 mg/kg) significantly reduced malondialdehyde concentration and increase glutathione level in the carrageenan-induced rat paw. TADP significantly decrease the number of cellular infiltrates in the histopathological assessment.
Conclusion
These results indicate that polyherbal product containing blended leaves of Ocimum gratissimum and Psidium guajava possess antinociceptive and anti-inflammatory properties, hence represents a promising alternative remedy in inflammation-induced pain.
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Feng B, Guo T. Visceral pain from colon and rectum: the mechanotransduction and biomechanics. J Neural Transm (Vienna) 2019; 127:415-429. [PMID: 31598778 DOI: 10.1007/s00702-019-02088-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 09/28/2019] [Indexed: 12/14/2022]
Abstract
Visceral pain is the cardinal symptom of functional gastrointestinal (GI) disorders such as the irritable bowel syndrome (IBS) and the leading cause of patients' visit to gastroenterologists. IBS-related visceral pain usually arises from the distal colon and rectum (colorectum), an intraluminal environment that differs greatly from environment outside the body in chemical, biological, thermal, and mechanical conditions. Accordingly, visceral pain is different from cutaneous pain in several key psychophysical characteristics, which likely underlies the unsatisfactory management of visceral pain by drugs developed for other types of pain. Colorectal visceral pain is usually elicited from mechanical distension/stretch, rather than from heating, cutting, pinching, or piercing that usually evoke pain from the skin. Thus, mechanotransduction, i.e., the encoding of colorectal mechanical stimuli by sensory afferents, is crucial to the underlying mechanisms of GI-related visceral pain. This review will focus on colorectal mechanotransduction, the process of converting colorectal mechanical stimuli into trains of action potentials by the sensory afferents to inform the central nervous system (CNS). We will summarize neurophysiological studies on afferent encoding of colorectal mechanical stimuli, highlight recent advances in our understanding of colorectal biomechanics that plays critical roles in mechanotransduction, and review studies on mechano-sensitive ion channels in colorectal afferents. This review calls for focused attention on targeting colorectal mechanotransduction as a new strategy for managing visceral pain, which can also have an added benefit of limited CNS side effects, because mechanotransduction arises from peripheral organs.
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Affiliation(s)
- Bin Feng
- Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, CT, 06269-3247, USA.
| | - Tiantian Guo
- Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, CT, 06269-3247, USA
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Switters JM, Podar S, Perraton L, Machotka Z. Is visceral manipulation beneficial for patients with low back pain? A systematic review of the literature. INT J OSTEOPATH MED 2019. [DOI: 10.1016/j.ijosm.2019.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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47
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Surgical site infiltration: A neuroanatomical approach. Best Pract Res Clin Anaesthesiol 2019; 33:317-324. [DOI: 10.1016/j.bpa.2019.07.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 07/19/2019] [Indexed: 12/11/2022]
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Siri S, Maier F, Santos S, Pierce DM, Feng B. Load-bearing function of the colorectal submucosa and its relevance to visceral nociception elicited by mechanical stretch. Am J Physiol Gastrointest Liver Physiol 2019; 317:G349-G358. [PMID: 31268771 PMCID: PMC6774086 DOI: 10.1152/ajpgi.00127.2019] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Mechanical distension beyond a particular threshold evokes visceral pain from distal colon and rectum (colorectum), and thus biomechanics plays a central role in visceral nociception. In this study we focused on the layered structure of the colorectum through the wall thickness and determined the biomechanical properties of layer-separated colorectal tissue. We harvested the distal 30 mm of mouse colorectum and dissected this tissue into inner and outer composite layers. The inner composite consists of the mucosa and submucosa, whereas the outer composite includes the muscular layers and serosa. We divided each composite axially into three 10-mm-long segments and conducted biaxial mechanical extension tests and opening-angle measurements for each tissue segment. In addition, we quantified the thickness of the rich collagen network in the submucosa by nonlinear imaging via second-harmonic generation (SHG). Our results reveal that the inner composite is slightly stiffer in the axial direction, whereas the outer composite is stiffer circumferentially. The stiffness of the inner composite in the axial direction is about twice that in the circumferential direction, consistent with the orientations of collagen fibers in the submucosa approximately ±30° to the axial direction. Submucosal thickness measured by SHG showed no difference from proximal to distal colorectum under the load-free condition, which likely contributes to the comparable tension stiffness of the inner composite along the colorectum. This, in turn, strongly indicates the submucosa as the load-bearing structure of the colorectum. This further implies nociceptive roles for the colorectal afferent endings in the submucosa, which likely encode tissue-injurious mechanical distension.NEW & NOTEWORTHY Visceral pain from distal colon and rectum (colorectum) is usually elicited from mechanical distension/stretch, rather than from heating, cutting, or pinching, which usually evoke pain from the skin. We conducted layer-separated biomechanical tests on mouse colorectum and identified an unexpected role of submucosa as the load-bearing structure of the colorectum. Outcomes of this study will focus attention on sensory nerve endings in the submucosa that likely encode tissue-injurious distension/stretch to cause visceral pain.
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Affiliation(s)
- Saeed Siri
- 1Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut
| | - Franz Maier
- 2Department of Mechanical Engineering, University of Connecticut, Storrs, Connecticut
| | - Stephany Santos
- 1Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut
| | - David M. Pierce
- 1Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut,2Department of Mechanical Engineering, University of Connecticut, Storrs, Connecticut
| | - Bin Feng
- 1Department of Biomedical Engineering, University of Connecticut, Storrs, Connecticut
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Liang M, Shao A, Tang X, Feng M, Wang J, Qiu Y. MiR-34a affects dexmedetomidine-inhibited chronic inflammatory visceral pain by targeting to HDAC2. BMC Anesthesiol 2019; 19:131. [PMID: 31324142 PMCID: PMC6642536 DOI: 10.1186/s12871-019-0801-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/10/2019] [Indexed: 12/13/2022] Open
Abstract
Background Dexmedetomidine (DEX) has been used as an anesthetic for decades. The present investigation aimed to elucidate the analgesic impact of DEX on 2,4,6-Trinitrobenzenesulfonic acid (TNBS)-induced chronic inflammatory visceral pain (CIVP) in rats. Methods TNBS with or without DEX to Male Sprague-Dawley SD rats were randomly divided into four groups: normal, CIVP, DEX, and vehicle. Pain behaviors were assessed and the abdominal withdrawal reflex, mechanical withdrawal threshold, and thermal withdrawal latency were recorded. Quantitative polymerase chain reaction data showed increased expressions of pro-inflammatory cytokines (IL-6, IL-1β and TNF-α) in the spinal cord tissues of rats. Results RNA microarray and quantitative polymerase chain reaction results indicated that miR-34a was downregulated by TNBS induction, but it was upregulated by DEX administration. Further studies showed that transfection of adenovirus-miR-34a inhibitor reversed the effect of DEX on the pain behaviors and spinal-cord pro-inflammatory-cytokine generation in CIVP rats. Additionally, we found that miR-34a targeted the 3′-UTR of the HDAC2 gene, as evinced by the increased HDAC2 expression in the CIVP and DEX + miR-34a inhibitor groups, and decreased HDAC2 signaling in the DEX group. Moreover, knock-down of HDAC2 restored DEX-attenuated pain behaviors and reduced pro-inflammatory cytokine production. Conclusions DEX thus exhibited an analgesic effect on CIVP rats through the miR-34a-mediated HDAC2 pathway and suppressed visceral hypersensitivity.
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Affiliation(s)
- Meng Liang
- Department of Anesthesiology, Weihai Central Hospital, No.3, West Mt. East Road, Wendeng District, Weihai City, 264400, Shandong, China
| | - Aijie Shao
- Department of Anesthesiology, Weihai Central Hospital, No.3, West Mt. East Road, Wendeng District, Weihai City, 264400, Shandong, China
| | - Xinsheng Tang
- Department of Anesthesiology, Weihai Central Hospital, No.3, West Mt. East Road, Wendeng District, Weihai City, 264400, Shandong, China
| | - Meiling Feng
- Department of Anesthesiology, Weihai Central Hospital, No.3, West Mt. East Road, Wendeng District, Weihai City, 264400, Shandong, China
| | - Jing Wang
- Department of Anesthesiology, Weihai Central Hospital, No.3, West Mt. East Road, Wendeng District, Weihai City, 264400, Shandong, China
| | - Yingna Qiu
- Department of Anesthesiology, Weihai Central Hospital, No.3, West Mt. East Road, Wendeng District, Weihai City, 264400, Shandong, China.
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Pereira FEXG, Medeiros FDC, Rocha HAL, Silva KSD. Effects of omega-6/3 and omega-9/6 nutraceuticals on pain and fertility in peritoneal endometriosis in rats. Acta Cir Bras 2019; 34:e201900405. [PMID: 31066787 PMCID: PMC6583929 DOI: 10.1590/s0102-865020190040000005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/17/2019] [Indexed: 01/06/2023] Open
Abstract
Purpose: To evaluate the effects of the nutraceuticals omega-6/3 and omega-9/6 on endometriosis-associated infertility and pain. Methods: Controlled experimental study, with each group composed of eight female rats. Fertility groups: sham-operated control (0.9% saline solution); control with endometriosis (0.9% saline); omega-6/3 (1.2 g/kg/day); omega-9/6 (1.2 g/kg/day); and meloxicam (0.8 mg/kg/day). Pain groups: sham-operated control (0.9% saline); control with endometriosis (0.9% saline); omega-6/3 (1.2 g/kg/day); omega-9/6 (1.2 g/kg/day); medroxyprogesterone acetate (5 mg/kg/every 3 days); and meloxicam (0.8 mg/kg/day). Peritoneal endometriosis was surgically induced. Pain was evaluated with the writhing test. Fertility was evaluated by counting the number of embryos in the left hemi-uterus. Results: The mean number of writhings was as follows: sham-operated, 11.1 ± 2.9; control with endometriosis, 49.3 ± 4.4; omega-6/3, 31.5 ± 2.7; omega-9/6, 34.1 ± 4.5; medroxyprogesterone acetate, 2.1 ± 0.8; meloxicam, 1 ± 0.3. There was a significant difference between both controls and all drugs used for treatment. Regarding fertility, the mean values were as follows: sham-operated, 6.8 ± 0.6; control with endometriosis, 4.2 ± 0.7; omega-6/3, 4.7 ± 1; omega-9/6, 3.8 ± 0.9; and meloxicam, 1.8 ± 0.9. Conclusions: The omega-6/3 and omega-9/6 nutraceuticals decreased pain compared to the controls. There was no improvement in fertility in any of the tested groups.
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Affiliation(s)
- Francisco Edson Ximenes Gomes Pereira
- Fellow PhD degree, Postgraduate Program in Medical and Surgical Sciences, Department of Surgery, Universidade Federal do Ceará (UFC), Fortaleza-Ce, Brazil. Conception of the study, technical procedures, acquisition of the data, manuscript writing
| | - Francisco das Chagas Medeiros
- PhD, Associate Professor, Department of Maternal and Child Health, UFC, Fortaleza-Ce, Brazil. Conception, design, intellectual and scientific content of the study; critical revision; final approval
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