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Mathew SE, Madhusudanan P, Shankarappa SA. Effect of Peritumoral Bupivacaine on Primary and Distal Hyperalgesia in Cancer-Induced Bone Pain. J Pain Res 2020; 13:1305-1313. [PMID: 32581572 PMCID: PMC7276331 DOI: 10.2147/jpr.s250198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/26/2020] [Indexed: 11/23/2022] Open
Abstract
Background Cancer-induced bone pain (CIBP) is a debilitating chronic pain condition caused by injury to bone nerve terminals due to primary or metastasized bone tumors. Pain manifests as enhanced sensitivity, not only over the affected bone site but also at distal areas that share common nerve innervation with the tumor. In this study, we aim to understand how tumor-induced primary and distal pain sensitivities are affected by bupivacaine-induced block of bone nerve endings in a rat model of CIBP. Methods MRMT-1 breast cancer cells were injected into the proximal segment of tibia in female Sprague–Dawley rats. Radiograms and micro-CT images were obtained to confirm tumor growth. Bupivacaine was injected peritumorally at day 7 or day 14 post-tumor induction, and withdrawal thresholds in response to pressure and punctate mechanical stimulus were recorded from the knee and hind-paw, respectively. Immunohistochemical studies for the determination of ATF3 and GFAP expression in DRG and spinal cord sections were performed. Results Rats developed primary and distal hyperalgesia after MRMT-1 administration that was sustained for 2 weeks. Peritumoral administration of bupivacaine in 7-day post-tumor-induced (PTI) rats resulted in a reversal of both primary and distal hyperalgesia for 20–30 mins. However, bupivacaine failed to reverse distal hyperalgesia in 14 day-PTI rats. ATF3 and GFAP expression were much enhanced in 14 day-PTI animals, compared to 7 day-PTI group. Conclusion Results from this study strongly suggest that distal hyperalgesia of late-stage CIBP demonstrates differential characteristics consistent with neuropathic pain as compared to early stage, which appears more inflammatory in nature.
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Affiliation(s)
- Sumi Elizabeth Mathew
- Center for Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham University, Kochi, Kerala 682041, India
| | - Pallavi Madhusudanan
- Center for Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham University, Kochi, Kerala 682041, India
| | - Sahadev A Shankarappa
- Center for Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham University, Kochi, Kerala 682041, India
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Grayson M, Furr A, Ruparel S. Depiction of Oral Tumor-Induced Trigeminal Afferent Responses Using Single-Fiber Electrophysiology. Sci Rep 2019; 9:4574. [PMID: 30872649 PMCID: PMC6418205 DOI: 10.1038/s41598-019-39824-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/22/2019] [Indexed: 02/02/2023] Open
Abstract
Considerable gap in knowledge exists about the mechanisms by which oral tumors regulate peripheral sensory fibers to produce pain and altered sensations. To address this gap, we used a murine model of oral squamous cell carcinoma (OSCC) of the tongue to investigate changes in response properties of trigeminal afferent neurons. Using this model, we developed an ex vivo method for single neuron recordings of the lingual nerve from isolated tongue tissue. Our data demonstrated that the tongue tumor produced increased spontaneous firing of lingual fibers compared to control as well as produced mechanical hypersensitivity and reduced von Frey thresholds of C- and A-slow-high-threshold mechanoreceptors (HTMR) fibers but had no effect on C-LTMR, A-slow-LTMR and A-fast lingual fibers. Mechanically-insensitive fibers were also detected in lingual afferents of the control group, that were significantly decreased in tumor-bearing preparations. Collectively, using single fiber electrophysiology of lingual sensory fibers, we show that human OSCC tumors sensitize peripheral trigeminal nerve terminals, providing a unique opportunity to study mechanisms of oral cancer pain.
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Affiliation(s)
- Max Grayson
- Department of Endodontics, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Ashley Furr
- Department of Endodontics, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Shivani Ruparel
- Department of Endodontics, University of Texas Health at San Antonio, San Antonio, TX, USA.
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Abstract
Resiniferatoxin (RTX) is the most potent among all known endogenous and synthetic agonists for the transient receptor potential vanilloid 1 (TRPV1) receptor, which is a calcium-permeable nonselective cation channel, expressed on the peripheral and central terminals of small-diameter sensory neurons. Prolonged calcium influx induced by RTX causes cytotoxicity and death of only those sensory neurons that express the TRPV1 ion channel leading to selective targeting and permanent deletion of the TRPV1-expressing C-fiber neuronal cell bodies in the dorsal root ganglia. The goal of this project was to provide preclinical efficacy data, that intrathecal RTX could provide effective pain relief and improve function in dogs with bone cancer without significant long-term side effects. In a single-blind, controlled study, 72 companion dogs with bone cancer pain were randomized to standard of care analgesic therapy alone (control, n = 36) or 1.2 μg/kg intrathecal RTX in addition to standard of care analgesic therapy (treated, n = 36). Significantly more dogs in the control group (78%) required unblinding and adjustment in analgesic protocol or euthanasia within 6 weeks of randomization, than dogs that were treated with RTX (50%; P < 0.03); and overall, dogs in the control group required unblinding significantly sooner than dogs that had been treated with RTX (P < 0.02). The analgesic effect was documented in these dogs without any evidence of development of deafferentation pain syndrome that can be seen with neurolytic therapies.
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Chen L, Wang K, Yang T, Wang W, Mei XP, Zhu C, Wang W, Zhang FX, Li YQ. Downregulation of spinal endomorphin-2 correlates with mechanical allodynia in a rat model of tibia cancer. Neuroscience 2014; 286:151-61. [PMID: 25457129 DOI: 10.1016/j.neuroscience.2014.11.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/18/2014] [Accepted: 11/20/2014] [Indexed: 01/13/2023]
Abstract
The endogenous tetrapeptide endomorphin-2 (EM2) participates in pain modulation by binding to pre- and/or post-synaptic μ opioid receptor (MOR). In the present study, pathological expression and antinociceptive effects of EM2 at the spinal level were investigated in a rat model of bone cancer pain. The model was established by introducing Walker 256 mammary gland carcinoma cells into the tibia medullary cavity. Immunohistochemical staining for EM2 showed a markedly reduced EM2-immunoreactivity in the ipsilateral spinal dorsal horn on days 6, 12 and 18 post Walker 256 inoculation (p < 0.05). Intrathecal injection (i.t.) of EM2 significantly attenuated cancer-induced mechanical allodynia (p < 0.05) which could be blocked by β-funaltrexamine (β-FNA), the μ receptor antagonist (p < 0.05). Furthermore, topical application of EM2 dose-dependently inhibited the electrically evoked C-fiber responses and postdischarge of wide dynamic range (WDR) neurons within the spinal cord (p < 0.05), and pretreatment with β-FNA abolished the hyperactivity of these neurons. Compared with the antinociception of morphine which took effect from 40 min to 100 min post application, the analgesic action of EM2 was characterized by quick onset and short-lived efficacy (p < 0.05), being most potent at 10 min and lasting about 20 min. These findings indicate that the down-regulated spinal EM2 is an important contributor to the neuropathological process of bone cancer pain and enhancing activation of EM2/μ receptor signaling might provide a therapeutic alternative to optimizing the treatment of cancer-induced bone pain.
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Affiliation(s)
- L Chen
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an 710032, China; Department of Ultrasound, Armed Police Tianjin Corps Hospital, Tianjin 300252,China
| | - K Wang
- Department of Pain Relief, Tianjin Key Laboratory of Cancer Prevention and Treatment, National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - T Yang
- Department of Ultrasound, Armed Police Tianjin Corps Hospital, Tianjin 300252,China
| | - W Wang
- Department of Anesthesiology, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - X-P Mei
- Department of Anesthesiology, School of Stomatology, Fourth Military Medical University, Xi'an 710032, China
| | - C Zhu
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an 710032, China
| | - W Wang
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an 710032, China
| | - F-X Zhang
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an 710032, China.
| | - Y-Q Li
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an 710032, China.
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Brown DC, Boston R, Coyne JC, Farrar JT. A novel approach to the use of animals in studies of pain: validation of the canine brief pain inventory in canine bone cancer. PAIN MEDICINE 2008; 10:133-42. [PMID: 18823385 DOI: 10.1111/j.1526-4637.2008.00513.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To validate the Canine Brief Pain Inventory (CBPI), which is based on the human Brief Pain Inventory (BPI), in a canine model of spontaneous bone cancer. DESIGN AND PARTICIPANTS One hundred owners of dogs with bone cancer self-administered the CBPI on three occasions to test the reliability, validity, and responsiveness of the measure. OUTCOME MEASURES Factor analysis, internal consistency, convergent validity, and an extreme group validation assessment were completed using the responses from the first administration of the CBPI. Test-retest reliability was evaluated using two administrations of the instrument, 1 week apart. Responsiveness was tested by comparing responses 3 weeks apart. RESULTS The "severity" and "interference" factors hypothesized based on the BPI were demonstrated in the CBPI in dogs with bone cancer. Internal consistency was high (Cronbach's alpha, 0.95 and 0.93), as was test-retest reliability (kappa, 0.73 and 0.65). Convergent validity was demonstrated with respect to quality of life (r = 0.49 and 0.63). Extreme group validation against normal dogs showed significantly higher factor scores (P < 0.001 for both). CONCLUSIONS The CBPI reliably measures the same pain constructs in the companion canine model of spontaneous bone cancer as the BPI does in people with bone cancer. This innovative approach to preclinical outcomes development, validating a preclinical outcome measure that directly corresponds to an outcome measure routinely used in clinical research, applied to a readily available animal model of spontaneous disease could transform the predictive ability of preclinical pain studies.
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Affiliation(s)
- Dorothy Cimino Brown
- Department of Clinical Studies, and Mari Lowe Center for Comparative Oncology Research, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6010, USA
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Yu S, Xu L, Wei PK, Qin ZF, Li J, Peng HD. Study on analgesic effect of traditional Chinese medicine. Chin J Integr Med 2008; 14:151-6. [DOI: 10.1007/s11655-008-0151-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Indexed: 10/21/2022]
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Endogenous tumor necrosis factor alpha (TNFalpha) requires TNF receptor type 2 to generate heat hyperalgesia in a mouse cancer model. J Neurosci 2008; 28:5072-81. [PMID: 18463260 DOI: 10.1523/jneurosci.4476-07.2008] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
To provide a tool to investigate the mechanisms inducing and maintaining cancer-related pain and hyperalgesia, a soft tissue tumor/metastasis model was developed that is applicable in C57BL/6J wild-type and transgenic mice. We show that the experimental tumor-induced heat hyperalgesia and nociceptor sensitization were prevented by systemic treatment with the tumor necrosis factor alpha (TNFalpha) antagonist etanercept. In naive mice, exogenous TNFalpha evoked heat hyperalgesia in vivo and sensitized nociceptive nerve fibers to heat in vitro. TNFalpha enhanced the expression of the nociceptor-specific heat transducer ion channel transient receptor potential vanilloid 1 (TRPV1) and increased the amplitudes of capsaicin and heat-activated ionic currents via p38/MAP (mitogen-activated protein) kinase and PKC (protein kinase C). Deletion of the tumor necrosis factor receptor type 2 (TNFR2) gene attenuated heat hyperalgesia and prevented TRPV1 upregulation in tumor-bearing mice, whereas TNFR1 gene deletion played a minor role. We propose endogenous TNFalpha as a key player in cancer-related heat hyperalgesia and nociceptor sensitization that generates TRPV1 upregulation and sensitization via TNFR2.
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Affiliation(s)
- Chao Ma
- Yale University School of Medicine, New Haven, Connecticut, 06510, USA.
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Abstract
Systemic administration of analgesics can lead to serious adverse side effects compromising therapeutic benefit in some patients. Information coding pain transmits along an afferent neuronal network, the first synapses of which reside principally in the spinal cord. Delivery of compounds to spinal cord, the intended site of action for some analgesics, is potentially a more efficient and precise method for inhibiting the pain signal. Activation of specific proteins that reside in spinal neuronal membranes can result in hyperpolarization of secondary neurons, which can prevent transmission of the pain signal. This is one of the mechanisms by which opioids induce analgesia. The spinal cord is enriched in such molecular targets, the activation of which inhibit the transmission of the pain signal early in the afferent neuronal network. This review describes the pre-clinical models that enable new target discovery and development of novel analgesics for site-directed pain management.
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Menéndez L, Lastra A, Fresno MF, Llames S, Meana A, Hidalgo A, Baamonde A. Initial thermal heat hypoalgesia and delayed hyperalgesia in a murine model of bone cancer pain. Brain Res 2003; 969:102-9. [PMID: 12676370 DOI: 10.1016/s0006-8993(03)02284-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The recent development of rodent models of bone cancer pain has started to provide the basis for demonstrating the particular neurochemical and behavioral entity of cancer pain. Behaviourally, both spontaneous pain and hyperalgesia related to mechanical, but not thermal, noxious stimuli have been described in cancer-bearing animals. We have carried out a histological and behavioural study focused on the reactivity to noxious heat in C3H/HeJ mice receiving an intratibial injection of 10(5) NCTC 2472 cells. These cells, able to induce an osteosarcoma, break through bone into soft tissues 2 weeks after cell inoculation, producing a macroscopical increase of the limb size from the fourth week. Thermal reactivity is diminished during the first 2 weeks after cell implantation, this hypoalgesia being reversed by the administration of naloxone (10 mg/kg). In contrast, during the fourth and fifth weeks after NCTC 2472 cell implantation, an increased nociceptive heat reactivity, instead of hypoalgesia, was obtained. This thermal hyperalgesia was prevented by the systemic administration of morphine (15 mg/kg). Throughout the whole period studied, mice showed signs of spontaneous pain behaviour that reached its maximum 3 weeks after inoculation. In conclusion, we show that the presence of thermal heat hyperalgesia is preceded by an initial opioid-mediated hypoalgesic state, in this murine model of bone cancer pain.
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Affiliation(s)
- Luis Menéndez
- Laboratorio de Farmacología, Facultad de Medicina, Universidad de Oviedo, C/ Julián Clavería 6, 33006, Asturias, Oviedo, Spain.
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Affiliation(s)
- Linda M Sutton
- Division of Medical Oncology and Transplantation, Duke Oncology Network, Duke University Medical Center, DUMC 2989, Durham, NC 27710, USA
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