1
|
Tao X, Luo G, Xiao J, Yao Y, Gao Q, Zou J, Wang T, Cheng Z, Sun D, Yan M. Chronic Postsurgical Pain Following Lung Transplantation: Characteristics, Risk Factors, Treatment, and Prevention: A Narrative Review. Pain Ther 2024; 13:719-731. [PMID: 38809395 PMCID: PMC11254876 DOI: 10.1007/s40122-024-00615-4] [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: 04/23/2024] [Accepted: 05/15/2024] [Indexed: 05/30/2024] Open
Abstract
Chronic pain after lung transplantation (LTx) can substantially reduce quality of life (QoL), yet current consensus guidelines say little about how to prevent or manage it. Research on pain after LTx has tended to focus on acute rather than chronic pain, and it has not extensively examined the factors associated with onset or resolution of chronic pain, which differ from factors influencing chronic pain after general thoracic surgery. This narrative review explores what is known about the epidemiology and risk factors of chronic pain after LTx, as well as effective ways to treat or prevent it. The review identifies key questions and issues that should be the focus of future research.
Collapse
Affiliation(s)
- Xinchen Tao
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Ge Luo
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Jie Xiao
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Yuanyuan Yao
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Qi Gao
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Jingcheng Zou
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Tingting Wang
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Zhenzhen Cheng
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Dawei Sun
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China
| | - Min Yan
- Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009, China.
| |
Collapse
|
2
|
Šanjug J, Kuna K, Goldštajn MŠ, Dunkić LF, Carek A, Negovetić Vranić D. Relationship between COMT Gene Polymorphism, Anxiety, and Pain Perception during Labour. J Clin Med 2023; 12:6298. [PMID: 37834942 PMCID: PMC10573766 DOI: 10.3390/jcm12196298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The COMT gene polymorphism is associated with neurological and psychiatric disorders and pain perception. The present study investigates the existence of anxiety and pain perception in relation to the COMT (catechol-O-methyltransferase) gene polymorphism in labouring women (during "natural" childbirth) with or without inhaled analgesia. METHODS A total of 181 women who chose vaginal birth were enrolled in this study. To present the difference in pain perception, the parturients were divided into one group (n = 90) that chose labour analgesia with inhaled nitrous oxide (50% nitrous oxide and 50% oxygen) and one group (n = 91) without analgesia. The blood samples were taken during the pregnancy as a part of routine pregnancy controls in the hospital. The COMT gene polymorphism was detected with the PCR technique. The pain perception of parturients was self-evaluated two times according to the VAS (Visual Analogue Scale), and anxiety as a personality trait was determined with the STAI-T (State Trait Anxiety Inventory). Pain perception as well as anxiety were compared according to COMT genotypes. RESULTS In the 181 pregnant women, there were 40 women (22%) of wild homozygotes (GG) of COMT, 95 women (53%) of mutant heterozygotes (GA), and 46 women (25%) of mutant homozygotes (AA). A negative association of pain perception with the GA (mutant heterozygote) polymorphism of the COMT gene versus the wild-type (GG polymorphism) was observed. The GA polymorphism of the COMT gene was associated with 0.46 units lower pain perception compared to the wild type (GG). The anxiety trait score in group AA was lower than in groups GA and GG. The difference reached statistical significance only when comparing AA versus GA (p > 0.042). Analgesic efficacy of nitrous oxide was noticed in 22% of labouring women who reported moderate pain (VAS score 4-7). CONCLUSIONS The COMT gene polymorphism was associated with pain perception and anxiety among parturients. The COMT gene polymorphism GA was associated with negative pain perception among labouring women. Nitrous oxide showed statistical significance in anxiolytic efficacy during labour in women with mild anxiety as a personality trait. Anxiolytic efficacy of nitrous oxide has shown better efficacy in parturients with the COMT gene polymorphism AA.
Collapse
Affiliation(s)
- Jadranka Šanjug
- Department of Gynaecology and Obstetrics, General Hospital Zabok and War Veterans’ Hospital, Bračak 8, 49210 Zabok, Croatia
| | - Krunoslav Kuna
- Department of Gynaecology and Obstetrics, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia;
| | - Marina Šprem Goldštajn
- Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
| | - Lidija Fumić Dunkić
- Division of Anesthesiology, Intensive Care and Pain Medicine, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia;
| | - Andreja Carek
- Department of Fixed Prosthodontics, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
| | - Dubravka Negovetić Vranić
- Department of Pediatric Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
| |
Collapse
|
3
|
Kafshdooz L, Kahroba H, Kafshdooz T, Roghayeh Sheervalilou, Pourfathi H. Labour analgesia; Molecular pathway and the role of nanocarriers: a systematic review. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:927-932. [PMID: 30873885 DOI: 10.1080/21691401.2019.1573736] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Labour is considered to be one of the most painful procedures in human experience. The most effective technique for pain relief during labour is neuraxial labour analgesia which provides analgesia without maternal or fetal sedation. Genetic predisposition may be of importance for pain perception and women experience varying degrees of pain in labour. Genetic variations in opioid receptor (OPR) genes may influence the response to epidural opioid analgesia during labour. The single-nucleotide polymorphism, A118G of the mu opioid receptor gene (oprm1), has been associated with altered pain perception. Targeted drug delivery reduces toxic side effects. Liposomes, nano-particles, nanofibres hydrogel, have been suggested to deliver anaesthetic drugs.
Collapse
Affiliation(s)
- Leila Kafshdooz
- a Womens Reproductive Health Research Center , Tabriz University of Medical Sciences , Tabriz , Iran.,b Molecular Medicine Research Center, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Houman Kahroba
- b Molecular Medicine Research Center, Tabriz University of Medical Sciences , Tabriz , Iran.,c Department of Molecular Medicine, Faculty of Advanced Medical Sciences , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Tayebeh Kafshdooz
- c Department of Molecular Medicine, Faculty of Advanced Medical Sciences , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Roghayeh Sheervalilou
- c Department of Molecular Medicine, Faculty of Advanced Medical Sciences , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hojjat Pourfathi
- d Department of Anesthesiology, Faculty of Medicine , Tabriz University of Medical Sciences , Tabriz , Iran
| |
Collapse
|
4
|
Effect of Deep Slow Breathing on Pain-Related Variables in Osteoarthritis. Pain Res Manag 2019; 2019:5487050. [PMID: 31281558 PMCID: PMC6589254 DOI: 10.1155/2019/5487050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/06/2019] [Indexed: 12/21/2022]
Abstract
This study evaluated the effect of a six-week deep slow breathing (DSB) program on pain, physical function, and heart rate variability (HRV) in subjects with lower extremity joint pain. Twenty subjects were assigned into training (n = 10) and control (n = 10) groups. The training group participated in a six-week DSB program consisting of weekly training sessions and at-home breathing exercises. DSB exercises focused on prolonging the exhalation and the pause following exhalation. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess pain and physical function, and HRV data were obtained before and after intervention. Results revealed no significant interactions between group and time for any of the variables. There was no significant main effect for group, but there was a significant main effect (p < 0.025) and a large effect size for time on both pain (η p 2 = 0.454) and physical function (η p 2 = 0.506). There were no significant main effects (p > 0.017) for group and time on LF power (group η p 2 = 0.039, time η p 2 = 0.061), HF power (group η p 2 = 0.039, time η p 2 = 0.039), and LF/HF ratio (group η p 2 = 0.036, time η p 2 = 0.169). Results indicated that the six-week DSB program was not sufficient to alleviate pain or improve physical function in subjects with lower extremity joint pain. Although the pain was not alleviated, other beneficial effects such as better coping with the pain were reported in the majority of training subjects. As this is the first study to examine the use of DSB for lower extremity joint pain and dysfunction, further research is needed to investigate the efficacy and applicability of DSB.
Collapse
|
5
|
Abstract
The Human Pain Genetics Database (HPGDB) is a comprehensive variant-focused inventory of genetic contributors to human pain. After curation, the HPGDB currently includes 294 studies reporting associations between 434 distinct genetic variants and various pain phenotypes. Variants were then submitted to a comprehensive analysis. First, they were validated in an independent high-powered replication cohort by testing the association of each variant with 10 different pain phenotypes (n = 1320-26,973). One hundred fifty-five variants replicated successfully (false discovery rate 20%) in at least one pain phenotype, and the association P values of the HPGDB variants were significantly lower compared with those of random controls. Among the 155 replicated variants, 21 had been included in the HPGDB because of their association with analgesia-related and 13 with nociception-related phenotypes, confirming analgesia and nociception as pathways of vulnerability for pain phenotypes. Furthermore, many genetic variants were associated with multiple pain phenotypes, and the strength of their association correlated between many pairs of phenotypes. These genetic variants explained a considerable amount of the variance between different pairs of pain phenotypes, indicating a shared genetic basis among pain phenotypes. In addition, we found that HPGDB variants show many pleiotropic associations, indicating that genetic pathophysiological mechanisms are also shared among painful and nonpainful conditions. Finally, we demonstrated that the HPGDB data set is significantly enriched for functional variants that modify gene expression, are deleterious, and colocalize with open chromatin regions. As such, the HPGDB provides a validated data set that represents a valuable resource for researchers in the human pain field.
Collapse
|
6
|
Clarke H, Rai A, Bao J, Poon M, Rao V, Djaiani G, Beattie S, Page G, Choiniere M, McGillion M, Parry M, Hunter J, Watt-Watson J, Martin L, Grosman-Rimon L, Kumbhare D, Hanlon J, Seltzer Z, Katz J. Toward a phenomic analysis of chronic postsurgical pain following cardiac surgery. Can J Pain 2019; 3:58-69. [PMID: 35005394 PMCID: PMC8730663 DOI: 10.1080/24740527.2019.1580142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background: Despite the same surgical approach, up to 40% of patients develop chronic postsurgical pain (CPSP) following cardiac surgery, whereas the rest are chronic pain free. This variability suggests that CPSP is controlled partially through genetics, but the genes for CPSP are largely unknown. Aims: The aim of this study was to identify potential CPSP phenotypes by comparing patients who developed CPSP following cardiac surgery vs. those who did not. Methods: A research ethics board–approved, cross-sectional study of post–cardiac surgery pain was conducted at Toronto General Hospital from 2011 to 2015. Patients were recruited to complete a short survey of chronic pain scores and the Short-Form McGill Pain Questionnaire–2. A subset of patients completed a longer survey of eight validated pain phenotyping questionnaires and/or four psychophysical assessments. All surveys and psychophysical testing were conducted after surgery. Patients were stratified by presence of chronic pain and groups were compared using descriptive statistics. Results: Six hundred forty-three patients completed the short form survey. The mean postsurgery assessment time was 41.5 (SD = ±25.1) months. Over a quarter (27.8%) reported CPSP at the chest as a consequence of their surgery. Of patients reporting CPSP, 46.6% reported mild pain (0–3), 35.8% reported moderate pain (4–7), and 17.6% reported severe pain (7–10) in accordance with the numerical rating scale. Patients with moderate and/or severe CPSP were younger, had a greater body mass index, and had higher anxiety sensitivity, pain catastrophizing, and somatization scores. Conclusions: Chronic pain levels after cardiac surgery are associated with anxiety, catastrophizing, and sensory abnormalities in body parts outside the field innervated by injured nerves, indicating the presence of widespread central sensitization to incoming sensory inputs from intact nerves.
Collapse
Affiliation(s)
- Hance Clarke
- Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.,Transitional Pain Service, Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.,Department of Anaesthesia, University of Toronto, Toronto, Ontario, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, Ontario, Canada
| | - Ajit Rai
- Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada
| | - James Bao
- Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada
| | - Michael Poon
- Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada
| | - Vivek Rao
- Department of Cardiovascular Surgery, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada
| | - George Djaiani
- Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.,Department of Anaesthesia, University of Toronto, Toronto, Ontario, Canada
| | - Scott Beattie
- Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.,Department of Anaesthesia, University of Toronto, Toronto, Ontario, Canada
| | - Gabrielle Page
- Département d'anesthésiologie et médecine de la douleur, Université de Montréal, Montreal, Quebec, Canada
| | - Manon Choiniere
- Département d'anesthésiologie et médecine de la douleur, Université de Montréal, Montreal, Quebec, Canada
| | | | - Monica Parry
- Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Judith Hunter
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Judy Watt-Watson
- Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Loren Martin
- Department of Psychology, University of Toronto Mississauga, Toronto, Ontario, Canada
| | - Liza Grosman-Rimon
- Department of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Dinesh Kumbhare
- Department of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - John Hanlon
- Department of Anaesthesia, University of Toronto, Toronto, Ontario, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, Ontario, Canada.,Department of Anaesthesia, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Ze'ev Seltzer
- Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.,Department of Anaesthesia, University of Toronto, Toronto, Ontario, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, Ontario, Canada.,University of Toronto Faculties of Dentistry and Medicine, University of Toronto, Toronto, Ontario, Canada.,Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Joel Katz
- Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.,Transitional Pain Service, Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada.,Department of Anaesthesia, University of Toronto, Toronto, Ontario, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, York University, Toronto, Ontario, Canada
| |
Collapse
|
7
|
Pan F, Jones G. Clinical Perspective on Pain and Pain Phenotypes in Osteoarthritis. Curr Rheumatol Rep 2018; 20:79. [DOI: 10.1007/s11926-018-0796-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
8
|
Abstract
PURPOSE OF REVIEW The development of acute to chronic pain involves distinct pathophysiological changes in the peripheral and central nervous systems. This article reviews the mechanisms, etiologies, and management of chronic pain syndromes with updates from recent findings in the literature. RECENT FINDINGS Chronic post-surgical pain (CPSP) is not limited to major surgeries and can develop after smaller procedures such as hernia repairs. While nerve injury has traditionally been thought to be the culprit for CPSP, it is evident that nerve-sparing surgical techniques are not completely preventative. Regional analgesia and agents such as ketamine, gabapentinoids, and COX-2 inhibitors have also been found to decrease the risks of developing chronic pain to varying degrees. Yet, given the correlation of central sensitization with the development of chronic pain, it is reasonable to utilize aggressive multimodal analgesia whenever possible. Development of chronic pain is typically a result of peripheral and central sensitization, with CPSP being one of the most common presentations. Using minimally invasive surgical techniques may reduce the risk of CPSP. Regional anesthetic techniques and preemptive analgesia should also be utilized when appropriate to reduce the intensity and duration of acute post-operative pain, which has been correlated with higher incidences of chronic pain.
Collapse
|
9
|
Hall BE, Prochazkova M, Sapio MR, Minetos P, Kurochkina N, Binukumar BK, Amin ND, Terse A, Joseph J, Raithel SJ, Mannes AJ, Pant HC, Chung MK, Iadarola MJ, Kulkarni AB. Phosphorylation of the Transient Receptor Potential Ankyrin 1 by Cyclin-dependent Kinase 5 affects Chemo-nociception. Sci Rep 2018; 8:1177. [PMID: 29352128 PMCID: PMC5775258 DOI: 10.1038/s41598-018-19532-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 01/04/2018] [Indexed: 12/25/2022] Open
Abstract
Cyclin-dependent kinase 5 (Cdk5) is a key neuronal kinase that is upregulated during inflammation, and can subsequently modulate sensitivity to nociceptive stimuli. We conducted an in silico screen for Cdk5 phosphorylation sites within proteins whose expression was enriched in nociceptors and identified the chemo-responsive ion channel Transient Receptor Potential Ankyrin 1 (TRPA1) as a possible Cdk5 substrate. Immunoprecipitated full length TRPA1 was shown to be phosphorylated by Cdk5 and this interaction was blocked by TFP5, an inhibitor that prevents activation of Cdk5. In vitro peptide-based kinase assay revealed that four of six TRPA1 Cdk5 consensus sites acted as substrates for Cdk5, and modeling of the ankyrin repeats disclosed that phosphorylation would occur at characteristic pockets within the (T/S)PLH motifs. Calcium imaging of trigeminal ganglion neurons from genetically engineered mice overexpressing or lacking the Cdk5 activator p35 displayed increased or decreased responsiveness, respectively, to stimulation with the TRPA1 agonist allylisothiocyanate (AITC). AITC-induced chemo-nociceptive behavior was also heightened in vivo in mice overexpressing p35 while being reduced in p35 knockout mice. Our findings demonstrate that TRPA1 is a substrate of Cdk5 and that Cdk5 activity is also able to modulate TRPA1 agonist-induced calcium influx and chemo-nociceptive behavioral responses.
Collapse
Affiliation(s)
- Bradford E Hall
- Functional Genomics Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - Michaela Prochazkova
- Functional Genomics Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - Matthew R Sapio
- Department of Perioperative Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Paul Minetos
- Functional Genomics Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.,Tulane University School of Medicine, New Orleans, LA, USA
| | | | - B K Binukumar
- Institute of Genomics and Integrative Biology, New Delhi, India
| | - Niranjana D Amin
- Neuronal Cytoskeletal Protein Regulation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Anita Terse
- Functional Genomics Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - John Joseph
- University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Stephen J Raithel
- Department of Perioperative Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Andrew J Mannes
- Department of Perioperative Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Harish C Pant
- Neuronal Cytoskeletal Protein Regulation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Man-Kyo Chung
- University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Michael J Iadarola
- Department of Perioperative Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Ashok B Kulkarni
- Functional Genomics Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.
| |
Collapse
|
10
|
Kennedy AE, Vohra R, Scott JA, Ross GM. Effects of serum albumin on SPR-measured affinity of small molecule inhibitors binding to nerve growth factor. SENSING AND BIO-SENSING RESEARCH 2017. [DOI: 10.1016/j.sbsr.2017.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
|
11
|
The Transition of Acute Postoperative Pain to Chronic Pain: An Integrative Overview of Research on Mechanisms. THE JOURNAL OF PAIN 2017; 18:359.e1-359.e38. [DOI: 10.1016/j.jpain.2016.11.004] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 10/15/2016] [Accepted: 11/16/2016] [Indexed: 01/01/2023]
|
12
|
|
13
|
Kim JS. What's in a Name? Roles of RFamide-Related Peptides Beyond Gonadotrophin Inhibition. J Neuroendocrinol 2016; 28. [PMID: 27369805 DOI: 10.1111/jne.12407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 12/29/2022]
Abstract
RFamide-related peptides (RFRPs) have been heavily implicated in the control of reproductive function subsequent to their discovery more than 16 years ago. However, recent studies using genetic and pharmacological tools have challenged their importance in regulating the hypothalamic-pituitary-gonadal axis. It is generally accepted that RFRPs act as part of a wider RFamide system, which involves two receptors, called the neuropeptide FF receptors (NPFFR1 and R2), and includes the closely-related neuropeptide NPFF. NPFF has been studied ever since the 1980s and many of the functions of NPFF are also shared by RFRPs. The current review questions whether these functions of NPFF are indeed specific to just NPFF alone and presents evidence from both neuroendocrine and pharmacological perspectives. Furthermore, recently emerging new functions of RFRPs are discussed with the overall goal of clarifying the functions of RFRPs beyond the hypothalamic-pituitary-gonadal axis.
Collapse
Affiliation(s)
- J S Kim
- Centre for Neuroendocrinology and Department of Anatomy, University of Otago, Dunedin, New Zealand
| |
Collapse
|
14
|
A data science approach to candidate gene selection of pain regarded as a process of learning and neural plasticity. Pain 2016; 157:2747-2757. [DOI: 10.1097/j.pain.0000000000000694] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
15
|
Quach TT, Lerch JK, Honnorat J, Khanna R, Duchemin AM. Neuronal networks in mental diseases and neuropathic pain: Beyond brain derived neurotrophic factor and collapsin response mediator proteins. World J Psychiatry 2016; 6:18-30. [PMID: 27014595 PMCID: PMC4804265 DOI: 10.5498/wjp.v6.i1.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 11/24/2015] [Accepted: 01/07/2016] [Indexed: 02/05/2023] Open
Abstract
The brain is a complex network system that has the capacity to support emotion, thought, action, learning and memory, and is characterized by constant activity, constant structural remodeling, and constant attempt to compensate for this remodeling. The basic insight that emerges from complex network organization is that substantively different networks can share common key organizational principles. Moreover, the interdependence of network organization and behavior has been successfully demonstrated for several specific tasks. From this viewpoint, increasing experimental/clinical observations suggest that mental disorders are neural network disorders. On one hand, single psychiatric disorders arise from multiple, multifactorial molecular and cellular structural/functional alterations spreading throughout local/global circuits leading to multifaceted and heterogeneous clinical symptoms. On the other hand, various mental diseases may share functional deficits across the same neural circuit as reflected in the overlap of symptoms throughout clinical diagnoses. An integrated framework including experimental measures and clinical observations will be necessary to formulate a coherent and comprehensive understanding of how neural connectivity mediates and constraints the phenotypic expression of psychiatric disorders.
Collapse
|
16
|
McLaughlin JM, Lambing A, Witkop ML, Anderson TL, Munn J, Tortella B. Racial Differences in Chronic Pain and Quality of Life among Adolescents and Young Adults with Moderate or Severe Hemophilia. J Racial Ethn Health Disparities 2016; 3:11-20. [PMID: 26896101 PMCID: PMC4761000 DOI: 10.1007/s40615-015-0107-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 02/27/2015] [Accepted: 03/16/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVE We explored racial differences in adherence to recommended clotting factor treatment regimens, chronic pain, and quality of life (QoL) among adolescents and young adults (AYAs) diagnosed with moderate or severe hemophilia. METHODS A convenience sample of hemophilia patients aged 13-25 years completed an online cross-sectional survey in 2012. Chronic pain was measured using the revised Faces Pain Scale (FPS-R) and dichotomized as high (FPS-R ≥ 4) or low (FPS-R < 4). QoL was measured with the SF-36. RESULTS Of 80 AYA participants (79 male), most had severe disease (91 %) and hemophilia A (91 %). Most were white (76 %) and non-Hispanic (88 %). At the univariate level, compared to whites, non-whites were more likely to have produced an inhibitor against clotting factor treatment (74 vs 38 %, p < .01), less likely to have commercial health insurance (16 vs 63 %, p < .001), more likely to report high levels of chronic pain (FPS-R ≥ 4) (63 vs 26 %, p < .01), and had lower SF-36 physical composite summary (PCS) scores. Adjusted logistic and quantile regression modeling, respectively, revealed that non-whites were 5.31 (95 % CI 1.62, 17.4; p < .01) times more likely to report high chronic pain and had median PCS scores that were 26.0 (95 % CI 11.0, 40.9; p < .01) points lower than whites. CONCLUSIONS Targeted efforts to prevent and manage chronic pain among non-white AYAs with moderate or severe hemophilia are necessary. After accounting for demographic and clinical differences, there were no racial differences in adherence to recommended clotting factor treatment regimens; however, non-whites were more than five times more likely to report high levels of chronic pain, which predicted worse overall physical QoL, bodily pain, physical and social functioning, and greater role limitations due to physical health.
Collapse
Affiliation(s)
| | - Angela Lambing
- Henry Ford Adult Hemophilia & Thrombosis Treatment Center, Detroit, MI, USA
| | | | | | - James Munn
- University of Michigan Hemophilia Treatment Center, Ann Arbor, MI, USA
| | | |
Collapse
|
17
|
Harte SE, Meyers JB, Donahue RR, Taylor BK, Morrow TJ. Mechanical Conflict System: A Novel Operant Method for the Assessment of Nociceptive Behavior. PLoS One 2016; 11:e0150164. [PMID: 26915030 PMCID: PMC4767889 DOI: 10.1371/journal.pone.0150164] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 02/10/2016] [Indexed: 11/19/2022] Open
Abstract
A new operant test for preclinical pain research, termed the Mechanical Conflict System (MCS), is presented. Rats were given a choice either to remain in a brightly lit compartment or to escape to a dark compartment by crossing an array of height-adjustable nociceptive probes. Latency to escape the light compartment was evaluated with varying probe heights (0, .5, 1, 2, 3, and 4 mm above compartment floor) in rats with neuropathic pain induced by constriction nerve injury (CCI) and in naive control rats. Escape responses in CCI rats were assessed following intraperitoneal administration of pregabalin (10 and 30 mg/kg), morphine (2.5 and 5 mg/kg), and the tachykinin NK1 receptor antagonist, RP 67580 (1 and 10 mg/kg). Results indicate that escape latency increased as a function of probe height in both naive and CCI rats. Pregabalin (10 and 30 mg/kg) and morphine (5 mg/kg), but not RP 67580, decreased latency to escape in CCI rats suggesting an antinociceptive effect. In contrast, morphine (10 mg/kg) but not pregabalin (30 mg/kg) increased escape latency in naive rats suggesting a possible anxiolytic action of morphine in response to light-induced fear. No order effects following multiple test sessions were observed. We conclude that the MCS is a valid method to assess behavioral signs of affective pain in rodents.
Collapse
Affiliation(s)
- Steven E. Harte
- Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, United States of America
- Neurology Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America
- * E-mail:
| | - Jessica B. Meyers
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, United States of America
- Neurology Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America
| | - Renee R. Donahue
- Department of Physiology, University of Kentucky, Lexington, Kentucky, United States of America
| | - Bradley K. Taylor
- Department of Physiology, University of Kentucky, Lexington, Kentucky, United States of America
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, Kentucky, United States of America
| | - Thomas J. Morrow
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, United States of America
- Neurology Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America
| |
Collapse
|
18
|
Barrett JE, Haas DA. Perspectives and Trends in Pharmacological Approaches to the Modulation of Pain. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2016; 75:1-33. [PMID: 26920007 DOI: 10.1016/bs.apha.2015.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Pharmacological approaches to our understanding and treatment of pain have had a long history and have traditionally relied on very few drugs that either have significant side effects and abuse liability, such as the nonsteroidal anti-inflammatory drugs or the opioids, respectively, or those that have been developed for other conditions such as the tricyclic antidepressants. The pathophysiology of pain is undoubtedly complex, complicated in part by the fact that it is not a singular condition, and has a variety of etiologies and a number of associated comorbidities that make treatment interventions challenging. Moreover, there are changes in the central nervous system during the course of the development of chronic pain that, in a manner parallel to neurodegenerative disorders, likely require different pharmacological approaches in the early stages of acute pain compared to those that would be effective when pain has become chronic. This chapter reviews the current status of the field of pain research focusing on some relatively underdeveloped areas, such as pain and its associated comorbidities, and the use of transgenic animals and drug self-administration procedures in the context of analgesic assessment. This chapter also incorporates more recent developments and emerging trends in the area of epigenetics, biomarkers, and the use of induced pluripotent stem cells for pharmacological evaluation, target identification, and validation. Recent progress in the study of "organs-on-a-chip" will also be included in this overview, setting expectations for future progress that integrates these advances for deeper insights into mechanisms, novel treatments, and facilitated efforts in drug discovery.
Collapse
Affiliation(s)
- James E Barrett
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
| | - Derick A Haas
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
19
|
Mravec B, Lejavova K, Vargovic P, Ondicova K, Horvathova L, Novak P, Manz G, Filipcik P, Novak M, Kvetnansky R. Tauopathy in transgenic (SHR72) rats impairs function of central noradrenergic system and promotes neuroinflammation. J Neuroinflammation 2016; 13:15. [PMID: 26792515 PMCID: PMC4719584 DOI: 10.1186/s12974-016-0482-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 01/13/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Brain norepinephrine (NE) plays an important role in the modulation of stress response and neuroinflammation. Recent studies indicate that in Alzheimer's disease (AD), the tau neuropathology begins in the locus coeruleus (LC) which is the main source of brain NE. Therefore, we investigated the changes in brain NE system and also the immune status under basal and stress conditions in transgenic rats over-expressing the human truncated tau protein. METHODS Brainstem catecholaminergic cell groups (LC, A1, and A2) and forebrain subcortical (nucleus basalis of Meynert), hippocampal (cornu ammonis, dentate gyrus), and neocortical areas (frontal and temporal association cortices) were analyzed for NE and interleukin 6 (IL-6) mRNA levels in unstressed rats and also in rats exposed to single or repeated immobilization. Moreover, gene expression of NE-biosynthetic enzyme, tyrosine hydroxylase (TH), and several pro- and anti-inflammatory mediators were determined in the LC. RESULTS It was found that tauopathy reduced basal NE levels in forebrain areas, while the gene expression of IL-6 was increased in all selected areas at the same time. The differences between wild-type and transgenic rats in brain NE and IL-6 mRNA levels were observed in stressed animals as well. Tauopathy increased also the gene expression of TH in the LC. In addition, the LC exhibited exaggerated expression of pro- and anti-inflammatory mediators (IL-6, TNFα, inducible nitric oxide synthases 2 (iNOS2), and interleukin 10 (IL-10)) in transgenic rats suggesting that tauopathy affects also the immune background in LC. Positive correlation between NE and IL-6 mRNA levels in cornu ammonis in stressed transgenic animals indicated the reduction of anti-inflammatory effect of NE. CONCLUSIONS Our data thus showed that tauopathy alters the functions of LC further leading to the reduction of NE levels and exaggeration of neuroinflammation in forebrain. These findings support the assumption that tau-related dysfunction of LC activates the vicious circle perpetuating neurodegeneration leading to the development of AD.
Collapse
Affiliation(s)
- Boris Mravec
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia.
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia.
| | - Katarina Lejavova
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia.
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia.
| | - Peter Vargovic
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia.
| | - Katarina Ondicova
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia.
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia.
| | - Lubica Horvathova
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia.
| | - Petr Novak
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia.
- Axon Neuroscience SE, Bratislava, Slovakia.
| | - Georg Manz
- LDN, Labor Diagnostika Nord, Nordhorn, Germany.
| | - Peter Filipcik
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia.
- Axon Neuroscience SE, Bratislava, Slovakia.
| | - Michal Novak
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia.
- Axon Neuroscience SE, Bratislava, Slovakia.
| | - Richard Kvetnansky
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia.
| |
Collapse
|
20
|
Pozek JPJ, Beausang D, Baratta JL, Viscusi ER. The Acute to Chronic Pain Transition: Can Chronic Pain Be Prevented? Med Clin North Am 2016; 100:17-30. [PMID: 26614716 DOI: 10.1016/j.mcna.2015.08.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Chronic postsurgical pain (CPSP) is a distressing disease process that can lead to long-term disability, reduced quality of life, and increased health care spending. Although the exact mechanism of development of CPSP is unknown, nerve injury and inflammation may lead to peripheral and central sensitization. Given the complexity of the disease process, no novel treatment has been identified. The preoperative use of multimodal analgesia has been shown to decrease acute postoperative pain, but it has no proven efficacy in preventing development of CPSP.
Collapse
Affiliation(s)
- John-Paul J Pozek
- Department of Anesthesiology, Thomas Jefferson University, Gibbon Building, Suite 8280, 111 South 11th Street, Philadelphia, PA 19107, USA.
| | - David Beausang
- Department of Anesthesiology, Thomas Jefferson University, Gibbon Building, Suite 8490, 111 South 11th Street, Philadelphia, PA 19107, USA
| | - Jaime L Baratta
- Department of Anesthesiology, Thomas Jefferson University, Gibbon Building, Suite 8280, 111 South 11th Street, Philadelphia, PA 19107, USA
| | - Eugene R Viscusi
- Department of Anesthesiology, Thomas Jefferson University, Gibbon Building, Suite 8490, 111 South 11th Street, Philadelphia, PA 19107, USA
| |
Collapse
|
21
|
Computational functional genomics based analysis of pain-relevant micro-RNAs. Hum Genet 2015; 134:1221-38. [DOI: 10.1007/s00439-015-1600-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 09/01/2015] [Indexed: 02/07/2023]
|
22
|
Mravec B, Vargovic P, Filipcik P, Novak M, Kvetnansky R. Effect of a single and repeated stress exposure on gene expression of catecholamine biosynthetic enzymes in brainstem catecholaminergic cell groups in rats. Eur J Neurosci 2015; 42:1872-86. [PMID: 25994480 DOI: 10.1111/ejn.12955] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 05/14/2015] [Accepted: 05/15/2015] [Indexed: 12/14/2022]
Abstract
Brainstem catecholaminergic neurons significantly participate in the regulation of neuroendocrine system activity, particularly during stressful conditions. However, so far the precise quantitative characterisation of basal and stress-induced changes in gene expression and protein levels of catecholaminergic biosynthetic enzymes in these neurons has been missing. Using a quantitative reverse transcription-polymerase chain reaction method, we investigated gene expression of catecholamine biosynthetic enzymes in brainstem noradrenergic and adrenergic cell groups in rats under resting conditions as well as in acutely and repeatedly stressed animals. For the first time, we described quantitative differences in basal levels of catecholamine biosynthetic enzyme mRNA in brainstem catecholaminergic ascending and descending projecting cell groups. Moreover, we found and defined some differences among catecholaminergic cell groups in the time-course of mRNA levels of catecholaminergic enzymes following a single and especially repeated immobilisation stress. The data obtained support the assumption that brainstem catecholaminergic cell groups represent a functionally differentiated system, which is highly (but specifically) activated in rats exposed to stress. Therefore, potential interventions for the treatment of stress-related diseases need to affect the activity of brainstem catecholaminergic neurons not uniformly but with some degree of selectivity.
Collapse
Affiliation(s)
- Boris Mravec
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia.,Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Peter Vargovic
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia
| | - Peter Filipcik
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Michal Novak
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Richard Kvetnansky
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 833 06, Bratislava, Slovakia
| |
Collapse
|
23
|
Seripa D, Latina P, Fontana A, Gravina C, Lattanzi M, Savino M, Gallo AP, Melchionda G, Santini SA, Margaglione M, Copetti M, di Mauro L, Panza F, Greco A, Pilotto A. Role of CYP2D6 Polymorphisms in the Outcome of Postoperative Pain Treatment. PAIN MEDICINE 2015; 16:2012-23. [PMID: 25989235 DOI: 10.1111/pme.12778] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 01/30/2015] [Accepted: 03/29/2015] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To investigate the role of CYP2D6 phenotype in the outcome of postoperative (PO) pain (POP) treatment. DESIGN Longitudinal cohort study. Open-label trial with post hoc analysis. SETTING General Hospital Surgery and Recovery Units. PATIENTS Ninety unrelated Caucasians submitted to abdominal/thoracic surgery. INTERVENTIONS Standard multimodal POP treatment including opioids (tramadol) and nonsteroidal anti-inflammatory drugs (ketoprofen) at different dosages and infusion rates according to the predicted mild, moderate, or severe POP. OUTCOME MEASURES Pain (Numeric Rating Scale-NRS) and sedation (Ramsay Sedation Scale-RSS) up to 24 hours after surgery. By genotyping 16 CYP2D6 alleles, the four CYP2D6 phenotypes poor metabolizer (PM), intermediate metabolizers (IM), extensive metabolizers (EM) and ultrarapid metabolizers (UM) were predicted. RESULTS As compared with the CYP2D6-EM phenotype, in the early PO time (30 min) a higher RSS mean score in IM was observed (P = 0.035). A suggestion towards higher mean score in PM (P = 0.091) and a minor mean score in UM (P = 0.091) was also detected. No difference in the outcome of pain across the CYP2D6 phenotypes was observed. CONCLUSIONS In respect to the normal CYP2D6 phenotype, our results suggested that slowly metabolizers (IMs and PMs) might have a major sedation, whereas more rapid metabolizers (UM) a minor sedation, in the early time after surgery. A minor role of CYP2D6 phenotype in PO analgesia may be suggested.
Collapse
Affiliation(s)
- Davide Seripa
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Paola Latina
- Recovery Unit 1, Emergency Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Andrea Fontana
- Biostatistics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Carolina Gravina
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | | | - Maria Savino
- Laboratory of Clinical Chemistry, Department of Clinical Pathology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Antonietta P Gallo
- Laboratory of Clinical Chemistry, Department of Clinical Pathology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Giuseppe Melchionda
- Recovery Unit 1, Emergency Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Stefano A Santini
- Laboratory of Hormonal Analyses and Clinical Molecular Biology, Department of Diagnostics and Laboratory Medicine, Catholic University School of Medicine, Rome, Italy
| | - Maurizio Margaglione
- Chair of Medical Genetics, Department of Biomedical Sciences, University of Foggia, Foggia, Italy
| | - Massimiliano Copetti
- Biostatistics Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Lazzaro di Mauro
- Laboratory of Clinical Chemistry, Department of Clinical Pathology, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Francesco Panza
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.,Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico,", Lecce, Italy
| | - Antonio Greco
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Alberto Pilotto
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.,Geriatrics Unit, Azienda ULSS16 Padova, S. Antonio Hospital, Padova, Italy
| |
Collapse
|
24
|
Association of functional variations in COMT and GCH1 genes with postherniotomy pain and related impairment. Pain 2015; 156:273-279. [DOI: 10.1097/01.j.pain.0000460307.48701.b0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
25
|
Clarke H, Katz J, Flor H, Rietschel M, Diehl SR, Seltzer Z. Genetics of chronic post-surgical pain: a crucial step toward personal pain medicine. Can J Anaesth 2014; 62:294-303. [DOI: 10.1007/s12630-014-0287-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 11/26/2014] [Indexed: 12/23/2022] Open
|
26
|
Belfer I, Greco CM, Lokshin A, Vulakovich K, Landsittel D, Dai F, Crossett L, Chelly JE. The design and methods of genetic studies on acute and chronic postoperative pain in patients after total knee replacement. PAIN MEDICINE (MALDEN, MASS.) 2014; 15:1590-602. [PMID: 25040948 PMCID: PMC4556363 DOI: 10.1111/pme.12487] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Total knee replacement (TKR) is the treatment option of choice for the millions of individuals whose osteoarthritis pain can no longer be managed through non-invasive methods. Over 500,000 TKRs are performed annually in the United States. Although most patients report improvement in pain and functioning following TKR, up to 30% report persistent pain that interferes with daily function. However, the reasons for poor outcomes are not clear. To best determine which patients are at risk for pain post TKR, a detailed and comprehensive approach is needed. In this article, we present the methodology of a study designed to identify a set of genetic, proteomic, clinical, demographic, psychosocial, and psychophysical risk factors for severe acute and chronic pain post TKR. DESIGN Prospective longitudinal observational study. SETTING University Hospital System. SUBJECTS Patients scheduled for unilateral TKR with a target number of 150. METHODS Prior to surgery, we collect demographic, psychosocial, and pain data. Biological data, including blood samples for genetic analyses, and serum, urine, and joint fluid for cytokine assessment are collected intraoperatively. Pain assessments as well as medication use are collected during each of the three days postsurgery. Additionally, pain and psychosocial information is collected 6 and 12 months following surgery. CONCLUSIONS This study, for the first time, captures the information on both genetic and "environmental" risk factors for acute and chronic pain post-TKR and has the potential to lead to the next step-multicenter large-scale studies on predictors and biomarkers of poor TKR outcomes as well as on tailored interventions and personalized medicine approaches for those at risk.
Collapse
Affiliation(s)
- Inna Belfer
- Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Carol M. Greco
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anna Lokshin
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Katie Vulakovich
- Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania
- Division of Acute Interventional Perioperative Pain and Regional Anesthesia, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Douglas Landsittel
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Feng Dai
- Yale Center for Analytical Sciences, New Haven, Connecticut, USA
| | - Lawrence Crossett
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jacques E. Chelly
- Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania
- Division of Acute Interventional Perioperative Pain and Regional Anesthesia, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
27
|
Kallianpur AR, Jia P, Ellis RJ, Zhao Z, Bloss C, Wen W, Marra CM, Hulgan T, Simpson DM, Morgello S, McArthur JC, Clifford DB, Collier AC, Gelman BB, McCutchan JA, Franklin D, Samuels DC, Rosario D, Holzinger E, Murdock DG, Letendre S, Grant I. Genetic variation in iron metabolism is associated with neuropathic pain and pain severity in HIV-infected patients on antiretroviral therapy. PLoS One 2014; 9:e103123. [PMID: 25144566 PMCID: PMC4140681 DOI: 10.1371/journal.pone.0103123] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 06/27/2014] [Indexed: 02/06/2023] Open
Abstract
HIV sensory neuropathy and distal neuropathic pain (DNP) are common, disabling complications associated with combination antiretroviral therapy (cART). We previously associated iron-regulatory genetic polymorphisms with a reduced risk of HIV sensory neuropathy during more neurotoxic types of cART. We here evaluated the impact of polymorphisms in 19 iron-regulatory genes on DNP in 560 HIV-infected subjects from a prospective, observational study, who underwent neurological examinations to ascertain peripheral neuropathy and structured interviews to ascertain DNP. Genotype-DNP associations were explored by logistic regression and permutation-based analytical methods. Among 559 evaluable subjects, 331 (59%) developed HIV-SN, and 168 (30%) reported DNP. Fifteen polymorphisms in 8 genes (p<0.05) and 5 variants in 4 genes (p<0.01) were nominally associated with DNP: polymorphisms in TF, TFRC, BMP6, ACO1, SLC11A2, and FXN conferred reduced risk (adjusted odds ratios [ORs] ranging from 0.2 to 0.7, all p<0.05); other variants in TF, CP, ACO1, BMP6, and B2M conferred increased risk (ORs ranging from 1.3 to 3.1, all p<0.05). Risks associated with some variants were statistically significant either in black or white subgroups but were consistent in direction. ACO1 rs2026739 remained significantly associated with DNP in whites (permutation p<0.0001) after correction for multiple tests. Several of the same iron-regulatory-gene polymorphisms, including ACO1 rs2026739, were also associated with severity of DNP (all p<0.05). Common polymorphisms in iron-management genes are associated with DNP and with DNP severity in HIV-infected persons receiving cART. Consistent risk estimates across population subgroups and persistence of the ACO1 rs2026739 association after adjustment for multiple testing suggest that genetic variation in iron-regulation and transport modulates susceptibility to DNP.
Collapse
Affiliation(s)
- Asha R. Kallianpur
- Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Peilin Jia
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Ronald J. Ellis
- Department of Neurology, University of California San Diego, San Diego, California, United States of America
| | - Zhongming Zhao
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Cinnamon Bloss
- Scripps Genomic Medicine, Scripps Translational Science Institute, and Scripps Health, La Jolla, California, United States of America
| | - Wanqing Wen
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Christina M. Marra
- Department of Neurology, University of Washington, Seattle, Washington, United States of America
| | - Todd Hulgan
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - David M. Simpson
- Department of Neurology, Icahn School of Medicine of Mt. Sinai, New York, New York, United States of America
| | - Susan Morgello
- Department of Neurology, Icahn School of Medicine of Mt. Sinai, New York, New York, United States of America
| | - Justin C. McArthur
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - David B. Clifford
- Department of Neurology, Washington University, St. Louis, Missouri, United States of America
| | - Ann C. Collier
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Benjamin B. Gelman
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - J. Allen McCutchan
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Donald Franklin
- HIV Neurobehavioral Research Center & CHARTER Center, University of California San Diego, San Diego, California, United States of America
| | - David C. Samuels
- Department of Molecular Physiology and Biophysics and Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Debralee Rosario
- HIV Neurobehavioral Research Center & CHARTER Center, University of California San Diego, San Diego, California, United States of America
| | - Emily Holzinger
- Department of Molecular Physiology and Biophysics and Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Deborah G. Murdock
- Department of Molecular Physiology and Biophysics and Center for Human Genetics Research, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Scott Letendre
- Department of Medicine, University of California San Diego, San Diego, California, United States of America
| | - Igor Grant
- Department of Psychiatry, University of California San Diego, San Diego, California, United States of America
| | | |
Collapse
|
28
|
Yoo S, Lim JY, Hwang SW. Resolvins: Endogenously-Generated Potent Painkilling Substances and their Therapeutic Perspectives. Curr Neuropharmacol 2014; 11:664-76. [PMID: 24396341 PMCID: PMC3849791 DOI: 10.2174/1570159x11311060009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 06/17/2013] [Accepted: 07/01/2013] [Indexed: 12/30/2022] Open
Abstract
The efficacy of many of pain-relieving drugs is based on mechanisms by which the drugs interfere with the body’s natural pain-mediating pathways. By contrast, although it is less popular, other drugs including opioids exert more powerful analgesic actions by augmenting endogenous inhibitory neural circuits for pain mediation. Recently, a novel endogenous pain-inhibitory principle was suggested and is now attracting both scientific and clinical attentions. The central players for the actions are particular body lipids: resolvins. Although research is in the preclinical phase, multiple hypotheses have actively been matured regarding the potency and molecular and neural processes of the analgesic effects of these substances. Consistently, accumulating experimental evidence has been demonstrating that treatment with these lipid substances is strongly effective at controlling diverse types of pain. Treatment of resolvins does not appear to disturb the body homeostasis as severely as many other therapeutic agents that interrupt the body’s natural signaling flow, which enables us to predict their fewer adverse effects. This paper serves as a review of currently documented painkilling actions of resolvins, summarizes the potential cellular and receptor-mediated mechanisms to date, and discusses the many clinical uses for these therapeutic lipids that have not yet been tested. Future scientific efforts will more concentrate to unveil such aspects of the substances and to construct clear proofs of concept for pain relief.
Collapse
Affiliation(s)
- Sungjae Yoo
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul 136-705, Korea
| | - Ji Yeon Lim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul 136-705, Korea
| | - Sun Wook Hwang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul 136-705, Korea
| |
Collapse
|
29
|
Ginosar Y, Birnbach DJ, Shirov TT, Arheart K, Caraco Y, Davidson EM. Duration of analgesia and pruritus following intrathecal fentanyl for labour analgesia: no significant effect of A118G μ-opioid receptor polymorphism, but a marked effect of ethnically distinct hospital populations. Br J Anaesth 2013; 111:433-44. [PMID: 23592691 DOI: 10.1093/bja/aet075] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Genetic polymorphism (A118G) in the μ-opioid receptor has been reported to affect systemic opioid analgesia. However, reported pharmacogenetic effects on spinal opioid analgesia, particularly in labour, have been equivocal. METHODS We prospectively assessed effects of the μ-opioid receptor A118G single nucleotide polymorphism (SNP) on analgesia after 20 μg of spinal fentanyl. We studied two ethnically distinct hospital populations (Miami and Jerusalem). Independent variables were A118G, ethnicity, and hospital. Primary outcome was time from spinal analgesia until analgesic request. Secondary outcomes were pain and pruritus, assessed at repeated intervals until analgesia request. RESULTS One hundred and twenty-five nulliparous parturients in early labour were analysed. The allelic frequency of A118G was 14.8% (14.4% in Miami; 15.5% in Jerusalem). Time to analgesia request (sd) in Miami was 122 (44) min and in Jerusalem was 87 (32) min, P<0.001; Hispanic 123 (46) min vs Jew/Arab 87 (32) min, P<0.001; Black 121 (41) min vs Jew/Arab 87 (32) min, P=0.015. There was no significant effect of A118G. Survival analysis showed Miami > Jerusalem, P<0.001; Hispanics and Black > Jew/Arab, P<0.001; no effect of A118G. Within hospital groups, A118G had no effect on time to analgesic request; within genomic groups there was a significant difference between hospitals. The time-course for pruritus exactly paralleled the time-course for analgesia and was affected by hospital (P=0.006) and by ethnic group (P=0.03), but not by A118G. CONCLUSIONS We found no significant effect for the A118G single nucleotide polymorphism (SNP) on analgesic duration after spinal fentanyl for labour. In contrast, ethnically distinct hospital population groups exerted a marked effect on the time-course of both analgesia and pruritus.
Collapse
Affiliation(s)
- Y Ginosar
- Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | | | | | | | | | | |
Collapse
|
30
|
Lötsch J, Doehring A, Mogil JS, Arndt T, Geisslinger G, Ultsch A. Functional genomics of pain in analgesic drug development and therapy. Pharmacol Ther 2013; 139:60-70. [PMID: 23567662 DOI: 10.1016/j.pharmthera.2013.04.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 03/19/2013] [Indexed: 12/28/2022]
Abstract
Advances in genomic research have led to the clarification of the detailed involvement of gene products in biological pathways and these are being increasingly exploited in strategies for drug discovery and repurposing. Concomitant developments in informatics have resulted in the acquisition of complex gene information through the application of computational analysis of molecular interaction networks. This approach enables the acquired knowledge on hundreds of genes to be used to view molecular disease mechanisms from a genetic point of view. By analyzing 410 genes which control the complex process of pain, we show by computational analysis, based on functional annotations to pain-related genes, that 12 clearly circumscribed functional areas are essential for pain perception and thus for analgesic drug development. The genetics perspective revealed that future development strategies should focus on substances modulating intracellular signal transduction, ion transport and anatomical structure development. These processes are involved in the genetic-based absence of pain and therefore, provide promising fields for curative or preventive treatments. In contrast, interactions with G-protein coupled receptor pathways seem merely to provide symptomatic, not preventative relief of pain. In addition, biological functions accessed either by analgesic drugs or microRNAs suggest that synergistic therapies may be a future direction for drug development. With modern computational functional genomics, it is possible to exploit genetic information from increasingly available data sets on complex diseases, such as pain, and offers a new insight into drug development and therapy which is complementary to pathway-centered approaches.
Collapse
Affiliation(s)
- Jörn Lötsch
- Institute of Clinical Pharmacology, Goethe-University Hospital, Theodor Stern Kai 7, D-60590 Frankfurt am Main, Germany
| | | | | | | | | | | |
Collapse
|
31
|
Belfer I. Nature and nurture of human pain. SCIENTIFICA 2013; 2013:415279. [PMID: 24278778 PMCID: PMC3820306 DOI: 10.1155/2013/415279] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 03/14/2013] [Indexed: 05/05/2023]
Abstract
Humans are very different when it comes to pain. Some get painful piercings and tattoos; others can not stand even a flu shot. Interindividual variability is one of the main characteristics of human pain on every level including the processing of nociceptive impulses at the periphery, modification of pain signal in the central nervous system, perception of pain, and response to analgesic strategies. As for many other complex behaviors, the sources of this variability come from both nurture (environment) and nature (genes). Here, I will discuss how these factors contribute to human pain separately and via interplay and how epigenetic mechanisms add to the complexity of their effects.
Collapse
Affiliation(s)
- Inna Belfer
- Departments of Anesthesiology and Human Genetics, University of Pittsburgh, Pittsburgh, PA 15213, USA
| |
Collapse
|
32
|
Hocking LJ, Morris AD, Dominiczak AF, Porteous DJ, Smith BH. Heritability of chronic pain in 2195 extended families. Eur J Pain 2012; 16:1053-63. [PMID: 22337623 DOI: 10.1002/j.1532-2149.2011.00095.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2011] [Indexed: 01/01/2023]
Abstract
Chronic pain is pathological, persisting beyond normal tissue healing time. Previous work has suggested ∼50% variation in chronic pain development is heritable. No data are currently available on the heritability of pain categorized using the Chronic Pain Grade (CPG). Furthermore, few existing studies have accounted for potential confounders that may themselves be under genetic control or indeed 'heritable' non-genetic traits. This study aimed to determine the relative contributions of genetic, measured and shared environmental and lifestyle factors to chronic pain. Chronic pain status was determined and CPG measured in participants from Generation Scotland: the Scottish Family Health Study, a large cohort of well-characterized, extended families from throughout Scotland, UK. Heritability estimates (h (2) ) for 'any chronic pain' and 'severe' chronic pain (CPG 3 or 4) were generated using SOLAR software, with and without adjustment for shared household effects and measured covariates age, body mass index, gender, household income, occupation and physical activity. Data were available for 7644 individuals in 2195 extended families. Without adjustment, h (2) for 'any chronic pain' was 29% [standard errors (SE) 6%; p < 0.001], and for 'severe' chronic pain was 44% (SE 3%; p <0.001). After adjustment, 'any chronic pain' h(2) = 16% (SE 7%; p = 0.02) and 'severe' chronic pain h(2) = 30% (SE 13%; p = 0.007). Co-heritability of both traits was 11% (SE 76%). This study supports the use of chronic pain as a phenotype in genetic studies, with adequate correction for confounders to specifically identify genetic risk factors for chronic pain.
Collapse
Affiliation(s)
- L J Hocking
- Aberdeen Pain Research Collaboration, University of Aberdeen, UK.
| | | | | | | | | |
Collapse
|
33
|
Pettersson FD, Grönbladh A, Nyberg F, Sundström-Poromaa I, Åkerud H. The A118G Single-Nucleotide Polymorphism of Human µ-Opioid Receptor Gene and Use of Labor Analgesia. Reprod Sci 2012; 19:962-7. [DOI: 10.1177/1933719112438970] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Alfhild Grönbladh
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Fred Nyberg
- Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | | | - Helena Åkerud
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| |
Collapse
|
34
|
Elhabazi K, Trigo JM, Mollereau C, Moulédous L, Zajac JM, Bihel F, Schmitt M, Bourguignon JJ, Meziane H, Petit-demoulière B, Bockel F, Maldonado R, Simonin F. Involvement of neuropeptide FF receptors in neuroadaptive responses to acute and chronic opiate treatments. Br J Pharmacol 2012; 165:424-35. [PMID: 21718302 DOI: 10.1111/j.1476-5381.2011.01563.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Opiates remain the most effective compounds for alleviating severe pain across a wide range of conditions. However, their use is associated with significant side effects. Neuropeptide FF (NPFF) receptors have been implicated in several opiate-induced neuroadaptive changes including the development of tolerance. In this study, we investigated the consequences of NPFF receptor blockade on acute and chronic stimulation of opioid receptors in mice by using RF9, a potent and selective antagonist of NPFF receptors that can be administered systemically. EXPERIMENTAL APPROACH The effects of RF9 were investigated on opioid pharmacological responses including locomotor activity, antinociception, opioid-induced hyperalgesia, rewarding properties and physical dependence. KEY RESULTS RF9 had no effect on morphine-induced horizontal hyperlocomotion and slightly attenuated the decrease induced in vertical activity. Furthermore, RF9 dose-dependently blocked the long-lasting hyperalgesia produced by either acute fentanyl or chronic morphine administration. RF9 also potentiated opiate early analgesic effects and prevented the development of morphine tolerance. Finally, RF9 increased morphine-induced conditioned place preference without producing any rewarding effect by itself and decreased naltrexone-precipitated withdrawal syndrome following chronic morphine treatment. CONCLUSION AND IMPLICATIONS The NPFF system is involved in the development of two major undesirable effects: tolerance and dependence, which are clinically associated with prolonged exposure to opiates. Our findings suggest that NPFF receptors are interesting therapeutic targets to improve the analgesic efficacy of opiates by limiting the development of tolerance, and for the treatment of opioid dependence.
Collapse
Affiliation(s)
- K Elhabazi
- Institut de Recherche de l'ESBS, Université de Strasbourg-CNRS, Illkirch, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Mogil JS. Pain genetics: past, present and future. Trends Genet 2012; 28:258-66. [PMID: 22464640 DOI: 10.1016/j.tig.2012.02.004] [Citation(s) in RCA: 223] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 02/16/2012] [Accepted: 02/22/2012] [Indexed: 01/01/2023]
Abstract
Chronic pain is a classic example of gene × environment interaction: inflammatory and/or nerve injuries are known or suspected to be the etiology of most chronic pain syndromes, but only a small minority of those subjected to such injuries actually develop chronic pain. Once chronic pain has developed, pain severity and analgesic response are also highly variable among individuals. Although animal genetics studies have been ongoing for over two decades, only recently have comprehensive human twin studies and large-scale association studies been performed. Here, I review recent and accelerating progress in, and continuing challenges to, the identification of genes contributing to such variability. Success in this endeavor will hopefully lead to both better management of pain using currently available therapies and the development and/or prioritizing of new ones.
Collapse
Affiliation(s)
- Jeffrey S Mogil
- Department of Psychology, McGill University, Montreal, QC, H3A 1B1, Canada.
| |
Collapse
|
36
|
Magerl W, Burkart D, Fernandez A, Schmidt LG, Treede RD. Persistent antinociception through repeated self-injury in patients with borderline personality disorder. Pain 2012; 153:575-584. [DOI: 10.1016/j.pain.2011.11.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 11/16/2011] [Accepted: 11/18/2011] [Indexed: 12/21/2022]
|
37
|
Parent AJ, Beaudet N, Beaudry H, Bergeron J, Bérubé P, Drolet G, Sarret P, Gendron L. Increased anxiety-like behaviors in rats experiencing chronic inflammatory pain. Behav Brain Res 2012; 229:160-7. [PMID: 22245257 DOI: 10.1016/j.bbr.2012.01.001] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 11/29/2011] [Accepted: 01/02/2012] [Indexed: 01/01/2023]
Abstract
For many patients, chronic pain is often accompanied, and sometimes amplified, by co-morbidities such as anxiety and depression. Although it represents important challenges, the establishment of appropriate preclinical behavioral models contributes to drug development for treating chronic inflammatory pain and associated psychopathologies. In this study, we investigated whether rats experiencing persistent inflammatory pain induced by intraplantar injection of complete Freund's adjuvant (CFA) developed anxiety-like behaviors, and whether clinically used analgesic and anxiolytic drugs were able to reverse CFA-induced anxiety-related phenotypes. These behaviors were evaluated over 28 days in both CFA- and saline-treated groups with a variety of behavioral tests. CFA-induced mechanical allodynia resulted in increased anxiety-like behaviors as evidenced by: (1) a significant decrease in percentage of time spent and number of entries in open arms of the elevated-plus maze (EPM), (2) a decrease in number of central squares visited in the open field (OF), and (3) a reduction in active social interactions in the social interaction test (SI). The number of entries in closed arms in the EPM and the distance traveled in the OF used as indicators of locomotor performance did not differ between treatments. Our results also reveal that in CFA-treated rats, acute administration of morphine (3mg/kg, s.c.) abolished tactile allodynia and anxiety-like behaviors, whereas acute administration of diazepam (1mg/kg, s.c) solely reversed anxiety-like behaviors. Therefore, pharmacological treatment of anxiety-like behaviors induced by chronic inflammatory pain can be objectively evaluated using multiple behavioral tests. Such a model could help identify/validate alternative potential targets that influence pain and cognitive dimensions of anxiety.
Collapse
Affiliation(s)
- Alexandre J Parent
- Department of Physiology and Biophysics, Faculty of Medicine and Health Sciences, Institut de pharmacologie de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
STUDY DESIGN A nonsystematic review of the literature. OBJECTIVE The objective was to present general schema for mechanisms of whiplash pain and review the role of animal models in understanding the development of chronic pain from whiplash injury. SUMMARY OF BACKGROUND DATA Extensive biomechanical and clinical studies of whiplash have been performed to understand the injury mechanisms and symptoms of whiplash injury. However, only recently have animal models of this painful disorder been developed based on other pain models in the literature. METHODS A nonsystematic review was performed and findings were integrated to formulate a generalized picture of mechanisms by which chronic whiplash pain develops from mechanical tissue injuries. RESULTS The development of chronic pain from tissue injuries in the neck due to whiplash involves complex interactions between the injured tissue and spinal neuroimmune circuits. A variety of animal models are beginning to define these mechanisms. CONCLUSION Continued work is needed in developing appropriate animal models to investigate chronic pain from whiplash injuries and care must be taken to determine whether such models aim to model the injury event or the pain symptoms.
Collapse
Affiliation(s)
- Beth A Winkelstein
- Department of Bioengineering and Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104-6321, USA.
| |
Collapse
|
39
|
Andersen KG, Kehlet H. Persistent Pain After Breast Cancer Treatment: A Critical Review of Risk Factors and Strategies for Prevention. THE JOURNAL OF PAIN 2011; 12:725-46. [DOI: 10.1016/j.jpain.2010.12.005] [Citation(s) in RCA: 320] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Revised: 11/25/2010] [Accepted: 12/08/2010] [Indexed: 01/09/2023]
|
40
|
Adegbola M. Genomics and pain research in sickle cell disease: an explanation of heterogeneity? ISRN NURSING 2011; 2011:672579. [PMID: 21808743 PMCID: PMC3146762 DOI: 10.5402/2011/672579] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 03/24/2011] [Indexed: 01/13/2023]
Abstract
Sickle cell disease (SCD) is a chronic illness, and the major complication, pain, results in complex multidimensional problems that affect an individual's ability to maintain adequate quality of life in multiple areas. Chronic SCD pain is inadequately treated, because it is not well understood, and the degree of chronic pain, clinical presentation, and sequela complications can vary from patient to patient, even among individuals with the same SCD genotype. The reason for this variation is unknown, but the underlying cause might be genetic. Researchers have not explored the contribution of a genomic variable to the occurrence of heterogeneous chronic SCD pain. Previous research on the guanosine triphosphate cyclohydrolase (GCH1) gene suggests that in some cases, phenotypic heterogeneity in human sensitivity to pain correlates with underlying genotypic variations in the GCH1 gene. These findings imply that genotypic variations might also explain why some SCD patients experience more chronic pain than others.
Collapse
Affiliation(s)
- Maxine Adegbola
- College of Nursing, University of Texas at Arlington, 411 S. Nedderman Drive, Arlington, TX 76019, USA
| |
Collapse
|
41
|
Fortin A, Diez E, Ritchie J, Sotocinal SG, Dube MP, Gagne M, Paquette O, Skamene E, Mogil JS. Positional cloning of a quantitative trait locus contributing to pain sensitivity: possible mediation by Tyrp1. GENES BRAIN AND BEHAVIOR 2011; 9:856-67. [PMID: 20633051 DOI: 10.1111/j.1601-183x.2010.00618.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To identify novel pain-relevant genes, a set of 35 recombinant congenic strains derived from the sensitive C57BL/6 and resistant A/J strains were tested for their sensitivity to noxious heat on the radiant heat paw-withdrawal test. Nine strains were found to display differential sensitivity, and the two most extreme responders were used to generate independent secondary crosses for quantitative trait locus (QTL) mapping. From these genetic analyses, a QTL, which we call Tpnr5, was mapped to a 14-Mb interval of mouse chromosome 4 containing 39 genes. In addition to the paw-withdrawal test phenotype, Tpnr5 may be relevant to mechanical and inflammatory nociception. A series of strategies - including in silico analyses, reverse transcriptase polymerase chain reaction (RT-PCR) in multiple tissues and exonic DNA sequencing - were used to generate a list of six prioritized candidate genes. One of these, tyrosinase-related protein 1 (Tyrp1), displayed enriched expression in the dorsal root ganglia, an inactivating (C110Y) mutation in the resistant A/J strain, and a null mutant found to be more resistant to thermal nociception compared to its wild-type counterpart. Although other genes cannot be definitively ruled out, existing data are supportive of the candidacy of Tyrp1 as representing the Tpnr5 QTL. Tyrosinase-related protein 1 is the rate-limiting enzyme in the production of eumelanin, and possible relationships between eumelanin-expressing cells and thermal nociception are discussed. The positional cloning of Tpnr5 is also considered in light of the heuristic value but continuing challenges of QTL mapping in the mouse.
Collapse
Affiliation(s)
- A Fortin
- Emerillon Therapeutics Inc., Montreal, Quebec, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
The transition from acute to chronic pain appears to occur in discrete pathophysiological and histopathological steps. Stimuli initiating a nociceptive response vary, but receptors and endogenous defence mechanisms in the periphery interact in a similar manner regardless of the insult. Chemical, mechanical, and thermal receptors, along with leucocytes and macrophages, determine the intensity, location, and duration of noxious events. Noxious stimuli are transduced to the dorsal horn of the spinal cord, where amino acid and peptide transmitters activate second-order neurones. Spinal neurones then transmit signals to the brain. The resultant actions by the individual involve sensory-discriminative, motivational-affective, and modulatory processes in an attempt to limit or stop the painful process. Under normal conditions, noxious stimuli diminish as healing progresses and pain sensation lessens until minimal or no pain is detected. Persistent, intense pain, however, activates secondary mechanisms both at the periphery and within the central nervous system that cause allodynia, hyperalgesia, and hyperpathia that can diminish normal functioning. These changes begin in the periphery with upregulation of cyclo-oxygenase-2 and interleukin-1β-sensitizing first-order neurones, which eventually sensitize second-order spinal neurones by activating N-methyl-d-aspartic acid channels and signalling microglia to alter neuronal cytoarchitecture. Throughout these processes, prostaglandins, endocannabinoids, ion-specific channels, and scavenger cells all play a key role in the transformation of acute to chronic pain. A better understanding of the interplay among these substances will assist in the development of agents designed to ameliorate or reverse chronic pain.
Collapse
Affiliation(s)
- C Voscopoulos
- Department of Anesthesiology, Critical Care, and Pain Medicine, University at Buffalo, Buffalo, NY, USA
| | | |
Collapse
|
43
|
Redheads, pain mechanisms and genetics: Lessons learned from inconclusive studies. Scand J Pain 2011; 2:1-2. [PMID: 29914001 DOI: 10.1016/j.sjpain.2010.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
44
|
Dai F, Belfer I, Schwartz CE, Banco R, Martha JF, Tighioughart H, Tromanhauser SG, Jenis LG, Kim DH. Association of catechol-O-methyltransferase genetic variants with outcome in patients undergoing surgical treatment for lumbar degenerative disc disease. Spine J 2010; 10:949-57. [PMID: 20863768 DOI: 10.1016/j.spinee.2010.07.387] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 06/23/2010] [Accepted: 07/26/2010] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Surgical treatment for lumbar degenerative disc disease (DDD) has been associated with highly variable results in terms of postoperative pain relief and functional improvement. Many experts believe that DDD should be considered a chronic pain disorder as opposed to a degenerative disease. Genetic variation of the catechol-O-methyltransferase (COMT) gene has been associated with variation in human pain sensitivity and response to analgesics in previous studies. PURPOSE To determine whether genetic variation of COMT is associated with clinical outcome after surgical treatment for DDD. STUDY DESIGN Prospective genetic association study. PATIENT SAMPLE Sixty-nine patients undergoing surgical treatment for lumbar DDD. Diagnosis was based on documentation of chronic disabling low back pain (LBP) present for a minimum of 6 months and unresponsive to supervised nonoperative treatment, including activity modification, medication, physical therapy, and/or injection therapy. Plain radiographs and magnetic resonance imaging revealed intervertebral disc desiccation, tears, and/or collapse without focal herniation, nerve root compression, stenosis, spondylolisthesis, spondylolysis, or alternative diagnoses. OUTCOME MEASURES Oswestry Disability Index (ODI) and visual analog score (VAS) for LBP. METHODS Surgical treatment included 65 instrumented fusions and four disc arthroplasty procedures. All patients completed preoperative and 1-year postoperative ODI questionnaires. DNA was extracted from a sample of venous blood, and genotype analysis was performed for five common COMT single nucleotide polymorphisms (SNPs). Potential genetic association between these COMT SNPs and the primary outcome variable, 1-year change in ODI, was investigated using both single-marker and haplotype association analyses. Association with VAS scores for LBP was analyzed as a secondary outcome variable. RESULTS Single-marker analysis revealed that the COMT SNP rs4633 was significantly associated with greater improvement in ODI score 1 year after surgery (p=.03), with individuals homozygous for the less common "T" allele demonstrating the largest improvement in ODI. Haplotype analysis of four COMT SNPs, rs6269, rs4633, rs4818, and rs4680, also identified a common haplotype "ATCA" (haplotype frequency of 39.3% in the study population) associated with greater improvement in ODI (p=.046). The greatest mean improvement in ODI was observed in patients homozygous for the "ATCA"COMT haplotype. A nonsignificant trend was observed between SNP rs4633 and greater improvement in VAS score for LBP. CONCLUSIONS This is the first study to report an association between surgical treatment success in DDD patients and genetic variation in the putative pain sensitivity gene COMT. These findings require replication in other DDD populations but suggest that genetic testing for pain-relevant genetic markers such as COMT may provide useful clinical information in terms of predicting outcome after surgery for patients diagnosed with DDD.
Collapse
Affiliation(s)
- Feng Dai
- Molecular Epidemiology of Pain Program, Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
Despite ongoing efforts, neither effective treatments nor mechanistic understanding of the pathogenesis of human neuropathic pain exists. Genetic association studies may point to the novel molecules that mediate neuropathic pain, facilitating its understanding and management. Several studies used a candidate gene approach to elucidate genetic contribution to neuropathic pain phenotypes; however, the data is limited and inconsistent. Possible reasons include: sample heterogeneity, underpowered study design, population admixture, poor phenotyping, genotyping errors, and statistical analytical mistakes. This article summarizes and discusses current strategies to optimize population-based association studies of human neuropathic pain focusing on principles of measuring neuropathic pain phenotypes and genotyping techniques. We also consider advantages and challenges of study designs and statistical analyses.
Collapse
|
46
|
Dabo F, Grönbladh A, Nyberg F, Sundström-Poromaa I, Akerud H. Different SNP combinations in the GCH1 gene and use of labor analgesia. Mol Pain 2010; 6:41. [PMID: 20633294 PMCID: PMC2912270 DOI: 10.1186/1744-8069-6-41] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 07/15/2010] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to investigate if there is an association between different SNP combinations in the guanosine triphosphate cyclohydrolase (GCH1) gene and a number of pain behavior related outcomes during labor. A population-based sample of pregnant women (n = 814) was recruited at gestational week 18. A plasma sample was collected from each subject. Genotyping was performed and three single nucleotide polymorphisms (SNP) previously defined as a pain-protective SNP combination of GCH1 were used. Results Homozygous carriers of the pain-protective SNP combination of GCH1 arrived to the delivery ward with a more advanced stage of cervical dilation compared to heterozygous carriers and non-carriers. However, homozygous carriers more often used second line labor analgesia compared to the others. Conclusion The pain-protective SNP combination of GCH1 may be of importance in the limited number of homozygous carriers during the initial dilation of cervix but upon arrival at the delivery unit these women are more inclined to use second line labor analgesia.
Collapse
Affiliation(s)
- Fatimah Dabo
- Department of Women's and Children's health, Uppsala University, Uppsala, Sweden
| | | | | | | | | |
Collapse
|
47
|
Overview of Chronic Post-thoracotomy Pain: Etiology and Treatment. Intensive Care Med 2010. [DOI: 10.1007/978-1-4419-5562-3_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
48
|
Abstract
Pain and analgesia traits are heritable in humans and in mice. To better understand the mechanisms of heritability, animal models that provide greater control than is possible in humans over genotype, previous history, environment, and stimulus parameters are available. This chapter will highlight several common methods to study the genetic mechanisms of heritable sensitivity to pain and pain-related traits in rodents. Methods to demonstrate and estimate the heritability of a trait are discussed, as are genetic correlation analysis and linkage mapping. Practical concerns are highlighted throughout this chapter. Due to limitations on the use of humans for similarly powered experiments, these and other animal models remain an essential component in the study of heritable mechanisms of pain and analgesia.
Collapse
|
49
|
|
50
|
Eibl JK, Chapelsky SA, Ross GM. Multipotent Neurotrophin Antagonist Targets Brain-Derived Neurotrophic Factor and Nerve Growth Factor. J Pharmacol Exp Ther 2009; 332:446-54. [DOI: 10.1124/jpet.109.159079] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|