1
|
Storrer A, Mackie JT, Gunew MN, Aslan J. Cutaneous lesions and clinical outcomes in five cats after frunevetmab injections. J Feline Med Surg 2023; 25:1098612X231198416. [PMID: 37975186 PMCID: PMC10812000 DOI: 10.1177/1098612x231198416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
CASE SERIES SUMMARY This case series describes five cats with cutaneous adverse events after subcutaneous administration of frunevetmab, a felinised anti-nerve growth factor monoclonal antibody, including histopathological findings in one case. All cats displayed moderate to severe pruritus resulting in self-trauma to the neck and/or head, causing lesions ranging from superficial dermatitis to alopecia and ulcerations. There were no reactions at the injection sites. In one cat, clinical signs developed after the second frunevetmab dose the cat received, with no reaction noted after the first dose. For the remaining cats, clinical signs were observed after their first dose of frunevetmab. The onset of the first episode of pruritus and self-trauma was 3-18 days after the most recent frunevetmab injection. Three cats had one or more additional frunevetmab injections after the original adverse event and all had subsequent reactions. Subsequent reactions were either similar in time frame or occurred more rapidly, with similar or more severe pruritus compared with the original reactions. Treatments and outcomes varied between cases. RELEVANCE AND NOVEL INFORMATION Frunevetmab is a novel, monthly injectable monoclonal antibody for the management of pain associated with osteoarthritis in cats. This is the first published report detailing the nature of cutaneous adverse events associated with this treatment, and the first report of the histopathological findings.
Collapse
Affiliation(s)
- Anjie Storrer
- Queensland Veterinary Specialists, North Lakes, QLD, Australia
| | | | | | - Jeylan Aslan
- Dermatology for Animals, Stafford, QLD, Australia
| |
Collapse
|
2
|
Di Cesare F, Negro V, Ravasio G, Villa R, Draghi S, Cagnardi P. Gabapentin: Clinical Use and Pharmacokinetics in Dogs, Cats, and Horses. Animals (Basel) 2023; 13:2045. [PMID: 37370556 DOI: 10.3390/ani13122045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
Gabapentin is an anticonvulsant drug, which presents an established clinical efficacy in human patients for the management of refractory partial seizures, secondarily generalized tonic-clonic seizures, and for the control of chronic neuropathic pain. Gabapentin was synthesized as a structural analogue of the inhibitory neurotransmitter GABA, with GABA-mimetic effects, able to cross the blood-brain barrier. In veterinary medicine, is extra-label used in combination with other treatments to control seizures when other drugs are no longer effective or become toxic or for neuropathic pain treatment and anxiety. This review aimed to clarify gabapentin use and pharmacokinetic aspects to promote conscious use in dogs, cats, and horses. In dogs, gabapentin was beneficial in the treatment of epilepsy, as well as chronic, neuropathic, and post-operative pain, as well as anxiety. In cats, it showed efficacy in post-ovariohysterectomy-related pain and in anxiety management. In horses, gabapentin has been administered as an analgesic for chronic pain management. In conclusion, when used in combination with other drugs, gabapentin can be considered an interesting therapeutic option for the treatment of neuropathic diseases and analgesia in postoperative and chronic pain. However, despite its beneficial use in different clinical settings, further trials and pharmacokinetic studies are needed for the definition of an effective dosage regimen through proper pharmacokinetic/pharmacodynamic correlation in dogs, cats, and horses.
Collapse
Affiliation(s)
- Federica Di Cesare
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, 26900 Lodi, Italy
| | - Viviana Negro
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, 26900 Lodi, Italy
| | - Giuliano Ravasio
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, 26900 Lodi, Italy
| | - Roberto Villa
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, 26900 Lodi, Italy
| | - Susanna Draghi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, 26900 Lodi, Italy
| | - Petra Cagnardi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, 26900 Lodi, Italy
| |
Collapse
|
3
|
Nürnberger F, Rummel C, Ott D, Gerstberger R, Schmidt MJ, Roth J, Leisengang S. Gabapentinoids Suppress Lipopolysaccharide-Induced Interleukin-6 Production in Primary Cell Cultures of the Rat Spinal Dorsal Horn. Neuroimmunomodulation 2022; 30:1-14. [PMID: 35843206 DOI: 10.1159/000525657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/18/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Gabapentin and pregabalin are drugs to treat neuropathic pain. Several studies highlighted effects on presynaptic terminals of nociceptors. Via binding to α2δ subunits of voltage-gated calcium channels, gabapentinoids modulate the synaptic transmission of nociceptive information. However, recent studies revealed further properties of these substances. Treatment with gabapentin or pregabalin in animal models of neuropathic pain resulted not only in reduced symptoms of hyperalgesia but also in an attenuated activation of glial cells and decreased production of pro-inflammatory mediators in the spinal dorsal horn. METHODS In the present study, we aimed to investigate the impact of gabapentinoids on the inflammatory response of spinal dorsal horn cells, applying the established model of neuro-glial primary cell cultures of the superficial dorsal horn (SDH). We studied effects of gabapentin and pregabalin on lipopolysaccharide (LPS)-induced cytokine release (bioassays), expression of inflammatory marker genes (RT-qPCR), activation of transcription factors (immunocytochemistry), and Ca2+ responses of SDH neurons to stimulation with substance P and glutamate (Ca2+-imaging). RESULTS We detected an attenuated LPS-induced expression and release of interleukin-6 by SDH cultures in the presence of gabapentinoids. In addition, a significant main effect of drug treatment was observed for mRNA expression of microsomal prostaglandin E synthase 1 and the inhibitor of nuclear factor kappa B. Nuclear translocation of inflammatory transcription factors in glial cells was not significantly affected by gabapentinoid treatment. Moreover, both substances did not modulate neuronal responses upon stimulation with substance P or glutamate. CONCLUSION Our results provide evidence for anti-inflammatory capacities of gabapentinoids on the acute inflammatory response of SDH primary cultures upon LPS stimulation. Such effects may contribute to the pain-relieving effects of gabapentinoids.
Collapse
Affiliation(s)
- Franz Nürnberger
- Institute of Veterinary Physiology and Biochemistry, Justus Liebig University Giessen, Giessen, Germany
| | - Christoph Rummel
- Institute of Veterinary Physiology and Biochemistry, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior - CMBB, Philipps University Marburg & Justus Liebig University Giessen, Giessen, Germany
| | - Daniela Ott
- Institute of Veterinary Physiology and Biochemistry, Justus Liebig University Giessen, Giessen, Germany
| | - Rüdiger Gerstberger
- Institute of Veterinary Physiology and Biochemistry, Justus Liebig University Giessen, Giessen, Germany
| | - Martin J Schmidt
- Department of Veterinary Clinical Sciences, Small Animal Clinic - Neurosurgery, Neuroradiology and Clinical Neurology, Justus Liebig University Giessen, Giessen, Germany
| | - Joachim Roth
- Institute of Veterinary Physiology and Biochemistry, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior - CMBB, Philipps University Marburg & Justus Liebig University Giessen, Giessen, Germany
| | - Stephan Leisengang
- Institute of Veterinary Physiology and Biochemistry, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior - CMBB, Philipps University Marburg & Justus Liebig University Giessen, Giessen, Germany
- Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
4
|
Wachtendorf LJ, Schaefer MS, Santer P, Azimaraghi O, Obeidat SS, Friedrich S, Zucco L, Woo A, Nabel S, Sundar E, Eikermann M, Ramachandran SK. Association between preoperative administration of gabapentinoids and 30-day hospital readmission: A retrospective hospital registry study. J Clin Anesth 2021; 73:110376. [PMID: 34098392 DOI: 10.1016/j.jclinane.2021.110376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
STUDY OBJECTIVE To evaluate the effectiveness of preoperative gabapentinoid administration. DESIGN Retrospective hospital registry study. SETTING Tertiary referral center (Boston, MA). PATIENTS 111,008 adult non-emergency, non-cardiac surgical patients between 2014 and 2018. INTERVENTIONS Preoperative administration of gabapentinoids (gabapentin or pregabalin). MEASUREMENTS We tested the primary hypothesis that preoperative gabapentinoid use was associated with lower odds of hospital readmission within 30 days. Contingent on this hypothesis, we examined whether lower intraoperative opioid utilization mediated this effect. Secondary outcome was postoperative respiratory complications. MAIN RESULTS Gabapentinoid administration was associated with lower odds of readmission (adjusted odds ratio [ORadj] 0.80 [95% CI, 0.75-0.85]; p < 0.001). This effect was in part mediated by lower intraoperative opioid utilization in patients receiving gabapentinoids (8.2% [2.4-11.5%]; p = 0.012). Readmissions for gastrointestinal disorders (ORadj 0.74 [0.60-0.90]; p = 0.003), neuro-psychiatric complications (ORadj 0.66 [0.49-0.87]; p = 0.004), non-surgical site infections (ORadj 0.68 [0.52-0.88; p = 0.004) and trauma or poisoning (ORadj 0.25 [0.16-0.41]; p < 0.001) occurred less frequently in patients receiving gabapentinoids. The risk of postoperative respiratory complications was lower in patients receiving gabapentinoids (ORadj 0.77 [0.70-0.85]; p < 0.001). Lower doses of pregabalin (< 75 mg) and gabapentin (< 300 mg) compared to both, no and high-dose administration of gabapentinoids, were associated with a lower risk of postoperative respiratory complications (ORadj 0.61 [0.50-0.75]; p < 0.001 and ORadj 0.70 [0.53-0.92]; p = 0.012, respectively). These lower gabapentinoid doses prevented 30-day readmission (ORadj 0.74 [0.65-0.85]; p < 0.001). The results were robust in several sensitivity analyses including surgical procedure defined subgroups and patients undergoing ambulatory surgery. CONCLUSIONS The preoperative use of pregabalin and gabapentin, up to doses of 75 and 300 mg respectively, mitigates the risks of hospital readmission and postoperative respiratory complications which can in part be explained by lower intraoperative opioid use. Further research is warranted to elucidate mechanisms of the preventive action.
Collapse
Affiliation(s)
- Luca J Wachtendorf
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Maximilian Sebastian Schaefer
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, Duesseldorf University Hospital, Duesseldorf, Germany.
| | - Peter Santer
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Omid Azimaraghi
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Salameh Sameh Obeidat
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Sabine Friedrich
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Liana Zucco
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Albert Woo
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Sarah Nabel
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Eswar Sundar
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Matthias Eikermann
- Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Klinik für Anästhesiologie und Intensivmedizin, Universität Duisburg-Essen, Essen, Germany.
| | - Satya Krishna Ramachandran
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
5
|
Sun W, Larson MJ, Kiyoshi CM, Annett AJ, Stalker WA, Peng J, Tedeschi A. Gabapentinoid treatment promotes corticospinal plasticity and regeneration following murine spinal cord injury. J Clin Invest 2020; 130:345-358. [PMID: 31793909 DOI: 10.1172/jci130391] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/02/2019] [Indexed: 02/06/2023] Open
Abstract
Axon regeneration failure causes neurological deficits and long-term disability after spinal cord injury (SCI). Here, we found that the α2δ2 subunit of voltage-gated calcium channels negatively regulates axon growth and regeneration of corticospinal neurons, the cells that originate the corticospinal tract. Increased α2δ2 expression in corticospinal neurons contributed to loss of corticospinal regrowth ability during postnatal development and after SCI. In contrast, α2δ2 pharmacological blockade through gabapentin administration promoted corticospinal structural plasticity and regeneration in adulthood. Using an optogenetic strategy combined with in vivo electrophysiological recording, we demonstrated that regenerating corticospinal axons functionally integrate into spinal circuits. Mice administered gabapentin recovered upper extremity function after cervical SCI. Importantly, such recovery relies on reorganization of the corticospinal pathway, as chemogenetic silencing of injured corticospinal neurons transiently abrogated recovery. Thus, targeting α2δ2 with a clinically relevant treatment strategy aids repair of motor circuits after SCI.
Collapse
Affiliation(s)
- Wenjing Sun
- Department of Neuroscience, Wexner Medical Center
| | | | | | | | | | - Juan Peng
- Center for Biostatistics and Bioinformatics, and
| | - Andrea Tedeschi
- Department of Neuroscience, Wexner Medical Center.,Chronic Brain Injury Program, The Ohio State University, Columbus, Ohio, USA
| |
Collapse
|
6
|
Taylor CP, Harris EW. Analgesia with Gabapentin and Pregabalin May Involve N-Methyl-d-Aspartate Receptors, Neurexins, and Thrombospondins. J Pharmacol Exp Ther 2020; 374:161-174. [DOI: 10.1124/jpet.120.266056] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/17/2020] [Indexed: 11/22/2022] Open
|
7
|
Alles SRA, Cain SM, Snutch TP. Pregabalin as a Pain Therapeutic: Beyond Calcium Channels. Front Cell Neurosci 2020; 14:83. [PMID: 32351366 PMCID: PMC7174704 DOI: 10.3389/fncel.2020.00083] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/20/2020] [Indexed: 12/12/2022] Open
Abstract
Initially developed to generate new treatments for epilepsy, gabapentin, and pregabalin (“gabapentinoids”) were engineered to mimic the action of GABA and to modulate GABA metabolism. Rather than their intended pharmacological action on GABA neurotransmission, instead, they exhibit a high affinity for the α2δ-1 and α2δ-2 subunits of voltage-activated calcium channels, wherein binding of gabapentinoids inhibits cellular calcium influx and attenuates neurotransmission. Despite a lack of activity on GABA levels, gabapentin and pregabalin are effective at suppressing seizures and subsequently approved as a new class of antiepileptic therapy for partial-onset epilepsy. Through the same hypothesized molecular mechanism and by controlling neuronal hyperexcitability, gabapentinoids demonstrate clear efficacy in pain management, which has arguably been their most extensively prescribed application to date. In this review, we focus on pregabalin as a second-generation gabapentinoid widely employed in the treatment of a variety of pain conditions. We also discuss the wider functional roles of α2δ subunits and the contributions that pregabalin might play in affecting physiological and pathophysiological processes.
Collapse
Affiliation(s)
- Sascha R A Alles
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States
| | - Stuart M Cain
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Terrance P Snutch
- Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada.,Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
8
|
Martínez San Segundo P, Terni B, Burgueño J, Monroy X, Dordal A, Merlos M, Llobet A. Outside-in regulation of the readily releasable pool of synaptic vesicles by α2δ-1. FASEB J 2019; 34:1362-1377. [PMID: 31914622 DOI: 10.1096/fj.201901551r] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/09/2019] [Accepted: 10/23/2019] [Indexed: 12/17/2022]
Abstract
The readily releasable pool (RRP) of synaptic vesicles is a key determinant of phasic neurotransmission. Although the size of the RRP is tightly regulated by intracellular factors, there is little evidence for its modification by extracellular signals. By studying the homogeneous population of synapses present in autaptic microcultures, we show that pregabalin, a prototypical gabapentinoid, decreases the effective RRP size. Simultaneous imaging of presynaptic calcium influx and recording of postsynaptic responses shows that the effect is not related to a reduction of calcium entry. The main cause is the impairment of the functional coupling among N-type calcium channels and the RRP, resembling an increase of intracellular mobile calcium buffers. The ectodomain of neurexin-1α shows a similar action to pregabalin, acting as an endogenous ligand of α2δ-1 that reduces the RRP size without affecting presynaptic calcium influx. The regulatory actions described for pregabalin and the ectodomain of neurexin-1α are mutually exclusive. The overexpression of α2δ-1 enhances the effect of pregabalin and the ectodomain of neurexin-1α on neurotransmission by decreasing their effective concentration. In contrast, knockdown of α2δ-1 causes a profound inhibition of synaptic transmission. These observations prompt to consider α2δ-1 as an outside-in signaling platform that binds exogenous and endogenous cues for regulating the coupling of voltage-gated calcium channels to synaptic vesicles.
Collapse
Affiliation(s)
- Pablo Martínez San Segundo
- Laboratory of Neurobiology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,Department of Pathology and Experimental Therapeutics, School of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Beatrice Terni
- Laboratory of Neurobiology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,Department of Pathology and Experimental Therapeutics, School of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Javier Burgueño
- Department of Pharmacology, Drug Discovery and Preclinical Development, ESTEVE, Barcelona, Spain
| | - Xavier Monroy
- Department of Pharmacology, Drug Discovery and Preclinical Development, ESTEVE, Barcelona, Spain
| | - Albert Dordal
- Department of Pharmacology, Drug Discovery and Preclinical Development, ESTEVE, Barcelona, Spain
| | - Manuel Merlos
- Department of Pharmacology, Drug Discovery and Preclinical Development, ESTEVE, Barcelona, Spain
| | - Artur Llobet
- Laboratory of Neurobiology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,Department of Pathology and Experimental Therapeutics, School of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| |
Collapse
|
9
|
Response to “Treating patients rather than their functional neuroimages” (Br J Anaesth 2018; 121: 969–71). Br J Anaesth 2019; 123:e166-e171. [DOI: 10.1016/j.bja.2019.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/14/2019] [Accepted: 01/21/2019] [Indexed: 11/23/2022] Open
|
10
|
Kazi JA, Zatilfarihiah R. Gabapentin completely neutralized the acute morphine activation in the rat hypothalamus: a c-Fos study. FUTURE NEUROLOGY 2019. [DOI: 10.2217/fnl-2018-0037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: The molecular mechanism of gabapentin (GBP)–morphine combinational function and its neuro-anatomical sites of action to prevent, to neutralize morphine side effects and also the enhancement its analgesic effect of morphine is unknown. Methods: Morphine (10 mg/kg), saline, co-injection: GBP (150 mg/kg) with morphine (10 mg/kg) were injected by intraperitoneal injection in rats under deep anaesthesia. C-Fos immunohistochemistry technique was used to locate c-Fos expression in rat hypothalamus. Results: Gabapentin in combination with morphine significantly (p < 0.01) attenuated the acute morphine induced c-Fos immunoreactive neuron in hypothalamus. Conclusion: GBP neutralized the morphine sensitization in rat hypothalamus. GBP might neuromodulate and or antagonize the receptor regulatory machinery of morphine sensitization circuit which might work for drug discovery of morphine abuse.
Collapse
Affiliation(s)
- Jamil Ahsan Kazi
- Universiti Teknologi MARA (UiTM), Faculty of Dentistry, Centre of Studies for Preclinical Science, Jalan Hospital, 47000 SUNGAI BULOH, Selangor, Malaysia
| | - Rasdi Zatilfarihiah
- Universiti Teknologi MARA (UiTM), Faculty of Dentistry, Centre of Studies for Preclinical Science, Jalan Hospital, 47000 SUNGAI BULOH, Selangor, Malaysia
| |
Collapse
|
11
|
Alles SRA, Smith PA. Comparison of ex vivo and in vitro actions of gabapentin in superficial dorsal horn and the role of extra-spinal sites of drug action. Neurosci Lett 2019; 694:148-153. [PMID: 30500395 DOI: 10.1016/j.neulet.2018.11.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
Although gabapentin (GBP) is a first-line treatment in the management of neuropathic pain, its mechanism of action is incompletely understood. We have previously shown, in rats made neuropathic following sciatic chronic constriction injury, that IP injection of 100 mg/kg GBP decreases overall excitability of spinal cord slices obtained ex vivo. Excitability was assessed using confocal imaging to monitor the amplitude of K+- induced increases in cytoplasmic Ca2+. This decrease in excitability involved a reduction in the frequency and amplitude of spontaneous EPSC's (sEPSC) in putative excitatory substantia gelatinosa neurons and an increase in sEPSC frequency in putative inhibitory neurons. We used have whole-cell recording to compare these ex vivo actions of GBP with its acute in vitro effects on spinal cord slices obtained from neuropathic but drug-free rats. While GBP (100μM) decreased sEPSC amplitude and frequency in excitatory neurons in vitro in a similar fashion to effects observed ex vivo, sEPSC frequency in inhibitory neurons was decreased in vitro rather than increased. Acute in vitro application of GBP also failed to decrease the overall excitability of slices from neuropathic animals as monitored by confocal Ca2+ imaging. Since spinal cord slices in vitro are disconnected from the periphery and higher brain centres, the GBP-induced increase in sEPSC frequency in inhibitory neurons previously reported and seen ex vivo must result from extra-spinal actions. It may be attributable to alterations in descending neurotrophic control of dorsal horn circuitry.
Collapse
Affiliation(s)
- Sascha R A Alles
- Neuroscience and Mental Health Institute and Department of Pharmacology, University of Alberta, Edmonton, AB, T6G 2H7, Canada
| | - Peter A Smith
- Neuroscience and Mental Health Institute and Department of Pharmacology, University of Alberta, Edmonton, AB, T6G 2H7, Canada.
| |
Collapse
|
12
|
Multiple sites and actions of gabapentin-induced relief of ongoing experimental neuropathic pain. Pain 2018; 158:2386-2395. [PMID: 28832395 DOI: 10.1097/j.pain.0000000000001040] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Gabapentin (GBP) is a first-line therapy for neuropathic pain, but its mechanisms and sites of action remain uncertain. We investigated GBP-induced modulation of neuropathic pain following spinal nerve ligation (SNL) in rats. Intravenous or intrathecal GBP reversed evoked mechanical hypersensitivity and produced conditioned place preference (CPP) and dopamine (DA) release in the nucleus accumbens (NAc) selectively in SNL rats. Spinal GBP also significantly inhibited dorsal horn wide-dynamic-range neuronal responses to a range of evoked stimuli in SNL rats. By contrast, GBP microinjected bilaterally into the rostral anterior cingulate cortex (rACC), produced CPP, and elicited NAc DA release selectively in SNL rats but did not reverse tactile allodynia and had marginal effects on wide-dynamic-range neuronal activity. Moreover, blockade of endogenous opioid signaling in the rACC prevented intravenous GBP-induced CPP and NAc DA release but failed to block its inhibition of tactile allodynia. Gabapentin, therefore, can potentially act to produce its pain relieving effects by (a) inhibition of injury-induced spinal neuronal excitability, evoked hypersensitivity, and ongoing pain and (b) selective supraspinal modulation of affective qualities of pain, without alteration of reflexive behaviors. Consistent with previous findings of pain relief from nonopioid analgesics, GBP requires engagement of rACC endogenous opioid circuits and downstream activation of mesolimbic reward circuits reflected in learned pain-motivated behaviors. These findings support the partial separation of sensory and affective dimensions of pain in this experimental model and suggest that modulation of affective-motivational qualities of pain may be the preferential mechanism of GBP's analgesic effects in patients.
Collapse
|
13
|
Wanigasekera V, Wartolowska K, Huggins J, Duff E, Vennart W, Whitlock M, Massat N, Pauer L, Rogers P, Hoggart B, Tracey I. Disambiguating pharmacological mechanisms from placebo in neuropathic pain using functional neuroimaging. Br J Anaesth 2018; 120:299-307. [DOI: 10.1016/j.bja.2017.11.064] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
|
14
|
Kato E, Matsuzawa R, Kobayashi S, Fukushima T, Maekawa M, Hori Y. Effects of pregabalin on spinal d-serine content and NMDA receptor-mediated synaptic transmission in mice with neuropathic pain. Neurosci Lett 2017; 636:270-275. [DOI: 10.1016/j.neulet.2016.10.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/23/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
|
15
|
Abstract
UNLABELLED There is little evidence for most of the medications currently used to treat functional abdominal pain disorders (FAPDs) in children. Not only are there very few clinical trials, but also most have significant variability in the methods used and outcomes measured. Thus, the decision on the most appropriate pharmacological treatment is frequently based on adult studies or empirical data. In children, peppermint oil, trimebutine, and drotaverine have shown significant benefit compared with placebo, each of them in a single randomized clinical trial. A small study found that cyproheptadine was beneficial in the treatment of FAPDs in children. There are conflicting data regarding amitriptyline. While one small study found a significant benefit in quality of life compared with placebo, a large multicenter study found no benefit compared with placebo. The antidepressant, citalopram, failed to meet the primary outcomes in intention-to-treat and per-protocol analysis. Rifaximin has been shown to be efficacious in the treatment of adults with IBS. Those findings differ from studies in children where no benefit was found compared to placebo. To date, there are no placebo-controlled trials published on the use of linaclotide or lubiprostone in children. Alpha 2 delta ligands such as gabapentin and pregabalin are sometimes used in the care of this group of children, but no clinical trials are available in children with FAPDs. Similarly, novel drugs that have been approved for the care of irritable bowel with diarrhea in adults such as eluxadoline have yet to be studied in children. CONCLUSIONS Little data support the use of most medications commonly used to treat FAPDs in children. More randomized, placebo-controlled studies are needed to assess the efficacy of pharmacological interventions in the treatment of FAPDs in children.
Collapse
Affiliation(s)
- Miguel Saps
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Adrian Miranda
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
16
|
Baba H, Petrenko AB, Fujiwara N. Clinically relevant concentration of pregabalin has no acute inhibitory effect on excitation of dorsal horn neurons under normal or neuropathic pain conditions: An intracellular calcium-imaging study in spinal cord slices from adult rats. Brain Res 2016; 1648:445-458. [PMID: 27543338 DOI: 10.1016/j.brainres.2016.08.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 08/11/2016] [Accepted: 08/13/2016] [Indexed: 01/10/2023]
Abstract
Pregabalin is thought to exert its therapeutic effect in neuropathic pain via binding to α2δ-1 subunits of voltage-gated calcium (Ca(2+)) channels. However, the exact analgesic mechanism after its binding to α2δ-1 subunits remains largely unknown. Whether a clinical concentration of pregabalin (≈10μM) can cause acute inhibition of dorsal horn neurons in the spinal cord is controversial. To address this issue, we undertook intracellular Ca(2+)-imaging studies using spinal cord slices with an intact attached L5 dorsal root, and examined if pregabalin acutely inhibits the primary afferent stimulation-evoked excitation of dorsal horn neurons in normal rats and in rats with streptozotocin-induced painful diabetic neuropathy. Under normal conditions, stimulation of a dorsal root evoked Ca(2+) signals predominantly in the superficial dorsal horn. Clinically relevant (10μM) and a very high concentration of pregabalin (100μM) did not affect the intensity or spread of dorsal root stimulation-evoked Ca(2+) signals, whereas an extremely high dose of pregabalin (300μM) slightly but significantly attenuated Ca(2+) signals in normal rats and in diabetic neuropathic (DN) rats. There was no difference between normal rats and DN rats with regard to the extent of signal attenuation at all concentrations tested. These results suggest that the activity of dorsal horn neurons in the spinal cord is not inhibited acutely by clinical doses of pregabalin under normal or DN conditions. It is very unlikely that an acute inhibitory action in the dorsal horn is the main analgesic mechanism of pregabalin in neuropathic pain states.
Collapse
Affiliation(s)
- Hiroshi Baba
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan.
| | - Andrey B Petrenko
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Naoshi Fujiwara
- Division of Medical Technology, Niigata University Graduate School of Health Sciences, 2-746 Asahimachi-dori, Chuo-ku, Niigata 951-8518, Japan
| |
Collapse
|
17
|
Alles SRA, Smith PA. The Anti-Allodynic Gabapentinoids: Myths, Paradoxes, and Acute Effects. Neuroscientist 2016; 23:40-55. [PMID: 27118808 DOI: 10.1177/1073858416628793] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The gabapentinoids (pregabalin and gabapentin) are first line treatments for neuropathic pain. They exert their actions by binding to the α2δ accessory subunits of voltage-gated Ca2+ channels. Because these subunits interact with critical aspects of the neurotransmitter release process, gabapentinoid binding prevents transmission in nociceptive pathways. Gabapentinoids also reduce plasma membrane expression of voltage-gated Ca2+ channels but this may have little direct bearing on their therapeutic actions. In animal models of neuropathic pain, gabapentinoids exert an anti-allodynic action within 30 minutes but most of their in vitro effects are 30-fold slower, taking at least 17 hours to develop. This difference may relate to increased levels of α2δ expression in the injured nervous system. Thus, in situations where α2δ is experimentally upregulated in vitro, gabapentinoids act within minutes to interrupt trafficking of α2δ subunits to the plasma membrane within nerve terminals. When α2δ is not up-regulated, gabapentinoids act slowly to interrupt trafficking of α2δ protein from cell bodies to nerve terminals. This improved understanding of the mechanism of gabapentinoid action is related to their slowly developing actions in neuropathic pain patients, to the concept that different processes underlie the onset and maintenance of neuropathic pain and to the use of gabapentinoids in management of postsurgical pain.
Collapse
Affiliation(s)
- Sascha R A Alles
- 1 Neuroscience and Mental Health Institute and Department of Pharmacology, University of Alberta, Edmonton, Alberta, Canada
| | - Peter A Smith
- 1 Neuroscience and Mental Health Institute and Department of Pharmacology, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
18
|
Park J, Yu YP, Zhou CY, Li KW, Wang D, Chang E, Kim DS, Vo B, Zhang X, Gong N, Sharp K, Steward O, Vitko I, Perez-Reyes E, Eroglu C, Barres B, Zaucke F, Feng G, Luo ZD. Central Mechanisms Mediating Thrombospondin-4-induced Pain States. J Biol Chem 2016; 291:13335-48. [PMID: 27129212 DOI: 10.1074/jbc.m116.723478] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Indexed: 12/30/2022] Open
Abstract
Peripheral nerve injury induces increased expression of thrombospondin-4 (TSP4) in spinal cord and dorsal root ganglia that contributes to neuropathic pain states through unknown mechanisms. Here, we test the hypothesis that TSP4 activates its receptor, the voltage-gated calcium channel Cavα2δ1 subunit (Cavα2δ1), on sensory afferent terminals in dorsal spinal cord to promote excitatory synaptogenesis and central sensitization that contribute to neuropathic pain states. We show that there is a direct molecular interaction between TSP4 and Cavα2δ1 in the spinal cord in vivo and that TSP4/Cavα2δ1-dependent processes lead to increased behavioral sensitivities to stimuli. In dorsal spinal cord, TSP4/Cavα2δ1-dependent processes lead to increased frequency of miniature and amplitude of evoked excitatory post-synaptic currents in second-order neurons as well as increased VGlut2- and PSD95-positive puncta, indicative of increased excitatory synapses. Blockade of TSP4/Cavα2δ1-dependent processes with Cavα2δ1 ligand gabapentin or genetic Cavα2δ1 knockdown blocks TSP4 induced nociception and its pathological correlates. Conversely, TSP4 antibodies or genetic ablation blocks nociception and changes in synaptic transmission in mice overexpressing Cavα2δ1 Importantly, TSP4/Cavα2δ1-dependent processes also lead to similar behavioral and pathological changes in a neuropathic pain model of peripheral nerve injury. Thus, a TSP4/Cavα2δ1-dependent pathway activated by TSP4 or peripheral nerve injury promotes exaggerated presynaptic excitatory input and evoked sensory neuron hyperexcitability and excitatory synaptogenesis, which together lead to central sensitization and pain state development.
Collapse
Affiliation(s)
- John Park
- From the Department of Pharmacology and
| | | | | | - Kang-Wu Li
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, California 92697
| | - Dongqing Wang
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139
| | - Eric Chang
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, California 92697
| | - Doo-Sik Kim
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, California 92697
| | - Benjamin Vo
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, California 92697
| | - Xia Zhang
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, California 92697
| | - Nian Gong
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, California 92697
| | - Kelli Sharp
- Reeve-Irvine Research Center, University of California, Irvine, School of Medicine, Irvine, California 92697
| | - Oswald Steward
- Reeve-Irvine Research Center, University of California, Irvine, School of Medicine, Irvine, California 92697
| | - Iuliia Vitko
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, Virginia 22908
| | - Edward Perez-Reyes
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, Virginia 22908
| | - Cagla Eroglu
- Cell Biology, Duke University Medical Center, Durham, North Carolina 27710
| | - Ben Barres
- Department of Neurobiology, Stanford University, Stanford, California 94305, and
| | - Frank Zaucke
- Center for Biochemistry and Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, D50931 Cologne, Germany
| | - Guoping Feng
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139
| | - Z David Luo
- From the Department of Pharmacology and Department of Anesthesiology and Perioperative Care, University of California, Irvine, California 92697, Reeve-Irvine Research Center, University of California, Irvine, School of Medicine, Irvine, California 92697,
| |
Collapse
|
19
|
Wanigasekera V, Mezue M, Andersson J, Kong Y, Tracey I. Disambiguating Pharmacodynamic Efficacy from Behavior with Neuroimaging: Implications for Analgesic Drug Development. Anesthesiology 2016; 124:159-68. [PMID: 26669989 PMCID: PMC4684093 DOI: 10.1097/aln.0000000000000924] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Attrition rates of new analgesics during drug development are high; poor assay sensitivity with reliance on subjective outcome measures being a crucial factor. METHODS The authors assessed the utility of functional magnetic resonance imaging with capsaicin-induced central sensitization, a mechanism relevant in neuropathic pain, for obtaining mechanism-based objective outcome measures that can differentiate an effective analgesic (gabapentin) from an ineffective analgesic (ibuprofen) and both from placebo. The authors used a double-blind, randomized phase I study design (N = 24) with single oral doses. RESULTS Only gabapentin suppressed the secondary mechanical hyperalgesia-evoked neural response in a region of the brainstem's descending pain modulatory system (right nucleus cuneiformis) and left (contralateral) posterior insular cortex and secondary somatosensory cortex. Similarly, only gabapentin suppressed the resting-state functional connectivity during central sensitization between the thalamus and secondary somatosensory cortex, which was plasma gabapentin level dependent. A power analysis showed that with 12 data sets, when using neural activity from the left posterior insula and right nucleus cuneiformis, a statistically significant difference between placebo and gabapentin was detected with probability ≥ 0.8. When using subjective pain ratings, this reduced to less than or equal to 0.6. CONCLUSIONS Functional imaging with central sensitization can be used as a sensitive mechanism-based assay to guide go/no-go decisions on selecting analgesics effective in neuropathic pain in early human drug development. We also show analgesic modulation of neural activity by using resting-state functional connectivity, a less challenging paradigm that is ideally suited for patient studies because it requires no task or pain provocation.
Collapse
Affiliation(s)
- Vishvarani Wanigasekera
- Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) & Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom. Telephone +441865 222736
| | - Melvin Mezue
- Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) & Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom. Telephone +441865 222736
| | - Jesper Andersson
- Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) & Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom. Telephone +441865 222736
| | - Yazhuo Kong
- Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) & Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom. Telephone +441865 222736
| | - Irene Tracey
- Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB) & Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom. Telephone +441865 222736
| |
Collapse
|
20
|
Li J, Zhang MM, Tu K, Wang J, Feng B, Zhang ZN, Lei J, Li YQ, Du JQ, Chen T. The excitatory synaptic transmission of the nucleus of solitary tract was potentiated by chronic myocardial infarction in rats. PLoS One 2015; 10:e0118827. [PMID: 25756354 PMCID: PMC4354907 DOI: 10.1371/journal.pone.0118827] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/06/2015] [Indexed: 12/16/2022] Open
Abstract
Angina pectoris is a common clinical symptom that often results from myocardial infarction. One typical characteristic of angina pectoris is that the pain does not match the severity of the myocardial ischemia. One possible explanation is that the intensity of cardiac nociceptive information could be dynamically regulated by certain brain areas. As an important nucleus for processing cardiac nociception, the nucleus of the solitary tract (NTS) has been studied to some extent. However, until now, the morphological and functional involvement of the NTS in chronic myocardial infarction (CMI) has remained unknown. In the present study, by exploring left anterior descending coronary artery ligation surgery, we found that the number of synaptophysin-immunoreactive puncta and Fos-immunoreactive neurons in the rat NTS two weeks after ligation surgery increased significantly. Excitatory pre- and postsynaptic transmission was potentiated. A bath application of a Ca2+ channel inhibitor GABApentin and Ca2+ permeable AMPA receptor antagonist NASPM could reverse the potentiated pre- and postsynaptic transmission, respectively. Meanwhile, rats with CMI showed significantly increased visceral pain behaviors. Microinjection of GABApentin or NASPM into the NTS decreased the CMI-induced visceral pain behaviors. In sum, our results suggest that the NTS is an important area for the process of cardiac afference in chronic myocardial infarction condition.
Collapse
Affiliation(s)
- Jing Li
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University, School of Medicine, Xi'an, 710061, China; Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Ming-Ming Zhang
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Ke Tu
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Jian Wang
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Ban Feng
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Zi-Nan Zhang
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Jie Lei
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Yun-Qing Li
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Jian-Qing Du
- Department of Physiology and Pathophysiology, Xi'an Jiaotong University, School of Medicine, Xi'an, 710061, China; Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China
| | - Tao Chen
- Department of Anatomy, Histology and Embryology, K. K. Leung Brain Research Centre, Fourth Military Medical University, Xi'an, 710032, China; Center for Neuron and Disease, Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
21
|
Zhou C, Luo ZD. Nerve injury-induced calcium channel alpha-2-delta-1 protein dysregulation leads to increased pre-synaptic excitatory input into deep dorsal horn neurons and neuropathic allodynia. Eur J Pain 2015; 19:1267-76. [PMID: 25691360 DOI: 10.1002/ejp.656] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Up-regulation of voltage-gated calcium channel α2 δ1 subunit post spinal nerve ligation (SNL) injury or in α2 δ1 -overexpressing transgenic (Tg) mice correlates with tactile allodynia, a pain state mediated mainly by Aβ sensory fibres forming synaptic connections with deep dorsal horn (DDH) neurons. It is not clear, however, whether dysregulated α2 δ1 alters DDH synaptic neurotransmission that underlies tactile allodynia development post nerve injury. METHODS Tactile allodynia was tested in the SNL and α2 δ1 Tg models. Miniature excitatory/inhibitory post-synaptic currents were recorded in DDH neurons from these animal models using whole-cell patch clamp slice recording techniques. RESULTS There was a significant increase in the frequency, but not amplitude, of miniature excitatory post-synaptic currents (mEPSC) in DDH neurons that correlated with tactile allodynia in SNL and α2 δ1 Tg mice. Gabapentin, an α2 δ1 ligand that is known to block tactile allodynia in these models, also normalized mEPSC frequency dose-dependently in DDH neurons from SNL and α2 δ1 Tg mice. In contrast, neither frequency nor amplitude of miniature inhibitory post-synaptic currents was altered in DDH neurons from SNL and α2 δ1 Tg mice. CONCLUSION Our data suggest that α2 δ1 dysregulation is highly likely contributing to tactile allodynia through a pre-synaptic mechanism involving facilitation of excitatory synaptic neurotransmission in DDH of spinal cord.
Collapse
Affiliation(s)
- C Zhou
- Department of Pharmacology, School of Medicine, University of California Irvine, USA
| | - Z D Luo
- Department of Pharmacology, School of Medicine, University of California Irvine, USA.,Department of Anesthesiology and Perioperative Care, School of Medicine, University of California Irvine, USA
| |
Collapse
|
22
|
Takasu K, Ogawa K, Nakamura A, Kanbara T, Ono H, Tomii T, Morioka Y, Hasegawa M, Shibasaki M, Mori T, Suzuki T, Sakaguchi G. Enhanced GABAergic synaptic transmission at VLPAG neurons and potent modulation by oxycodone in a bone cancer pain model. Br J Pharmacol 2015; 172:2148-64. [PMID: 25521524 PMCID: PMC4386988 DOI: 10.1111/bph.13039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 11/29/2014] [Accepted: 12/09/2014] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND PURPOSE We demonstrated previously that oxycodone has potent antinociceptive effects at supraspinal sites. In this study, we investigated changes in neuronal function and antinociceptive mechanisms of oxycodone at ventrolateral periaqueductal gray (VLPAG) neurons, which are a major site of opioid action, in a femur bone cancer (FBC) model with bone cancer-related pain. EXPERIMENTAL APPROACH We characterized the supraspinal antinociceptive profiles of oxycodone and morphine on mechanical hypersensitivity in the FBC model. Based on the disinhibition mechanism underlying supraspinal opioid antinociception, the effects of oxycodone and morphine on GABAA receptor-mediated inhibitory postsynaptic currents (IPSCs) in VLPAG neurons were evaluated in slices from the FBC model. KEY RESULTS The supraspinal antinociceptive effects of oxycodone, but not morphine, were abolished by blocking G protein-gated inwardly rectifying potassium1 (Kir 3.1) channels. In slices from the FBC model, GABAergic synaptic transmission at VLPAG neurons was enhanced, as indicated by a leftward shift of the input-output relationship curve of evoked IPSCs, the increased paired-pulse facilitation and the enhancement of miniature IPSC frequency. Following treatment with oxycodone and morphine, IPSCs were reduced in the FBC model, and the inhibition of presynaptic GABA release by oxycodone, but not morphine was enhanced and dependent on Kir 3.1 channels. CONCLUSION AND IMPLICATIONS Our results demonstrate that Kir 3.1 channels are important for supraspinal antinociception and presynaptic GABA release inhibition by oxycodone in the FBC model. Enhanced GABAergic synaptic transmission at VLPAG neurons in the FBC model is an important site of supraspinal antinociception by oxycodone via Kir 3.1 channel activation.
Collapse
Affiliation(s)
- Keiko Takasu
- Pain and Neurology, Discovery Research Laboratory for Core Therapeutic Areas, Shionogi Co., Ltd., Toyonaka, Osaka, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Hirsch S, Dickenson A, Corradini L. Anesthesia influences neuronal activity and drug effectiveness in neuropathic rats. Pain 2014; 155:2583-2590. [DOI: 10.1016/j.pain.2014.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 09/16/2014] [Accepted: 09/16/2014] [Indexed: 01/16/2023]
|
24
|
Abstract
The perception of pain in children is easily influenced by environmental factors and psychological comorbidities that are known to play an important role in its origin and response to therapy. Chronic abdominal pain is one of the most commonly treated conditions in modern pediatric gastroenterology and is the hallmark of 'functional' disorders that include irritable bowel syndrome, functional dyspepsia, and functional abdominal pain. The development of pharmacological therapies for these disorders in adults and children has been limited by the lack of understanding of the putative, pathophysiological mechanisms that underlie them. Peripheral and central pain-signaling mechanisms are known to be involved in chronic pain originating from the gastrointestinal tract, but few therapies have been developed to target specific pathways or enhance correction of the underlying pathophysiology. The responses to therapy have been variable, potentially reflecting the heterogeneity of the disorders for which they are used. Only a few small, randomized clinical trials have evaluated the benefit of pain medications for chronic abdominal pain in children and thus, the decision on the most appropriate treatment is often based on adult studies and empirical data. This review discusses the most common, non-narcotic pharmacological treatments for chronic abdominal pain in children and includes a thorough review of the literature to support or refute their use. Because of the dearth of pediatric studies, the focus is on pharmacological and alternative therapies where there is sufficient evidence of benefit in either adults or children with chronic abdominal pain.
Collapse
Affiliation(s)
- Adrian Miranda
- Division of Gastroenterology and Hepatology, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA,
| | | |
Collapse
|
25
|
Abstract
Cancer pain is a serious health problem, and imposes a great burden on the lives of patients and their families. Pain can be associated with delay in treatment, denial of treatment, or failure of treatment. If the pain is not treated properly it may impair the quality of life. Neuropathic cancer pain (NCP) is one of the most complex phenomena among cancer pain syndromes. NCP may result from direct damage to nerves due to acute diagnostic/therapeutic interventions. Chronic NCP is the result of treatment complications or malignancy itself. Although the reason for pain is different in NCP and noncancer neuropathic pain, the pathophysiologic mechanisms are similar. Data regarding neuropathic pain are primarily obtained from neuropathic pain studies. Evidence pertaining to NCP is limited. NCP due to chemotherapeutic toxicity is a major problem for physicians. In the past two decades, there have been efforts to standardize NCP treatment in order to provide better medical service. Opioids are the mainstay of cancer pain treatment; however, a new group of therapeutics called coanalgesic drugs has been introduced to pain treatment. These coanalgesics include gabapentinoids (gabapentin, pregabalin), antidepressants (tricyclic antidepressants, duloxetine, and venlafaxine), corticosteroids, bisphosphonates, N-methyl-D-aspartate antagonists, and cannabinoids. Pain can be encountered throughout every step of cancer treatment, and thus all practicing oncologists must be capable of assessing pain, know the possible underlying pathophysiology, and manage it appropriately. The purpose of this review is to discuss neuropathic pain and NCP in detail, the relevance of this topic, clinical features, possible pathology, and treatments of NCP.
Collapse
Affiliation(s)
- Ece Esin
- Medical Oncology Department, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Suayib Yalcin
- Medical Oncology Department, Hacettepe University Cancer Institute, Ankara, Turkey
| |
Collapse
|
26
|
Matsuzawa R, Fujiwara T, Nemoto K, Fukushima T, Yamaguchi S, Akagawa K, Hori Y. Presynaptic inhibitory actions of pregabalin on excitatory transmission in superficial dorsal horn of mouse spinal cord: further characterization of presynaptic mechanisms. Neurosci Lett 2013; 558:186-91. [PMID: 24269977 DOI: 10.1016/j.neulet.2013.11.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 10/29/2013] [Accepted: 11/12/2013] [Indexed: 01/17/2023]
Abstract
Pregabalin is widely used as an analgesic for the treatment of neuropathic pain. In the present experiments using mouse spinal slices, we recorded electrically evoked glutamatergic excitatory postsynaptic currents (eEPSCs) from superficial dorsal horn neurons. Pregabalin reduced the amplitude of eEPSCs, and increased the paired pulse ratio. Pregabalin also inhibited the frequency of spontaneously occurring miniature EPSCs without affecting their amplitude. Partial ligation of the sciatic nerve increased the expression of the calcium channel α2δ-1 subunit, and increased the presynaptic inhibitory action of pregabalin. Intrathecal injection of antisense oligodeoxynucleotide against the α2δ-1 subunit, decreased the expression of α2δ-1 mRNA in the spinal dorsal horn, and decreased pregabalin's action. These results provide further evidence that pregabalin exerts its presynaptic inhibitory action via binding with the α2δ subunit in a state-dependent manner. Furthermore, presynaptic actions of pregabalin were attenuated in knockout mice lacking the protein syntaxin 1A, a component of the synaptic vesicle release machinery, indicating that syntaxin 1A is required for pregabalin to exert its full presynaptic inhibitory action. These observations might suggest that direct and/or indirect interactions with the presynaptic proteins composing the release machinery underlie at least some part of pregabalin's presynaptic actions.
Collapse
Affiliation(s)
- Rie Matsuzawa
- Department of Physiology and Biological Information, Dokkyo Medical University, Kitakobayashi 880, Mibu, Tochigi 321-0293, Japan
| | - Tomonori Fujiwara
- Department of Cell Physiology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Kohei Nemoto
- Department of Physiology and Biological Information, Dokkyo Medical University, Kitakobayashi 880, Mibu, Tochigi 321-0293, Japan
| | - Teruyuki Fukushima
- Department of Physiology and Biological Information, Dokkyo Medical University, Kitakobayashi 880, Mibu, Tochigi 321-0293, Japan
| | - Shigeki Yamaguchi
- Department of Physiology and Biological Information, Dokkyo Medical University, Kitakobayashi 880, Mibu, Tochigi 321-0293, Japan
| | - Kimio Akagawa
- Department of Cell Physiology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Yuuichi Hori
- Department of Physiology and Biological Information, Dokkyo Medical University, Kitakobayashi 880, Mibu, Tochigi 321-0293, Japan.
| |
Collapse
|
27
|
Zhou C, Luo ZD. Electrophysiological characterization of spinal neuron sensitization by elevated calcium channel alpha-2-delta-1 subunit protein. Eur J Pain 2013; 18:649-58. [PMID: 24151064 DOI: 10.1002/j.1532-2149.2013.00416.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Voltage-gated calcium channel α2 δ1 subunit is the binding site for gabapentin, an effective drug in controlling neuropathic pain states including thermal hyperalgesia. Hyperalgesia to noxious thermal stimuli in both spinal nerve-ligated (SNL) and voltage-gated calcium channel α2 δ1 overexpressing transgenic (Tg) mice correlates with higher α2 δ1 levels in dorsal root ganglia and dorsal spinal cord. In this study, we investigated whether abnormal synaptic transmission is responsible for thermal hyperalgesia induced by elevated α2 δ1 expression in these models. METHODS Behavioural sensitivities to thermal stimuli were test in L4 SNL and sham mice, as well as in α2 δ1 Tg and wild-type mice. Miniature excitatory (mEPSC) and inhibitory (mIPSC) post-synaptic currents were recorded in superficial dorsal spinal cord neurons from these models using whole-cell patch clamp slice recording techniques. RESULTS The frequency, but not amplitude, of mEPSC in superficial dorsal horn neurons was increased in SNL and α2 δ1 Tg mice, which could be attenuated by gabapentin dose dependently. Intrathecal α2 δ1 antisense oligodeoxynucleotide treatment diminished increased mEPSC frequency and gabapentin's inhibitory effects in elevated mEPSC frequency in the SNL mice. In contrast, neither the frequency nor the amplitude of mIPSC was altered in superficial dorsal horn neurons from the SNL and α2 δ1 Tg mice. CONCLUSIONS Our findings support a role of peripheral nerve injury-induced α2 δ1 in enhancing pre-synaptic excitatory input onto superficial dorsal spinal cord neurons that contributes to nociception development.
Collapse
Affiliation(s)
- C Zhou
- Department of Pharmacology, School of Medicine, University of California Irvine, USA
| | | |
Collapse
|
28
|
Nasca C, Orlando R, Marchiafava M, Boldrini P, Battaglia G, Scaccianoce S, Matrisciano F, Pittaluga A, Nicoletti F. Exposure to predator odor and resulting anxiety enhances the expression of the α2 δ subunit of voltage-sensitive calcium channels in the amygdala. J Neurochem 2013; 125:649-56. [PMID: 22849384 DOI: 10.1111/j.1471-4159.2012.07895.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 07/11/2012] [Accepted: 07/12/2012] [Indexed: 11/28/2022]
Abstract
The α2 δ subunit of voltage-sensitive calcium channels (VSCCs) is the molecular target of pregabalin and gabapentin, two drugs marked for the treatment of focal epilepsy, neuropathic pain, and anxiety disorders. Expression of the α2 δ subunit is up-regulated in the dorsal horns of the spinal cord in models of neuropathic pain, suggesting that plastic changes in the α2 δ subunit are associated with pathological states. Here, we examined the expression of the α2 δ-1 subunit in the amygdala, hippocampus, and frontal cortex in the trimethyltiazoline (TMT) mouse model of innate anxiety. TMT is a volatile molecule present in the feces of the rodent predator, red fox. Mice that show a high defensive behavior during TMT exposure developed anxiety-like behavior in the following 72 h, as shown by the light-dark test. Anxiety was associated with an increased expression of the α2 δ-1 subunit of VSCCs in the amygdaloid complex at all times following TMT exposure (4, 24, and 72 h). No changes in the α2 δ-1 protein levels were seen in the hippocampus and frontal cortex of mice exposed to TMT. Pregabalin (30 mg/kg, i.p.) reduced anxiety-like behavior in TMT-exposed mice, but not in control mice. These data offer the first demonstration that the α2 δ-1 subunit of VSCCs undergoes plastic changes in a model of innate anxiety, and supports the use of pregabalin as a disease-dependent drug in the treatment of anxiety disorders.
Collapse
Affiliation(s)
- Carla Nasca
- Department of Physiology and Pharmacology, University Sapienza, Roma, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Yang JL, Xu B, Li SS, Zhang WS, Xu H, Deng XM, Zhang YQ. Gabapentin reduces CX3CL1 signaling and blocks spinal microglial activation in monoarthritic rats. Mol Brain 2012; 5:18. [PMID: 22647647 PMCID: PMC3517515 DOI: 10.1186/1756-6606-5-18] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 04/05/2012] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Spinal glia, particularly microglia and astrocytes, are of the utmost importance in the development and maintenance of chronic pain. A recent study from our laboratory revealed that gabapentin, a recommended first-line treatment for multiple neuropathic conditions, could also efficiently antagonize thermal hyperalgesia evoked by complete Freund's adjuvant (CFA)-induced monoarthritis (MA). In the present study, we investigated whether the spinal glia are involved in the anti-hyperalgesic effect of gabapentin and how this event occurs. RESULTS Unilateral intra-articular injection of CFA produced a robust activation of microglia and astrocytes. These cells exhibited large cell bodies, thick processes and increases in the ionized calcium binding adapter molecule 1 (Iba-1, a microglial marker) or the glia fibrillary acidic protein (GFAP, an astrocytic marker). These cells also displayed immunoreactive signals, and an upregulation of the voltage-gated calcium channels (VGCCs) α2/δ-1 subunit, CX3CL1 and CX3CR1 expression levels in the spinal cord. These changes were associated with the development of thermal hyperalgesia. Immunofluorescence staining showed that VGCC α2/δ-1 subunit, a proposed gabapentin target of action, was widely distributed in primary afferent fibers terminals and dorsal horn neurons. CX3CL1, a potential trigger to activate microglia, colocalized with VGCC α2/δ-1 subunits in the spinal dorsal horn. However, its receptor CX3CR1 was mainly expressed in the spinal microglia. Multiple intraperitoneal (i.p.) gabapentin injections (100 mg/kg, once daily for 4 days with the first injection 60 min before intra-articular CFA) suppressed the activation of spinal microglia, downregulated spinal VGCC α2/δ-1 subunits decreased CX3CL1 levels and blocked the development of thermal hyperalgesia in MA rats. CONCLUSIONS Here we provide the first evidence that gabapentin diminishes CX3CL1 signaling and spinal microglia activation induced by joint inflammation. We also show that the VGCC α2/δ-1 subunits might be involved in these events.
Collapse
Affiliation(s)
- Jia-Le Yang
- Institute of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200032, China
| | | | | | | | | | | | | |
Collapse
|
30
|
Davis MP. Drug management of visceral pain: concepts from basic research. PAIN RESEARCH AND TREATMENT 2012; 2012:265605. [PMID: 22619712 PMCID: PMC3348642 DOI: 10.1155/2012/265605] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 02/13/2012] [Indexed: 12/24/2022]
Abstract
Visceral pain is experienced by 40% of the population, and 28% of cancer patients suffer from pain arising from intra- abdominal metastasis or from treatment. Neuroanatomy of visceral nociception and neurotransmitters, receptors, and ion channels that modulate visceral pain are qualitatively or quantitatively different from those that modulate somatic and neuropathic pain. Visceral pain should be recognized as distinct pain phenotype. TRPV1, Na 1.8, and ASIC3 ion channels and peripheral kappa opioid receptors are important mediators of visceral pain. Mu agonists, gabapentinoids, and GABAB agonists reduce pain by binding to central receptors and channels. Combinations of analgesics and adjuvants in animal models have supra-additive antinociception and should be considered in clinical trials. This paper will discuss the neuroanatomy, receptors, ion channels, and neurotransmitters important to visceral pain and provide a basic science rationale for analgesic trials and management.
Collapse
Affiliation(s)
- Mellar P. Davis
- Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA
- Solid Tumor Division, Harry R. Horvitz Center for Palliative Medicine, Taussig Cancer Institute, USA
| |
Collapse
|
31
|
Bala I, Bharti N, Chaubey VK, Mandal AK. Efficacy of Gabapentin for Prevention of Postoperative Catheter-related Bladder Discomfort in Patients Undergoing Transurethral Resection of Bladder Tumor. Urology 2012; 79:853-7. [DOI: 10.1016/j.urology.2011.11.050] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 11/25/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
|
32
|
Morgado C, Terra PP, Tavares I. Neuronal hyperactivity at the spinal cord and periaqueductal grey during painful diabetic neuropathy: Effects of gabapentin. Eur J Pain 2012; 14:693-9. [DOI: 10.1016/j.ejpain.2009.11.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 11/04/2009] [Accepted: 11/27/2009] [Indexed: 02/08/2023]
|
33
|
Martinez JA, Kasamatsu M, Rosales-Hernandez A, Hanson LR, Frey WH, Toth CC. Comparison of central versus peripheral delivery of pregabalin in neuropathic pain states. Mol Pain 2012; 8:3. [PMID: 22236461 PMCID: PMC3285045 DOI: 10.1186/1744-8069-8-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 01/11/2012] [Indexed: 11/10/2022] Open
Abstract
Background Although pregabalin therapy is beneficial for neuropathic pain (NeP) by targeting the CaVα2δ-1 subunit, its site of action is uncertain. Direct targeting of the central nervous system may be beneficial for the avoidance of systemic side effects. Results We used intranasal, intrathecal, and near-nerve chamber forms of delivery of varying concentrations of pregabalin or saline delivered over 14 days in rat models of experimental diabetic peripheral neuropathy and spinal nerve ligation. As well, radiolabelled pregabalin was administered to determine localization with different deliveries. We evaluated tactile allodynia and thermal hyperalgesia at multiple time points, and then analyzed harvested nervous system tissues for molecular and immunohistochemical changes in CaVα2δ-1 protein expression. Both intrathecal and intranasal pregabalin administration at high concentrations relieved NeP behaviors, while near-nerve pregabalin delivery had no effect. NeP was associated with upregulation of CACNA2D1 mRNA and CaVα2δ-1 protein within peripheral nerve, dorsal root ganglia (DRG), and dorsal spinal cord, but not brain. Pregabalin's effect was limited to suppression of CaVα2δ-1 protein (but not CACNA2D1 mRNA) expression at the spinal dorsal horn in neuropathic pain states. Dorsal root ligation prevented CaVα2δ-1 protein trafficking anterograde from the dorsal root ganglia to the dorsal horn after neuropathic pain initiation. Conclusions Either intranasal or intrathecal pregabalin relieves neuropathic pain behaviours, perhaps due to pregabalin's effect upon anterograde CaVα2δ-1 protein trafficking from the DRG to the dorsal horn. Intranasal delivery of agents such as pregabalin may be an attractive alternative to systemic therapy for management of neuropathic pain states.
Collapse
Affiliation(s)
- Jose A Martinez
- Department of Clinical Neurosciences and the University of Calgary, Calgary, AB, Canada
| | | | | | | | | | | |
Collapse
|
34
|
Luszczki JJ, Kolacz A, Czuczwar M, Przesmycki K, Czuczwar SJ. Synergistic interaction of gabapentin with tiagabine in the formalin test in mice: An isobolographic analysis. Eur J Pain 2012; 13:665-72. [DOI: 10.1016/j.ejpain.2008.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 08/10/2008] [Accepted: 08/10/2008] [Indexed: 10/21/2022]
|
35
|
Vadalouca A, Raptis E, Moka E, Zis P, Sykioti P, Siafaka I. Pharmacological treatment of neuropathic cancer pain: a comprehensive review of the current literature. Pain Pract 2011; 12:219-51. [PMID: 21797961 DOI: 10.1111/j.1533-2500.2011.00485.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neuropathic cancer pain (NCP), commonly encountered in clinical practice, may be cancer-related, namely resulting from nervous system tumor invasion, surgical nerve damage during tumor removal, radiation-induced nerve damage and chemotherapy-related neuropathy, or may be of benign origin, unrelated to cancer. A neuropathic component is evident in about 1/3 of cancer pain cases. Although from a pathophysiological perspective NCP may differ from chronic neuropathic pain (NP), such as noncancer-related pain, clinical practice, and limited publications have shown that these two pain entities may share some treatment modalities. For example, co-analgesics have been well integrated into cancer pain-management strategies and are often used as First-Line options for the treatment of NCP. These drugs, including antidepressants and anticonvulsants, are recommended by evidence-based guidelines, whereas, others such as lidocaine patch 5%, are supported by randomized, controlled, clinical data and are included in guidelines for restricted conditions treatment. The vast majority of these drugs have already been proven useful in the management of benign NP syndromes. Treatment decisions for patients with NP can be difficult. The intrinsic difficulties in performing randomized controlled trials in cancer pain have traditionally justified the acceptance of drugs already known to be effective in benign NP for the management of malignant NP, despite the lack of relevant high quality data. Interest in NCP mechanisms and pharmacotherapy has increased, resulting in significant mechanism-based treatment advances for the future. In this comprehensive review, we present the latest knowledge regarding NCP pharmacological management.
Collapse
Affiliation(s)
- Athina Vadalouca
- 1st Anaesthesiology Clinic, Pain Relief and Palliative Care Unit, Aretaieion University Hospital, University of Athens, Greece.
| | | | | | | | | | | |
Collapse
|
36
|
Gale JD, Houghton LA. Alpha 2 Delta (α(2)δ) Ligands, Gabapentin and Pregabalin: What is the Evidence for Potential Use of These Ligands in Irritable Bowel Syndrome. Front Pharmacol 2011; 2:28. [PMID: 21713059 PMCID: PMC3114047 DOI: 10.3389/fphar.2011.00028] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 05/29/2011] [Indexed: 12/12/2022] Open
Abstract
Irritable bowel syndrome (IBS) is a complex disorder that is characterized by abdominal pain and altered bowel habit, and often associates with other gastrointestinal symptoms such as feelings of incomplete bowel movement and abdominal bloating, and extra-intestinal symptoms such as headache, dyspareunia, heartburn, muscle pain, and back pain. It also frequently coexists with conditions that may also involve central sensitization processes, such as fibromyalgia, irritable bladder disorder, and chronic cough. This review examines the evidence to date on gabapentin and pregabalin which may support further and continued research and development of the α2δ ligands in disorders characterized by visceral hypersensitivity, such as IBS. The distribution of the α2δ subunit of the voltage-gated calcium channel, possible mechanisms of action, pre-clinical data which supports an effect on motor–sensory mechanisms and clinical evidence that points to potential benefits in patients with IBS will be discussed.
Collapse
Affiliation(s)
- Jeremy D Gale
- Clinical Research, Pfizer Global Research and Development Sandwich, UK
| | | |
Collapse
|
37
|
Dhasmana S, Singh V, Pal US. The combined analgesic effect of gabapentin and transdermal fentanyl patch on acute and chronic pain after maxillary cancer surgeries. J Maxillofac Oral Surg 2009; 8:55-9. [PMID: 23139472 DOI: 10.1007/s12663-009-0014-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 03/02/2009] [Indexed: 11/30/2022] Open
Abstract
UNLABELLED Purpose of this study was to evaluate the combined analgesic effect of gabapentin and transdermal fentanyl patch, on acute and chronic pain after surgery for maxillary cancer. STUDY DESIGN The Study was double blind and prospective. 100 subjects belonging to ASA grade I and II, 30-50 years age group, scheduled for maxillary cancer surgery were randomized into two groups; treatment group (GT): to receive gabapentin, transdermal fentanyl patch or control group ©: two placebos. For acute postoperative pain (Visual Analogue Score) and analgesic requirements were assessed 2, 4, 8 hours and 7 days after surgery. Subjects were also assessed for chronic pain 2, 4, 6 months later. RESULTS Subjects in treatment group required lesser dose of analgesic, as compared to control group, in the post operative period. Visual Analogue Scores were also significantly lower in the treatment group throughout the post operative period. Occurrence of side effects was non significant between both groups. 2, 4 and 6 months after surgery, 40, 35 and 28 subjects respectively, out of total 45 subjects of the control group, reported chronic pain. In comparison, 25, 10 and 4 subjects out of 42 subjects in the treatment group reported chronic pain 2, 4, 6 months respectively after surgery. 15, 10 and 6 out of 45 of the control group required analgesics, whereas 2, 0 and 0 out of 42 in the treatment group, required analgesics respectively 2, 4 and 6 months after surgery CONCLUSION Acute and chronic pain after maxillary cancer surgery is significantly reduced by multimodal analgesia.
Collapse
Affiliation(s)
- Satish Dhasmana
- Department of Anesthesiology, Chattrapati Shahuji Maharaj Medical University, Lucknow, India ; Department of Anesthesiology, Chattrapati Shahuji Maharaj Medical University (Formerly King George Medical University), Lucknow, 226003 Uttar Pradesh India
| | | | | |
Collapse
|
38
|
Bauer CS, Nieto-Rostro M, Rahman W, Tran-Van-Minh A, Ferron L, Douglas L, Kadurin I, Sri Ranjan Y, Fernandez-Alacid L, Millar NS, Dickenson AH, Lujan R, Dolphin AC. The increased trafficking of the calcium channel subunit alpha2delta-1 to presynaptic terminals in neuropathic pain is inhibited by the alpha2delta ligand pregabalin. J Neurosci 2009; 29:4076-88. [PMID: 19339603 PMCID: PMC6665374 DOI: 10.1523/jneurosci.0356-09.2009] [Citation(s) in RCA: 323] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 02/19/2009] [Indexed: 02/05/2023] Open
Abstract
Neuropathic pain results from damage to the peripheral sensory nervous system, which may have a number of causes. The calcium channel subunit alpha(2)delta-1 is upregulated in dorsal root ganglion (DRG) neurons in several animal models of neuropathic pain, and this is causally related to the onset of allodynia, in which a non-noxious stimulus becomes painful. The therapeutic drugs gabapentin and pregabalin (PGB), which are both alpha(2)delta ligands, have antiallodynic effects, but their mechanism of action has remained elusive. To investigate this, we used an in vivo rat model of neuropathy, unilateral lumbar spinal nerve ligation (SNL), to characterize the distribution of alpha(2)delta-1 in DRG neurons, both at the light- and electron-microscopic level. We found that, on the side of the ligation, alpha(2)delta-1 was increased in the endoplasmic reticulum of DRG somata, in intracellular vesicular structures within their axons, and in the plasma membrane of their presynaptic terminals in superficial layers of the dorsal horn. Chronic PGB treatment of SNL animals, at a dose that alleviated allodynia, markedly reduced the elevation of alpha(2)delta-1 in the spinal cord and ascending axon tracts. In contrast, it had no effect on the upregulation of alpha(2)delta-1 mRNA and protein in DRGs. In vitro, PGB reduced plasma membrane expression of alpha(2)delta-1 without affecting endocytosis. We conclude that the antiallodynic effect of PGB in vivo is associated with impaired anterograde trafficking of alpha(2)delta-1, resulting in its decrease in presynaptic terminals, which would reduce neurotransmitter release and spinal sensitization, an important factor in the maintenance of neuropathic pain.
Collapse
Affiliation(s)
- Claudia S. Bauer
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Manuela Nieto-Rostro
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Wahida Rahman
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Alexandra Tran-Van-Minh
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Laurent Ferron
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Leon Douglas
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Ivan Kadurin
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Yorain Sri Ranjan
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | | | - Neil S. Millar
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Anthony H. Dickenson
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| | - Rafael Lujan
- Departamento Ciencias Medicas, Universidad de Castilla-La Mancha, 02006 Albacete, Spain
| | - Annette C. Dolphin
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom, and
| |
Collapse
|
39
|
Antihyperalgesic effect of systemic dexmedetomidine and gabapentin in a rat model of monoarthritis. Brain Res 2009; 1264:57-66. [DOI: 10.1016/j.brainres.2009.01.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 01/19/2009] [Accepted: 01/20/2009] [Indexed: 11/23/2022]
|
40
|
Tanabe M, Takasu K, Takeuchi Y, Ono H. Pain relief by gabapentin and pregabalin via supraspinal mechanisms after peripheral nerve injury. J Neurosci Res 2009; 86:3258-64. [PMID: 18655202 DOI: 10.1002/jnr.21786] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The antihypersensitivity actions of gabapentin and pregabalin have been well characterized in a large number of studies, although the underlying mechanisms have yet to be defined. We have been focusing on the supraspinal structure as a possible site for their action and have demonstrated that intracerebroventricular (i.c.v.) administration of gabapentin and pregabalin indeed decreases thermal and mechanical hypersensitivity in a murine chronic pain model involving partial ligation of the sciatic nerve. This novel supraspinally mediated analgesic effect was markedly suppressed by either depletion of central noradrenaline (NA) or blockade of spinal alpha(2)-adrenergic receptors. Moreover, i.c.v. injection of gabapentin and pregabalin increased spinal NA turnover in mice only after peripheral nerve injury. In locus coeruleus (LC) neurons in brainstem slices prepared from mice after peripheral nerve injury, gabapentin reduced the gamma-aminobutyric acid (GABA) type A receptor-mediated inhibitory postsynaptic currents (IPSCs). Glutamate-mediated excitatory synaptic transmission was hardly affected. Moreover, gabapentin did not reduce IPSCs in slices taken from mice given a sham operation. Although gabapentin altered neither the amplitude nor the frequency of miniature IPSCs, it reduced IPSCs together with an increase in the paired-pulse ratio, suggesting that gabapentin acts on the presynaptic GABAergic nerve terminals in the LC. Together, the data suggest that gabapentin presynaptically reduces GABAergic synaptic transmission, thereby removing the inhibitory influence on LC neurons only in neuropathic pain states, leading to activation of the descending noradrenergic system.
Collapse
Affiliation(s)
- Mitsuo Tanabe
- Laboratory of CNS Pharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan.
| | | | | | | |
Collapse
|
41
|
Yamamoto T, Katayama Y, Obuchi T, Kano T, Kobayashi K, Oshima H, Chikashi F. Drug challenge test and drip infusion of ketamine for post-stroke pain . ACTA ACUST UNITED AC 2009. [DOI: 10.11154/pain.24.191] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Takamitsu Yamamoto
- Division of Applied System Neuroscience, Department of Advanced Medical Science, Nihon University School of Medicine
| | - Yoichi Katayama
- Department of Neurological Surgery, Nihon University School of Medicine
| | - Toshiki Obuchi
- Department of Neurological Surgery, Nihon University School of Medicine
| | - Toshikazu Kano
- Department of Neurological Surgery, Nihon University School of Medicine
| | | | - Hideki Oshima
- Department of Neurological Surgery, Nihon University School of Medicine
| | - Fukaya Chikashi
- Division of Applied System Neuroscience, Department of Advanced Medical Science, Nihon University School of Medicine
| |
Collapse
|
42
|
Gauchan P, Andoh T, Ikeda K, Fujita M, Sasaki A, Kato A, Kuraishi Y. Mechanical Allodynia Induced by Paclitaxel, Oxaliplatin and Vincristine: Different Effectiveness of Gabapentin and Different Expression of Voltage-Dependent Calcium Channel .ALPHA.2.DELTA.-1 Subunit. Biol Pharm Bull 2009; 32:732-4. [DOI: 10.1248/bpb.32.732] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Punam Gauchan
- Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Tsugunobu Andoh
- Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Kenichiro Ikeda
- Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Masahide Fujita
- Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Atsushi Sasaki
- Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Atsushi Kato
- Department of Hostpital Pharmacy, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| | - Yasushi Kuraishi
- Department of Applied Pharmacology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama
| |
Collapse
|
43
|
Park S, Ahn ES, Han DW, Lee JH, Min KT, Kim H, Hong YW. Pregabalin and gabapentin inhibit substance P-induced NF-κB activation in neuroblastoma and glioma cells. J Cell Biochem 2008; 105:414-23. [DOI: 10.1002/jcb.21837] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
44
|
Takasu K, Ono H, Tanabe M. Gabapentin produces PKA-dependent pre-synaptic inhibition of GABAergic synaptic transmission in LC neurons following partial nerve injury in mice. J Neurochem 2008; 105:933-42. [DOI: 10.1111/j.1471-4159.2008.05212.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
45
|
|
46
|
Koç S, Memis D, Sut N. The preoperative use of gabapentin, dexamethasone, and their combination in varicocele surgery: a randomized controlled trial. Anesth Analg 2007; 105:1137-42, table of contents. [PMID: 17898401 DOI: 10.1213/01.ane.0000278869.00918.b7] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND We investigated the effects of gabapentin and dexamethasone given together or separately 1 h before the start of surgery on laryngoscopy, tracheal intubation, intraoperative hemodynamics, opioid consumption, and postoperative pain in patients undergoing varicocele operations. METHODS Patients were randomly divided into four double-blind groups: group C (control, n = 20) received placebo, group G (gabapentin, n = 20) received 800 mg gabapentin, group D (dexamethasone, n = 20) received 8 mg dexamethasone, group GD (gabapentin plus dexamethasone) received both 800 mg gabapentin and 8 mg dexamethasone IV 1 h before the start of surgery. Standard induction and maintenance of anesthesia were accomplished and continued by propofol and remifentanil infusion. Heart rate and arterial blood pressure were recorded before induction and after intubation. Intraoperative total remifentanil consumption was recorded. Hemodynamic variables and visual analog scale were recorded for 24 h. Side effects were noted. RESULTS Hemodynamics at 1, 3, 5, and 10 min after tracheal intubation, total remifentanil consumption during surgery, postoperative visual analog scale scores at 30 min, 1, 2, 4, 6, and 12 h, and postoperative nausea and vomiting were found to be significantly lower in group GD than in group G and group D (P < 0.05 for both), and substantially lower when compared with group C (P < 0.001). All values in group C were also higher than in groups G and D (P < 0.05). CONCLUSION Gabapentin and dexamethasone administered together an hour before varicocele surgery results in less laryngeal and tracheal intubation response, improves postoperative analgesia, and prevents postoperative nausea and vomiting better than individual administration of each drug.
Collapse
Affiliation(s)
- Serhat Koç
- Department of Anaesthesiology and Reanimation, Medical Faculty, Trakya University, Edirne, Turkey
| | | | | |
Collapse
|
47
|
Davis JL, Posner LP, Elce Y. Gabapentin for the treatment of neuropathic pain in a pregnant horse. J Am Vet Med Assoc 2007; 231:755-8. [PMID: 17764439 DOI: 10.2460/javma.231.5.755] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 24-year-old 732-kg (1,610-lb) pregnant Belgian draft horse mare developed neuropathy and signs of intractable pain following colic surgery. CLINICAL FINDINGS Following recovery from colic surgery to treat compression of the small and large intestines because of a large fetus, the mare was noticed to have signs of femoral neuropathy involving the left hind limb. Within 36 hours after recovery, the mare developed signs of severe pain that were unresponsive to conventional treatment. No gastrointestinal tract or muscular abnormalities were found, and the discomfort was attributed to neuropathic pain. TREATMENT AND OUTCOME The mare was treated with gabapentin (2.5 mg/kg [1.1 mg/lb], PO, q 12 h). Shortly after this treatment was initiated, the mare appeared comfortable and no longer had signs of pain. Treatment was continued for 6 days, during which the dosage was progressively decreased, and the mare was discharged. The mare subsequently delivered a healthy foal. CLINICAL RELEVANCE Gabapentin appeared to be a safe, effective, and economical treatment for neuropathic pain in this horse.
Collapse
Affiliation(s)
- Jennifer L Davis
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | | | | |
Collapse
|
48
|
Kazi JA, Gee CF. Effect of Gabapentin on c-Fos Expression in the CNS after Paw Surgery in Rats. J Mol Neurosci 2007; 32:228-34. [PMID: 17873368 DOI: 10.1007/s12031-007-0048-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Revised: 11/30/1999] [Accepted: 05/21/2007] [Indexed: 10/23/2022]
Abstract
Gabapentin (neurontin), a GABA analogue anticonvulsant has proven to be effective in anti-nociceptive activity as well as for the treatment of anxiety. Gabapentin (GBP) is well tolerated and shows very favorable side effects profile: The exact molecular mechanism of action of GBP to block postoperative pain and stress is not known. Therefore, to identify the functional neuroanatomical target sites of GBP in post-surgery as well as its effect on postsurgical process, we examined the effects of GBP on c-Fos expression in the supraspinal part of the central nervous system in rats. Using a well-validated rat model of surgical pain, we studied the neuroanatomical functional target sites of gabapentin after paw surgery. The effect of GBP was examined by means of c-Fos immunohistochemistry. A single intraperitoneal injection (i.p.) of GBP (150 mg/kg) or saline (control) was administered 20 min before surgical incision in the paw under anesthesia. Ninety minutes after surgical incision, the deeply anesthetized rats were perfused transcardially with 4% paraformaldehyde. Serial 40-microm-thick sections of whole brain (except spinal cord) were cut and processed by immunohistochemistry to locate and quantify the sites and number of neurons with c-Fos immunoreactivity. Detection of c-Fos protein was performed using the peroxidase-antiperoxidase detection protocol. Our present study demonstrated that compared to control, administration of GBP (150 mg/kg, i.p.) before paw surgery significantly (p < 0.01) attenuated the incision-induced c-Fos expression only in the paraventricular nucleus of the hypothalamus. In addition, GBP-induced increase in c-Fos expression was observed in the dorsal raphe (DRN) and in the nucleus raphe magnus. Present results indicate that GBP may differentially modulate c-Fos expression in surgical paw incision. Moreover, this study provides some clue to examine whether GBP exerts its action simultaneously through two separate pathways in post-surgery.
Collapse
Affiliation(s)
- Jamil Ahsan Kazi
- Department of Anaesthesia, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
| | | |
Collapse
|
49
|
Kazi JA, Gee CF. Gabapentin completely attenuated the acute morphine induced c-Fos expression in the rat striatum. J Mol Neurosci 2007; 32:47-52. [PMID: 17873287 DOI: 10.1007/s12031-007-0007-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Revised: 11/30/1999] [Accepted: 01/26/2007] [Indexed: 11/30/2022]
Abstract
The neuro-anatomical sites and molecular mechanism of action of gabapentin (GBP)-morphine interaction to prevent and reverse morphine side effects as well as enhancement of the analgesic effect of morphine is not known. Therefore, we examined the combined effects of GBP-Morphine on acute morphine induced c-Fos expression in rat striatum. The combined effect of GBP-Morphine was examined by means of c-Fos immunohistochemistry. A single intraperitoneal injection (i.p.) of morphine (10 mg/kg), saline (control), co-injection of GBP (150 mg/kg) with morphine (10 mg/kg) was administered under anaesthesia. Ninety minutes after drugs administration the deeply anesthetized rats were perfused transcardially with 4% paraformaldehyde. Serial 40 mum thick sections of brain were cut and processed by immunohistochemistry to locate and quantify the sites and number of neurons with c-Fos immunoreactivity. Detection of c-Fos protein was performed using the peroxidase-antiperoxidase (PAP) detection protocol. Our present study demonstrated that, administration of GBP (150 mg/kg, i.p.) in combination with morphine (10 mg/kg, i.p.) significantly (p < 0.01) attenuated the acute morphine (10 mg/kg, i.p.) induced c-Fos expression in the rat striatum. Present results showed that GBP-morphine combination action prevented the acute morphine induced c-Fos expression in rat striatum. Moreover, this study provides first evidence of neuro-anatomical site and that GBP neutralized the morphine induced activation of rat striatum.
Collapse
Affiliation(s)
- Jamil Ahsan Kazi
- Department of Anaesthesia, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
| | | |
Collapse
|
50
|
Dooley DJ, Taylor CP, Donevan S, Feltner D. Ca2+ channel alpha2delta ligands: novel modulators of neurotransmission. Trends Pharmacol Sci 2007; 28:75-82. [PMID: 17222465 DOI: 10.1016/j.tips.2006.12.006] [Citation(s) in RCA: 271] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Revised: 10/25/2006] [Accepted: 12/19/2006] [Indexed: 10/23/2022]
Abstract
The term 'Ca2+ channel alpha2delta ligands' has recently been applied to an evolving drug class that includes gabapentin (Neurontin) and pregabalin (Lyrica), and reflects significant progress over the past decade in elucidating the mechanism of action of these drugs: a novel, specific action at one of the subunits constituting voltage-sensitive Ca2+ channels. Binding of these ligands to the alpha2delta subunit is considered to explain their usefulness in treating several clinical disorders, including epilepsy, pain from diabetic neuropathy, postherpetic neuralgia and fibromyalgia, and generalized anxiety disorder. The evidence indicates a relationship between alpha2delta subunit binding and the modulation of processes that subserve neurotransmission. This modulation is characterized by a reduction of the excessive neurotransmitter release that is observed in certain neurological and psychiatric disorders.
Collapse
Affiliation(s)
- David J Dooley
- Department of CNS Pharmacology, Pfizer Global Research and Development, Ann Arbor, MI 48105, USA.
| | | | | | | |
Collapse
|