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Salati SA, Alsulaim L, Alharbi MH, Alharbi NH, Alsenaid TM, Alaodah SA, Alsuhaibani AS, Albaqami KA. Postmastectomy Pain Syndrome: A Narrative Review. Cureus 2023; 15:e47384. [PMID: 38021812 PMCID: PMC10657609 DOI: 10.7759/cureus.47384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Postmastectomy pain syndrome is a very common disorder in breast cancer survivors. The impact on the quality of patients' lives is significantly adverse. The precise pathophysiology has not been determined as yet though various risk factors have been identified that make the patient vulnerable. Required preoperative work includes the identification and possible elimination of risk factors. Treatment is multidisciplinary involving surgical and non-surgical modalities. There is a great scope of research in this field.
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Affiliation(s)
- Sajad Ahmad Salati
- General Surgery, Unaizah College of Medicine & Medical Sciences, Qassim University, Qassim, SAU
| | - Lamees Alsulaim
- Surgery, Unaizah College of Medicine & Medical Sciences, Qassim University, Qassim, SAU
| | - Mariyyah H Alharbi
- College of Medicine, Unaizah College of Medicine & Medical Sciences, Qassim University, Qassim, SAU
| | - Norah H Alharbi
- College of Medicine, Unaizah College of Medicine & Medical Sciences, Qassim University, Qassim, SAU
| | - Thana M Alsenaid
- College of Medicine, Unaizah College of Medicine & Medical Sciences, Qassim University, Qassim, SAU
| | - Shoug A Alaodah
- College of Medicine, Unaizah College of Medicine & Medical Sciences, Qassim University, Qassim, SAU
| | - Abdulsalam S Alsuhaibani
- College of Medicine, Unaizah College of Medicine & Medical Sciences, Qassim University, Qassim, SAU
| | - Khalid A Albaqami
- College of Medicine, Unaizah College of Medicine & Medical Sciences, Qassim University, Qassim, SAU
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Cho SJ, Lee JY, Jeong Y, Cho SY, Lee DG, Choi JY, Park HJ. Milnacipran Has an Antihyperalgesic Effect on Cisplatin-Induced Neuropathy. Pharmaceutics 2023; 15:2218. [PMID: 37765187 PMCID: PMC10535450 DOI: 10.3390/pharmaceutics15092218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/20/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Milnacipran is a typical serotonin-norepinephrine reuptake inhibitor and has been shown to have analgesic effects in several pain models. However, its antihyperalgesic effect in cisplatin-induced neuropathy remains unknown. We examined the effects of intraperitoneal (IP) milnacipran on allodynia in cisplatin-induced peripheral neuropathic mice. (2) Methods: Peripheral neuropathy was induced by injecting cisplatin (2.3 mg/kg/day, IP) six times, on every other day. Saline or milnacipran (10, 30, 50 mg/kg, IP) were then administered to the neuropathic mice. We examined mechanical allodynia using von Frey hairs at preadministration and at 30, 60, 90, 120, 180, 240 min and 24 h after drug administration. We also measured the dorsal root ganglion (DRG) activating transcription factor 3 (ATF3) to confirm the analgesic effects of milnacipran. (3) Results: For the milnacipran groups, the decreased paw withdrawal thresholds to mechanical stimuli were significantly reversed when compared to the preadministration values and the values in the saline-injected control group (p < 0.0001). Milnacipran administration to cisplatin-induced peripheral neuropathic mice resulted in a significant suppression of neuronal ATF3 activation (p < 0.01). (4) Conclusions: Milnacipran given via IP injection attenuates mechanical allodynia in mouse models of cisplatin-induced poly-neuropathic pain. These effects were confirmed by significant suppression of neuronal ATF3 activation in the DRG.
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Affiliation(s)
- Sun Jin Cho
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.C.); (Y.J.); (S.Y.C.); (D.-G.L.); (J.Y.C.)
| | - Jin Young Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, College of Medicine, The Sungkyunkwan University of Korea, Seoul 06351, Republic of Korea;
| | - Yujin Jeong
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.C.); (Y.J.); (S.Y.C.); (D.-G.L.); (J.Y.C.)
| | - So Yeon Cho
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.C.); (Y.J.); (S.Y.C.); (D.-G.L.); (J.Y.C.)
| | - Do-Gyeong Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.C.); (Y.J.); (S.Y.C.); (D.-G.L.); (J.Y.C.)
| | - Ji Yeon Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.C.); (Y.J.); (S.Y.C.); (D.-G.L.); (J.Y.C.)
| | - Hue Jung Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (S.J.C.); (Y.J.); (S.Y.C.); (D.-G.L.); (J.Y.C.)
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O'Brien JB, Roman DL. Novel treatments for chronic pain: moving beyond opioids. Transl Res 2021; 234:1-19. [PMID: 33727192 DOI: 10.1016/j.trsl.2021.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 02/06/2023]
Abstract
It is essential that safe and effective treatment options be available to patients suffering from chronic pain. The emergence of an opioid epidemic has shaped public opinions and created stigmas surrounding the use of opioids for the management of pain. This reality, coupled with high risk of adverse effects from chronic opioid use, has led chronic pain patients and their healthcare providers to utilize nonopioid treatment approaches. In this review, we will explore a number of cellular reorganizations that are associated with the development and progression of chronic pain. We will also discuss the safety and efficacy of opioid and nonopioid treatment options for chronic pain. Finally, we will review the evidence for adenylyl cyclase type 1 (AC1) as a novel target for the treatment of chronic pain.
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Affiliation(s)
- Joseph B O'Brien
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, Iowa
| | - David L Roman
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, Iowa; Iowa Neuroscience Institute, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa.
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Khakpai F, Ramezanikhah M, Valizadegan F, Zarrindast MR. Synergistic effect between imipramine and citicoline upon induction of analgesic and antidepressant effects in mice. Neurosci Lett 2021; 760:136095. [PMID: 34216716 DOI: 10.1016/j.neulet.2021.136095] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 06/11/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022]
Abstract
Imipramine is a tricyclic antidepressant (TCA) drug that is sometimes used to treat neuropathic pain. Citicoline is a dietary supplement that has been used as a neuroprotective agent for neurological disorders. Probable interaction between imipramine and citicoline on pain and depression behaviors was examined in mice using a tail-flick test, open field test (OFT), forced swimming test (FST), and tail suspension test (TST). The results indicated that the intraperitoneal (i.p.) administration of citicoline (50 mg/kg) induced analgesic and antidepressant-like behaviors in mice. Similarly, i.p. injection of imipramine (5 mg/kg) induced dose-dependent anti-nociceptive and anti-depressive effects. Co-administration of different doses of imipramine (1.25, 2.5, and 5 mg/kg) along with an ineffective dose of citicoline (6.25 mg/kg) increased tail-flick latency and decreased immobility time in the FST, suggesting an analgesic and antidepressant-like behaviors. Interestingly, there is a synergistic effect between imipramine and citicoline upon the induction of analgesic and antidepressant effects. All doses of the drugs had no significant effect on the locomotor activity. Based on these results, it can be concluded that the administration of citicoline (as an adjuvant drug) in combination with imipramine increased the efficacy of TCA drugs for modulation of pain and depression behaviors.
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Affiliation(s)
- Fatemeh Khakpai
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mahsa Ramezanikhah
- Department of Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Farhad Valizadegan
- Department of Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Topical Treatments and Their Molecular/Cellular Mechanisms in Patients with Peripheral Neuropathic Pain-Narrative Review. Pharmaceutics 2021; 13:pharmaceutics13040450. [PMID: 33810493 PMCID: PMC8067282 DOI: 10.3390/pharmaceutics13040450] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 12/25/2022] Open
Abstract
Neuropathic pain in humans results from an injury or disease of the somatosensory nervous system at the peripheral or central level. Despite the considerable progress in pain management methods made to date, peripheral neuropathic pain significantly impacts patients' quality of life, as pharmacological and non-pharmacological methods often fail or induce side effects. Topical treatments are gaining popularity in the management of peripheral neuropathic pain, due to excellent safety profiles and preferences. Moreover, topical treatments applied locally may target the underlying mechanisms of peripheral sensitization and pain. Recent studies showed that peripheral sensitization results from interactions between neuronal and non-neuronal cells, with numerous signaling molecules and molecular/cellular targets involved. This narrative review discusses the molecular/cellular mechanisms of drugs available in topical formulations utilized in clinical practice and their effectiveness in clinical studies in patients with peripheral neuropathic pain. We searched PubMed for papers published from 1 January 1995 to 30 November 2020. The key search phrases for identifying potentially relevant articles were "topical AND pain", "topical AND neuropathic", "topical AND treatment", "topical AND mechanism", "peripheral neuropathic", and "mechanism". The result of our search was 23 randomized controlled trials (RCT), 9 open-label studies, 16 retrospective studies, 20 case (series) reports, 8 systematic reviews, 66 narrative reviews, and 140 experimental studies. The data from preclinical studies revealed that active compounds of topical treatments exert multiple mechanisms of action, directly or indirectly modulating ion channels, receptors, proteins, and enzymes expressed by neuronal and non-neuronal cells, and thus contributing to antinociception. However, which mechanisms and the extent to which the mechanisms contribute to pain relief observed in humans remain unclear. The evidence from RCTs and reviews supports 5% lidocaine patches, 8% capsaicin patches, and botulinum toxin A injections as effective treatments in patients with peripheral neuropathic pain. In turn, single RCTs support evidence of doxepin, funapide, diclofenac, baclofen, clonidine, loperamide, and cannabidiol in neuropathic pain states. Topical administration of phenytoin, ambroxol, and prazosin is supported by observational clinical studies. For topical amitriptyline, menthol, and gabapentin, evidence comes from case reports and case series. For topical ketamine and baclofen, data supporting their effectiveness are provided by both single RCTs and case series. The discussed data from clinical studies and observations support the usefulness of topical treatments in neuropathic pain management. This review may help clinicians in making decisions regarding whether and which topical treatment may be a beneficial option, particularly in frail patients not tolerating systemic pharmacotherapy.
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Peripheral Mechanisms of Neuropathic Pain-the Role of Neuronal and Non-Neuronal Interactions and Their Implications for Topical Treatment of Neuropathic Pain. Pharmaceuticals (Basel) 2021; 14:ph14020077. [PMID: 33498496 PMCID: PMC7909513 DOI: 10.3390/ph14020077] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 12/16/2022] Open
Abstract
Neuropathic pain in humans arises as a consequence of injury or disease of somatosensory nervous system at peripheral or central level. Peripheral neuropathic pain is more common than central neuropathic pain, and is supposed to result from peripheral mechanisms, following nerve injury. The animal models of neuropathic pain show extensive functional and structural changes occurring in neuronal and non-neuronal cells in response to peripheral nerve injury. These pathological changes following damage lead to peripheral sensitization development, and subsequently to central sensitization initiation with spinal and supraspinal mechanism involved. The aim of this narrative review paper is to discuss the mechanisms engaged in peripheral neuropathic pain generation and maintenance, with special focus on the role of glial, immune, and epithelial cells in peripheral nociception. Based on the preclinical and clinical studies, interactions between neuronal and non-neuronal cells have been described, pointing out at the molecular/cellular underlying mechanisms of neuropathic pain, which might be potentially targeted by topical treatments in clinical practice. The modulation of the complex neuro-immuno-cutaneous interactions in the periphery represents a strategy for the development of new topical analgesics and their utilization in clinical settings.
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Effect of Nortriptyline on Spreading Depolarization. ARCHIVES OF NEUROSCIENCE 2020. [DOI: 10.5812/ans.102102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Spreading depolarization is associated with the extension of lesion size and complications in some important neurological diseases such as stroke, epilepsy, migraine, and traumatic brain injury. Objectives: This study aimed to reveal some molecular aspects of spreading depolarization and suggesting new therapeutic targets for its control by changing the function of different astrocytic and neuronal ion channels. Methods: The effects of nortriptyline on spreading depolarization in cortical and hippocampal tissues and on the electrophysiological properties of CA1 hippocampal pyramidal neurons were assessed by extra- and intracellular recording, following washing rat brain slices by the drug. Results: Nortriptyline made a significant increase in the amplitude of spreading depolarization in cortical and hippocampal tissues relative to control but did not change the duration significantly in each of the tissues. No significant difference was found in the effects of spreading depolarization on the electrophysiological properties of the CA1 pyramidal neurons between nortriptyline and control groups. Conclusions: The stimulating effect of nortriptyline on spreading depolarization is probably related to the augmentation of extracellular potassium collection in the cortex and hippocampus due to inhibition of astrocytic potassium scavenging function. This change can make more neurons prone to depolarization and increase the overall amplitude of spreading depolarization waves. Further studies should assess the effect of enhancing the clearance function of astrocyte-specific inwardly rectifying potassium channels, Kir4.1, or preventing other factors contributing to spreading depolarization on control of the process.
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Bravo L, Llorca-Torralba M, Berrocoso E, Micó JA. Monoamines as Drug Targets in Chronic Pain: Focusing on Neuropathic Pain. Front Neurosci 2019; 13:1268. [PMID: 31942167 PMCID: PMC6951279 DOI: 10.3389/fnins.2019.01268] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 11/08/2019] [Indexed: 12/11/2022] Open
Abstract
Monoamines are involved in regulating the endogenous pain system and indeed, peripheral and central monoaminergic dysfunction has been demonstrated in certain types of pain, particularly in neuropathic pain. Accordingly, drugs that modulate the monaminergic system and that were originally designed to treat depression are now considered to be first line treatments for certain types of neuropathic pain (e.g., serotonin and noradrenaline (and also dopamine) reuptake inhibitors). The analgesia induced by these drugs seems to be mediated by inhibiting the reuptake of these monoamines, thereby reinforcing the descending inhibitory pain pathways. Hence, it is of particular interest to study the monoaminergic mechanisms involved in the development and maintenance of chronic pain. Other analgesic drugs may also be used in combination with monoamines to facilitate descending pain inhibition (e.g., gabapentinoids and opioids) and such combinations are often also used to alleviate certain types of chronic pain. By contrast, while NSAIDs are thought to influence the monoaminergic system, they just produce consistent analgesia in inflammatory pain. Thus, in this review we will provide preclinical and clinical evidence of the role of monoamines in the modulation of chronic pain, reviewing how this system is implicated in the analgesic mechanism of action of antidepressants, gabapentinoids, atypical opioids, NSAIDs and histaminergic drugs.
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Affiliation(s)
- Lidia Bravo
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, University of Cádiz, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Meritxell Llorca-Torralba
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, University of Cádiz, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Esther Berrocoso
- Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Cádiz, Spain
| | - Juan Antonio Micó
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, University of Cádiz, Cádiz, Spain
- Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Juan Antonio Micó,
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Akbari E, Mirzaei E, Rezaee L, Zarrabian S, Haghparast A. The effect of amitriptyline administration on pain-related behaviors in morphine-dependent rats: Hypoalgesia or hyperalgesia? Neurosci Lett 2018; 683:185-189. [PMID: 30081059 DOI: 10.1016/j.neulet.2018.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 07/31/2018] [Accepted: 08/02/2018] [Indexed: 11/25/2022]
Abstract
Pain control in opioid-dependent individuals is a clinical complication. The present study investigated the effects of different doses of amitriptyline in the three stages of the formalin test in morphine-dependent rats (MDRs). Morphine dependency was induced using the oral method, and then, amitriptyline-induced antinociceptive effects were measured at 4 doses (2.5, 5, 10, and 20 mg/kg) and compared with the control group in a formalin-based model of pain. There was no observed antinociceptive effect in the MDRs and morphine-naïve rats (MNRs) in phase I. In the interphase, amitriptyline induced pain suppression at doses of 5 and 20 mg/kg. In phase II, at doses of 5, 10, and 20 mg/kg, the hypoalgesic effect on pain-related behaviors was seen in the MNRs. In MDRs, amitriptyline at doses of 2.5 and 5 mg/kg caused the hyperalgesic effect, whereas at 10 and 20 mg/kg doses, it induced a hypoalgesic effect. A significant attenuation was observed in the latency to fall from the accelerating rotarod at doses of 10 and 20 mg/kg in the MDRs, and at a dose of 20 mg/kg in the MNRs. Data showed that amitriptyline dose-dependently induced paradoxical hypo- and hyper-algesic effects in MDRs.
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Affiliation(s)
- Esmaeil Akbari
- Immunogenetic Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Department of Physiology and Pharmacology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ebrahim Mirzaei
- School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Laleh Rezaee
- Neuroscience Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahram Zarrabian
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Abbas Haghparast
- Neuroscience Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Schliessbach J, Siegenthaler A, Bütikofer L, Limacher A, Juni P, Vuilleumier PH, Stamer U, Arendt-Nielsen L, Curatolo M. Effect of single-dose imipramine on chronic low-back and experimental pain. A randomized controlled trial. PLoS One 2018; 13:e0195776. [PMID: 29742109 PMCID: PMC5942791 DOI: 10.1371/journal.pone.0195776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 03/09/2018] [Indexed: 11/18/2022] Open
Abstract
Antidepressants are frequently prescribed as co-analgesics in chronic pain. While their efficacy is well documented for neuropathic pain, the evidence is less clear in musculoskeletal pain conditions. The present study therefore evaluated the effect of the tricyclic antidepressant imipramine on chronic low-back pain in a randomized, double-blinded placebo-controlled design. To explore the mechanisms of action and the influence of drug metabolism, multimodal quantitative sensory tests (QST) and genotyping for cytochrome P450 2D6 (CYP2D6) were additionally performed. A single oral dose of imipramine 75 mg was compared to active placebo (tolterodine 1 mg) in 50 patients (32 females) with chronic non-specific low-back pain. Intensity of low-back pain was assessed on a 0–10 numeric rating scale at baseline and every 30 minutes after drug intake. Multimodal QST were performed at baseline and in hourly intervals for 2 hours. Pharmacogenetic influences of cytochrome P450 were addressed by CYP2D6 genotyping. No significant analgesic effect was detected neither on low-back pain nor on any of the sensory tests in the overall analyses. However, evidence for an interaction of the imipramine effect and CYP2D6 genotype was found for electrical and for pressure pain detection thresholds. Intermediate but not extensive metabolizers had a 1.20 times greater electrical pain threshold (95%-CI 1.10 to 1.31) and a 1.10 times greater pressure pain threshold (95%-CI 1.01 to 1.21) 60 minutes after imipramine than after placebo (p<0.001 and p = 0.034, respectively). The present study failed to demonstrate an immediate analgesic effect of imipramine on low-back pain. Anti-nociceptive effects as assessed by quantitative sensory tests may depend on CYP2D6 genotype, indicating that metabolizer status should be accounted for when future studies with tricyclic antidepressants are undertaken.
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Affiliation(s)
- Jürg Schliessbach
- Institute of Anesthesiology, University Hospital Zürich, Zürich, Switzerland
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
- * E-mail:
| | | | - Lukas Bütikofer
- CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Andreas Limacher
- CTU Bern, and Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Peter Juni
- Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Department of Medicine, University of Toronto, Toronto, Canada
| | - Pascal H. Vuilleumier
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Ulrike Stamer
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Lars Arendt-Nielsen
- Centre of Sensory Motor Interaction SMI, School of Medicine, University of Aalborg, Aalborg, Denmark
| | - Michele Curatolo
- Centre of Sensory Motor Interaction SMI, School of Medicine, University of Aalborg, Aalborg, Denmark
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States of America
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Analgesic Mechanisms of Antidepressants for Neuropathic Pain. Int J Mol Sci 2017; 18:ijms18112483. [PMID: 29160850 PMCID: PMC5713449 DOI: 10.3390/ijms18112483] [Citation(s) in RCA: 195] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/17/2017] [Accepted: 11/19/2017] [Indexed: 12/16/2022] Open
Abstract
Tricyclic antidepressants and serotonin noradrenaline reuptake inhibitors are used to treat chronic pain, such as neuropathic pain. Why antidepressants are effective for treatment of neuropathic pain and the precise mechanisms underlying their effects, however, remain unclear. The inhibitory effects of these antidepressants for neuropathic pain manifest more quickly than their antidepressive effects, suggesting different modes of action. Recent studies of animal models of neuropathic pain revealed that noradrenaline is extremely important for the inhibition of neuropathic pain. First, increasing noradrenaline in the spinal cord by reuptake inhibition directly inhibits neuropathic pain through α2-adrenergic receptors. Second, increasing noradrenaline acts on the locus coeruleus and improves the function of an impaired descending noradrenergic inhibitory system. Serotonin and dopamine may reinforce the noradrenergic effects to inhibit neuropathic pain. The mechanisms of neuropathic pain inhibition by antidepressants based mainly on experimental findings from animal models of neuropathic pain are discussed in this review.
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Ghorbanzadeh B, Mansouri MT, Naghizadeh B, Alboghobeish S. Local antinociceptive action of fluoxetine in the rat formalin assay: role of l-arginine/nitric oxide/cGMP/K ATP channel pathway. Can J Physiol Pharmacol 2017; 96:165-172. [PMID: 28787580 DOI: 10.1139/cjpp-2017-0003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The present study was conducted to evaluate the local antinociceptive actions of fluoxetine, a selective serotonin reuptake inhibitor, and the possible involvement of the l-arginine/NO/cGMP/KATP channel pathway in this effect using the formalin test in rats. To elucidate the underlying mechanisms, animals were pre-treated with l-NAME, aminoguanidine, methylene blue, glibenclamide, l-arginine, sodium nitroprusside, or diazoxide. Local ipsilateral, but not contralateral, administration of fluoxetine (10-300 μg/paw) dose-dependently suppressed flinching number during both early and late phases of the test, and this was comparable with morphine also given peripherally. Pre-treatment with l-NAME, aminoguanidine, methylene blue, or glibenclamide dose-dependently prevented fluoxetine (100 μg/paw)-induced antinociception in the late phase. In contrast, administration of l-arginine, sodium nitroprusside, and diazoxide significantly enhanced the antinociception caused by fluoxetine in the late phase of the test. However, these treatments had no significant effect on the antinociceptive response of fluoxetine in the early phase of the formalin test. Our data demonstrate that local peripheral antinociception of fluoxetine during the late phase of the formalin test could be due to activation of l-arginine/NO/cGMP/KATP channel pathway. The peripheral action of fluoxetine raises the possibility that topical application of this drug (e.g., as a cream, ointment, or jelly) may be a useful method for relieving the inflammatory pain states.
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Affiliation(s)
- Behnam Ghorbanzadeh
- a Department of Pharmacology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Mohammad Taghi Mansouri
- b Department of Pharmacology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahareh Naghizadeh
- b Department of Pharmacology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Soheila Alboghobeish
- b Department of Pharmacology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Wattiez AS, Dupuis A, Privat AM, Chalus M, Chapuy E, Aissouni Y, Eschalier A, Courteix C. Disruption of 5-HT 2A-PDZ protein interaction differently affects the analgesic efficacy of SSRI, SNRI and TCA in the treatment of traumatic neuropathic pain in rats. Neuropharmacology 2017; 125:308-318. [PMID: 28780039 DOI: 10.1016/j.neuropharm.2017.07.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 07/27/2017] [Accepted: 07/31/2017] [Indexed: 01/17/2023]
Abstract
Antidepressants remain one of the first line treatments prescribed to neuropathic pain patients despite their limited efficacy and/or their numerous side effects. More and more, pharmacotherapy for neuropathic pain has evolved towards the use of therapeutic combinations. The goal of the present study was to assess the efficacy of the combination of antidepressants - selective serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors-with a peptide (TAT-2ASCV) able to disrupt the interaction between serotonin type 2A (5-HT2A) receptors and associated PDZ proteins. Mechanical hypersensitivity was assessed in sciatic nerve ligation-induced neuropathic pain in rats using paw pressure test after acute treatment with TAT-2ASCV alone or in combination with repeated treatment with fluoxetine or duloxetine or clomipramine. First, we validated the anti-hyperalgesic effect of TAT-2ASCV on mechanical hypersensitivity at the dose of 100 ng/rat (single i.t. injection). Second, using selective receptor antagonists, we found that the effect of TAT-2ASCV on mechanical hypersensitivity involves 5-HT2A as well as GABAA receptors. Finally, we showed that the association of TAT-2ASCV (100 ng, single i.t. injection) with fluoxetine (10 mg/kg, five i.p. injections) reveals its anti-hyperalgesic effect, while the association with duloxetine (1 mg/kg, five i.p. injections) or clomipramine (2.5 mg/kg, five i.p. injections) is only additive. Those results further accentuate the interest to develop small molecules acting like TAT-2ASCV in order to treat neuropathic pain as a monotherapy or in combination with antidepressants.
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Affiliation(s)
- Anne-Sophie Wattiez
- Université Clermont Auvergne, INSERM U1107, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Amandine Dupuis
- Université Clermont Auvergne, INSERM U1107, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Anne-Marie Privat
- Université Clermont Auvergne, INSERM U1107, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Maryse Chalus
- Université Clermont Auvergne, INSERM U1107, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Eric Chapuy
- Université Clermont Auvergne, INSERM U1107, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Youssef Aissouni
- Université Clermont Auvergne, INSERM U1107, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Alain Eschalier
- Université Clermont Auvergne, INSERM U1107, NEURO-DOL, F-63000 Clermont-Ferrand, France
| | - Christine Courteix
- Université Clermont Auvergne, INSERM U1107, NEURO-DOL, F-63000 Clermont-Ferrand, France.
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Kim MK, Kang H, Baek CW, Jung YH, Woo YC, Choi GJ, Shin HY, Kim KS. Antinociceptive and anti-inflammatory effects of ginsenoside Rf in a rat model of incisional pain. J Ginseng Res 2017; 42:183-191. [PMID: 29719465 PMCID: PMC5925619 DOI: 10.1016/j.jgr.2017.02.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 01/16/2017] [Accepted: 02/27/2017] [Indexed: 12/18/2022] Open
Abstract
Background Ginseng saponin has long been used as a traditional Asian medicine and is known to be effective in treating various kinds of pain. Ginsenoside Rf is one of the biologically active saponins found in ginseng. We evaluated ginsenoside Rf’s antinociceptive and anti-inflammatory effects, and its mechanism of action on adrenergic and serotonergic receptors, in an incisional pain model. Methods Mechanical hyperalgesia was induced via plantar incision in rats followed by intraperitoneal administration of increasing doses of ginsenoside Rf (vehicle, 0.5 mg/kg, 1 mg/kg, 1.5 mg/kg, and 2 mg/kg). The antinociceptive effect was also compared in a Positive Control Group that received a ketorolac (30 mg/kg) injection, and the Naïve Group, which did not undergo incision. To evaluate the mechanism of action, rats were treated with prazosin (1 mg/kg), yohimbine (2 mg/kg), or ketanserin (1 mg/kg) prior to receiving ginsenoside Rf (1.5 mg/kg). The mechanical withdrawal threshold was measured using von Frey filaments at various time points before and after ginsenoside Rf administration. To evaluate the anti-inflammatory effect, serum interleukin (IL)-1β, IL-6, and tumor necrotizing factor-α levels were measured. Results Ginsenoside Rf increased the mechanical withdrawal threshold significantly, with a curvilinear dose–response curve peaking at 1.5 mg/kg. IL-1β, IL-6, and tumor necrotizing factor-α levels significantly decreased after ginsenoside Rf treatment. Ginsenoside Rf’s antinociceptive effect was reduced by yohimbine, but potentiated by prazosin and ketanserin. Conclusion Intraperitoneal ginsenoside Rf has an antinociceptive effect peaking at a dose of 1.5 mg/kg. Anti-inflammatory effects were also detected.
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Affiliation(s)
- Min Kyoung Kim
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Chong Wha Baek
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yong Hun Jung
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Young Cheol Woo
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Geun Joo Choi
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hwa Yong Shin
- Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Kyung Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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Dupuis A, Wattiez AS, Pinguet J, Richard D, Libert F, Chalus M, Aissouni Y, Sion B, Ardid D, Marin P, Eschalier A, Courteix C. Increasing spinal 5-HT 2A receptor responsiveness mediates anti-allodynic effect and potentiates fluoxetine efficacy in neuropathic rats. Evidence for GABA release. Pharmacol Res 2016; 118:93-103. [PMID: 27663259 DOI: 10.1016/j.phrs.2016.09.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 09/17/2016] [Accepted: 09/19/2016] [Indexed: 01/13/2023]
Abstract
Antidepressants are one of the first line treatments for neuropathic pain but their use is limited by the incidence and severity of side effects of tricyclics and the weak effectiveness of selective serotonin reuptake inhibitors (SSRIs). Serotonin type 2A (5-HT2A) receptors interact with PDZ proteins that regulate their functionality and SSRI efficacy to alleviate pain. We investigated whether an interfering peptide (TAT-2ASCV) disrupting the interaction between 5-HT2A receptors and associated PDZ proteins would improve the treatment of traumatic neuropathic allodynia. Tactile allodynia was assessed in spinal nerve ligation-induced neuropathic pain in rats using von Frey filaments after acute treatment with TAT-2ASCV and/or 5-HT2A receptor agonist, alone or in combination with repeated treatment with fluoxetine. In vivo microdialysis was performed in order to examine the involvement of GABA in TAT-2ASCV/fluoxetine treatment-associated analgesia. TAT-2ASCV (100ng, single i.t. injection) improved SNL-induced tactile allodynia by increasing 5-HT2A receptor responsiveness to endogenous 5-HT. Fluoxetine alone (10mg/kg, five i.p. injections) slightly increased tactile thresholds and its co-administration with TAT-2ASCV (100ng, single i.t. injection) further enhanced the anti-allodynic effect. This effect depends on the integrity of descending serotonergic bulbospinal pathways and spinal release of GABA. The anti-allodynic effect of fluoxetine can be enhanced by disrupting 5-HT2A receptor-PDZ protein interactions. This enhancement depends on 5-HT2A receptor activation, spinal GABA release and GABAA receptor activation.
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Affiliation(s)
- Amandine Dupuis
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France
| | - Anne-Sophie Wattiez
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France
| | - Jérémy Pinguet
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Pharmacologie, Clermont-Ferrand, France
| | - Damien Richard
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Pharmacologie, Clermont-Ferrand, France
| | - Frédéric Libert
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Pharmacologie, Clermont-Ferrand, France
| | - Maryse Chalus
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France
| | - Youssef Aissouni
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France
| | - Benoit Sion
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France
| | - Denis Ardid
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France
| | - Philippe Marin
- Institut de Génomique Fonctionnelle, CNRS, UMR 5203, INSERM U1191, Université de Montpellier, F-34094 Montpellier Cedex 5, France
| | - Alain Eschalier
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Pharmacologie, Clermont-Ferrand, France
| | - Christine Courteix
- INSERM, U 1107, Neuro-Dol, F-63001 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, Pharmacologie Fondamentale et Clinique de la Douleur, BP 10448, F-63000 Clermont-Ferrand, France.
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Li C, Ji BU, Kim Y, Lee JE, Kim NK, Kim ST, Koo S. Electroacupuncture Enhances the Antiallodynic and Antihyperalgesic Effects of Milnacipran in Neuropathic Rats. Anesth Analg 2016; 122:1654-62. [DOI: 10.1213/ane.0000000000001212] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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de Carvalho EF, de Oliveira SK, Nardi VK, Gelinski TC, Bortoluzzi MC, Maraschin M, Nardi GM. Ilex paraguariensis Promotes Orofacial Pain Relief After Formalin Injection: Involvement of Noradrenergic Pathway. Pharmacognosy Res 2016; 8:S31-7. [PMID: 27114689 PMCID: PMC4821104 DOI: 10.4103/0974-8490.178643] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background: Drinking mate or chimarrão, a hot infusion of Ilex paraguariensis (ILEX) leaves, is a common habit in Southern South America that has a social and almost ritualistic role. It has been used as a stimulant beverage in South America and analgesic in regions of Argentina for treatment of headache and others painful inflammatory conditions such as arthritis and rheumatism. Objective: The aim of this study was to evaluate the pharmacological activity of I. paraguariensis infusion (ILEX) on orofacial nociception model induced by formalin, and study its mechanism of action. Materials and Methods: The analgesic effect of ILEX was assessed through writhing test, paw formalin test, paw edema induced by carrageenan, and orofacial pain induced by formalin. To study the action mechanism of ILEX, opioidergic, dopaminergic, nitrergic, and adrenergic pathways were investigated. Results: The high-performance liquid chromatography analysis of ILEX infusion revealed caffeine and theobromine. The treatment with ILEX reduced the number of writhing. However, it was effective neither in the formalin paw test nor in the paw edema induced by carrageenan. Different from formalin paw test, ILEX was able to reduce the orofacial reactivity to formalin in 31.8% (70.4 ± 2.5 s; first phase), and 20% (127.3 ± 18.9 s; second phase). The analgesic effect of ILEX results from the modulation of noradrenergic pathways since prazosin (α1-adrenoceptor antagonist, 0.15 mg/kg; intraperitoneal) reversed the analgesic effect of ILEX. Conclusions: The present report demonstrates that analgesic effect of ILEX in orofacial formalin test is due mainly to modulation of noradrenergic pathways. SUMMARY Ilex paraguariensis (ILEX) has been used as a stimulant beverage in South America and analgesic in regions of Argentina for the treatment of headache and others painful inflammatory conditions such arthritis and rheumatism. The aim of this study was to evaluate the pharmacological activity of ILEX on orofacial nociception model induced by formalin, and study its mechanism of action. ILEX reduced the number of writhing and orofacial reactivity to formalin in mice. However, it was effective neither in the formalin paw test nor in the paw edema induced by carrageenan. The analgesic effect of ILEX results from the modulation of noradrenergic pathways.
Abbreviation Used: ILEX: Infusion of Ilex paraguariensis, NSAIDs: Nonsteroidal anti-inflammatory drugs, L-NOARG: L-NG-nitro-arginine, UV: Ultraviolet, i.p.: Intraperitoneal, NOS: Nitric Oxide Synthase, ANOVA: Analysis of variance, S.E.M.: Standard error of mean, HPLC: High-performance liquid chromatography, NO: Nitric Oxide, v.o.: Oral route, DCQ: dicaffeoylquinic acid, BMS: Burning mouth syndrome, PBS: Phosphate-buffered saline.
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Affiliation(s)
- Eudislaine Fonseca de Carvalho
- Laboratory of Pharmacology, Area of Biological and Health Science, University of the West of Santa Catarina, Joaçaba, Brazil
| | - Simone Kobe de Oliveira
- Department of Plant Science, Plant Morphogenesis and Biochemistry Laboratory, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Viviane Koepp Nardi
- Laboratory of Pharmacology, Area of Biological and Health Science, University of the West of Santa Catarina, Joaçaba, Brazil
| | - Tathiana Carla Gelinski
- Laboratory of Pharmacology, Area of Biological and Health Science, University of the West of Santa Catarina, Joaçaba, Brazil
| | | | - Marcelo Maraschin
- Department of Plant Science, Plant Morphogenesis and Biochemistry Laboratory, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Geisson Marcos Nardi
- Laboratory of Pharmacology, Area of Biological and Health Science, University of the West of Santa Catarina, Joaçaba, Brazil
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Dourado M, Cardoso-Cruz H, Monteiro C, Galhardo V. Effect of Motor Impairment on Analgesic Efficacy of Dopamine D2/3 Receptors in a Rat Model of Neuropathy. J Exp Neurosci 2016; 10:51-7. [PMID: 27081316 PMCID: PMC4824324 DOI: 10.4137/jen.s36492] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 11/19/2015] [Accepted: 11/29/2015] [Indexed: 11/24/2022] Open
Abstract
Testing the clinical efficacy of drugs that also have important side effects on locomotion needs to be properly designed in order to avoid erroneous identification of positive effects when the evaluation depends on motor-related tests. One such example is the evaluation of analgesic role of drugs that act on dopaminergic receptors, since the pain perception tests used in animal models are based on motor responses that can also be compromised by the same substances. The apparent analgesic effect obtained by modulation of the dopaminergic system is still a highly disputed topic. There is a lack of acceptance of this effect in both preclinical and clinical settings, despite several studies showing that D2/3 agonists induce antinociception. Some authors raised the hypothesis that this antinociceptive effect is enhanced by dopamine-related changes in voluntary initiation of movement. However, the extent to which D2/3 modulation changes locomotion at analgesic effective doses is still an unresolved question. In the present work, we performed a detailed dose-dependent analysis of the changes that D2/3 systemic modulation have on voluntary locomotor activity and response to four separate tests of both thermal and mechanical pain sensitivity in adult rats. Using systemic administration of the dopamine D2/3 receptor agonist quinpirole, and of the D2/3 antagonist raclopride, we found that modulation of D2/3 receptors impairs locomotion and exploratory activity in a dose-dependent manner across the entire range of tested dosages. None of the drugs were able to consistently diminish either thermal or mechanical pain perception when administered at lower concentrations; on the other hand, the larger concentrations of raclopride (0.5–1.0 mg/kg) strongly abolished pain responses, and also caused severe motor impairment. Our results show that administration of both agonists and antagonists of dopaminergic D2/3 receptors affects sensorimotor behaviors, with the effect over locomotion and exploratory activity being stronger than the observed effect over pain responses.
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Affiliation(s)
- Margarida Dourado
- Departamento de Biologia Experimental, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.; Instituto de Biologia Molecular e Celular (IBMC), Grupo de Morfofisiologia do Sistema Somatosensitivo, Universidade do Porto, Porto, Portugal.; Instituto de Investigação e Inovação em Saúde-i3S, Universidade do Porto, Porto, Portugal
| | - Helder Cardoso-Cruz
- Departamento de Biologia Experimental, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.; Instituto de Biologia Molecular e Celular (IBMC), Grupo de Morfofisiologia do Sistema Somatosensitivo, Universidade do Porto, Porto, Portugal.; Instituto de Investigação e Inovação em Saúde-i3S, Universidade do Porto, Porto, Portugal
| | - Clara Monteiro
- Departamento de Biologia Experimental, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.; Instituto de Biologia Molecular e Celular (IBMC), Grupo de Morfofisiologia do Sistema Somatosensitivo, Universidade do Porto, Porto, Portugal.; Instituto de Investigação e Inovação em Saúde-i3S, Universidade do Porto, Porto, Portugal
| | - Vasco Galhardo
- Departamento de Biologia Experimental, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.; Instituto de Biologia Molecular e Celular (IBMC), Grupo de Morfofisiologia do Sistema Somatosensitivo, Universidade do Porto, Porto, Portugal.; Instituto de Investigação e Inovação em Saúde-i3S, Universidade do Porto, Porto, Portugal
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Matsuura W, Harada S, Tokuyama S. Effects of Adjuvant Analgesics on Cerebral Ischemia-Induced Mechanical Allodynia. Biol Pharm Bull 2016; 39:856-62. [DOI: 10.1248/bpb.b15-01035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Wataru Matsuura
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Kobe Gakuin University
| | - Shinichi Harada
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Kobe Gakuin University
| | - Shogo Tokuyama
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Kobe Gakuin University
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Norkus C, Rankin D, KuKanich B. Pharmacokinetics of intravenous and oral amitriptyline and its active metabolite nortriptyline in Greyhound dogs. Vet Anaesth Analg 2015; 42:580-9. [DOI: 10.1111/vaa.12248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 12/01/2014] [Indexed: 11/30/2022]
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Handa J, Sekiguchi M, Krupkova O, Konno SI. The effect of serotonin–noradrenaline reuptake inhibitor duloxetine on the intervertebral disk-related radiculopathy in rats. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:877-87. [DOI: 10.1007/s00586-015-4239-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 08/17/2015] [Accepted: 09/10/2015] [Indexed: 01/23/2023]
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Safrany-Fark A, Petrovszki Z, Kekesi G, Liszli P, Benedek G, Keresztes C, Horvath G. In vivo potency of different ligands on voltage-gated sodium channels. Eur J Pharmacol 2015; 762:158-64. [PMID: 26033207 DOI: 10.1016/j.ejphar.2015.05.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/19/2015] [Accepted: 05/20/2015] [Indexed: 12/24/2022]
Abstract
The Ranvier nodes of thick myelinated nerve fibers contain almost exclusively voltage-gated sodium channels (Navs), while the unmyelinated fibers have several receptors (e.g., cannabinoid, transient receptor potential vanilloid receptor 1), too. Therefore, a nerve which contains only motor fibers can be an appropriate in vivo model for selective influence of Navs. The goals were to evaluate the potency of local anesthetic drugs on such a nerve in vivo; furthermore, to investigate the effects of ligands with different structures (arachidonic acid, anandamide, capsaicin and nisoxetine) that were proved to inhibit Navs in vitro with antinociceptive properties. The marginal mandibular branch of the facial nerve was explored in anesthetized Wistar rats; after its stimulation, the electrical activity of the vibrissae muscles was registered following the perineural injection of different drugs. Lidocaine, bupivacaine and ropivacaine evoked dose-dependent decrease in electromyographic activity, i.e., lidocaine had lower potency than bupivacaine or ropivacaine. QX-314 did not cause any effect by itself, but its co-application with lidocaine produced a prolonged inhibition. Nisoxetine had a very low potency. While anandamide and capsaicin in high doses caused about 50% decrease in the amplitude of action potential, arachidonic acid did not influence the responses. We proved that the classical local anesthetics have high potency on motor nerves, suggesting that this method might be a reliable model for selective targeting of Navs in vivo circumstances. It is proposed that the effects of these endogenous lipids and capsaicin on sensory fibers are not primarily mediated by Navs.
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Affiliation(s)
- Arpad Safrany-Fark
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of Szeged, Tisza L. krt. 64, H-6720 Szeged, Hungary.
| | - Zita Petrovszki
- Institute of Physical Education and Sport Science, Juhász Gyula Faculty of Education, University of Szeged, Hattyas sor 10, H-6725 Szeged, Hungary.
| | - Gabriella Kekesi
- Department of Physiology, Faculty of Medicine, University of Szeged, Dóm tér 10, H-6720 Szeged, Hungary.
| | - Peter Liszli
- Department of Physiology, Faculty of Medicine, University of Szeged, Dóm tér 10, H-6720 Szeged, Hungary.
| | - Gyorgy Benedek
- Department of Physiology, Faculty of Medicine, University of Szeged, Dóm tér 10, H-6720 Szeged, Hungary.
| | - Csilla Keresztes
- Department of Medical Communication and Translation, Faculty of Medicine, University of Szeged, Szentháromság u. 5, H-6720 Szeged, Hungary.
| | - Gyongyi Horvath
- Department of Physiology, Faculty of Medicine, University of Szeged, Dóm tér 10, H-6720 Szeged, Hungary.
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Mehr-un-Nisa, Munawar MA, Lee YS, Rankin D, Munir J, Lai J, Khan MA, Hruby VJ. Design, synthesis, and biological evaluation of a series of bifunctional ligands of opioids/SSRIs. Bioorg Med Chem 2015; 23:1251-9. [PMID: 25703306 DOI: 10.1016/j.bmc.2015.01.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 01/15/2015] [Accepted: 01/26/2015] [Indexed: 11/25/2022]
Abstract
A series of opioid and serotonin re-uptake inhibitors (SSRIs) bifunctional ligands have been designed, synthesized, and tested for their activities and efficacies at μ-, δ- and κ opioid receptors and SSRIs receptors. Most of the compounds showed high affinities for μ- and δ-opioid receptors and lower affinities for SSRIs and κ opioid receptors. A docking study on the μ-opioid receptor binding pocket has been carried out for ligands 3-11. The ligands 7 and 11 have displayed the highest binding profiles for the μ-opioid receptor binding site with ΔGbind (-12.14kcal/mol) and Ki value (1.0nM), and ΔGbind (-12.41kcal/mol) and Ki value (0.4nM), respectively. Ligand 3 was shown to have the potential of dual acting serotonin/norepinephrine re-uptake inhibitor (SNRI) antidepressant activity in addition to opioid activities, and thus could be used for the design of multifunctional ligands in the area of a novel approach for the treatment of pain and depression.
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Affiliation(s)
- Mehr-un-Nisa
- Institute of Chemistry, University of the Punjab, Lahore 54590, Pakistan; Department of Chemistry and Biochemistry, University of Arizona, Tucson, AZ 85721, USA
| | - Munawar A Munawar
- Institute of Chemistry, University of the Punjab, Lahore 54590, Pakistan
| | - Yeon Sun Lee
- Department of Chemistry and Biochemistry, University of Arizona, Tucson, AZ 85721, USA.
| | - David Rankin
- Department of Pharmacology, University of Arizona, Tucson, AZ 85721, USA
| | - Jawaria Munir
- Institute of Chemistry, University of the Punjab, Lahore 54590, Pakistan; Institute of Molecular Sciences & Bioinformatics, Lahore 54000, Pakistan
| | - Josephine Lai
- Department of Pharmacology, University of Arizona, Tucson, AZ 85721, USA
| | - Misbahul A Khan
- Institute of Chemistry, University of the Punjab, Lahore 54590, Pakistan
| | - Victor J Hruby
- Department of Chemistry and Biochemistry, University of Arizona, Tucson, AZ 85721, USA.
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Miranda HF, Noriega V, Zepeda R, Zanetta P, Prieto-Rayo J, Prieto JC, Sierralta F. Antinociceptive Synergism of Gabapentin and Nortriptyline in Mice with Partial Sciatic Nerve Ligation. Pharmacology 2015; 95:59-64. [DOI: 10.1159/000370244] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 12/01/2014] [Indexed: 11/19/2022]
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The role of spinal serotonin receptor and alpha adrenoceptor on the antiallodynic effects induced by intrathecal milnacipran in chronic constriction injury rats. Eur J Pharmacol 2014; 738:57-65. [DOI: 10.1016/j.ejphar.2014.05.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 04/04/2014] [Accepted: 05/10/2014] [Indexed: 11/17/2022]
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The antinociceptive effect of intravenous imipramine in colorectal distension-induced visceral pain in rats: The role of serotonergic and noradrenergic receptors. Pharmacol Biochem Behav 2014; 122:1-6. [DOI: 10.1016/j.pbb.2014.02.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 02/19/2014] [Accepted: 02/20/2014] [Indexed: 11/20/2022]
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Cobacho N, de la Calle JL, Paíno CL. Dopaminergic modulation of neuropathic pain: analgesia in rats by a D2-type receptor agonist. Brain Res Bull 2014; 106:62-71. [PMID: 24959942 DOI: 10.1016/j.brainresbull.2014.06.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 06/13/2014] [Accepted: 06/16/2014] [Indexed: 11/28/2022]
Abstract
Experimental studies have shown that dopaminergic mechanisms can modulate both nociception and chronic pain perception, but such property is not exploited pharmacologically at the clinical level. We have previously shown that levodopa produces D2-receptor-mediated antiallodynic effects in rats with peripheral mononeuropathy. Here, we test the effects of a D2-type receptor (D2R) agonist, quinpirole, on neuropathic pain in rats. Allodynic responses to cooling and light touch were measured in the hind limbs of rats with chronic constriction injury of one sciatic nerve. Single intraperitoneal injection of quinpirole (1 mg/kg) totally inhibited cold and tactile allodynic responses for over 3 and 48 h, respectively. At that dose, quinpirole had no effect on nocifensive responses to heat. Lumbar intrathecal injection of quinpirole produced short-term inhibition of the responses to cold and tactile stimuli, suggesting that spinal mechanisms may contribute to the antiallodynic activity of quinpirole. Chronic subcutaneous infusion of quinpirole by implanted Alzet pumps (0.025 mg/kg·day) provided a slowly progressing inhibition of cold and tactile allodynic responses, which re-emerged after the pumps were removed. These experiments show the involvement of dopaminergic systems in the modulation of chronic allodynias and provide experimental support for proposing the use of D2R agonists for neuropathic pain relief.
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Affiliation(s)
- Nuria Cobacho
- Service of Neurobiology-Research, IRYCIS, Hospital Ramón y Cajal, Carretera de Colmenar km 9, 28034 Madrid, Spain
| | | | - Carlos Luis Paíno
- Service of Neurobiology-Research, IRYCIS, Hospital Ramón y Cajal, Carretera de Colmenar km 9, 28034 Madrid, Spain.
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Bernik M, Sampaio TPA, Gandarela L. Fibromyalgia comorbid with anxiety disorders and depression: combined medical and psychological treatment. Curr Pain Headache Rep 2014; 17:358. [PMID: 23904203 DOI: 10.1007/s11916-013-0358-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Fibromyalgia is associated with high level of pain and suffering. Lack of diagnosis leads to onerous indirect economic costs. Recent data indicate that fibromyalgia; anxiety disorders, and depression tend to occur as comorbid conditions. They also share some common neurochemical dysfunctions and central nervous system alterations such as hypofunctional serotonergic system and altered reactivity of the hypothalamic-pituitary-adrenal axis. Conversely, functional neuroimaging findings point to different patterns of altered pain processing mechanisms between fibromyalgia and depression. There is no cure for fibromyalgia, and treatment response effect size is usually small to moderate. Treatment should be based on drugs that also target the comorbid psychiatric condition. Combined pharmacotherapy and cognitive-behavior therapy should ideally be offered to all patients. Lifestyle changes, such as physical exercise should be encouraged. The message to patients should be that all forms of pain are true medical conditions and deserve proper care.
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Affiliation(s)
- Marcio Bernik
- Anxiety Disorders Program, Institute of Psychiatry FMUSP, R. Dr. Ovidio Pires de Campos, 785, Caixa Postal 3671, CEP 01060-970, Sao Paulo, SP, Brazil.
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Katsuyama S, Aso H, Otowa A, Yagi T, Kishikawa Y, Komatsu T, Sakurada T, Nakamura H. Antinociceptive Effects of the Serotonin and Noradrenaline Reuptake Inhibitors Milnacipran and Duloxetine on Vincristine-Induced Neuropathic Pain Model in Mice. ISRN PAIN 2014; 2014:915464. [PMID: 27335884 PMCID: PMC4893398 DOI: 10.1155/2014/915464] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 01/14/2014] [Indexed: 01/31/2023]
Abstract
Vincristine is an anticancer drug used to treat a variety of cancer types, but it frequently causes peripheral neuropathy. Neuropathic pain is often associated with the appearance of abnormal sensory signs, such as allodynia. Milnacipran and duloxetine, serotonin/noradrenaline reuptake inhibitors, have shown efficacy against several chronic pain syndromes. In this study, we investigated the attenuation of vincristine-induced mechanical allodynia in mice by milnacipran and duloxetine. To induce peripheral neuropathy, vincristine was administered once per day (0.1 mg/kg, intraperitoneally (i.p.)) for 7 days. Mechanical allodynia was evaluated by measuring the withdrawal response to stimulation with a von Frey filament. In vincristine-treated mice, mechanical allodynia was observed on days 3-28 of vincristine administration. A single administration of milnacipran (40 mg/kg, i.p.) or duloxetine (20 mg/kg, i.p.) had no effect on vincristine-induced mechanical allodynia. However, repeated administration of milnacipran (20 or 40 mg/kg, once per day, i.p.) or duloxetine (5, 10, or 20 mg/kg, once per day, i.p.) for 7 days significantly reduced vincristine-induced mechanical allodynia. These results suggest that chronic vincristine administration induces mechanical allodynia, and that repeated milnacipran and duloxetine administration may be an effective approach for the treatment of neuropathic pain caused by vincristine treatment for cancer.
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Affiliation(s)
- Soh Katsuyama
- Department of Clinical Pharmaceutics, Tohoku Pharmaceutical University, 4-4-1 Komatsushima, Aoba-ku, Sendai 981-8558, Japan
| | - Hiromu Aso
- Department of Clinical Pharmaceutics, Tohoku Pharmaceutical University, 4-4-1 Komatsushima, Aoba-ku, Sendai 981-8558, Japan
| | - Akira Otowa
- Department of Clinical Pharmaceutics, Tohoku Pharmaceutical University, 4-4-1 Komatsushima, Aoba-ku, Sendai 981-8558, Japan
| | - Tomomi Yagi
- Department of Clinical Pharmaceutics, Tohoku Pharmaceutical University, 4-4-1 Komatsushima, Aoba-ku, Sendai 981-8558, Japan
| | - Yukinaga Kishikawa
- Department of Clinical Pharmaceutics, Tohoku Pharmaceutical University, 4-4-1 Komatsushima, Aoba-ku, Sendai 981-8558, Japan
| | - Takaaki Komatsu
- Department of Pharmacology, Daiichi College of Pharmaceutical Sciences, 22-1 Tamagawa-cho, Minami-ku, Fukuoka 815-8511, Japan
| | - Tsukasa Sakurada
- Department of Pharmacology, Daiichi College of Pharmaceutical Sciences, 22-1 Tamagawa-cho, Minami-ku, Fukuoka 815-8511, Japan
| | - Hitoshi Nakamura
- Department of Clinical Pharmaceutics, Tohoku Pharmaceutical University, 4-4-1 Komatsushima, Aoba-ku, Sendai 981-8558, Japan
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Tomoyose O, Kodama D, Ono H, Tanabe M. Presynaptic Inhibitory Effects of Fluvoxamine, a Selective Serotonin Reuptake Inhibitor, on Nociceptive Excitatory Synaptic Transmission in Spinal Superficial Dorsal Horn Neurons of Adult Mice. J Pharmacol Sci 2014; 126:136-45. [DOI: 10.1254/jphs.14127fp] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Disruption of 5-HT2A receptor-PDZ protein interactions alleviates mechanical hypersensitivity in carrageenan-induced inflammation in rats. PLoS One 2013; 8:e74661. [PMID: 24058620 PMCID: PMC3776748 DOI: 10.1371/journal.pone.0074661] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 08/02/2013] [Indexed: 11/19/2022] Open
Abstract
Despite common pathophysiological mechanisms, inflammatory and neuropathic pain do not respond equally to the analgesic effect of antidepressants, except for selective serotonin reuptake inhibitors (SSRIs), which show a limited efficacy in both conditions. We previously demonstrated that an interfering peptide (TAT-2ASCV) disrupting the interaction between 5-HT2A receptors and its associated PDZ proteins (e.g. PSD-95) reveals a 5-HT2A receptor-mediated anti-hyperalgesic effect and enhances the efficacy of fluoxetine (a SSRI) in diabetic neuropathic pain conditions in rats. Here, we have examined whether the same strategy would be useful to treat inflammatory pain. Sub-chronic inflammatory pain was induced by injecting λ-carrageenan (100 µl, 2%) into the left hind paw of the rat. Mechanical hyperalgesia was assessed after acute treatment with TAT-2ASCV or/and fluoxetine (SSRI) 2.5 h after λ-carrageenan injection. Possible changes in the level of 5-HT2A receptors and its associated PDZ protein PSD-95 upon inflammation induction were quantified by Western blotting in dorsal horn spinal cord. Administration of TAT-2ASCV peptide (100 ng/rat, intrathecally) but not fluoxetine (10 mg/kg, intraperitoneally) relieves mechanical hyperalgesia (paw pressure test) in inflamed rats. This anti-hyperalgesic effect involves spinal 5-HT2A receptors and GABAergic interneurons as it is abolished by a 5-HT2A antagonist (M100907, 150 ng/rat, intrathecally) and a GABAA antagonist, (bicuculline, 3 µg/rat, intrathecally). We also found a decreased expression of 5-HT2A receptors in the dorsal spinal cord of inflamed animals which could not be rescued by TAT-2ASCV injection, while the amount of PSD-95 was not affected by inflammatory pain. Finally, the coadministration of fluoxetine does not further enhance the anti-hyperalgesic effect of TAT-2ASCV peptide. This study reveals a role of the interactions between 5-HT2A receptors and PDZ proteins in the pathophysiological pathways of inflammatory pain and opens new perspectives in its control thanks to molecules disrupting 5-HT2A receptor/PDZ protein interactions.
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Dai F, Lei Y, Li S, Song G, Chen JDZ. Desvenlafaxine succinate ameliorates visceral hypersensitivity but delays solid gastric emptying in rats. Am J Physiol Gastrointest Liver Physiol 2013; 305:G333-9. [PMID: 23764892 DOI: 10.1152/ajpgi.00224.2012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Desvenlafaxine succinate (DVS) is a novel serotonin and norepinephrine reuptake inhibitor. The aim of this study was to investigate the effects of DVS on visceral hypersensitivity and solid gastric emptying in a rodent model of gastric hyperalgesia. Twenty-eight gastric hyperalgesia rats and 20 control rats were used. Visceral sensitivity during gastric distention (GD) was assessed by recording of electromyogram (EMG) at pressures of 20, 40, 60, and 80 mmHg. DVS with doses of 1, 10, and 30 mg/kg were administrated by gavage, 5-HT1A antagonist (WAY-100635, 0.3 mg/kg) was given subcutaneously, and 5-HT2A antagonist (ketanserin, 1 mg/kg) was given intraperitoneally. The level of norepinephrine in plasma was measured by enzyme-linked immunosorbent assay. We found that 1) visceral hypersensitivity induced by acetic acid was validated. 2) DVS dose-dependently reduced visceral hypersensitivity in the gastric hypersensitivity rats. The EMG (% of baseline value without GD) during GD at 60 and 80 mmHg with DVS at a dose of 30 mg/kg were 119.4 ± 2.3% (vs. saline 150.9 ± 2.7%, P < 0.001) and 128.2 ± 3.2% (vs. saline 171.1 ± 2.4%, P < 0.001). Similar findings were observed at a dose of 10 mg/kg. DVS at a dose of 1 mg/kg reduced visceral hypersensitivity only during GD at 60 mmHg. 3) Neither WAY-100635 nor ketanserin blocked the effect of DVS on visceral sensitivity. 4) DVS at 30 mg/kg significantly increased plasma NE level (P = 0.012 vs. saline). 5) DVS at 30 mg/kg significantly delayed solid gastric emptying (P < 0.05 vs. saline). We conclude that DVS reduces visceral sensitivity in a rodent model of visceral hypersensitivity and delays solid gastric emptying. Caution should be made when DVS is used for treating patients.
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Affiliation(s)
- Fei Dai
- Ningbo Pace Translational Medical Research Center, Beilun, Ningbo, China.
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Grégoire S, Neugebauer V. 5-HT2CR blockade in the amygdala conveys analgesic efficacy to SSRIs in a rat model of arthritis pain. Mol Pain 2013; 9:41. [PMID: 23937887 PMCID: PMC3751088 DOI: 10.1186/1744-8069-9-41] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 08/09/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pain, including arthritic pain, has a negative affective component and is often associated with anxiety and depression. However, selective serotonin reuptake inhibitor antidepressants (SSRIs) show limited effectiveness in pain. The amygdala plays a key role in the emotional-affective component of pain, pain modulation and affective disorders. Neuroplasticity in the basolateral and central amygdala (BLA and CeA, respectively) correlate positively with pain behaviors. Evidence suggests that serotonin receptor subtype 5-HT2CR in the amygdala contributes critically to anxiogenic behavior and anxiety disorders. In this study, we tested the hypothesis that 5-HT2CR in the amygdala accounts for the limited effectiveness of SSRIs in reducing pain behaviors and that 5-HT2CR blockade in the amygdala renders SSRIs effective. RESULTS Nocifensive reflexes, vocalizations and anxiety-like behavior were measured in adult male Sprague-Dawley rats. Behavioral experiments were done in sham controls and in rats with arthritis induced by kaolin/carrageenan injections into one knee joint. Rats received a systemic (i.p.) administration of an SSRI (fluvoxamine, 30 mg/kg) or vehicle (sterile saline) and stereotaxic application of a selective 5-HT2CR antagonist (SB242084, 10 μM) or vehicle (ACSF) into BLA or CeA by microdialysis. Compared to shams, arthritic rats showed decreased hindlimb withdrawal thresholds (increased reflexes), increased duration of audible and ultrasonic vocalizations, and decreased open-arm choices in the elevated plus maze test suggesting anxiety-like behavior. Fluvoxamine (i.p.) or SB242084 (intra-BLA) alone had no significant effect, but their combination inhibited the pain-related increase of vocalizations and anxiety-like behavior without affecting spinal reflexes. SB242084 applied into the CeA in combination with systemic fluvoxamine had no effect on vocalizations and spinal reflexes. CONCLUSIONS The data suggest that 5-HT2CR in the amygdala, especially in the BLA, limits the effectiveness of SSRIs to inhibit pain-related emotional-affective behaviors.
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Affiliation(s)
- Stéphanie Grégoire
- Department of Neuroscience and Cell Biology, The University of Texas Medical Branch, Galveston Texas 77555-1069, USA
| | - Volker Neugebauer
- Department of Neuroscience and Cell Biology, The University of Texas Medical Branch, Galveston Texas 77555-1069, USA
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Dharmshaktu P, Tayal V, Kalra BS. Efficacy of Antidepressants as Analgesics: A Review. J Clin Pharmacol 2013; 52:6-17. [DOI: 10.1177/0091270010394852] [Citation(s) in RCA: 211] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Differential Involvement of Central and Peripheral α2 Adrenoreceptors in the Antinociception Induced by Aerobic and Resistance Exercise. Anesth Analg 2013; 116:703-11. [DOI: 10.1213/ane.0b013e31827ab6e4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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36
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Leung YM, Chu CC, Kuo CS, Chen YW, Wang JJ. Nisoxetine blocks sodium currents and elicits spinal anesthesia in rats. Pharmacol Rep 2013; 65:350-7. [DOI: 10.1016/s1734-1140(13)71010-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 11/26/2012] [Indexed: 11/16/2022]
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Effects of monoamine reuptake inhibitors in assays of acute pain-stimulated and pain-depressed behavior in rats. THE JOURNAL OF PAIN 2013; 14:246-59. [PMID: 23332494 DOI: 10.1016/j.jpain.2012.11.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 10/12/2012] [Accepted: 11/12/2012] [Indexed: 01/23/2023]
Abstract
UNLABELLED Pain is associated with stimulation of some behaviors (eg, withdrawal reflexes) but depression of many other behaviors (eg, feeding, locomotion, positively reinforced operant behavior). Drugs that block reuptake of serotonin, norepinephrine, and/or dopamine are widely used to treat depression, and they have also emerged as useful drugs for treatment of pain. This study compared effects of selective and mixed-action inhibitors of serotonin, norepinephrine, and/or dopamine reuptake in assays of acute pain-stimulated and pain-depressed behavior. Intraperitoneal injection of dilute acid served as a noxious stimulus to stimulate a writhing response or depress intracranial self-stimulation (ICSS) in Sprague Dawley rats. Selective reuptake inhibitors of serotonin (citalopram, clomipramine) and norepinephrine (nisoxetine, nortriptyline) and a mixed-action reuptake inhibitor of serotonin and norepinephrine (milnacipran) blocked acid-stimulated writhing but failed to block acid-induced depression of ICSS. Selective dopamine reuptake inhibitors (RTI-113 [3ß-(4-chlorophenyl)tropane-2ß-carboxylic acid phenyl ester hydrochloride], bupropion) and a triple reuptake inhibitor of dopamine, serotonin, and norepinephrine (RTI-112 [3ß-(3-methyl-4-chlorophenyl)tropane-2ß-carboxylic acid methyl ester hydrochloride]) blocked both acid-stimulated writhing and acid-induced depression of ICSS, although these drugs also produced an abuse-related facilitation of ICSS in the absence of the noxious stimulus. These results support further consideration of dopamine reuptake inhibitors as candidate analgesics, although abuse liability remains a concern. PERSPECTIVE Monoamine reuptake inhibitors are used to treat depression and some forms of pain. This study examined effects of monoamine reuptake inhibitors in a preclinical assay of pain-related behavioral depression. The results support further consideration of dopamine reuptake inhibitors as candidate analgesics under selected circumstances, although abuse liability remains a concern.
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Erthal V, da Silva MD, Cidral-Filho FJ, Santos ARS, Nohama P. ST36 laser acupuncture reduces pain-related behavior in rats: involvement of the opioidergic and serotonergic systems. Lasers Med Sci 2013; 28:1345-51. [PMID: 23291880 DOI: 10.1007/s10103-012-1260-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 12/26/2012] [Indexed: 11/28/2022]
Abstract
Laser acupuncture is a modality of low-level light therapy used as an alternative to needling for the past three decades. Although it has proved effective for the treatment of various conditions, the mechanisms underlying its effects are not fully understood. To contribute to this understanding, this study was designed to (1) evaluate the antinociceptive effect of ST36 laser acupuncture (830 nm, 3 J/cm(2)) in rat models of acute nociception and (2) to investigate the opioidergic and serotonergic systems involvement in this effect. Our results demonstrate that ST36 laser acupuncture inhibited (36 ± 2 %) acetic acid-induced abdominal constrictions and both neurogenic (48 ± 7 %) and inflammatory (phase IIA 42 ± 8 % and phase IIB 83 ± 6 %) phases of formalin-induced nociceptive behavior. Moreover, the antinociceptive activity of laser irradiation in the acetic acid test was significantly reversed by preadministration of naloxone (1 mg/kg, nonselective opioid receptor antagonist), pindolol (1 mg/kg, subcutaneous; nonselective 5-HT 1A/B receptor antagonist), and ketanserin (1 mg/kg; selective 5-HT2A receptor antagonist) but not by ondansetron (1 mg/kg, selective 5-HT3 receptor antagonist). Taken together, our data demonstrate, for the first time, that (1) ST36 laser acupuncture elicited significant antinociceptive effect against acetic acid- and formalin-induced behavior in rats and that (2) this effect is mediated by activation of the opioidergic and serotonergic (5-HT1 and 5-HT2A receptors) systems.
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Affiliation(s)
- Vanessa Erthal
- Programa de Pós-Graduação em Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná (PUCPR), Rua Imaculada Conceição, 1155, Curitiba, 80215-901, Paraná, Brazil
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Leung YM, Chu CC, Kuo CS, Chen YW, Hung CH, Wang JJ. Isobolographic analysis of interaction between nisoxetine- and mepivacaine-induced spinal blockades in rats. Fundam Clin Pharmacol 2012; 28:88-94. [DOI: 10.1111/j.1472-8206.2012.01070.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 06/28/2012] [Accepted: 07/19/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Yuk-Man Leung
- Graduate Institute of Neural and Cognitive Sciences; China Medical University; Taichung Taiwan
| | - Chin-Chen Chu
- Department of Anesthesiology; Chi-Mei Medical Center; Tainan Taiwan
- Department of Recreation and Health-Care Management; Chia Nan University of Pharmacy and Science; Tainan Taiwan
| | - Chang-Shin Kuo
- Graduate Institute of Neural and Cognitive Sciences; China Medical University; Taichung Taiwan
| | - Yu-Wen Chen
- Graduate Institute of Neural and Cognitive Sciences; China Medical University; Taichung Taiwan
- Department of Physical Therapy; China Medical University; Taichung Taiwan
| | - Ching-Hsia Hung
- Institute & Department of Physical Therapy; National Cheng Kung University; No.1 Ta-Hsueh Road Tainan Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research; Chi-Mei Medical Center; Tainan Taiwan
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Kohno T, Kimura M, Sasaki M, Obata H, Amaya F, Saito S. Milnacipran inhibits glutamatergic N-methyl-D-aspartate receptor activity in spinal dorsal horn neurons. Mol Pain 2012; 8:45. [PMID: 22716121 PMCID: PMC3407012 DOI: 10.1186/1744-8069-8-45] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 06/19/2012] [Indexed: 01/10/2023] Open
Abstract
Background Antidepressants, which are widely used for treatment of chronic pain, are thought to have antinociceptive effects by blockade of serotonin and noradrenaline reuptake. However, these drugs also interact with various receptors such as excitatory glutamatergic receptors. Thermal hyperalgesia was induced by intrathecal injection of NMDA in rats. Paw withdrawal latency was measured after intrathecal injection of antidepressants. The effects of antidepressants on the NMDA and AMPA-induced responses were examined in lamina II neurons of rat spinal cord slices using the whole-cell patch-clamp technique. The effects of milnacipran followed by application of NMDA on pERK activation were also investigated in the spinal cord. Results Intrathecal injection of milnacipran (0.1 μmol), but not citalopram (0.1 μmol) and desipramine (0.1 μmol), followed by intrathecal injection of NMDA (1 μg) suppressed thermal hyperalgesia. Milnacipran (100 μM) reduced the amplitude of NMDA (56 ± 3 %, 64 ± 5 % of control)-, but not AMPA (98 ± 5 %, 97 ± 5 % of control)-mediated currents induced by exogenous application and dorsal root stimulation, respectively. Citalopram (100 μM) and desipramine (30 μM) had no effect on the amplitude of exogenous NMDA-induced currents. The number of pERK-positive neurons in the group treated with milnacipran (100 μM), but not citalopram (100 μM) or desipramine (30 μM), followed by NMDA (100 μM) was significantly lower compared with the NMDA-alone group. Conclusions The antinociceptive effect of milnacipran may be dependent on the drug’s direct modulation of NMDA receptors in the superficial dorsal horn. Furthermore, in addition to inhibiting the reuptake of monoamines, glutamate NMDA receptors are also important for analgesia induced by milnacipran.
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Affiliation(s)
- Tatsuro Kohno
- Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 757 Asahimachi, Japan.
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Bilge SS, Bozkurt A, Ilkaya F, Ciftcioğlu E, Kesim Y, Uzbay TI. The antinociceptive effects of intravenous tianeptine in colorectal distension-induced visceral pain in rats: the role of 5-HT₃ receptors. Eur J Pharmacol 2012; 681:44-9. [PMID: 22348811 DOI: 10.1016/j.ejphar.2012.01.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 01/20/2012] [Accepted: 01/28/2012] [Indexed: 11/18/2022]
Abstract
Tianeptine is an unusual tricyclic antidepressant drug. In this study, we aimed to investigate the antinociceptive effect of tianeptine on visceral pain in rats and to determine whether possible antinociceptive effect of tianeptine is mediated by serotonergic (5-HT(2,3)) and noradrenergic (α(1,2)) receptor subtypes. Male Sprague Dawley rats (250-300 g) were supplied with a venous catheter, for drug administrations, and enameled nichrome electrodes, for electromyography, at external oblique musculature. Colorectal distension (CRD) was employed as the noxious visceral stimulus and the visceromotor response (VMR) to CRD was quantified electromyographically before and 5, 15, 30, 60, 90 and 120 min after tianeptine administration. Antagonists were administered 10 min before tianeptine for their ability to change tianeptine antinociception. Intravenous administration of tianeptine (2.5-20 mg/kg) produced a dose-dependent reduction in VMR. Administration of 5-HT(3) receptor antagonist ondansetron (0.5, 1 and 2 mg/kg), but not 5-HT(2) receptor antagonist ketanserine (0.5, 1 and 2 mg/kg), reduced the antinociceptive effect of tianeptine (10mg/kg). In addition, administration of α(1)-adrenoceptor antagonist prazosin (1 mg/kg) or α(2)-adrenoceptor antagonist yohimbine (1 mg/kg) did not cause any significant effect on the tianeptine-induced antinociception. Our data indicate that intravenous tianeptine exerts a pronounced antinociception against CRD-induced visceral pain in rats, and suggests that the antinociceptive effect of tianeptine appears to be mediated in part by 5-HT(3) receptors, but does not involve 5-HT(2) receptors or α-adrenoceptors.
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MESH Headings
- Analgesics/administration & dosage
- Analgesics/pharmacology
- Animals
- Antidepressive Agents, Tricyclic/administration & dosage
- Antidepressive Agents, Tricyclic/pharmacology
- Disease Models, Animal
- Dose-Response Relationship, Drug
- Electromyography
- Injections, Intravenous
- Male
- Rats
- Rats, Sprague-Dawley
- Receptors, Adrenergic, alpha/drug effects
- Receptors, Adrenergic, alpha/metabolism
- Receptors, Serotonin, 5-HT2/drug effects
- Receptors, Serotonin, 5-HT2/metabolism
- Receptors, Serotonin, 5-HT3/drug effects
- Receptors, Serotonin, 5-HT3/metabolism
- Thiazepines/administration & dosage
- Thiazepines/pharmacology
- Time Factors
- Visceral Pain/drug therapy
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Affiliation(s)
- S Sırrı Bilge
- Ondokuz Mayıs University, School of Medicine, Department of Pharmacology, Samsun, Turkey.
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Chen YW, Chu CC, Chen YC, Wang JJ, Hung CH, Shao DZ. Nisoxetine produces local but not systemic analgesia against cutaneous nociceptive stimuli in the rat. Eur J Pharmacol 2012; 675:22-5. [DOI: 10.1016/j.ejphar.2011.11.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 11/16/2011] [Accepted: 11/27/2011] [Indexed: 10/14/2022]
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43
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Duric V, McCarson KE. Hippocampal Mechanisms Linking Chronic Pain and Depression. ACTA ACUST UNITED AC 2011. [DOI: 10.3109/j426v02n04_03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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44
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Depoortère R, Meleine M, Bardin L, Aliaga M, Muller E, Ardid D, Newman-Tancredi A. Milnacipran is active in models of irritable bowel syndrome and abdominal visceral pain in rodents. Eur J Pharmacol 2011; 672:83-7. [DOI: 10.1016/j.ejphar.2011.09.182] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 09/20/2011] [Accepted: 09/24/2011] [Indexed: 12/28/2022]
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45
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Song Z, Meyerson BA, Linderoth B. The interaction between antidepressant drugs and the pain-relieving effect of spinal cord stimulation in a rat model of neuropathy. Anesth Analg 2011; 113:1260-5. [PMID: 21788322 DOI: 10.1213/ane.0b013e3182288851] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Spinal cord stimulation (SCS) has proven to be a valuable treatment in neuropathic pain. On the basis of our previous studies on the mode of action of SCS, intrathecal administration of subeffective doses of certain drugs has been shown to enhance the pain-relieving effect in patients with SCS. Antidepressants have a well-established beneficial effect in neuropathic pain. We performed the present study to examine potential synergistic or antagonistic effects on SCS of antidepressants: amitriptyline (tricyclic antidepressant), fluoxetine (selective serotonin reuptake inhibitor), and milnacipran (selective serotonin/noradrenaline reuptake inhibitor). METHODS In rats, the effect of SCS on mechanical hypersensitivity after peripheral nerve injury was assessed in awake, freely moving animals. Antidepressants were administered intrathecally. RESULTS When combining SCS with subeffective doses of amitriptyline or milnacipran, the suppressive effect of SCS on the mechanical hypersensitivity was enhanced in comparison with that obtained with SCS alone. There was no detectable effect of fluoxetine. No signs of an antagonistic effect of the drugs on the SCS effect were observed. CONCLUSIONS These findings suggest a possible clinical application with a combination of SCS and a tricyclic antidepressant or selective serotonin/noradrenaline reuptake inhibitor drug in cases in which SCS per se has proven inefficient.
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Affiliation(s)
- Zhiyang Song
- Department of Clinical Neuroscience, Section of Clinical CNS Research, R2:02, Karolinska University Hospital, S-171 76 Stockholm, Sweden.
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Hache G, Coudore F, Gardier AM, Guiard BP. Monoaminergic Antidepressants in the Relief of Pain: Potential Therapeutic Utility of Triple Reuptake Inhibitors (TRIs). Pharmaceuticals (Basel) 2011. [PMCID: PMC4053958 DOI: 10.3390/ph4020285] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Over 75% of depressed patients suffer from painful symptoms predicting a greater severity and a less favorable outcome of depression. Imaging, anatomical and functional studies have demonstrated the existence of common brain structures, neuronal pathways and neurotransmitters in depression and pain. In particular, the ascending serotonergic and noradrenergic pathways originating from the raphe nuclei and the locus coeruleus; respectively, send projections to the limbic system. Such pathways control many of the psychological functions that are disturbed in depression and in the perception of pain. On the other hand, the descending pathways, from monoaminergic nuclei to the spinal cord, are specifically implicated in the inhibition of nociception providing rationale for the use of serotonin (5-HT) and/or norepinephrine (NE) reuptake inhibitors (SSRIs, NRIs, SNRIs), in the relief of pain. Compelling evidence suggests that dopamine (DA) is also involved in the pathophysiology and treatment of depression. Indeed, recent insights have demonstrated a central role for DA in analgesia through an action at both the spinal and suprasinal levels including brain regions such as the periaqueductal grey (PAG), the thalamus, the basal ganglia and the limbic system. In this context, dopaminergic antidepressants (i.e., containing dopaminergic activity), such as bupropion, nomifensine and more recently triple reuptake inhibitors (TRIs), might represent new promising therapeutic tools in the treatment of painful symptoms with depression. Nevertheless, whether the addition of the dopaminergic component produces more robust effects than single- or dual-acting agents, has yet to be demonstrated. This article reviews the main pathways regulating pain transmission in relation with the monoaminergic systems. It then focuses on the current knowledge regarding the in vivo pharmacological properties and mechanism of action of monoaminergic antidepressants including SSRIs, NRIs, SNRIs and TRIs. Finally, a synthesis of the preclinical studies supporting the efficacy of these antidepressants in analgesia is also addressed in order to highlight the relative contribution of 5-HT, NE and DA to nociception.
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Affiliation(s)
- Guillaume Hache
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: 011-331-46-83-53-61
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Kawaura K, Miki R, Urashima Y, Honda S, Shehata AM, Soeda F, Shirasaki T, Takahama K. Tipepidine enhances the antinociceptive-like action of carbamazepine in the acetic acid writhing test. Eur J Pharmacol 2011; 651:106-8. [DOI: 10.1016/j.ejphar.2010.10.086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Revised: 10/06/2010] [Accepted: 10/29/2010] [Indexed: 10/18/2022]
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Levodopa analgesia in experimental neuropathic pain. Brain Res Bull 2010; 83:304-9. [PMID: 20813171 DOI: 10.1016/j.brainresbull.2010.08.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 08/19/2010] [Accepted: 08/24/2010] [Indexed: 01/22/2023]
Abstract
Levodopa has been shown to produce analgesia in various clinical and experimental settings, but its use for chronic pain treatment has not been established. We have undertaken a study of the antiallodynic actions of levodopa in a rat model of painful mononeuropathy. When administered systemically, levodopa produced a decrease in tactile and cold allodynia lasting at least 3h. Direct intrathecal (i.t.) levodopa injection at lumbar levels produced a similar, though shorter, antiallodynic effect. This effect was blocked by the D2-type receptor antagonist sulpiride, which supports the involvement of the spinal dopaminergic system in the analgesic action of levodopa on neuropathic pain. These results provide experimental support on the antiallodynic effect of levodopa in neuropathic pain and suggest that at least part of the analgesic action takes place in the spinal cord and involves dopaminergic D2-type receptors.
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Palmer RH, Periclou A, Banerjee P. Milnacipran: a selective serotonin and norepinephrine dual reuptake inhibitor for the management of fibromyalgia. Ther Adv Musculoskelet Dis 2010; 2:201-20. [PMID: 22870448 PMCID: PMC3383514 DOI: 10.1177/1759720x10372551] [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] [Indexed: 01/22/2023] Open
Abstract
Milnacipran, a serotonin and norepinephrfrine reuptake inhibitor with preferential inhibition of norepinephrine reuptake over serotonin, is approved in the United States for the management of fibromyalgia. Owing to its effects on norepinephrine and serotonin, as well as its lack of activity at other receptor systems, it was hypothesized that milnacipran would provide improvements in pain and other fibromyalgia symptoms without some of the unpleasant side effects associated with other medications historically used for treating fibromyalgia. The clinical safety and efficacy of milnacipran 100 and 200 mg/day in individuals with fibromyalgia has been investigated in four large, randomized, double-blind, placebo-controlled studies and three long-term extension studies. The clinical studies used composite responder analyses to identify the proportion of individual patients reporting simultaneous and clinically significant improvements in pain, global status, and physical function, in addition to assessing improvement in various symptom domains such as fatigue and dyscognition. In the clinical studies, patients receiving milnacipran reported significant improvements in pain and other symptoms for up to 15 months of treatment. Most adverse events were mild to moderate in severity and were related to the intrinsic pharmacologic properties of the drug. Long-term exposure to milnacipran did not result in any new safety concerns. As with other serotonin and norepinephrine reuptake inhibitors, increases in heart rate and blood pressure have been observed in some patients with milnacipran treatment.
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Affiliation(s)
- Robert H. Palmer
- Forest Research Institute, Harborside Financial Center, Plaza V, Jersey City, NJ 07311, USA
| | - Antonia Periclou
- Forest Research Institute, Harborside Financial Center, Plaza V, Jersey City, NJ 07311, USA
| | - Pradeep Banerjee
- Forest Research Institute, Harborside Financial Center, Plaza V, Jersey City, NJ 07311, USA
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Effectiveness of milnacipran for the treatment of chronic pain in the orofacial region. Clin Neuropharmacol 2010; 33:79-83. [PMID: 20375656 DOI: 10.1097/wnf.0b013e3181cb5793] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The effect of milnacipran for the treatment of chronic pain in the orofacial region, including burning mouth syndrome (BMS) and atypical odontalgia (AO), was assessed while accounting for the influence of concurrent depressive symptoms on the pain-relieving effect. METHODS Milnacipran was administered for 12 weeks to 36 patients with chronic pain in the orofacial region (3 men and 29 women, aged between 22 and 76 years with a mean age of 59 years). Of those patients, 22 and 10 patients had BMS and AO, respectively. The initial dose of milnacipran was 15 mg a day, and the dose was raised up to 100 mg a day. Pain was assessed using the visual analog scale, and symptoms of depression were evaluated using the Hamilton Depression Rating Scale at baseline and at weeks 1, 2, 4, 6, 8, 10, and 12 of the study treatment. RESULTS Data from 32 patients who completed the study were included in the analysis. The visual analog scale score significantly decreased after the 12-week treatment, and it showed a similar time course of decline irrespective of concurrent depressive symptoms during the 12 weeks. CONCLUSIONS Treatment with milnacipran resulted in a significant improvement of chronic pain in the orofacial region irrespective of concurrent symptoms of depression. The present results suggested that milnacipran may be an effective agent for treatment of such disorders.
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