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Likar R, Poglitsch R, Bejvančický Š, Carl L, Ferencik M, Klein-Watrycz A, Rieger M, Flores KS, Schumich A, Vlamaki Z, Werner M. The Use of High-Dose Intravenous L-Ascorbate in Pain Therapy: Current Evidence from the Literature. Pain Ther 2024:10.1007/s40122-024-00622-5. [PMID: 38864974 DOI: 10.1007/s40122-024-00622-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/24/2024] [Indexed: 06/13/2024] Open
Abstract
INTRODUCTION Pain is the most common reason for seeking medical treatment. Despite extensive research efforts and effective analgesics modulating pain, there is still a major therapeutic gap in addressing the root causes of pain. Pain is associated with tissue damage induced by oxidative stress and induction of inflammatory mediators following high consumption of antioxidants. The role of antioxidants in general, and the administration of L-ascorbate in particular, is still controversially discussed and underestimated in the daily clinical practice. METHODS The current literature on the therapeutic effect of L-ascorbate, ascorbic acid, and vitamin C on various pain conditions was evaluated against the background of evidence-based medicine. Those articles, obtained from systematic search in PubMed, were critically assessed and rated in terms of evidence level and methodological quality by two independent experts. The primary purpose of this work was to establish specific pain therapy guidance for intravenous L-ascorbate. RESULTS A PubMed search revealed 14 suitable articles comprising controlled clinical trials and meta-analyses. An additional ten publications could be identified via secondary literature. There is supporting evidence for the efficacy of ascorbate treatment in inflammatory pain conditions, in the complex regional pain syndrome, in post zoster neuralgia, in neuropathic pain, in post-operative pain conditions, and in tumor-related pain. However, the considered studies differ in the type of administration, in dosage, in duration of treatment, as well as in quality of research. Despite all study heterogeneity, it became evident that research of high scientific quality is in support of the efficacy of L-ascorbate in pain treatment. DISCUSSION Oxidative stress is present in almost all pain conditions. Because oral administration of most magistral formulas of vitamin C does not provide biological availability, parenteral administration should be preferred and can be supported by an oral dose with high bioavailability on days without intravenous treatment. L-ascorbate should be preferred for parenteral high dosage, rather than ascorbic acid, as it does not release acid valences under physiological conditions. CONCLUSIONS L-ascorbate is an effective, safe, and economically favorable integrative treatment option for various pain conditions, addressing the root cause of tissue damage and inflammatory mediator burst.
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Affiliation(s)
- Rudolf Likar
- Department of Anesthesiology and Intensive Care Medicine, Klinikum Klagenfurt Am Wörthersee, Chair of Palliative Medicine SFU Vienna, Klagenfurt am Wörthersee, Austria.
| | - Ruth Poglitsch
- Medical Institute Dr. Poglitsch, Pain Medicine, Graz, Austria
| | - Štěpán Bejvančický
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Pilsen, Pilsen, Czech Republic
| | - Ludwig Carl
- Department of Anesthesiology and Intensive Care Medicine, Klinikum Mutterhaus Trier, Johannes Gutenberg University, Mainz, Germany
| | - Miroslav Ferencik
- Department of Algesiology SZU, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia
| | - Alfred Klein-Watrycz
- Institute of Physical Medicine and Rehabilitation, Hospital Mistelbach, Mistelbach, Austria
| | - Monika Rieger
- Pain Therapy Practice Rieger, Bingen am Rhein, Germany
| | | | - Astrid Schumich
- Private Practice for General Medicine, Orthopaedics, Orthopaedic Surgery and Functional Myodiagnostics, Vienna, Austria
| | - Zoe Vlamaki
- General Surgery and Breast Oncoplastic Surgery, NMC Royal Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
| | - Marc Werner
- Clinic for Naturopathy and Integrative Medicine, Evangelische Kliniken Essen-Mitte GmbH, Essen, Germany
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Sarzi-Puttini P, Giorgi V, Sirotti S, Bazzichi L, Lucini D, Di Lascio S, Pellegrino G, Fornasari D. Pharmacotherapeutic advances in fibromyalgia: what's new on the horizon? Expert Opin Pharmacother 2024; 25:999-1017. [PMID: 38853631 DOI: 10.1080/14656566.2024.2365326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/04/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION This review delves into Fibromyalgia Syndrome (FMS), a chronic pain condition demanding thorough understanding for precise diagnosis and treatment. Yet, a definitive pharmacological solution for FMS remains elusive. AREAS COVERED In this article, we systematically analyze various pharmacotherapeutic prospects for FMS treatment, organized into sections based on the stage of drug development and approval. We begin with an overview of FDA-approved drugs, discussing their efficacy in FMS treatment. Next, we delve into other medications currently used for FMS but still undergoing further study, including opioids and muscle relaxants. Further, we evaluate the evidence behind medications that are currently under study, such as cannabinoids and naltrexone. Lastly, we explore new drugs that are in phase II trials. Our research involved a thorough search on PUBMED, Google Scholar, and clinicaltrials.gov. We also discuss the action mechanisms of these drugs and their potential use in specific patient groups. EXPERT OPINION A focus on symptom-driven, combination therapy is crucial in managing FMS. There is also a need for ongoing research into drugs that target neuroinflammation, immunomodulation, and the endocannabinoid system. Bridging the gap between benchside research and clinical application is challenging, but it holds potential for more targeted and effective treatment strategies.
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Affiliation(s)
- Piercarlo Sarzi-Puttini
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Valeria Giorgi
- Unità di Ricerca Clinica, Gruppo Ospedaliero Moncucco, Lugano, Switzerland
| | - Silvia Sirotti
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Laura Bazzichi
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Daniela Lucini
- BIOMETRA Department, University of Milan, Milan, Italy
- IRCCS Istituto Auxologico Italiano, Exercise Medicine Unit, Milan, Italy
| | - Simona Di Lascio
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Greta Pellegrino
- Rheumatology Unit, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Diego Fornasari
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
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Zhang SH, Feng Y, Zhong MM, Xie JH, Xu W. Association between oxidative stress and chronic orofacial pain and potential druggable targets: Evidence from a Mendelian randomization study. J Oral Rehabil 2024; 51:970-981. [PMID: 38414129 DOI: 10.1111/joor.13663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 01/22/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Oxidative stress indicators affect chronic orofacial pain (COFP), but how to reduce these effects is uncertain. OBJECTIVES 11 oxidative stress biomarkers were collected as exposures, while four forms of COFP were chosen as outcomes for Mendelian randomization (MR) study. METHODS The effect estimates between oxidative stress and COFP were calculated using inverse variance-weighted MR (IVW-MR). Then, functional mapping and annotation (FUMA) was utilized in order to carry out SNP-based functional enrichment analyses. In addition, the IVW-MR method was applied to combine effect estimates when using genetic variants associated with oxidative stress biomarkers as an instrument for exploring potential druggable targets. RESULTS The results indicated that oxidative stress biomarkers (causal OR of uric acid (UA), 0.998 for myofascial pain, 95% CI 0.996-1.000, p < .05; and OR of glutathione transferase (GST), 1.002 for dentoalveolar pain, 95% CI 1.000-1.003, p < .05) were significantly linked with the probability of COFP. Functional analysis also demonstrated that UA and myofascial pain genes were prominent in nitrogen and uracil metabolism, while GST and dentoalveolar pain genes were enriched in glutathione metabolism. Also, the study provided evidence that solute carrier family 2 member 9 (SLC2A9) and glutathione S-transferase alpha 2 (GSTA2) cause discomfort in the myofascial pain (OR = 1.003, 95% CI 1.000-1.006; p < .05) and dentoalveolar region (OR = 1.001, 95% CI 1.000-1.002; p < .05), respectively. CONCLUSIONS In conclusion, this MR study indicates that genetically predicted myofascial pain was significantly associated with decreased UA and dentoalveolar pain was significantly associated with increased GST level. SLC2A9 inhibitor and GSTA2 inhibitor were novel chronic orofacial pain therapies and biomarkers, but clinical trials are called to examine if these oxidative biomarkers have the protective effect against orofacial pain, and further research are needed to explore the underlying mechanisms.
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Affiliation(s)
- Shao-Hui Zhang
- Department of Stomatology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Yao Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Meng-Mei Zhong
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jia-Hao Xie
- Institute of Artificial Intelligence & Robotics (IAIR), Key Laboratory of Traffic Safety on Track of Ministry of Education, School of Traffic and Transportation Engineering, Central South University, Changsha, China
| | - Wei Xu
- Department of Stomatology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
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Brum ES, Fialho MFP, Souza Monteiro de Araújo D, Landini L, Marini M, Titiz M, Kuhn BL, Frizzo CP, Araújo PHS, Guimarães RM, Cunha TM, Silva CR, Trevisan G, Geppetti P, Nassini R, De Logu F, Oliveira SM. Schwann cell TRPA1 elicits reserpine-induced fibromyalgia pain in mice. Br J Pharmacol 2024. [PMID: 38772415 DOI: 10.1111/bph.16413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/29/2024] [Accepted: 03/30/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND AND PURPOSE Fibromyalgia is a complex clinical disorder with an unknown aetiology, characterized by generalized pain and co-morbid symptoms such as anxiety and depression. An imbalance of oxidants and antioxidants is proposed to play a pivotal role in the pathogenesis of fibromyalgia symptoms. However, the precise mechanisms by which oxidative stress contributes to fibromyalgia-induced pain remain unclear. The transient receptor potential ankyrin 1 (TRPA1) channel, known as both a pain sensor and an oxidative stress sensor, has been implicated in various painful conditions. EXPERIMENTAL APPROACH The feed-forward mechanism that implicates reactive oxygen species (ROS) driven by TRPA1 was investigated in a reserpine-induced fibromyalgia model in C57BL/6J mice employing pharmacological interventions and genetic approaches. KEY RESULTS Reserpine-treated mice developed pain-like behaviours (mechanical/cold hypersensitivity) and early anxiety-depressive-like disorders, accompanied by increased levels of oxidative stress markers in the sciatic nerve tissues. These effects were not observed upon pharmacological blockade or global genetic deletion of the TRPA1 channel and macrophage depletion. Furthermore, we demonstrated that selective silencing of TRPA1 in Schwann cells reduced reserpine-induced neuroinflammation (NADPH oxidase 1-dependent ROS generation and macrophage increase in the sciatic nerve) and attenuated fibromyalgia-like behaviours. CONCLUSION AND IMPLICATIONS Activated Schwann cells expressing TRPA1 promote an intracellular pathway culminating in the release of ROS and recruitment of macrophages in the mouse sciatic nerve. These cellular and molecular events sustain mechanical and cold hypersensitivity in the reserpine-evoked fibromyalgia model. Targeting TRPA1 channels on Schwann cells could offer a novel therapeutic approach for managing fibromyalgia-related behaviours.
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Affiliation(s)
- Evelyne Silva Brum
- Graduate Program in Biological Sciences: Toxicological Biochemistry, Centre of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, Brazil
| | - Maria Fernanda Pessano Fialho
- Graduate Program in Biological Sciences: Toxicological Biochemistry, Centre of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Lorenzo Landini
- Department of Health Sciences, Clinical Pharmacology Unit, University of Florence, Florence, Italy
| | - Matilde Marini
- Department of Health Sciences, Clinical Pharmacology Unit, University of Florence, Florence, Italy
| | - Mustafa Titiz
- Department of Health Sciences, Clinical Pharmacology Unit, University of Florence, Florence, Italy
| | - Bruna Luiza Kuhn
- Heterocycle Chemistry Nucleus (NUQUIMHE), Federal University of Santa Maria, Santa Maria, Brazil
| | - Clarissa Piccinin Frizzo
- Heterocycle Chemistry Nucleus (NUQUIMHE), Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Rafaela Mano Guimarães
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Thiago Mattar Cunha
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Cássia Regina Silva
- Department of Genetic and Biochemistry, University of Uberlândia, Uberlândia, Brazil
| | - Gabriela Trevisan
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Pierangelo Geppetti
- Department of Health Sciences, Clinical Pharmacology Unit, University of Florence, Florence, Italy
| | - Romina Nassini
- Department of Health Sciences, Clinical Pharmacology Unit, University of Florence, Florence, Italy
| | - Francesco De Logu
- Department of Health Sciences, Clinical Pharmacology Unit, University of Florence, Florence, Italy
| | - Sara Marchesan Oliveira
- Graduate Program in Biological Sciences: Toxicological Biochemistry, Centre of Natural and Exact Sciences, Federal University of Santa Maria, Santa Maria, Brazil
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Gkouvi A, Tsiogkas SG, Bogdanos DP, Gika H, Goulis DG, Grammatikopoulou MG. Proteomics in Patients with Fibromyalgia Syndrome: A Systematic Review of Observational Studies. Curr Pain Headache Rep 2024:10.1007/s11916-024-01244-4. [PMID: 38652420 DOI: 10.1007/s11916-024-01244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW Fibromyalgia syndrome (FMS) is a disease of unknown pathophysiology, with the diagnosis being based on a set of clinical criteria. Proteomic analysis can provide significant biological information for the pathophysiology of the disease but may also reveal biomarkers for diagnosis or therapeutic targets. The present systematic review aims to synthesize the evidence regarding the proteome of adult patients with FMS using data from observational studies. RECENT FINDINGS An extensive literature search was conducted in MEDLINE/PubMed, CENTRAL, and clinicaltrials.gov from inception until November 2022. The study protocol was published in OSF. Two independent reviewers evaluated the studies and extracted data. The quality of studies was assessed using the modified Newcastle-Ottawa scale adjusted for proteomic research. Ten studies fulfilled the protocol criteria, identifying 3328 proteins, 145 of which were differentially expressed among patients with FMS against controls. The proteins were identified in plasma, serum, cerebrospinal fluid, and saliva samples. The control groups included healthy individuals and patients with pain (inflammatory and non-inflammatory). The most important proteins identified involved transferrin, α-, β-, and γ-fibrinogen chains, profilin-1, transaldolase, PGAM1, apolipoprotein-C3, complement C4A and C1QC, immunoglobin parts, and acute phase reactants. Weak correlations were observed between proteins and pain sensation, or quality of life scales, apart from the association of transferrin and a2-macroglobulin with moderate-to-severe pain sensation. The quality of included studies was moderate-to-good. FMS appears to be related to protein dysregulation in the complement and coagulation cascades and the metabolism of iron. Several proteins may be dysregulated due to the excessive oxidative stress response.
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Affiliation(s)
- Arriana Gkouvi
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Sotirios G Tsiogkas
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
| | - Dimitrios P Bogdanos
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece.
| | - Helen Gika
- Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Biomic_AUTh, Balkan Center Thermi B1.4, GR-57001, Thessaloniki, Greece
- Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, GR-54124, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria G Grammatikopoulou
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Al Sharie S, Varga SJ, Al-Husinat L, Sarzi-Puttini P, Araydah M, Bal’awi BR, Varrassi G. Unraveling the Complex Web of Fibromyalgia: A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:272. [PMID: 38399559 PMCID: PMC10890445 DOI: 10.3390/medicina60020272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
Fibromyalgia is a complex and often misunderstood chronic pain disorder. It is characterized by widespread musculoskeletal pain, fatigue, and heightened sensitivity, and has evolved in diagnostic criteria and understanding over the years. Initially met with skepticism, fibromyalgia is now recognized as a global health concern affecting millions of people, with a prevalence transcending demographic boundaries. The clinical features and diagnosis of fibromyalgia encompass a range of symptoms beyond pain, including sleep disturbances and cognitive difficulties. This study emphasizes the importance of a comprehensive evaluation for accurate diagnosis, considering the shift from tender point reliance to a more holistic approach. Etiology and pathophysiology involve genetic predisposition, neurotransmitter dysregulation, central sensitization, and immune system involvement. Risk factors such as gender, age, family history, and comorbid conditions contribute to susceptibility. The impact on quality of life is profound, affecting physical and social aspects, often accompanied by mood disorders. Management approaches include pharmacological interventions, non-pharmacological therapies, lifestyle modifications, and alternative treatments. This study also delves into emerging research, exploring advances in neurobiological understanding, brain imaging, genetic markers, glutamate modulation, cannabinoids, gut microbiome, and digital health tools for fibromyalgia management. Overall, this study provides a nuanced and up-to-date overview of the complexities surrounding fibromyalgia, aiming to enhance understanding and support for individuals grappling with this challenging condition.
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Affiliation(s)
- Sarah Al Sharie
- Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan
| | - Scott J. Varga
- Department of Neurology, OhioHealth Mansfield General Hospital, Mansfield, OH 44903, USA;
| | - Lou’i Al-Husinat
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan;
| | - Piercarlo Sarzi-Puttini
- Rheumatology Unit, Internal Medicine Department, ASST Fatebenefratelli-Sacco, University School of Medicine, 20157 Milan, Italy;
| | - Mohammad Araydah
- Department of Internal Medicine, Istishari Hospital, Amman 11942, Jordan;
| | - Batool Riyad Bal’awi
- Department of Family Medicine, Jordan Royal Medical Services, Amman 11855, Jordan;
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Carrasco-Querol N, Cabricano-Canga L, Bueno Hernández N, Gonçalves AQ, Caballol Angelats R, Pozo Ariza M, Martín-Borràs C, Montesó-Curto P, Castro Blanco E, Dalmau Llorca MR, Aguilar Martín C. Nutrition and Chronobiology as Key Components of Multidisciplinary Therapeutic Interventions for Fibromyalgia and Associated Chronic Fatigue Syndrome: A Narrative and Critical Review. Nutrients 2024; 16:182. [PMID: 38257075 PMCID: PMC10818822 DOI: 10.3390/nu16020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Fibromyalgia (FM) is often accompanied by chronic fatigue syndrome (CFS). It is a poorly understood disorder that mainly affects women and leads to chronic pain, fatigue, and insomnia, among other symptoms, which decrease quality of life. Due to the inefficiency of current pharmacological treatments, increasing interest is being directed towards non-pharmacological multicomponent therapies. However, nutrition and chronobiology are often overlooked when developing multicomponent therapies. This narrative and critical review explore the relevance of nutritional and chronobiological strategies in the therapeutic management of FM and the often-associated CFS. Reviewed literature offers scientific evidence for the association of dietary habits, nutrient levels, body composition, gut microbiota imbalance, chronobiological alterations, and their interrelation with the development and severity of symptoms. This review highlights the key role of nutrition and chronobiology as relevant and indispensable components in a multidisciplinary approach to FM and CFS.
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Affiliation(s)
- Noèlia Carrasco-Querol
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
| | | | - Nerea Bueno Hernández
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
| | - Alessandra Queiroga Gonçalves
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 08007 Barcelona, Spain
| | - Rosa Caballol Angelats
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 08007 Barcelona, Spain; (R.C.A.); (P.M.-C.); (M.R.D.L.)
- Servei d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
| | - Macarena Pozo Ariza
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
| | - Carme Martín-Borràs
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
- Departament de Fisioteràpia, Facultat de Ciencies de la Salut Blanquerna, Universitat Ramón Llull, 08025 Barcelona, Spain
| | - Pilar Montesó-Curto
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 08007 Barcelona, Spain; (R.C.A.); (P.M.-C.); (M.R.D.L.)
- Servei d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
- Departament de Medicina i Cirurgia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili (URV), 43201 Reus, Spain
| | - Elisabet Castro Blanco
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
| | - Maria Rosa Dalmau Llorca
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 08007 Barcelona, Spain; (R.C.A.); (P.M.-C.); (M.R.D.L.)
- Servei d’Atenció Primària Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
| | - Carina Aguilar Martín
- Unitat de Suport a la Recerca Terres de l’Ebre, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol I Gurina (IDIAPJGol), 43500 Tortosa, Spain; (N.B.H.); (A.Q.G.); (M.P.A.); (C.M.-B.); (E.C.B.); (C.A.M.)
- Unitat d’Avaluació i Recerca, Direcció d’Atenció Primària Terres de l’Ebre i Gerència Territorial Terres de l’Ebre, Institut Català de la Salut (ICS), 43500 Tortosa, Spain
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Vicente-Campos D, Sánchez-Jorge S, Martí L, Buffet J, Mendoza-Laiz N, Rodriguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Chicarro JL, Calvo-Lobo C. Skin Bioimpedance Analysis to Determine Cellular Integrity by Phase Angle in Women with Fibromyalgia: A Cross-Sectional Study. Biomedicines 2023; 11:3321. [PMID: 38137542 PMCID: PMC10741687 DOI: 10.3390/biomedicines11123321] [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: 09/28/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Oxidative stress has been proposed as a significant part of the pathogenesis of fibromyalgia, and the phase angle in bioelectrical impedance analysis has been explored as a potential technique to screen oxidative abnormalities. This study recruited 35 women with fibromyalgia and 35 healthy women, who underwent bioelectrical impedance analysis and maximum isometric handgrip strength tests. Women with fibromyalgia showed lower bilateral handgrip strength (right hand: 16.39 ± 5.87 vs. 27.53 ± 4.09, p < 0.001; left hand: 16.31 ± 5.51 vs. 27.61 ± 4.14, p < 0.001), as well as higher body fat mass (27.14 ± 10.21 vs. 19.94 ± 7.25, p = 0.002), body fat percentage (37.80 ± 8.32 vs. 30.63 ± 7.77, p < 0.001), and visceral fat area (136.76 ± 55.31 vs. 91.65 ± 42.04, p < 0.01) compared with healthy women. There was no statistically significant difference in muscle mass between groups, but women with fibromyalgia showed lower phase angles in all body regions when compared with healthy control women (right arm: 4.42 ± 0.51 vs. 4.97 ± 0.48, p < 0.01; left arm: 4.23 ± 0.48 vs. 4.78 ± 0.50, p < 0.001; trunk: 5.62 ± 0.77 vs. 6.78 ± 0.84, p < 0.001; right leg: 5.28 ± 0.56 vs. 5.81 ± 0.60, p < 0.001; left leg: 5.07 ± 0.51 vs. 5.69 ± 0.58, p < 0.001; whole body: 4.81 ± 0.47 vs. 5.39 ± 0.49, p < 0.001). Moreover, whole-body phase-angle reduction was only predicted by the presence of fibromyalgia (R2 = 0.264; β = 0.639; F(1,68) = 24.411; p < 0.001). Our study revealed significantly lower phase angle values, lower handgrip strength, and higher fat levels in women with fibromyalgia compared to healthy controls, which are data of clinical relevance when dealing with such patients.
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Affiliation(s)
- Davinia Vicente-Campos
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Sandra Sánchez-Jorge
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Luis Martí
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Jorge Buffet
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - Nuria Mendoza-Laiz
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain; (D.V.-C.); (L.M.); (J.B.); (N.M.-L.)
| | - David Rodriguez-Sanz
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - Ricardo Becerro-de-Bengoa-Vallejo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - J. L. Chicarro
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
| | - César Calvo-Lobo
- Faculty of Nursing, Physical Therapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (D.R.-S.); (R.B.-d.-B.-V.); (J.L.C.); (C.C.-L.)
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9
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del Amo LL, Durán-González E, Ramírez-Tejero JA, Martínez-Lara A, Cotán D. Study protocol for FIBROKIT: a new tool for fibromyalgia diagnosis and patient follow-up. Front Neurol 2023; 14:1286539. [PMID: 38073622 PMCID: PMC10710143 DOI: 10.3389/fneur.2023.1286539] [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] [Received: 08/31/2023] [Accepted: 11/06/2023] [Indexed: 02/27/2024] Open
Abstract
Fibromyalgia (FM) is a complex disease that is characterized by chronic musculoskeletal pain and has great economic impact. FM prevalence is about 2% to 4% worldwide, affecting mainly middle-aged women, and its complex pathophysiology complicates diagnosis, treatment and the findings of solid biomarkers. Previous studies have suggested an association between the disease and oxidative stress, mitochondrial metabolism, intestinal microbiota and inflammation, providing sufficient data to support the multifactorial origin of FM. Hence, the objective of this randomized, prospective, low-interventional, double-blinded and placebo-controlled clinical trial is the development of a specific panel of FM biomarkers and the evaluation of their response to a six-month nutritional intervention based on the Mediterranean diet supplemented with extra virgin olive oil (EVOO). For this purpose, the experimental design implies the recruitment of a large cohort of female Spanish patients. Middle-aged women who meet the diagnostic criteria for FM according to the American College of Rheumatology (ACR) will be eligible, along with age-matched healthy women. Both groups will be randomly divided into placebo (olive oil, OO) and treatment groups (extra virgin olive oil, EVOO), and will provide samples at the beginning (T0), after 3 months of nutritional intervention (T1), at the end of the nutritional intervention in 6 months (T2), and 6 months after the end of nutritional intervention (TF), being enrolled for 1 year. Data will be collected through health questionnaires, and whole blood and stool samples will be taken and analyzed. Blood will be used for western-blotting and proteomic analysis of mitochondrial homeostasis and plasma proteome, while stool will undergo metagenomic analysis, respectively. This study represents the first low-interventional investigation with more than 200 participants focused on exploring the association of oxidative stress, mitochondrial metabolism, intestinal microbiota and related pathways with a nutritional intervention in the context of FM. As a result, the outcomes of this study will significantly contribute to the development of a comprehensive and robust panel of diagnostic biomarkers, and will shed some light on their modulation with non-pharmacological therapies such as nutrition. Clinical trial registration: https://clinicaltrials.gov/study/NCT05921409, identifier: NCT05921409.
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10
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Gianò M, Franco C, Castrezzati S, Rezzani R. Involvement of Oxidative Stress and Nutrition in the Anatomy of Orofacial Pain. Int J Mol Sci 2023; 24:13128. [PMID: 37685933 PMCID: PMC10487620 DOI: 10.3390/ijms241713128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
Pain is a very important problem of our existence, and the attempt to understand it is one the oldest challenges in the history of medicine. In this review, we summarize what has been known about pain, its pathophysiology, and neuronal transmission. We focus on orofacial pain and its classification and features, knowing that is sometimes purely subjective and not well defined. We consider the physiology of orofacial pain, evaluating the findings on the main neurotransmitters; in particular, we describe the roles of glutamate as approximately 30-80% of total peripheric neurons associated with the trigeminal ganglia are glutamatergic. Moreover, we describe the important role of oxidative stress and its association with inflammation in the etiogenesis and modulation of pain in orofacial regions. We also explore the warning and protective function of orofacial pain and the possible action of antioxidant molecules, such as melatonin, and the potential influence of nutrition and diet on its pathophysiology. Hopefully, this will provide a solid background for future studies that would allow better treatment of noxious stimuli and for opening new avenues in the management of pain.
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Affiliation(s)
- Marzia Gianò
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Caterina Franco
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Stefania Castrezzati
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (M.G.); (C.F.); (S.C.)
- Interdipartimental University Center of Research “Adaption and Regeneration of Tissues and Organs (ARTO)”, University of Brescia, 25123 Brescia, Italy
- Italian Society for the Study of Orofacial Pain (Società Italiana Studio Dolore Orofacciale—SISDO), 25123 Brescia, Italy
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11
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Vrbanović E, Zlendić M, Trošelj KG, Tomljanović M, Vuković Đerfi K, Alajbeg IZ. Association of Oxidative-Stress-Related Gene Polymorphisms with Pain-Related Temporomandibular Disorders and Oral Behavioural Habits. Antioxidants (Basel) 2023; 12:1195. [PMID: 37371925 DOI: 10.3390/antiox12061195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
The frequency of selected polymorphisms, one in each gene coding for proteins with antioxidative properties (CAT(rs1001179), SOD2(rs4880), GPX1(rs1050450), and NQO1(rs689452)), was compared between patients suffering from pain-related temporomandibular disorders (TMDp; n = 85) and control subjects (CTR; n = 85). The same was evaluated when participants were divided with respect to oral behavioural habits frequency into high-frequency parafunction (HFP; n = 98) and low-frequency parafunction (LFP; n = 72) groups. Another aim was to investigate whether polymorphisms in these genes can be associated with participants' psychological and psychosomatic characteristics. Polymorphisms were genotyped using the genomic DNA extracted from buccal mucosa swabs and real-time TaqMan genotyping assays. No differences in genotype distribution between TMDp patients and control subjects were found. Still, TMDp patients who were homozygous for minor allele A, related to the GPX1 polymorphism rs1050450, reported significantly more waking-state oral behaviours than GA + GG genotype carriers (score: 30 vs. 23, p = 0.019). The frequency of genotype AA for rs1050450 polymorphism was higher in HFP than in LFP participants (14.3% vs. 4.2%, p = 0.030). The most important predictors of waking-state oral behaviours were depression, anxiety, AA genotype (rs1050450), and female sex. The explored gene polymorphisms were not found to be significant risk factors for either TMDp or sleep-related oral behaviours. The association of waking-state oral behaviours with selected gene polymorphisms additionally supports previous assumptions that daytime bruxism is more closely linked to various stress manifestations, which might also be reflected through the variability related to the cellular antioxidative activity.
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Affiliation(s)
- Ema Vrbanović
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Marko Zlendić
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Koraljka Gall Trošelj
- Laboratory for Epigenomics, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Marko Tomljanović
- Laboratory for Epigenomics, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Kristina Vuković Đerfi
- Laboratory for Personalized Medicine, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Iva Z Alajbeg
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
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12
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Rodkin S, Nwosu C, Sannikov A, Tyurin A, Chulkov VS, Raevskaya M, Ermakov A, Kirichenko E, Gasanov M. The Role of Gasotransmitter-Dependent Signaling Mechanisms in Apoptotic Cell Death in Cardiovascular, Rheumatic, Kidney, and Neurodegenerative Diseases and Mental Disorders. Int J Mol Sci 2023; 24:ijms24076014. [PMID: 37046987 PMCID: PMC10094524 DOI: 10.3390/ijms24076014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 04/14/2023] Open
Abstract
Cardiovascular, rheumatic, kidney, and neurodegenerative diseases and mental disorders are a common cause of deterioration in the quality of life up to severe disability and death worldwide. Many pathological conditions, including this group of diseases, are based on increased cell death through apoptosis. It is known that this process is associated with signaling pathways controlled by a group of gaseous signaling molecules called gasotransmitters. They are unique messengers that can control the process of apoptosis at different stages of its implementation. However, their role in the regulation of apoptotic signaling in these pathological conditions is often controversial and not completely clear. This review analyzes the role of nitric oxide (NO), carbon monoxide (CO), hydrogen sulfide (H2S), and sulfur dioxide (SO2) in apoptotic cell death in cardiovascular, rheumatic, kidney, and neurodegenerative diseases. The signaling processes involved in apoptosis in schizophrenia, bipolar, depressive, and anxiety disorders are also considered. The role of gasotransmitters in apoptosis in these diseases is largely determined by cell specificity and concentration. NO has the greatest dualism; scales are more prone to apoptosis. At the same time, CO, H2S, and SO2 are more involved in cytoprotective processes.
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Affiliation(s)
- Stanislav Rodkin
- Faculty of Bioengineering and Veterinary Medicine, Department of Bioengineering, Don State Technical University, Rostov-on-Don 344000, Russia
| | - Chizaram Nwosu
- Faculty of Bioengineering and Veterinary Medicine, Department of Bioengineering, Don State Technical University, Rostov-on-Don 344000, Russia
| | - Alexander Sannikov
- Department of Psychiatry, Rostov State Medical University, Rostov-on-Don 344022, Russia
| | - Anton Tyurin
- Internal Medicine Department, Bashkir State Medical University, Ufa 450008, Russia
| | | | - Margarita Raevskaya
- Faculty of Bioengineering and Veterinary Medicine, Department of Bioengineering, Don State Technical University, Rostov-on-Don 344000, Russia
| | - Alexey Ermakov
- Faculty of Bioengineering and Veterinary Medicine, Department of Bioengineering, Don State Technical University, Rostov-on-Don 344000, Russia
| | - Evgeniya Kirichenko
- Faculty of Bioengineering and Veterinary Medicine, Department of Bioengineering, Don State Technical University, Rostov-on-Don 344000, Russia
| | - Mitkhat Gasanov
- Department of Internal Diseases #1, Rostov State Medical University, Rostov-on-Don 344022, Russia
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13
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Huang C, Zhang N, Wei M, Pan Q, Cheng C, Lu KE, Mo J, Chen Y. Methylation factors as biomarkers of fibromyalgia. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:169. [PMID: 36923073 PMCID: PMC10009573 DOI: 10.21037/atm-22-6631] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
Background Fibromyalgia (FM) is a common and intractable chronic musculoskeletal pain syndrome, but its exact underlying mechanisms are unknown. This study sought to identify biomarkers of FM and the underlying molecular mechanisms of the disease. Methods FM-related gene expression profiles (GSE67311) and methylation profiles (GSE85506) were obtained from the Gene Expression Omnibus database, and a differential expression analysis was performed to identify the methylation factors. Subsequently, an enrichment analysis and gene set enrichment analysis (GSEA) were conducted to examine the methylation factors. In addition, the transcriptional regulators of the methylation factors were predicted, and key methylation factors were identified by a receiver operating characteristic curve analysis and nomogram models. Finally, the relationship between FM and cell death (pyroptosis, necroptosis, and cuproptosis) was assessed by a GSEA and gene set variation analysis. Results A total of 455 methylation factors were identified. The enrichment analysis and GSEA results showed that methylation factors were clearly involved in the biological functions and signaling pathways related to neural, immune inflammation, and pain responses. The transcriptional regulator specificity protein 1 (SP1) may have a broad regulatory role. Finally, seven key methylation factors were identified, of which amino beta (A4) precursor protein binding family B member 2 (APBB2), A-kinase anchor protein 12 (AKAP12), and cluster of differentiation 38 (CD38) had strong clinical diagnostic power. In addition, AKAP12 and CD38 were significantly and negatively associated with sepsis, necrotizing sepsis, and cupular sepsis. Conclusions Our study suggests that FM is associated with deoxyribonucleic acid methylation. The methylation factors APBB2, AKAP12, and CD38 may be potential biomarkers and should be further examined to provide a new biological framework of the possible disease mechanisms underlying FM.
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Affiliation(s)
- Chengyu Huang
- Department of Basic Science, Yuandong International Academy of Life Sciences, Hong Kong, China.,Biology Institute, Guangxi Academy of Sciences, Nanning, China
| | - Nan Zhang
- Department of Basic Science, Yuandong International Academy of Life Sciences, Hong Kong, China
| | - Mengxin Wei
- Department of Basic Science, Yuandong International Academy of Life Sciences, Hong Kong, China
| | - Qinchun Pan
- School of Medicine and Health, Guangxi Vocational and Technical Institute of Industry, Nanning, China
| | - Chunyan Cheng
- College of Food and Drug Engineering, Guangxi Vocational University of Agriculture, Nanning, China
| | - Ke-Er Lu
- College of Life Sciences, Tianjin Normal University, Tianjin, China
| | - Jianwen Mo
- Department of Basic Science, Yuandong International Academy of Life Sciences, Hong Kong, China.,Biology Institute, Guangxi Academy of Sciences, Nanning, China
| | - Yixuan Chen
- Department of Basic Science, Yuandong International Academy of Life Sciences, Hong Kong, China.,Biology Institute, Guangxi Academy of Sciences, Nanning, China
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14
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Paramakrishnan N, Chavan L, Lim KG, Paramaswaran Y, Muthuraman A. Reversal of Neuralgia Effect of Beta Carotene in Streptozotocin-Associated Diabetic Neuropathic Pain in Female Zebrafish via Matrix Metalloprotease-13 Inhibition. Pharmaceuticals (Basel) 2023; 16:157. [PMID: 37259308 PMCID: PMC9959792 DOI: 10.3390/ph16020157] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 08/26/2023] Open
Abstract
Beta carotene is a natural anti-oxidant agent, and it inhibits the matrix metalloprotease (MMP) activity. Diabetic neuropathic pain (DNP) is produced by cellular oxidative stress. The role of the beta carotene effect in diabetic neuropathic pain is not explored yet. The present study is designed for the evaluation of the palm oil mill effluent-derived beta carotene (PBC) effect in DNP in zebrafish. The DNP was induced by the intraperitoneal administration of streptozotocin (STZ). Blood glucose levels of above 15 mM were considered to be diabetic conditions. The zebrafish were exposed to test compound PBC (25, 50, and 100 µM), pregabalin (PG: 10 μM), and an MMP-13 inhibitor (CL-82198; 10 μM) for 10 consecutive days from day 11. The neuralgic behavioral parameters, i.e., temperature test, acetic acid test, and fin clip test were assessed on day 0 and the 7th, 14th, and 21st days. On the 22nd day, the blood glucose and MMP-13 levels and brain thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH), and MMP-13 activity levels were estimated. The treatment of PBC ameliorated the DNP-associated behavioral and biochemical changes. The results are similar to those of PG and CL-82198 treatments. Hence, the PBC possesses a potentially ameliorative effect against DNP due to its potential anti-oxidant, anti-lipid peroxidation, and MMP-13 inhibitory actions.
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Affiliation(s)
| | - Laxmikant Chavan
- Faculty of Medicine, AIMST University, Semeling, Bedong 08100, Kedah, Malaysia
| | - Khian Giap Lim
- Pharmacology Unit, Faculty of Pharmacy, AIMST University, Semeling, Bedong 08100, Kedah, Malaysia
| | - Yamunna Paramaswaran
- Pharmacology Unit, Faculty of Pharmacy, AIMST University, Semeling, Bedong 08100, Kedah, Malaysia
| | - Arunachalam Muthuraman
- Pharmacology Unit, Faculty of Pharmacy, AIMST University, Semeling, Bedong 08100, Kedah, Malaysia
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