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Mogil JS, Parisien M, Esfahani SJ, Diatchenko L. Sex differences in mechanisms of pain hypersensitivity. Neurosci Biobehav Rev 2024; 163:105749. [PMID: 38838876 DOI: 10.1016/j.neubiorev.2024.105749] [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: 04/10/2024] [Revised: 05/23/2024] [Accepted: 06/02/2024] [Indexed: 06/07/2024]
Abstract
The introduction of sex-as-a-biological-variable policies at funding agencies around the world has led to an explosion of very recent observations of sex differences in the biology underlying pain. This review considers evidence of sexually dimorphic mechanisms mediating pain hypersensitivity, derived from modern assays of persistent pain in rodent animal models. Three well-studied findings are described in detail: the male-specific role of spinal cord microglia, the female-specific role of calcitonin gene-related peptide (CGRP), and the female-specific role of prolactin and its receptor. Other findings of sex-specific molecular involvement in pain are subjected to pathway analyses and reveal at least one novel hypothesis: that females may preferentially use Th1 and males Th2 T cell activity to mediate chronic pain.
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Affiliation(s)
- Jeffrey S Mogil
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC H3A 1B1, Canada.
| | - Marc Parisien
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC H3A 1B1, Canada
| | - Sahel J Esfahani
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC H3A 1B1, Canada
| | - Luda Diatchenko
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC H3A 1B1, Canada
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See LP, Sripinun P, Lu W, Li J, Alboloushi N, Alvarez-Periel E, Lee SM, Karabucak B, Wang S, Jordan Sciutto KL, Theken KN, Mitchell CH. Increased Purinergic Signaling in Human Dental Pulps With Inflammatory Pain is Sex-Dependent. THE JOURNAL OF PAIN 2024; 25:1039-1058. [PMID: 37956743 PMCID: PMC11129867 DOI: 10.1016/j.jpain.2023.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/22/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023]
Abstract
An enhanced understanding of neurotransmitter systems contributing to pain transmission aids in drug development, while the identification of biological variables like age and sex helps in the development of personalized pain management and effective clinical trial design. This study identified enhanced expression of purinergic signaling components specifically in painful inflammation, with levels increased more in women as compared to men. Inflammatory dental pain is common and potentially debilitating; as inflammation of the dental pulp can occur with or without pain, it provides a powerful model to examine distinct pain pathways in humans. In control tissues, P2X3 and P2X2 receptors colocalized with PGP9.5-positive nerves. Expression of the ecto-nucleotidase NTPDase1 (CD39) increased with exposure to extracellular adenosine triphosphate (ATP), implying CD39 acted as a marker for sustained elevation of extracellular ATP. Both immunohistochemistry and immunoblots showed P2X2, P2X3, and CD39 increased in symptomatic pulpitis, suggesting receptors and the ATP agonist were elevated in patients with increased pain. The increased expression of P2X3 and CD39 was more frequently observed in women than men. In summary, this study identifies CD39 as a marker for chronic elevation of extracellular ATP in fixed human tissue. It supports a role for increased purinergic signaling in humans with inflammatory dental pain and suggests the contribution of purines shows sexual dimorphism. This highlights the potential for P2X antagonists to treat pain in humans and stresses the need to consider sex in clinical trials that target pain and purinergic pathways. PERSPECTIVE: This article demonstrates an elevation of ATP-marker CD39 and of ATP receptors P2X2 and P2X3 with inflammatory pain and suggests the rise is greater in women. This highlights the potential for P2X antagonists to treat pain and stresses the consideration of sexual dimorphism in studies of purines and pain.
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Affiliation(s)
- Lily P. See
- Departments of Basic and Translational Science, University of Pennsylvania, Philadelphia, PA 19104
- Department of Endodontics, University of Pennsylvania, Philadelphia, PA 19104
| | - Puttipong Sripinun
- Departments of Basic and Translational Science, University of Pennsylvania, Philadelphia, PA 19104
- Department of Orthodontics, University of Pennsylvania, Philadelphia, PA 19104
| | - Wennan Lu
- Departments of Basic and Translational Science, University of Pennsylvania, Philadelphia, PA 19104
| | - Jiaqi Li
- Departments of Basic and Translational Science, University of Pennsylvania, Philadelphia, PA 19104
| | - Naela Alboloushi
- Department of Endodontics, University of Pennsylvania, Philadelphia, PA 19104
- Department of Oral Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | | | - Su-Min Lee
- Department of Endodontics, University of Pennsylvania, Philadelphia, PA 19104
| | - Bekir Karabucak
- Department of Endodontics, University of Pennsylvania, Philadelphia, PA 19104
| | - Steven Wang
- Department of Oral Surgery, University of Pennsylvania, Philadelphia, PA 19104
| | | | - Katherine N. Theken
- Department of Oral Surgery, University of Pennsylvania, Philadelphia, PA 19104
| | - Claire H. Mitchell
- Departments of Basic and Translational Science, University of Pennsylvania, Philadelphia, PA 19104
- Department of Physiology, University of Pennsylvania, Philadelphia, PA 19104
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Errante EL, Costello MC, Tigre JY, Burks SS. Commentary: Sexually Dimorphic Pattern of Pain Mitigation Following Prophylactic Regenerative Peripheral Nerve Interface in a Rat Neuroma Model. Neurosurgery 2023; 93:e127-e128. [PMID: 37702664 DOI: 10.1227/neu.0000000000002593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 09/14/2023] Open
Affiliation(s)
- Emily L Errante
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami , Florida , USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami , Florida , USA
| | - Meredith C Costello
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami , Florida , USA
| | - Joseph Yunga Tigre
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami , Florida , USA
| | - S Shelby Burks
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami , Florida , USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami , Florida , USA
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Bizzoca D, Solarino G, Pulcrano A, Brunetti G, Moretti AM, Moretti L, Piazzolla A, Moretti B. Gender-Related Issues in the Management of Low-Back Pain: A Current Concepts Review. Clin Pract 2023; 13:1360-1368. [PMID: 37987423 PMCID: PMC10660510 DOI: 10.3390/clinpract13060122] [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: 07/01/2023] [Revised: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is an emerging disease. This review aims to investigate the role of gender-related factors in the diagnosis, clinical, and surgical management of LBP. METHODS From January 2002 to March 2023, EMBASE, SCOPUS, OVID-MEDLINE, Google Scholar, PubMed, and Web of Science were searched to identify relevant papers for further analysis. RESULTS Fifteen papers were included in this review. Sex- and gender-related differences were analyzed regarding the following points: (1) LBP epidemiology; (2) LBP physiopathology; (3) conservative management of LBP; (4) major vertebral surgery for LBP. The conservative treatment of LBP highlights that women claim services later in terms of poorer health status than men. In the postoperative phase, female patients show worse LBP, quality of life, and disability, but equal or greater interval change, compared with male patients complaining of lumbar degenerative disease. CONCLUSIONS LBP epidemiology and clinical outcomes, following conservative and surgical management of patients complaining of back pain, might depend on both sex- and gender-related factors. It is mandatory to assess gender-related indicators in patients referred to LBP and address them to improve their clinical outcomes and quality of life.
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Affiliation(s)
- Davide Bizzoca
- UOSD Vertebral Surgery, AOU Consorziale Policlinico di Bari, 70124 Bari, Italy;
- Ph.D. Course in Public Health, Clinical Medicine and Oncology, Department DiMePre-J, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giuseppe Solarino
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy; (G.S.); (B.M.)
| | - Alessandro Pulcrano
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy; (G.S.); (B.M.)
| | - Giovanni Brunetti
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy; (G.S.); (B.M.)
| | - Anna Maria Moretti
- Department of Pneumology, Santa Maria Hospital, Via De Ferrariis 18/D, 70124 Bari, Italy
| | - Lorenzo Moretti
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy; (G.S.); (B.M.)
| | - Andrea Piazzolla
- UOSD Vertebral Surgery, AOU Consorziale Policlinico di Bari, 70124 Bari, Italy;
| | - Biagio Moretti
- Orthopedics Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN”, School of Medicine and Surgery, University of Bari, General Hospital, 70124 Bari, Italy; (G.S.); (B.M.)
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Tsao CH, Wu KY, Su NC, Edwards A, Huang GJ. The influence of sex difference on behavior and adult hippocampal neurogenesis in C57BL/6 mice. Sci Rep 2023; 13:17297. [PMID: 37828065 PMCID: PMC10570284 DOI: 10.1038/s41598-023-44360-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023] Open
Abstract
Animal models have been used extensively in in vivo studies, especially within the biomedical field. Traditionally, single-sex studies, mostly males, are used to avoid any potential confounding variation caused by sex difference and the female estrous cycle. Historically, female animal subjects are believed to exhibit higher variability, and this could increase the statistical power needed to test a hypothesis. This study sets out to evaluate whether a sex difference does exist in mouse behavior, and whether female mice featured higher variability. We assessed the sensorimotor skills, anxiety-like behavior, depression-like behavior, and cognitive abilities of mice through a series of commonly used behavioral tests. Except for the stronger grip force and lower tactile sensory sensitivity detected in male mice, there was no significant difference between males and females in other tests. Furthermore, immunolabeling of neurogenesis markers suggested no significant difference between sexes in adult hippocampal neurogenesis. Within group variances were equivalent; females did not exhibit higher variability than males. However, the overall negative results could be due to the limitation of small sample size. In conclusion, our study provides evidence that sex difference in mice does not significantly influence these commonly used behavioral tests nor adult neurogenesis under basal conditions. We suggest that female mice could also be considered for test inclusion in future experiment design.
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Affiliation(s)
- Chi-Hui Tsao
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Kuan-Yu Wu
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Nicole Ching Su
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Andrew Edwards
- Department of Psychiatry, Dykebar Hospital, National Health Service Greater Glasgow and Clyde, Paisley, PA2 7DE, Scotland
| | - Guo-Jen Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan.
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan.
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Taoyuan, 333, Taiwan.
- Molecular Medicine Research Center, Chang Gung University, Taoyuan, 333, Taiwan.
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Tkachenko Y, Khmyz V, Buta A, Isaev D, Maximyuk O, Krishtal O. Acid-sensing ion channel blocker diminazene facilitates proton-induced excitation of afferent nerves in a similar manner that Na +/H + exchanger blockers do. Front Cell Neurosci 2023; 17:1131661. [PMID: 37502464 PMCID: PMC10368877 DOI: 10.3389/fncel.2023.1131661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 06/26/2023] [Indexed: 07/29/2023] Open
Abstract
Tissue acidification causes sustained activation of primary nociceptors, which causes pain. In mammals, acid-sensing ion channels (ASICs) are the primary acid sensors; however, Na+/H+ exchangers (NHEs) and TRPV1 receptors also contribute to tissue acidification sensing. ASICs, NHEs, and TRPV1 receptors are found to be expressed in nociceptive nerve fibers. ASIC inhibitors reduce peripheral acid-induced hyperalgesia and suppress inflammatory pain. Also, it was shown that pharmacological inhibition of NHE1 promotes nociceptive behavior in acute pain models, whereas inhibition of TRPV1 receptors gives relief. The murine skin-nerve preparation was used in this study to assess the activation of native polymodal nociceptors by mild acidification (pH 6.1). We have found that diminazene, a well-known antagonist of ASICs did not suppress pH-induced activation of CMH-fibers at concentrations as high as 25 μM. Moreover, at 100 μM, it induces the potentiation of the fibers' response to acidic pH. At the same time, this concentration virtually completely inhibited ASIC currents in mouse dorsal root ganglia (DRG) neurons (IC50 = 17.0 ± 4.5 μM). Non-selective ASICs and NHEs inhibitor EIPA (5-(N-ethyl-N-isopropyl)amiloride) at 10 μM, as well as selective NHE1 inhibitor zoniporide at 0.5 μM induced qualitatively the same effects as 100 μM of diminazene. Our results indicate that excitation of afferent nerve terminals induced by mild acidification occurs mainly due to the NHE1, rather than acid-sensing ion channels. At high concentrations, diminazene acts as a weak blocker of the NHE. It lacks chemical similarity with amiloride, EIPA, and zoniporide, so it may represent a novel structural motif for the development of NHE antagonists. However, the effect of diminazene on the acid-induced excitation of primary nociceptors remains enigmatic and requires additional investigations.
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Quijas MM, Queme LF, Weyler AA, Butterfield A, Joshi DP, Mitxelena-Balerdi I, Jankowski MP. Sex specific role of RNA-binding protein, AUF1, on prolonged hypersensitivity after repetitive ischemia with reperfusion injury. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.08.544080. [PMID: 37333316 PMCID: PMC10274888 DOI: 10.1101/2023.06.08.544080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Repetitive ischemia with reperfusion (I/R) injury is a common cause of myalgia. I/R injuries occur in many conditions that differentially affect males and females including complex regional pain syndrome and fibromyalgia. Our preclinical studies have indicated that primary afferent sensitization and behavioral hypersensitivity due to I/R may be due to sex specific gene expression in the DRGs and distinct upregulation of growth factors and cytokines in the affected muscles. In order to determine how these unique gene expression programs may be established in a sex dependent manner in a model that more closely mimics clinical scenarios, we utilized a newly developed prolonged ischemic myalgia model in mice whereby animals experience repeated I/R injuries to the forelimb and compared behavioral results to unbiased and targeted screening strategies in male and female DRGs. Several distinct proteins were found to be differentially expressed in male and female DRGs, including AU-rich element RNA binding protein (AUF1), which is known to regulate gene expression. Nerve specific siRNA-mediated knockdown of AUF1 inhibited prolonged hypersensitivity in females only, while overexpression of AUF1 in male DRG neurons increased some pain-like responses. Further, AUF1 knockdown was able to specifically inhibit repeated I/R induced gene expression in females but not males. Data suggests that RNA binding proteins like AUF1 may underlie the sex specific effects on DRG gene expression that modulate behavioral hypersensitivity after repeated I/R injury. This study may aid in finding distinct receptor differences related to the evolution of acute to chronic ischemic muscle pain development between sexes.
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Affiliation(s)
- Meranda M. Quijas
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Luis F. Queme
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Alex A. Weyler
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Ally Butterfield
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Diya P. Joshi
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Irati Mitxelena-Balerdi
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Michael P. Jankowski
- Department of Anesthesia, Division of Pain Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Pediatric Pain Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
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8
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Da Vitoria Lobo ME, Weir N, Hardowar L, Al Ojaimi Y, Madden R, Gibson A, Bestall SM, Hirashima M, Schaffer CB, Donaldson LF, Bates DO, Hulse RP. Hypoxia-induced carbonic anhydrase mediated dorsal horn neuron activation and induction of neuropathic pain. Pain 2022; 163:2264-2279. [PMID: 35353768 PMCID: PMC9578530 DOI: 10.1097/j.pain.0000000000002627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 11/27/2022]
Abstract
ABSTRACT Neuropathic pain, such as that seen in diabetes mellitus, results in part from central sensitisation in the dorsal horn. However, the mechanisms responsible for such sensitisation remain unclear. There is evidence that disturbances in the integrity of the spinal vascular network can be causative factors in the development of neuropathic pain. Here we show that reduced blood flow and vascularity of the dorsal horn leads to the onset of neuropathic pain. Using rodent models (type 1 diabetes and an inducible endothelial-specific vascular endothelial growth factor receptor 2 knockout mouse) that result in degeneration of the endothelium in the dorsal horn, we show that spinal cord vasculopathy results in nociceptive behavioural hypersensitivity. This also results in increased hypoxia in dorsal horn neurons, depicted by increased expression of hypoxia markers such as hypoxia inducible factor 1α, glucose transporter 3, and carbonic anhydrase 7. Furthermore, inducing hypoxia through intrathecal delivery of dimethyloxalylglycine leads to the activation of dorsal horn neurons as well as mechanical and thermal hypersensitivity. This shows that hypoxic signalling induced by reduced vascularity results in increased hypersensitivity and pain. Inhibition of carbonic anhydrase activity, through intraperitoneal injection of acetazolamide, inhibited hypoxia-induced pain behaviours. This investigation demonstrates that induction of a hypoxic microenvironment in the dorsal horn, as occurs in diabetes, is an integral process by which neurons are activated to initiate neuropathic pain states. This leads to the conjecture that reversing hypoxia by improving spinal cord microvascular blood flow could reverse or prevent neuropathic pain.
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Affiliation(s)
- Marlene E. Da Vitoria Lobo
- Division of Cancer and Stem Cells, School of Medicine, Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Nick Weir
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Lydia Hardowar
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Yara Al Ojaimi
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Ryan Madden
- Division of Cancer and Stem Cells, School of Medicine, Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Alex Gibson
- Division of Cancer and Stem Cells, School of Medicine, Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
| | - Samuel M. Bestall
- Pain Centre Versus Arthritis and School of Life Sciences, The Medical School QMC, University of Nottingham, Nottingham, United Kingdom
| | - Masanori Hirashima
- Division of Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Chris B. Schaffer
- Nancy E. and Peter C. Meinig School of Biomedical Engineering, Cornell University, United States
| | - Lucy F. Donaldson
- Pain Centre Versus Arthritis and School of Life Sciences, The Medical School QMC, University of Nottingham, Nottingham, United Kingdom
| | - David O. Bates
- Division of Cancer and Stem Cells, School of Medicine, Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
- Centre of Membrane and Protein and Receptors (COMPARE), University of Birmingham and University of Nottingham, Midlands, United Kingdom
| | - Richard Philip Hulse
- Division of Cancer and Stem Cells, School of Medicine, Biodiscovery Institute, University of Nottingham, Nottingham, United Kingdom
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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Lenert ME, Gomez R, Lane BT, Dailey DL, Vance CGT, Rakel BA, Crofford LJ, Sluka KA, Merriwether EN, Burton MD. Translating Outcomes from the Clinical Setting to Preclinical Models: Chronic Pain and Functionality in Chronic Musculoskeletal Pain. PAIN MEDICINE (MALDEN, MASS.) 2022; 23:1690-1707. [PMID: 35325207 PMCID: PMC9527603 DOI: 10.1093/pm/pnac047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022]
Abstract
Fibromyalgia (FM) is a chronic pain disorder characterized by chronic widespread musculoskeletal pain (CWP), resting pain, movement-evoked pain (MEP), and other somatic symptoms that interfere with daily functioning and quality of life. In clinical studies, this symptomology is assessed, while preclinical models of CWP are limited to nociceptive assays. The aim of the study was to investigate the human-to-model translatability of clinical behavioral assessments for spontaneous (or resting) pain and MEP in a preclinical model of CWP. For preclinical measures, the acidic saline model of FM was used to induce widespread muscle pain in adult female mice. Two intramuscular injections of acidic or neutral pH saline were administered following baseline measures, 5 days apart. An array of adapted evoked and spontaneous pain measures and functional assays were assessed for 3 weeks. A novel paradigm for MEP assessment showed increased spontaneous pain following activity. For clinical measures, resting and movement-evoked pain and function were assessed in adult women with FM. Moreover, we assessed correlations between the preclinical model of CWP and in women with fibromyalgia to examine whether similar relationships between pain assays that comprise resting and MEP existed in both settings. For both preclinical and clinical outcomes, MEP was significantly associated with mechanical pain sensitivity. Preclinically, it is imperative to expand how the field assesses spontaneous pain and MEP when studying multi-symptom disorders like FM. Targeted pain assessments to match those performed clinically is an important aspect of improving preclinical to clinical translatability of animal models.
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Affiliation(s)
- Melissa E Lenert
- Neuroimmunology and Behavior Laboratory, Department of Neuroscience, Center for Advanced Pain Studies (CAPS), School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Rachelle Gomez
- Inclusive and Translational Research in Pain Lab, Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Brandon T Lane
- Neuroimmunology and Behavior Laboratory, Department of Neuroscience, Center for Advanced Pain Studies (CAPS), School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Dana L Dailey
- Neurobiology of Pain Lab, Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Department of Physical Therapy, Center for Health Sciences, St. Ambrose University, Davenport, Iowa, USA
| | - Carol G T Vance
- Neurobiology of Pain Lab, Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Barbara A Rakel
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kathleen A Sluka
- Neurobiology of Pain Lab, Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Ericka N Merriwether
- Inclusive and Translational Research in Pain Lab, Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Michael D Burton
- Neuroimmunology and Behavior Laboratory, Department of Neuroscience, Center for Advanced Pain Studies (CAPS), School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
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Strath LJ, Sims AM, Overstreet DS, Penn TM, Bakshi RJ, Stansel BK, Quinn TL, Sorge RE, Long DL, Goodin BR. Dietary Inflammatory Index (DII) is Associated with Movement-Evoked Pain Severity in Adults with Chronic Low Back Pain: Sociodemographic Differences. THE JOURNAL OF PAIN 2022; 23:1437-1447. [PMID: 35417792 PMCID: PMC9356984 DOI: 10.1016/j.jpain.2022.03.237] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/03/2022] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Abstract
Chronic low back pain (CLBP) is one of the leading causes of pain and disability in adults in the United States and disproportionately burdens non-Hispanic Black (NHB) individuals and females. Approximately 90% of CLBP cases are of unknown cause, and it is imperative that potential causes be explored. It has been reported that diet quality can influence pain state via diet-induced inflammation. The present study assessed the relationship between Dietary Inflammatory Index (DII) and movement evoked-pain severity in people with CLBP and investigated whether race/sex moderated the relationship between DII and movement-evoked pain. Results revealed no significant differences in DII scores between males and females, or between NHB and non-Hispanic White (NHW) participants. Participant sex significantly modified the relationship between DII and movement-evoked pain severity (P = .0155), such that movement-evoked pain severity was significantly impacted by DII scores in females, but not males. Participant race did not significantly moderate the DII - movement-evoked pain severity relationship. These results suggest that diet-induced inflammation may impact the CLBP experiences of females to a greater degree than males. Further research is needed to determine whether dietary interventions that reduce inflammation improve CLBP outcomes and whether these interventions may be differentially-beneficial based on sex. PERSPECTIVE: This article highlights the impact of diet-induced inflammation in a community-based sample as a whole, as well as stratified in various sociodemographic groups. This work expands our understanding of the influence of diet on pain experience and suggests that modifications to diet may be efficacious treatments for reducing chronic pain.
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Affiliation(s)
- Larissa J Strath
- Department of Psychology, The University of Alabama at Birmingham, Birmingham Alabama
| | - Andrew M Sims
- Department of Biostatistics, The University of Alabama at Birmingham, Birmingham Alabama
| | - Demario S Overstreet
- Department of Psychology, The University of Alabama at Birmingham, Birmingham Alabama
| | - Terence M Penn
- Department of Psychology, The University of Alabama at Birmingham, Birmingham Alabama
| | - Rahm J Bakshi
- Department of Psychology, The University of Alabama at Birmingham, Birmingham Alabama
| | - Brooke K Stansel
- Department of Psychology, The University of Alabama at Birmingham, Birmingham Alabama
| | - Tammie L Quinn
- Department of Psychology, The University of Alabama at Birmingham, Birmingham Alabama
| | - Robert E Sorge
- Department of Psychology, The University of Alabama at Birmingham, Birmingham Alabama.
| | - D Leann Long
- Department of Biostatistics, The University of Alabama at Birmingham, Birmingham Alabama
| | - Burel R Goodin
- Department of Psychology, The University of Alabama at Birmingham, Birmingham Alabama
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Sensory Neuron TLR4 mediates the development of nerve-injury induced mechanical hypersensitivity in female mice. Brain Behav Immun 2021; 97:42-60. [PMID: 34174335 PMCID: PMC8453057 DOI: 10.1016/j.bbi.2021.06.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 02/07/2023] Open
Abstract
Recent studies have brought to light the necessity to discern sex-specific differences in various pain states and different cell-types that mediate these differences. These studies have uncovered the role of neuroimmune interactions to mediate pain states in a sex-specific fashion. While investigating immune function in pain development, we discovered that females utilize immune components of sensory neurons to mediate neuropathic pain development. We utilized two novel transgenic mouse models that eitherrestore expression of toll-like receptor (TLR) 4 inNav1.8 nociceptors on a TLR4-null background (TLR4LoxTB) or remove TLR4 specifically from Nav1.8 nociceptors (TLR4fl/fl). After spared nerve injury (SNI), a model of neuropathic injury, we observed a robust female-specific onset of mechanical hypersensitivity in our transgenic animals. Female Nav1.8-TLR4fl/fl knockout animals were less mechanically sensitive than cre-negative TLR4fl/fl littermates. Conversely, female Nav1.8-TLR4LoxTB reactivated animals were as mechanically sensitive as their wild-type counterparts. These sex and cell-specific effects were not recapitulated in male animals of either strain. Additionally, we find the danger associated molecular pattern, high mobility group box-1 (HGMB1), a potent TLR4 agonist, localization and ATF3 expression in females is dependent on TLR4 expression in dorsal root ganglia (DRG) populations following SNI. These experiments provide novel evidence toward sensory neuron specific modulation of pain in a sex-dependent manner.
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Early Life Nociception is Influenced by Peripheral Growth Hormone Signaling. J Neurosci 2021; 41:4410-4427. [PMID: 33888610 DOI: 10.1523/jneurosci.3081-20.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 12/28/2022] Open
Abstract
A number of cellular systems work in concert to modulate nociceptive processing in the periphery, but the mechanisms that regulate neonatal nociception may be distinct compared with adults. Our previous work indicated a relationship between neonatal hypersensitivity and growth hormone (GH) signaling. Here, we explored the peripheral mechanisms by which GH modulated neonatal nociception under normal and injury conditions (incision) in male and female mice. We found that GH receptor (GHr) signaling in primary afferents maintains a tonic inhibition of peripheral hypersensitivity. After injury, a macrophage dependent displacement of injury-site GH was found to modulate neuronal transcription at least in part via serum response factor (SRF) regulation. A single GH injection into the injured hindpaw muscle effectively restored available GH signaling to neurons and prevented acute pain-like behaviors, primary afferent sensitization, and neuronal gene expression changes. GH treatment also inhibited long-term somatosensory changes observed after repeated peripheral insult. Results may indicate a novel mechanism of neonatal nociception.SIGNIFICANCE STATEMENT Although it is noted that mechanisms of pain development in early life are unique compared with adults, little research focuses on neonatal-specific peripheral mechanisms of nociception. This gap is evident in the lack of specialized care for infants following an injury including surgeries. This report evaluates how distinct cellular systems in the periphery including the endocrine, immune and nervous systems work together to modulate neonatal-specific nociception. We uncovered a novel mechanism by which muscle injury induces a macrophage-dependent sequestration of peripheral growth hormone (GH) that effectively removes its normal tonic inhibition of neonatal nociceptors to promote acute pain-like behaviors. Results indicate a possible new strategy for treatment of neonatal postsurgical pain.
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Messner F, Thurner M, Müller J, Blumer M, Hofmann J, Marksteiner R, Couillard-Despres S, Troppmair J, Öfner D, Schneeberger S, Hautz T. Myogenic progenitor cell transplantation for muscle regeneration following hindlimb ischemia and reperfusion. Stem Cell Res Ther 2021; 12:146. [PMID: 33627196 PMCID: PMC7905585 DOI: 10.1186/s13287-021-02208-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
Background Muscle is severely affected by ischemia/reperfusion injury (IRI). Quiescent satellite cells differentiating into myogenic progenitor cells (MPC) possess a remarkable regenerative potential. We herein established a model of local application of MPC in murine hindlimb ischemia/reperfusion to study cell engraftment and differentiation required for muscle regeneration. Methods A clamping model of murine (C57b/6 J) hindlimb ischemia was established to induce IRI in skeletal muscle. After 2 h (h) warm ischemic time (WIT) and reperfusion, reporter protein expressing MPC (TdTomato or Luci-GFP, 1 × 106 cells) obtained from isolated satellite cells were injected intramuscularly. Surface marker expression and differentiation potential of MPC were analyzed in vitro by flow cytometry and differentiation assay. In vivo bioluminescence imaging and histopathologic evaluation of biopsies were performed to quantify cell fate, engraftment and regeneration. Results 2h WIT induced severe IRI on muscle, and muscle fiber regeneration as per histopathology within 14 days after injury. Bioluminescence in vivo imaging demonstrated reporter protein signals of MPC in 2h WIT animals and controls over the study period (75 days). Bioluminescence signals were detected at the injection site and increased over time. TdTomato expressing MPC and myofibers were visible in host tissue on postoperative days 2 and 14, respectively, suggesting that injected MPC differentiated into muscle fibers. Higher reporter protein signals were found after 2h WIT compared to controls without ischemia, indicative for enhanced growth and/or engraftment of MPC injected into IRI-affected muscle antagonizing muscle damage caused by IRI. Conclusion WIT-induced IRI in muscle requests increased numbers of injected MPC to engraft and persist, suggesting a possible rational for cell therapy to antagonize IRI. Further investigations are needed to evaluate the regenerative capacity and therapeutic advantage of MPC in the setting of ischemic limb injury. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02208-w.
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Affiliation(s)
- Franka Messner
- Daniel Swarovski Research Laboratory (DSL), Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck (MUI), Innrain 66, 6020, Innsbruck, Austria
| | - Marco Thurner
- Daniel Swarovski Research Laboratory (DSL), Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck (MUI), Innrain 66, 6020, Innsbruck, Austria.,Innovacell Biotechnologie AG, Innsbruck, Austria
| | - Jule Müller
- Daniel Swarovski Research Laboratory (DSL), Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck (MUI), Innrain 66, 6020, Innsbruck, Austria
| | - Michael Blumer
- Department of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria
| | - Julia Hofmann
- Daniel Swarovski Research Laboratory (DSL), Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck (MUI), Innrain 66, 6020, Innsbruck, Austria
| | | | - Sebastien Couillard-Despres
- Institute of Experimental Neuroregeneration, Spinal Cord Injury and Tissue Regeneration, Center Salzburg (SCI-TReCS), Paracelsus Medical University, Salzburg, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Jakob Troppmair
- Daniel Swarovski Research Laboratory (DSL), Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck (MUI), Innrain 66, 6020, Innsbruck, Austria
| | - Dietmar Öfner
- Daniel Swarovski Research Laboratory (DSL), Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck (MUI), Innrain 66, 6020, Innsbruck, Austria
| | - Stefan Schneeberger
- Daniel Swarovski Research Laboratory (DSL), Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck (MUI), Innrain 66, 6020, Innsbruck, Austria. .,Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Theresa Hautz
- Daniel Swarovski Research Laboratory (DSL), Department of Visceral, Transplant and Thoracic Surgery (VTT), Center of Operative Medicine, Medical University of Innsbruck (MUI), Innrain 66, 6020, Innsbruck, Austria.
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14
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Berardi G, Senefeld JW, Hunter SK, Bement MKH. Impact of isometric and concentric resistance exercise on pain and fatigue in fibromyalgia. Eur J Appl Physiol 2021; 121:1389-1404. [PMID: 33616753 DOI: 10.1007/s00421-021-04600-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/10/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study was to determine the local and systemic effects of isometric and concentric muscle contractions on experimental pain and performance fatigability in people with and without fibromyalgia. METHODS Forty-seven fibromyalgia (FM: 51.3 ± 12.3 year) and 47 control (CON: 52.5 ± 14.7 year) participants performed submaximal isometric and concentric exercise for 10 min with the right elbow flexors. Assessments before and after exercise included pressure pain thresholds (PPT) of the biceps and quadriceps, central pain summation, self-reported exercising arm and whole-body pain, and maximal voluntary isometric contraction (MVIC) of the right elbow flexors and left handgrip. RESULTS People with FM experienced greater reductions in local fatigue (right elbow flexor MVIC: CON: - 4.0 ± 6.7%, FM: - 9.8 ± 13.8%; p = 0.013) and similar reductions in systemic fatigue (left handgrip MVIC: - 6.5 ± 10.2%; p < 0.001) as CON participants, which were not different by contraction type nor related to baseline clinical pain, perceived fatigue, or reported pain with exercise. Following exercise both groups reported an increase in PPTs at the biceps (pre: 205.5 ± 100.3 kPa, post: 219.0 ± 109.3 kPa, p = 0.004) only and a decrease in central pain summation (pre: 6.8 ± 2.9, post: 6.5 ± 2.9; p = 0.013). FM reported greater exercising arm pain following exercise (CON: 0.7 ± 1.3, FM: 2.9 ± 2.3; p < 0.001), and both groups reported greater arm pain following concentric (isometric: 1.4 ± 2.0, concentric: 2.2 ± 2.9; p = 0.001) than isometric exercise. Neither group reported an increase in whole-body pain following exercise. CONCLUSION People with FM experienced greater performance fatigability in the exercising muscle compared to CON that was not related to central mechanisms of fatigue or pain. These results suggest changes in performance fatigability in FM may be due to differences occurring at the muscular level. TRIAL REGISTRATION #: NCT #: NCT03778385, December 19, 2018, retrospectively registered. IRB#: HR-3035.
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Affiliation(s)
- Giovanni Berardi
- Department of Physical Therapy, Marquette University, 561 N 15 St, Milwaukee, WI, 53233, USA.
| | - Jonathon W Senefeld
- Department of Physical Therapy, Marquette University, 561 N 15 St, Milwaukee, WI, 53233, USA.,Exercise Science Program, Marquette University, Milwaukee, WI, USA.,Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sandra K Hunter
- Department of Physical Therapy, Marquette University, 561 N 15 St, Milwaukee, WI, 53233, USA.,Exercise Science Program, Marquette University, Milwaukee, WI, USA
| | - Marie K Hoeger Bement
- Department of Physical Therapy, Marquette University, 561 N 15 St, Milwaukee, WI, 53233, USA
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15
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Qin L, Li J. Nerve growth factor in muscle afferent neurons of peripheral artery disease and autonomic function. Neural Regen Res 2021; 16:694-699. [PMID: 33063730 PMCID: PMC8067946 DOI: 10.4103/1673-5374.293132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In peripheral artery disease patients, the blood supply directed to the lower limbs is reduced. This results in severe limb ischemia and thereby enhances pain sensitivity in lower limbs. The painful perception is induced and exaggerate during walking, and is relieved by rest. This symptom is termed by intermittent claudication. The limb ischemia also amplifies autonomic responses during exercise. In the process of pain and autonomic responses originating exercising muscle, a number of receptors in afferent nerves sense ischemic changes and send signals to the central nervous system leading to autonomic responses. This review integrates recent study results in terms of perspectives including how nerve growth factor affects muscle sensory nerve receptors in peripheral artery disease and thereby alters responses of sympathetic nerve activity and blood pressure to active muscle. For the sensory nerve receptors, we emphasize the role played by transient receptor potential vanilloid type 1, purinergic P2X purinoceptor 3 and acid sensing ion channel subtype 3 in amplified sympathetic nerve activity responses in peripheral artery disease.
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Affiliation(s)
- Lu Qin
- Heart & Vascular Institute, Penn State University College of Medicine, Hershey, PA, USA
| | - Jianhua Li
- Heart & Vascular Institute, Penn State University College of Medicine, Hershey, PA, USA
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16
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Pacifici F, Della-Morte D, Piermarini F, Arriga R, Scioli MG, Capuani B, Pastore D, Coppola A, Rea S, Donadel G, Andreadi A, Abete P, Sconocchia G, Bellia A, Orlandi A, Lauro D. Prdx6 Plays a Main Role in the Crosstalk Between Aging and Metabolic Sarcopenia. Antioxidants (Basel) 2020; 9:antiox9040329. [PMID: 32316601 PMCID: PMC7222359 DOI: 10.3390/antiox9040329] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 12/17/2022] Open
Abstract
With the increase in average life expectancy, several individuals are affected by age-associated non-communicable chronic diseases (NCDs). The presence of NCDs, such as type 2 diabetes mellitus (T2DM), leads to the reduction in skeletal muscle mass, a pathological condition defined as sarcopenia. A key factor linking sarcopenia with cellular senescence and diabetes mellitus (DM) is oxidative stress. We previously reported as the absence of Peroxiredoxin 6 (Prdx6), an antioxidant enzyme implicated in maintaining intracellular redox homeostasis, induces an early-stage of T2DM. In the present study we sought to understand the role of Prdx6 in the crosstalk between aging and diabetic sarcopenia, by using Prdx6 knockout (Prdx6-/-) mice. Absence of Prdx6 reduced telomeres length and Sirtuin1 (SIRT1) nuclear localization. An increase in Sa-β-Gal activity and p53-p21 pro-aging pathway were also evident. An impairment in IGF-1 (Insulin-like Groth Factor-1)/Akt-1/mTOR pathway leading to a relative increase in Forkhead Box O1 (FOXO1) nuclear localization and in a decrease of muscle differentiation as per lower levels of myoblast determination protein 1 (MyoD) was observed. Muscle atrophy was also present in Prdx6-/- mice by the increase in Muscle RING finger 1 (MuRF1) levels and proteins ubiquitination associated to a reduction in muscle strength. The present study, innovatively, highlights a fundamental role of Prdx6, in the crosstalk between aging, sarcopenia, and DM.
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Affiliation(s)
- Francesca Pacifici
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
| | - David Della-Morte
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, 00166 Rome, Italy
- Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Francesca Piermarini
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
| | - Roberto Arriga
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
| | - Maria Giovanna Scioli
- Department of Biomedicine and Prevention, Anatomic Pathology Section, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.G.S.); (A.O.)
| | - Barbara Capuani
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
| | - Donatella Pastore
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
| | - Andrea Coppola
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
| | - Silvia Rea
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
| | - Giulia Donadel
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Aikaterini Andreadi
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
| | - Pasquale Abete
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy;
| | - Giuseppe Sconocchia
- Institute of Translational Pharmacology, National Research Council, 00133 Rome, Italy;
| | - Alfonso Bellia
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
- Department of Medical Sciences, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy
| | - Augusto Orlandi
- Department of Biomedicine and Prevention, Anatomic Pathology Section, University of Rome “Tor Vergata”, 00133 Rome, Italy; (M.G.S.); (A.O.)
| | - Davide Lauro
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (F.P.); (D.D.-M.); (F.P.); (R.A.); (B.C.); (D.P.); (A.C.); (S.R.); (A.A.); (A.B.)
- Department of Medical Sciences, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy
- Correspondence: ; Tel.: +39-06-20904666 or +39-337735770; Fax: +39-0620904668
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Cowie AM, Menzel AD, O’Hara C, Lawlor MW, Stucky CL. NOD-like receptor protein 3 inflammasome drives postoperative mechanical pain in a sex-dependent manner. Pain 2019; 160:1794-1816. [PMID: 31335648 PMCID: PMC6662742 DOI: 10.1097/j.pain.0000000000001555] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Postoperative pain management continues to be suboptimal because of the lack of effective nonopioid therapies and absence of understanding of sex-driven differences. Here, we asked how the NLRP3 inflammasome contributes to postoperative pain. Inflammasomes are mediators of the innate immune system that are responsible for activation and secretion of IL-1β upon stimulation by specific molecular signals. Peripheral IL-1β is known to contribute to the mechanical sensitization induced by surgical incision. However, it is not known which inflammasome mediates the IL-1β release after surgical incision. Among the 9 known inflammasomes, the NLRP3 inflammasome is ideally positioned to drive postoperative pain through IL-1β production because NLRP3 can be activated by factors that are released by incision. Here, we show that male mice that lack NLRP3 (NLRP3) recover from surgery-induced behavioral and neuronal mechanical sensitization faster and display less surgical site inflammation than mice expressing NLRP3 (wild-type). By contrast, female NLRP3 mice exhibit minimal attenuation of the postoperative mechanical hypersensitivity and no change in postoperative inflammation compared with wild-type controls. Sensory neuron-specific deletion of NLRP3 revealed that in males, NLRP3 expressed in non-neuronal cells and potentially sensory neurons drives postoperative pain. However, in females, only the NLRP3 that may be expressed in sensory neurons contributes to postoperative pain where the non-neuronal cell contribution is NLRP3 independent. This is the first evidence of a key role for NLRP3 in postoperative pain and reveals immune-mediated sex differences in postoperative pain.
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Affiliation(s)
- Ashley M. Cowie
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Anthony D. Menzel
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Crystal O’Hara
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226
| | - Michael W. Lawlor
- Division of Pediatric Pathology, Department of Pathology and Laboratory Medicine
- Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Cheryl L. Stucky
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226
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Abstract
Clinical conditions resulting in musculoskeletal pain show important sex differences in both prevalence and degree of functional disability. The underlying mechanisms for these distinctions in pain manifestation are not fully known. However, recent preclinical studies have shown at the primary afferent level that males and females present fundamental differences in their peripheral response properties and injury-related gene expression patterns that may underlie observed afferent sensitization. At the spinal cord level, studies in various models of pain suggest important roles for the immune system, glutamate signaling and hormones in modulating sex differences. While preclinical studies have been able to characterize some of the basic underlying molecular mechanisms of sex differences in muscle pain, human studies have relied mainly on functional brain imaging studies to explain differences. Further complicating our understanding of how sex influences muscle pain is the notion that the type of injury sustained, or clinical condition may differentially activate distinct mechanisms of muscle pain development in males versus females. More research is necessary to better understand how the sexes differ in their perception of muscle pain. This review highlights recent advances in both human and animal studies of sex differences in muscle pain.
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20
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Sadler KE, Stucky CL. Neuronal transient receptor potential (TRP) channels and noxious sensory detection in sickle cell disease. Neurosci Lett 2018; 694:184-191. [PMID: 30508569 DOI: 10.1016/j.neulet.2018.11.056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/21/2022]
Abstract
Pain is the leading cause for hospitalization in patients with sickle cell disease (SCD). While the characteristics of SCD pain can vary widely between patients and between phases of the disease (e.g. vasoocclusive crisis pain vs. chronic pain), similar neuronal mechanisms likely underlie the various aspects of nociceptive processing. In the peripheral nervous system, small unmyelinated C fibers and lightly-myelinated Aδ fibers detect and transmit noxious stimuli. Both classes of neurons express members of the transient receptor potential (TRP) family, a group of ligand gated ion-channels that are activated by thermal, chemical, and mechanical stimuli. Promiscuous TRP channel family members are activated by a wide range of stimuli, many of which are dysregulated in patients with SCD and transgenic SCD mouse models. In 2011, our lab published the first report of TRP channel contributions to rodent SCD pain. Since that time, additional basic and clinical research efforts have investigated the genetic and biochemical status of TRP channels in SCD, placing particular focus on TRPV1. This review will discuss these advances and highlight the clinical SCD presentations that have not yet been studied, but which may be mediated by TRP channel activity.
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Affiliation(s)
- Katelyn E Sadler
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States.
| | - Cheryl L Stucky
- Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States
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