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Parwez S, Mahapatra PP, Ahmed S, Siddiqi MI. Identification of novel TACE inhibitors using DNN based- virtual screening, molecular dynamics and biological evaluation. J Biomol Struct Dyn 2024; 42:5869-5880. [PMID: 37382224 DOI: 10.1080/07391102.2023.2229444] [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: 01/07/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]
Abstract
Rheumatoid Arthritis (RA) is a well-known autoimmune inflammatory disease, distressing roughly 1% of the adult population throughout the globe. Many studies have suggested that overexpression of TNF-α, a pro-inflammatory cytokine, is responsible for the progression of RA. Furthermore, inhibition of the shedding rate of TNF-α is regulated by the TACE (TNF-α converting enzyme) protein and, hence is considered as an important therapeutic target for the prevention of progressive synovial joint destruction in rheumatoid arthritis. In the present study, we have proposed a deep neural network (DNN)-based workflow for the virtual screening of compounds towards the identification of potential inhibitors against the TACE proteins. Subsequently, a set of compounds were shortlisted, based on the molecular docking and subjected to the biological evaluation to validate the inhibitory activities of the screened compounds, determine the practical applicability of the DNN-based model, and strengthen the hypothesis. Out of seven, three compounds (BTB10246, BTB10247, and BTB10245) showed significant inhibition at 10 µM and 0.1 µM concentration. These three compounds also showed a stable and significant interaction potential against the TACE protein as compared with the re-docked complex system and can serve as a novel scaffold for further design of new molecules with improved inhibitory activities against TACE.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Shahid Parwez
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Pinaki Parsad Mahapatra
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Shakil Ahmed
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Mohammad Imran Siddiqi
- Biochemistry and Structural Biology Division, CSIR-Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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2
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Leerling AT, Niesters M, Flendrie M, Tel M, Appelman-Dijkstra NM, Dekkers OM, Winter EM. Neuropathic and Nociplastic Pain Profiles are Common in Adult Chronic Nonbacterial Osteitis (CNO). Calcif Tissue Int 2024; 114:603-613. [PMID: 38627292 PMCID: PMC11090977 DOI: 10.1007/s00223-024-01214-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 05/14/2024]
Abstract
Chronic nonbacterial osteitis (CNO) is a rare musculoskeletal disease causing chronic bone pain. It is known that chronic musculoskeletal pain may involve other mechanisms than nociceptive pain only. We investigate the prevalence of neuropathic and nociplastic pain in adult CNO and their association with clinical characteristics and treatment outcomes. Survey study among the Dutch adult CNO cohort (n = 84/195 participated), including PAIN-detect for neuropathic pain, and the Central Sensitization Inventory (CSI), Fibromyalgia Rapid Screening Tool (FiRST), and ACTTION-APS Pain Taxonomy (AAPT) for nociplastic pain. Clinical characteristics and CNO-related bone pain scores were compared between patients with exclusive nociceptive pain and those with nociceptive pain plus neuropathic and/or nociplastic pain (mixed pain). 31% (95% CI 21-41) of patients classified as likely having neuropathic pain according to PAIN-detect. 53% (41-64) of patients displayed central sensitization on CSI, 61% (50-72) screened positive for fibromyalgia on FiRST and 14% (7-23) of patients fulfilled the AAPT criteria, all indicative of nociplastic pain. Mixed pain was associated with longer diagnostic delay (mean difference 2.8 years, 95% CI 0.4-5.2, p = 0.023), lower educational level (72% versus 20%, p < 0.001), and opioid use (37% versus 13%, p = 0.036). Despite comparable disease severity and extent, patients with mixed pain reported significantly higher CNO-related bone pain scores. This study demonstrates the high prevalence of mixed pain in adult CNO, in which neuropathic and nociplastic pain exist alongside nociceptive inflammatory bone pain. Disease burden in CNO may extend beyond inflammatory activity, highlighting the need for a multifaceted management approach.
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Affiliation(s)
- Anne T Leerling
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke Niesters
- Department of Anesthesiology and Pain Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Marcel Flendrie
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Marije Tel
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Natasha M Appelman-Dijkstra
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Olaf M Dekkers
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Elizabeth M Winter
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
- Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands.
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3
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Awad NB, Axon DR. Characteristics Associated with Good Self-Perceived Mental Health among United States Adults with Arthritis. Behav Sci (Basel) 2022; 12:bs12080256. [PMID: 36004827 PMCID: PMC9405205 DOI: 10.3390/bs12080256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
Mental health disorders are prevalent among United States (US) adults with arthritis. Yet, little is known about characteristics associated with mental health among US adults with arthritis. This retrospective cross-sectional study used 2019 Medical Expenditures Panel Survey data to assess the association between multiple personal characteristics and mental health status among US adults with arthritis. Hierarchical logistic regression models modeled associations between personal characteristics and mental health status. Model 1 included predisposing factors, model 2 included predisposing and enabling factors, while model 3 included predisposing, enabling, and need factors. The a priori alpha level was 0.05. Analyses accounted for the complex survey design and were weighted to produce national estimates. Among 28,512 individuals, 4984 met the inclusion criteria. Of these, 4181 had good mental health (85.5%, 95% confidence interval (CI) = 84.3%, 86.7%). The following characteristics were associated with good mental health status in the final adjusted model: age 18–64 vs. ≥65 (adjusted odds ratio (AOR) = 0.29, 95% CI = 0.12, 0.71), Midwest vs. West census region (AOR = 5.17, 95% CI = 1.63, 16.46), no degree vs. higher than high school education (AOR = 0.34, 95% CI = 0.12, 0.92), and high school diploma vs. higher than high school education (AOR = 0.40, 95% CI = 0.18, 0.86). In conclusion, this study suggests such characteristics may be targeted to help improve mental health among this population. Additional efforts are needed to help satisfy the unmet need for mental healthcare among this population.
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Pavlović JM, Derby CA. Pain in midlife women: a growing problem in need of further research. Womens Midlife Health 2022; 8:4. [PMID: 35509086 PMCID: PMC9068256 DOI: 10.1186/s40695-022-00074-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
More than 10% of American adults experience some level of daily pain, and nearly 40 million (17.6%) experience episodes of severe pain annually. Women are particularly impacted by both episodic and chronic pain with higher prevalence and a greater level of pain-related disability compared to men. Midlife is a critical period for women during which the frequency of pain complaints begins to increase. Although pain is known to be influenced and controlled by sex hormones, it has not been widely recognized as a symptom of the menopausal transition outside of the menopause research community. The recent thematic series in this journal has specifically highlighted pain related conditions including rheumatoid arthritis, migraine and abdominal pain for which the significance among midlife women is not typically recognized. The studies presented in this thematic series present a small fraction of relevant, understudied questions regarding pain and its impact on women in midlife. Addressing the gaps in knowledge will require longitudinal studies that consider the emergence of pain symptomatology in relation to midlife trajectories of other symptoms and health determinants, as well as further study of new and emerging therapies.
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Affiliation(s)
- Jelena M Pavlović
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA. .,Montefiore Headache Center, Montefiore Medical Center, Bronx, NY, USA.
| | - Carol A Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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Maity S, Wairkar S. Dietary polyphenols for management of rheumatoid arthritis: Pharmacotherapy and novel delivery systems. Phytother Res 2022; 36:2324-2341. [PMID: 35318759 DOI: 10.1002/ptr.7444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic, complex, systemic autoimmune disease causing chronic inflammation, swelling, and pain. It affects pulmonary and ocular physiology, gastrointestinal disturbance, skeletal disorders, and renal malfunctioning. Although conventional and biological drugs available to treat RA are potent and effective, they lead to life-threatening side effects and patient discomfort. Hence, alternative therapies are explored for their treatment which is safe, effective, and economical. Herbal drugs are widely used as an alternative therapy and some medicinal plants, especially dietary polyphenols proved their efficacy in treating RA. Polyphenols are secondary metabolites of plants possessing several pharmacological actions. They exert anti-inflammatory, immunomodulatory and anti-rheumatoid activity by modulating tumor necrosis factor, mitogen-activated protein kinase, nuclear factor kappa-light-chain-enhancer of activated B cells, and c-Jun N-terminal kinases. Thus, polyphenols could be a promising option for the management of RA. Unfortunately, polyphenols suffer from poor bioavailability due to their physicochemical properties and incorporation into novel delivery systems such as liposomes, nanoparticles, nanoemulsions, micelles improved their oral bioavailability. This review article summarizes dietary polyphenols, their pharmacological actions and novel delivery systems for the treatment of RA. Nevertheless, the commercial translation of polyphenols could be only possible after establishing their safety profile and successful clinical trials.
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Affiliation(s)
- Siddharth Maity
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKMs NMIMS, Mumbai, India
| | - Sarika Wairkar
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKMs NMIMS, Mumbai, India
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6
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Hassan MS, Mostafa DI, Abdelhady EI, Sarhan SA, Abdelghani M, Seleem DA. Psychosocial and clinical impact of COVID-19 pandemic and its relationship to the quality of life in patients with rheumatoid arthritis: a cross-sectional study, Egypt. MIDDLE EAST CURRENT PSYCHIATRY 2022. [PMCID: PMC8863409 DOI: 10.1186/s43045-022-00184-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Data have been pouring on the impact of the COVID-19 pandemic on patients with chronic diseases. This study aimed to address the relationship between the perceived fears of COVID-19 virus (FCV), psychological status, and quality of life (QoL) among patients with rheumatoid arthritis (RA) during the pandemic. This study included 100 patients with RA and an equal number of control subjects, who were recruited from Zagazig University rheumatology outpatient clinics, Egypt. All subjects were interviewed using the fear of COVID-19 scale (FCV-19S), Symptom Checklist-90 scale (SCL-90), and World Health Organization Quality of Life Scale (WHOQOL-BREF). Patients were additionally assessed using the Disease Activity Score 28 (DAS28) and Modified Health Assessment Questionnaire (MHAQ). Results There were significant differences between both groups in all QoL domains and most psychological dimensions. Most patients with RA experienced moderate-to-high disease activity and mild-to-moderate functional impairment (85% and 80%, respectively). FCV was correlated with the number of family members (P-value 0.020), and obsessive-compulsive (P-value 0.006), interpersonal sensitivity (P-value 0.035), hostility (P-value 0.017), phobia (P-value 0.010), and psychoticism (P-value 0.034) symptoms. Moderate-to-high disease activity was associated with reduced psychological QoL. Patients with moderate-to-severe functional impairment had worse QoL in all domains (except social). Prolonged illness duration was associated with worse social QoL. Conclusions QoL was adversely affected in patients with RA during the pandemic. There was a robust relationship between FCV and the emergence of psychological symptoms. RA-related clinical factors like illness duration, disease activity, and functional disability were associated with reduced QoL in those patients.
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Romera Baures M, Seoane-Mato D, Alegre-Sancho JJ, León L, Caracuel Ruiz MA, Calvo-Alen J, Stoye C, Fernández B, Núñez-Monje V, Freites-Núñez D, Ortega Castro R. Impact of rheumatoid arthritis on sexuality: adaptation and validation of the Qualisex questionnaire for use in Spain. Rheumatol Int 2021; 42:1819-1829. [PMID: 34783890 DOI: 10.1007/s00296-021-05043-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
Patients with rheumatoid arthritis (RA) have a significantly increased risk of sexual dysfunction. However, it is not properly included in commonly used questionnaires to assess health-related quality of life in RA. Qualisex is a questionnaire developed in France to assess the impact of RA on patients´ sexual function. Our aim was to adapt and validate this questionnaire for use with Spanish RA patients. Two independent translations and a backward translation were obtained. The final version was tested in a pilot study with 10 RA patients to detect any aspects that could hinder interpretation. The validity and reliability of the linguistically validated questionnaire were studied in a multicenter cross-sectional study, with a longitudinal component for reliability estimation. 125 RA patients were included. The response process, discrimination, internal consistency, internal structure, convergent validity (correlation with MGH-SFQ questionnaire, DAS-28, physician global assessment, patient global health assessment, RAID, HAQ, HADS and SF-12©) and reliability were analyzed. The inclusion of two extra items was proposed in the pilot study. The validity analysis detected responses for item 10 that were not coherent with responses for the rest of items. The Cronbach alpha coefficient was 0.971. The highest correlation (0.665) was obtained with MGH-SFQ (questionnaire measuring sexual functioning), followed by RAID (0.516). The intra-class correlation was 0.880 (95% CI 0.815; 0.923), higher than 0.85, which indicates excellent reliability. All parameters used to assess this questionnaire show highly acceptable values. Qualisex allows for a global score of RA patients' sexual functioning and can be self-administered.
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Affiliation(s)
- Montserrat Romera Baures
- Rheumatology Service, Hospital Universitari de Bellvitge, Barcelona, Spain. .,Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, C/ Josep Trueta, 08195, Sant Cugat del Vallès, Barcelona, Spain.
| | | | | | - Leticia León
- Rheumatology Department and IDISSC, Hospital Clínico San Carlos, Madrid, Spain.,Health Sciences, Universidad Camilo José Cela, Madrid, Spain
| | | | - Jaime Calvo-Alen
- Rheumatology Service, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - Claudia Stoye
- Rheumatology Service, Hospital Universitario Araba, Vitoria-Gasteiz, Spain
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Wilhelm EA, Soares PS, Reis AS, Motta KP, Lemos BB, Domingues WB, Blödorn EB, Araujo DR, Barcellos AM, Perin G, Soares MP, Campos VF, Luchese C. Se-[(2,2-Dimethyl-1,3-dioxolan-4-yl)methyl] 4-Chlorobenzoselenolate Attenuates Inflammatory Response, Nociception, and Affective Disorders Related to Rheumatoid Arthritis in Mice. ACS Chem Neurosci 2021; 12:3760-3771. [PMID: 34553902 DOI: 10.1021/acschemneuro.1c00512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Despite major advances, not all patients achieve rheumatoid arthritis (RA) remission, thus highlighting a pressing need for new therapeutic treatments. Given this scenario, this study sought to evaluate Se-[(2,2-dimethyl-1,3-dioxolan-4-yl)methyl] 4-chlorobenzoselenolate (Se-DMC) potential on a complete Freund's adjuvant (CFA)-induced unilateral arthritis model. The effects of Se-DMC (5 mg/kg; oral dose) and meloxicam (5 mg/kg; oral dose), both administered to animals daily for 14 days, on paw edema, mechanical sensitivity, neurobehavioral deficits (anxiogenic- and depressive-like behaviors), Na+/K+-ATPase activity, oxidative stress, and inflammation were evaluated in male Swiss mice exposed to CFA (intraplantar injection of 0.1 mL; 10 mg/mL). Se-DMC reduced the paw withdrawal threshold and CFA-induced paw edema. Histopathological results revealed the antiedematogenic potential of the compound, which was evidenced by lower quantities of dilated lymphatic vessels compared with the CFA group. Se-DMC reduced mRNA relative expression levels of tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB) in the hippocampus and paw of CFA mice. The CFA-induced anxiogenic- and depressive-like behaviors were reversed by Se-DMC to the control levels in the elevated plus-maze and tail suspension tests. Se-DMC reduced the paw reactive species levels and restored the superoxide dismutase (hippocampus and paw) and Na+/K+-ATPase (hippocampus) activities previously increased by CFA. Moreover, CFA administration inhibited serum creatinine kinase activity, albeit the Se-DMC effects did not appear to involve the modulation of this enzyme and were equal to or greater than meloxicam. Se-DMC attenuates CFA-induced inflammatory response, nociception, and neurobehavioral deficits in mice.
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Affiliation(s)
- Ethel A. Wilhelm
- Laboratório de Pesquisa em Farmacologia Bioquímica, CCQFA, Universidade Federal de Pelotas, UFPel, Pelotas 96010-900, Brazil
| | - Paola S. Soares
- Laboratório de Pesquisa em Farmacologia Bioquímica, CCQFA, Universidade Federal de Pelotas, UFPel, Pelotas 96010-900, Brazil
| | - Angélica S. Reis
- Laboratório de Pesquisa em Farmacologia Bioquímica, CCQFA, Universidade Federal de Pelotas, UFPel, Pelotas 96010-900, Brazil
| | - Ketlyn P. Motta
- Laboratório de Pesquisa em Farmacologia Bioquímica, CCQFA, Universidade Federal de Pelotas, UFPel, Pelotas 96010-900, Brazil
| | - Briana B. Lemos
- Laboratório de Pesquisa em Farmacologia Bioquímica, CCQFA, Universidade Federal de Pelotas, UFPel, Pelotas 96010-900, Brazil
| | - William B. Domingues
- Programa de Pós-Graduação em Bioquímica e Bioprospecção, Laboratório de Genômica Estrutural, Biotecnologia, Universidade Federal de Pelotas, UFPel, Campus Capão do Leão, Pelotas 96010-900, RS, Brazil
| | - Eduardo B. Blödorn
- Programa de Pós-Graduação em Bioquímica e Bioprospecção, Laboratório de Genômica Estrutural, Biotecnologia, Universidade Federal de Pelotas, UFPel, Campus Capão do Leão, Pelotas 96010-900, RS, Brazil
| | - Daniela R. Araujo
- Laboratório de Síntese Orgânica Limpa, CCQFA, Universidade Federal de Pelotas—UFPel, Pelotas 96010-900, Brazil
| | - Angelita M. Barcellos
- Laboratório de Síntese Orgânica Limpa, CCQFA, Universidade Federal de Pelotas—UFPel, Pelotas 96010-900, Brazil
| | - Gelson Perin
- Laboratório de Síntese Orgânica Limpa, CCQFA, Universidade Federal de Pelotas—UFPel, Pelotas 96010-900, Brazil
| | - Mauro P. Soares
- Laboratório Regional de Diagnóstico, Faculdade de Veterinária, Universidade Federal de Pelotas, UFPel, Pelotas 96010-900, Brazil
| | - Vinicius F. Campos
- Programa de Pós-Graduação em Bioquímica e Bioprospecção, Laboratório de Genômica Estrutural, Biotecnologia, Universidade Federal de Pelotas, UFPel, Campus Capão do Leão, Pelotas 96010-900, RS, Brazil
| | - Cristiane Luchese
- Laboratório de Pesquisa em Farmacologia Bioquímica, CCQFA, Universidade Federal de Pelotas, UFPel, Pelotas 96010-900, Brazil
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Cucinello-Ragland JA, Mitchell-Cleveland R, Bradley Trimble W, Urbina AP, Yeh AY, Edwards KN, Molina PE, Simon Peter L, Edwards S. Alcohol amplifies cingulate cortex signaling and facilitates immobilization-induced hyperalgesia in female rats. Neurosci Lett 2021; 761:136119. [PMID: 34280506 PMCID: PMC8387454 DOI: 10.1016/j.neulet.2021.136119] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 12/28/2022]
Abstract
Complex Regional Pain Syndrome (CRPS) is a musculoskeletal pain condition that often develops after limb injury and/or immobilization. Although the exact mechanisms underlying CRPS are unknown, the syndrome is associated with central and autonomic nervous system dysregulation and peripheral hyperalgesia symptoms. These symptoms also manifest in alcoholic neuropathy, suggesting that the two conditions may be pathophysiologically accretive. Interestingly, people assigned female at birth (AFAB) appear to be more sensitive to both CRPS and alcoholic neuropathy. To better understand the biobehavioral mechanisms underlying these conditions, we investigated a model of combined CRPS and alcoholic neuropathy in female rats. Animals were pair-fed either a Lieber-DeCarli alcohol liquid diet or a control diet for ten weeks. CRPS was modeled via unilateral hind limb cast immobilization for seven days, allowing for the other limb to serve as a within-subject control for hyperalgesia measures. To investigate the role of circulating ovarian hormones on pain-related behaviors, half of the animals underwent ovariectomy (OVX). Using the von Frey procedure to record mechanical paw withdrawal thresholds, we found that cast immobilization and chronic alcohol drinking separately and additively produced mechanical hyperalgesia observed 3 days after cast removal. We then examined neuroadaptations in AMPA GluR1 and NMDA NR1 glutamate channel subunits, extracellular signal-regulated kinase (ERK), and cAMP response element-binding protein (CREB) in bilateral motor and cingulate cortex across all groups. Consistent with increased pain-related behavior, chronic alcohol drinking increased GluR1, NR1, ERK, and CREB phosphorylation in the cingulate cortex. OVX did not alter any of the observed effects. Our results suggest accretive relationships between CRPS and alcoholic neuropathy symptoms and point to novel therapeutic targets for these conditions.
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Affiliation(s)
- Jessica A Cucinello-Ragland
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States
| | | | - W Bradley Trimble
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States
| | - Amy P Urbina
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States
| | - Alice Y Yeh
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States
| | - Kimberly N Edwards
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States
| | - Patricia E Molina
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States; Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans, United States
| | - Liz Simon Peter
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States; Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans, United States
| | - Scott Edwards
- Department of Physiology and School of Medicine, LSU Health-New Orleans, United States; Alcohol & Drug Abuse Center of Excellence, LSU Health-New Orleans, United States; Neuroscience Center of Excellence, LSU Health-New Orleans, United States; Comprehensive Alcohol-HIV/AIDS Research Center, LSU Health-New Orleans, United States.
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10
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Alok S, Nessa S, Tata SS, Begum AS. Will she-won’t she: determinants of complementary and alternative medicines use among female rheumatoid arthritis patients. ADVANCES IN TRADITIONAL MEDICINE 2021. [DOI: 10.1007/s13596-021-00604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Mathias K, Amarnani A, Pal N, Karri J, Arkfeld D, Hagedorn JM, Abd-Elsayed A. Chronic Pain in Patients with Rheumatoid Arthritis. Curr Pain Headache Rep 2021; 25:59. [PMID: 34269913 DOI: 10.1007/s11916-021-00973-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Chronic pain is highly prevalent in patients with rheumatoid arthritis (RA) and can cause various physical and psychological impairments. Unfortunately, the appropriate diagnosis of chronic pain syndromes in this population can be challenging because pain may be primary to RA-specific inflammation and/or secondary to other conditions, typically osteoarthritis (OA) and fibromyalgia (FM). This disparity further poses a clinical challenge, given that chronic pain can often be discordant or undetected with standard RA-specific surveillance strategies, including serological markers and imaging studies. In this review, we provide a robust exploration of chronic pain in the RA population with emphasis on epidemiology, mechanisms, and management strategies. RECENT FINDINGS Chronic pain associated with RA typically occurs in patients with anxiety, female sex, and elevated inflammatory status. Up to 50% of these patients are thought to have chronic pain despite appropriate inflammatory suppression, typically due to peripheral and central sensitization as well as secondary OA and FM. In addition to the standard-of-care management for OA and FM, patients with RA and chronic pain benefit from behavioral and psychological treatment options. Moreover, early and multimodal therapies, including non-pharmacological, pharmacological, interventional, and surgical strategies, exist, albeit with varying efficacy, to help suppress inflammation, provide necessary analgesia, and optimize functional outcomes. Overall, chronic pain in RA is a difficult entity for both patients and providers. Early diagnosis, improved understanding of its mechanisms, and initiation of early, targeted approaches to pain control may help to improve outcomes in this population.
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Affiliation(s)
- Kristen Mathias
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA
| | - Abhimanyu Amarnani
- Department of Internal Medicine, Division of Rheumatology, Los Angeles County + University of Southern California (LAC + USC) and Keck Medicine of USC, Los Angeles, CA, USA
| | - Neha Pal
- Texas A&M School of Medicine, Bryan, TX, USA
| | - Jay Karri
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Daniel Arkfeld
- Department of Internal Medicine, Division of Rheumatology, Los Angeles County + University of Southern California (LAC + USC) and Keck Medicine of USC, Los Angeles, CA, USA
| | - Jonathan M Hagedorn
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesia, Division of Pain Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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Wang J, Yang Z, Zheng Y, Peng Y, Wang Q, Xia H, Wang Y, Ding J, Zhu P, Shang L, Zheng Z. Effects of illness perceptions on health-related quality of life in patients with rheumatoid arthritis in China. Health Qual Life Outcomes 2021; 19:126. [PMID: 33879176 PMCID: PMC8056365 DOI: 10.1186/s12955-021-01770-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 04/14/2021] [Indexed: 01/22/2023] Open
Abstract
Objectives For patients with rheumatoid arthritis (RA) in China, little is known of how their illness perceptions affect their health-related quality of life (HRQoL). The present study investigated associations between specific illness perceptions due to RA and HRQoL features. Methods For 191 patients with RA, illness perceptions were measured using the Brief Illness Perceptions Questionnaire (BIPQ) comprising 8 domains. HRQoL was determined with the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Multivariate linear regression analyses were performed. Results The overall BIPQ of patients with RA was 49.09 ± 11.06. The highest and lowest scores were for concern (9.15 ± 1.81) and personal control (4.30 ± 2.52), respectively. Multivariate stepwise regression analyses showed that the overall BIPQ was significantly negatively associated with each HRQoL feature, and HRQoL total score (β = − 0.343, P < 0.001, 95% CI − 7.080 to − 4.077). Positive associations between BIPQ features and HRQoL included personal control (β = 0.119, P = 0.004, 95% CI 2.857–14.194) and treatment control (β = 0.084, P = 0.029, 95% CI 0.640–12.391). Negative associations with HRQoL were identity (β = − 0.105, P = 0.034, 95% CI − 13.159 to − 0.430) and emotional response (β = − 0.207, P < 0.001, 95% CI − 18.334 to − 6.811). Conclusions Patients with RA in China perceive their illness in ways that affect their HRQoL. These results suggest that strategies that target these perceptions may improve the quality of life of these patients.
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Affiliation(s)
- Juan Wang
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Zhe Yang
- Department of Health Statistics, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Yan Zheng
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Yaling Peng
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Qing Wang
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Hongli Xia
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Yan Wang
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Jin Ding
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Ping Zhu
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China.
| | - Lei Shang
- Department of Health Statistics, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China.
| | - Zhaohui Zheng
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China.
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Pain in Women: A Perspective Review on a Relevant Clinical Issue that Deserves Prioritization. Pain Ther 2021; 10:287-314. [PMID: 33723717 PMCID: PMC8119594 DOI: 10.1007/s40122-021-00244-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/08/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction Gender equity and gender medicine are opportunities not to be missed, and this Expert Group Opinion Paper on pain in women aims to review the treatment of pain conditions mainly affecting women, as well as the fundamental aspects of the different clinical response to drug treatment between the genders, and what can be done for gender-specific rehabilitation. Methods Perspective review. Results Genotypic and phenotypic differences in pain between the sexes are conditioned by anatomical, physiological, neural, hormonal, psychological, social, and cultural factors, such as the response to pharmacological treatment to control pain. The examination of these factors shows that women are affected by pain diseases more frequently and severely than men and that they report pain more frequently and with a lower pain threshold than men. Some forms of pain are inherently related to gender differences, such as pain related to the genitourinary system. However, other forms of chronic pain are seen more frequently in women than men, such as migraine, rheumatological, and musculoskeletal pain, in particular fibromyalgia. Discussion Research is needed into the pathophysiological basis for gender differences in the generation of acute pain and maintenance of chronic pain, including the factors that put women at higher risk for developing chronic pain. In addition, different specialties need to collaborate to develop gender-related diagnostic and therapeutic guidelines, and healthcare professionals need to upskill themselves in the appropriate management of pain using existing diagnostic tools and therapeutic options.
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Borbély É, Hunyady Á, Pohóczky K, Payrits M, Botz B, Mócsai A, Berger A, Szőke É, Helyes Z. Hemokinin-1 as a Mediator of Arthritis-Related Pain via Direct Activation of Primary Sensory Neurons. Front Pharmacol 2021; 11:594479. [PMID: 33519457 PMCID: PMC7839295 DOI: 10.3389/fphar.2020.594479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/09/2020] [Indexed: 01/17/2023] Open
Abstract
The tachykinin hemokinin-1 (HK-1) is involved in immune cell development and inflammation, but little is known about its function in pain. It acts through the NK1 tachykinin receptor, but several effects are mediated by a yet unidentified target. Therefore, we investigated the role and mechanism of action of HK-1 in arthritis models of distinct mechanisms with special emphasis on pain. Arthritis was induced by i.p. K/BxN serum (passive transfer of inflammatory cytokines, autoantibodies), intra-articular mast cell tryptase or Complete Freund's Adjuvant (CFA, active immunization) in wild type, HK-1- and NK1-deficient mice. Mechanical- and heat hyperalgesia determined by dynamic plantar esthesiometry and increasing temperature hot plate, respectively, swelling measured by plethysmometry or micrometry were significantly reduced in HK-1-deleted, but not NK1-deficient mice in all models. K/BxN serum-induced histopathological changes (day 14) were also decreased, but early myeloperoxidase activity detected by luminescent in vivo imaging increased in HK-1-deleted mice similarly to the CFA model. However, vasodilation and plasma protein extravasation determined by laser Speckle and fluorescent imaging, respectively, were not altered by HK-1 deficiency in any models. HK-1 induced Ca2+-influx in primary sensory neurons, which was also seen in NK1-deficient cells and after pertussis toxin-pretreatment, but not in extracellular Ca2+-free medium. These are the first results showing that HK-1 mediates arthritic pain and cellular, but not vascular inflammatory mechanisms, independently of NK1 activation. HK-1 activates primary sensory neurons presumably via Ca2+ channel-linked receptor. Identifying its target opens new directions to understand joint pain leading to novel therapeutic opportunities.
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Affiliation(s)
- Éva Borbély
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Ágnes Hunyady
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Krisztina Pohóczky
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- Department of Pharmacology, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Maja Payrits
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Bálint Botz
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary
| | - Attila Mócsai
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | - Alexandra Berger
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Éva Szőke
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Helyes
- János Szentágothai Research Centre and Centre for Neuroscience, University of Pécs, Pécs, Hungary
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, Pécs, Hungary
- PharmInVivo Ltd., Pécs, Hungary
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Anti-Inflammatory Properties of Injectable Betamethasone-Loaded Tyramine-Modified Gellan Gum/Silk Fibroin Hydrogels. Biomolecules 2020; 10:biom10101456. [PMID: 33080875 PMCID: PMC7603075 DOI: 10.3390/biom10101456] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/28/2020] [Accepted: 10/10/2020] [Indexed: 12/11/2022] Open
Abstract
Rheumatoid arthritis is a rheumatic disease for which a healing treatment does not presently exist. Silk fibroin has been extensively studied for use in drug delivery systems due to its uniqueness, versatility and strong clinical track record in medicine. However, in general, natural polymeric materials are not mechanically stable enough, and have high rates of biodegradation. Thus, synthetic materials such as gellan gum can be used to produce composite structures with biological signals to promote tissue-specific interactions while providing the desired mechanical properties. In this work, we aimed to produce hydrogels of tyramine-modified gellan gum with silk fibroin (Ty–GG/SF) via horseradish peroxidase (HRP), with encapsulated betamethasone, to improve the biocompatibility and mechanical properties, and further increase therapeutic efficacy to treat rheumatoid arthritis (RA). The Ty–GG/SF hydrogels presented a β-sheet secondary structure, with gelation time around 2–5 min, good resistance to enzymatic degradation, a suitable injectability profile, viscoelastic capacity with a significant solid component and a betamethasone-controlled release profile over time. In vitro studies showed that Ty–GG/SF hydrogels did not produce a deleterious effect on cellular metabolic activity, morphology or proliferation. Furthermore, Ty–GG/SF hydrogels with encapsulated betamethasone revealed greater therapeutic efficacy than the drug applied alone. Therefore, this strategy can provide an improvement in therapeutic efficacy when compared to the traditional use of drugs for the treatment of rheumatoid arthritis.
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Lwin MN, Serhal L, Holroyd C, Edwards CJ. Rheumatoid Arthritis: The Impact of Mental Health on Disease: A Narrative Review. Rheumatol Ther 2020; 7:457-471. [PMID: 32535834 PMCID: PMC7410879 DOI: 10.1007/s40744-020-00217-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Indexed: 02/06/2023] Open
Abstract
Over 60% of rheumatoid arthritis (RA) patients achieve a good response after 12 months of treatment when following the European league against rheumatism (EULAR) guidelines for treatment. However, almost half of patients still suffer from moderate to severe disease activity despite this. In addition, mental health problems may remain despite reduced measures of inflammation systemically and within joints. Depression is two times more common in RA patients than in the general population, and intriguingly a bi-directional relationship with RA has been shown in cross-sectional studies. Chronic inflammation impairs the physiological responses to stress including effective coping behaviours, resulting in depression, which leads to a worse long-term outcome in RA. In RA patients, the pain score is not always solely related to inflammatory arthritis and immunological disease activity by Bąk et al. (Patient Prefer Adherence 13:223-231, [1]). Non-inflammatory pain secondary to anxiety, depression, sleep disturbance and the psychosocial situation needs to be considered whilst fibromyalgia, mechanical pain and neuropathic pain can also contribute to overall pain scores by Chancay et al. (Women's Midlife Health 5:3, [2]). Hence, the UK National Institute for Health and Care Excellence (NICE) guideline for the management of RA included psychological interventions for fatigue, low mood and social well-being (NICE NG100, 2018) [3], and the NICE clinical guidelines (CG91) [4] suggest managing mental health and depression in chronic medical conditions to improve treatment outcomes. This is a narrative review of the impact of mental health on RA disease activity in terms of patient-reported outcomes (PROs).
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Affiliation(s)
- May N Lwin
- University Hospital Southampton, Southampton, UK.
| | - Lina Serhal
- University Hospital Southampton, Southampton, UK
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Zhang L, Cai P, Zhu W. Depression has an impact on disease activity and health-related quality of life in rheumatoid arthritis: A systematic review and meta-analysis. Int J Rheum Dis 2019; 23:285-293. [PMID: 31858731 DOI: 10.1111/1756-185x.13774] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The aim of this study was to explore the impact of depression on pain, disease activity, functional disability and quality of life in patients with rheumatoid arthritis (RA). METHODS English (PubMed, the Cochrane Library, Web of Science and PsycINFO) and Chinese (Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until 30 September, 2019. Studies evaluating the impact of depression on pain, disease activity, functional disability and quality of life with the use of the Short Form-36 questionnaire (SF-36) scoring system were included. Statistical analyses were performed with Revman5.3. Data were pooled using a fixed or random-effects model according to heterogeneity. RESULTS A total of 7 identified studies matched the inclusion criteria, reporting on a total of 1078 patients with RA in the analysis. The total Disease Activity Score in 28 joints was significantly higher in patients with depression than in patients without depression [standardized mean difference (SMD) =0.47, 95% CI 0.10-0.85, P = .01]. All SF-36 dimensions (physical function, role physical function, emotional role function, vitality, mental health, social function, body pain, general health, physical component scale, mental component scale) were lower in patients with depression than in groups without depression. Interestingly, the results of this meta-analysis showed no significant difference between patients with and without depression in pain (SMD = 0.57, 95% CI - 0.03-1.17, P = .06) and functional disability (SMD = 0.48, 95% CI - 0.03-0.99, P = .43). CONCLUSION This meta-analysis showed that RA patients with depression tended to have higher disease activity and lower quality of life than patients without depression.
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Affiliation(s)
- Lijuan Zhang
- Department of Gastrointestinal Surgery, Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pingping Cai
- Department of Nursing, Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiyi Zhu
- Department of Nursing, Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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