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Ibarra AJ, Roman K, Nguyen E, Yates ME, Nicholas A, Lim G. Translational research updates in female health anesthesiology: a narrative review. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:357. [PMID: 37675293 PMCID: PMC10477624 DOI: 10.21037/atm-22-3547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 03/24/2023] [Indexed: 09/08/2023]
Abstract
Background and Objective Females represent 49.6% of the global population and constitute a significant proportion of surgical patients and hospital admissions. Little is known about the bi-directional effects of sex and anesthetics or the impact of anesthetic interventions on long-term female health outcomes. Sex differences in pain pathways can influence pain experience and treatment effectiveness. The impact of anesthetic management on the recurrence of breast cancer is poorly understood, as are the long-term consequences of cardiovascular disease and safe and effective treatments in pregnancy. This review aims to outline recent advances in translational science in female health anesthesiology research and highlight critical research opportunities in pain, cancer outcomes, and cardiovascular disorders. Methods We searched PubMed and summarized relevant articles published in English between December 2021 and June 2022. Key Content and Findings Studies reveal sex differences in pain pathways and highlight the importance of sex as a biological variable in experimental designs and translational medicine. Sex differences have also been observed in side effects attributed to opioid analgesics. We summarize some of the neural circuits that might underlie these differences. In the perioperative setting, specific anesthetics are implicated in metastatic seeding potential and acute and chronic pain outcomes, suggesting the importance of anesthetic selection in comprehensive care during oncologic surgery. In the peridelivery setting, preeclampsia, a cardiovascular disorder of pregnancy, affects maternal outcomes; however, biomarkers can risk-stratify females at risk for preeclampsia and hold promise for identifying the risk of adverse neurological and other health outcomes. Conclusions Research that builds diagnostic and predictive tools in pain and cardiovascular disease will help anesthesiologists minimize sex-related risks and side effects associated with anesthetics and peri-hospital treatments. Sex-specific anesthesia care will improve outcomes, as will the provision of practical information to patients and clinicians about the effectiveness of therapies and behavioral interventions. However, more research studies and specific analytic plans are needed to continue addressing sex-based outcomes in anesthesiology.
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Affiliation(s)
- Andrea J. Ibarra
- Department of Anesthesiology and Perioperative Medicine, Division of Obstetric & Women’s Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kenny Roman
- Department of Anesthesiology and Perioperative Medicine, Division of Obstetric & Women’s Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Eileen Nguyen
- Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Megan E. Yates
- Medical Scientist Training Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alexandra Nicholas
- Department of Anesthesiology and Perioperative Medicine, Division of Obstetric & Women’s Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Grace Lim
- Department of Anesthesiology and Perioperative Medicine, Division of Obstetric & Women’s Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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2
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Bayrer JR, Castro J, Venkataraman A, Touhara KK, Rossen ND, Morrie RD, Maddern J, Hendry A, Braverman KN, Garcia-Caraballo S, Schober G, Brizuela M, Castro Navarro FM, Bueno-Silva C, Ingraham HA, Brierley SM, Julius D. Gut enterochromaffin cells drive visceral pain and anxiety. Nature 2023; 616:137-142. [PMID: 36949192 PMCID: PMC10827380 DOI: 10.1038/s41586-023-05829-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 02/10/2023] [Indexed: 03/24/2023]
Abstract
Gastrointestinal (GI) discomfort is a hallmark of most gut disorders and represents an important component of chronic visceral pain1. For the growing population afflicted by irritable bowel syndrome, GI hypersensitivity and pain persist long after tissue injury has resolved2. Irritable bowel syndrome also exhibits a strong sex bias, afflicting women three times more than men1. Here, we focus on enterochromaffin (EC) cells, which are rare excitable, serotonergic neuroendocrine cells in the gut epithelium3-5. EC cells detect and transduce noxious stimuli to nearby mucosal nerve endings3,6 but involvement of this signalling pathway in visceral pain and attendant sex differences has not been assessed. By enhancing or suppressing EC cell function in vivo, we show that these cells are sufficient to elicit hypersensitivity to gut distension and necessary for the sensitizing actions of isovalerate, a bacterial short-chain fatty acid associated with GI inflammation7,8. Remarkably, prolonged EC cell activation produced persistent visceral hypersensitivity, even in the absence of an instigating inflammatory episode. Furthermore, perturbing EC cell activity promoted anxiety-like behaviours which normalized after blockade of serotonergic signalling. Sex differences were noted across a range of paradigms, indicating that the EC cell-mucosal afferent circuit is tonically engaged in females. Our findings validate a critical role for EC cell-mucosal afferent signalling in acute and persistent GI pain, in addition to highlighting genetic models for studying visceral hypersensitivity and the sex bias of gut pain.
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Affiliation(s)
- James R Bayrer
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
| | - Joel Castro
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia
- Hopwood Centre for Neurobiology, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, South Australia, Australia
| | - Archana Venkataraman
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, CA, USA
| | - Kouki K Touhara
- Department of Physiology, University of California, San Francisco, CA, USA
| | - Nathan D Rossen
- Department of Physiology, University of California, San Francisco, CA, USA
- Tetrad Graduate Program, University of California, San Francisco, CA, USA
| | - Ryan D Morrie
- Department of Physiology, University of California, San Francisco, CA, USA
- Maze Therapeutics, San Francisco, CA, USA
| | - Jessica Maddern
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia
- Hopwood Centre for Neurobiology, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, South Australia, Australia
| | - Aenea Hendry
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia
- Hopwood Centre for Neurobiology, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, South Australia, Australia
| | - Kristina N Braverman
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
- Jansen, Johnson & Johnson, San Diego, CA, USA
| | - Sonia Garcia-Caraballo
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia
- Hopwood Centre for Neurobiology, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, South Australia, Australia
| | - Gudrun Schober
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia
- Hopwood Centre for Neurobiology, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, South Australia, Australia
| | - Mariana Brizuela
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia
- Hopwood Centre for Neurobiology, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, South Australia, Australia
| | | | - Carla Bueno-Silva
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Holly A Ingraham
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, CA, USA.
| | - Stuart M Brierley
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
- Hopwood Centre for Neurobiology, Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, South Australia, Australia.
| | - David Julius
- Department of Physiology, University of California, San Francisco, CA, USA.
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3
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Wu D, Zhao D, Huang D, Sun X, Li KX, Feng Y, Yan QX, Li XY, Cui CP, Li HD, Li BY. Estrogen-dependent depressor response of melatonin via baroreflex afferent function and intensification of PKC-mediated Na v1.9 activation. Acta Pharmacol Sin 2022; 43:2313-2324. [PMID: 35132193 PMCID: PMC9433371 DOI: 10.1038/s41401-022-00867-w] [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: 11/23/2021] [Accepted: 01/16/2022] [Indexed: 11/09/2022] Open
Abstract
Recent studies suggest that melatonin (Mel) plays an important role in the regulation of blood pressure (BP) via the aortic baroreflex pathway. In this study, we investigated the interaction between the baroreflex afferent pathway and Mel-mediated BP regulation in rats under physiological and hypertensive conditions. Mel (0.1, 0.3, and 1.0 mg/mL) was microinjected into the nodose ganglia (NG) of rats. We showed that Mel-induced reduction of mean arterial pressure in female rats was significantly greater than that in male and in ovariectomized rats under physiological condition. Consistently, the expression of Mel receptors (MTNRs) in the NG of female rats was significantly higher than that of males. In L-NAME-induced hypertensive and spontaneously hypertensive rat models, MTNRs were upregulated in males but downregulated in female models. Interestingly, Mel-induced BP reduction was found in male hypertensive models. In whole-cell recording from identified baroreceptor neurons (BRNs) in female rats, we found that Mel (0.1 μM) significantly increased the excitability of a female-specific subpopulation of Ah-type BRNs by increasing the Nav1.9 current density via a PKC-mediated pathway. Similar results were observed in baroreceptive neurons of the nucleus tractus solitarius, showing the facilitation of spontaneous and evoked excitatory post-synaptic currents in Ah-type neurons. Collectively, this study reveals the estrogen-dependent effect of Mel/MTNRs under physiological and hypertensive conditions is mainly mediated by Ah-type BRNs, which may provide new theoretical basis and strategies for the gender-specific anti-hypertensive treatment in clinical practice.
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Affiliation(s)
- Di Wu
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
- Department of Pharmacy, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116023, China
| | - Dan Zhao
- Department of Clinical Pharmacy, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Di Huang
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Xun Sun
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Ke-Xin Li
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Yan Feng
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Qiu-Xin Yan
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Xin-Yu Li
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Chang-Peng Cui
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Hu-Die Li
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China
| | - Bai-Yan Li
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Medicine Research, Ministry of Education), College of Pharmacy, Harbin Medical University, Harbin, 150081, China.
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Lara-García O, Lara-García M, Nicolás-Toledo L, Sengelaub DR, Pacheco P. Reflex activity of the pubococcygeus muscle is modified throughout the estrous cycle in Wistar rats. Neurosci Lett 2022; 768:136375. [PMID: 34852286 DOI: 10.1016/j.neulet.2021.136375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/09/2021] [Accepted: 11/25/2021] [Indexed: 11/24/2022]
Abstract
Pubococcygeus muscle reflex activity has been reported to be driven by specialized neuronal circuitry, including the participation of spinal cord interneurons. Both the reflex and elements of the circuit are known to be sensitive to gonadal hormones, but studies using female rats have not considered the potential effects of estrous phase. Hence, in the present study we used mechanical stimulation of the clitoris to produce reflex activity, and recorded across the different phases of the estrous cycle, including the dark and light periods during each phase. Afterdischarge activity was observed only during the light and dark periods of proestrus, and during the light period of estrus coincident with the receptivity period in the rat́s reproductive behavior. Moreover, this reflex activity comprises at least five different motor unit groups with different firing patterns that are dependent on gonadal hormones variation.
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Affiliation(s)
- O Lara-García
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Carretera Federal Tlaxcala-Puebla Km. 1.5 CP, 90000 Tlaxcala, Mexico.
| | - M Lara-García
- Instituto de Neuroetología, Universidad Veracruzana, Av. Luis Castelazo Ayala s/n Col, Industrial Animas CP91190, Xalapa, Veracruz, Mexico
| | - L Nicolás-Toledo
- Centro Tlaxcala de Biología de la Conducta, Universidad Autónoma de Tlaxcala, Carretera Federal Tlaxcala-Puebla Km. 1.5 CP, 90000 Tlaxcala, Mexico
| | - D R Sengelaub
- Psychological and Brain Sciences, Indiana University, 1101 E. 10th St. Bloomington, IN 47405-7007, USA
| | - P Pacheco
- Instituto de Neuroetología, Universidad Veracruzana, Av. Luis Castelazo Ayala s/n Col, Industrial Animas CP91190, Xalapa, Veracruz, Mexico; Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito, Mario de La Cueva s/n, C.U., Coyoacán, 04510 Ciudad de México, CDMX, Mexico
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Duan LL, Qiu XY, Wei SQ, Su HY, Bai FR, Traub RJ, Zhou Q, Cao DY. Spinal CCK contributes to somatic hyperalgesia induced by orofacial inflammation combined with stress in adult female rats. Eur J Pharmacol 2021; 913:174619. [PMID: 34748768 DOI: 10.1016/j.ejphar.2021.174619] [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: 03/05/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022]
Abstract
In some chronic primary pain conditions such as temporomandibular disorder (TMD) and fibromyalgia syndrome (FMS), mild or chronic stress enhances pain. TMD and FMS often occur together, but the underlying mechanisms are unclear. The purpose of this study was to investigate the role of cholecystokinin (CCK) in the spinal cord in somatic hyperalgesia induced by orofacial inflammation combined with stress. Somatic hyperalgesia was detected by the thermal withdrawal latency and mechanical withdrawal threshold. The expression of CCK1 receptors, CCK2 receptors, ERK1/2 and p-ERK1/2 in the spinal cord was examined by Western blot. After the stimulation of orofacial inflammation combined with 3 day forced swim, the expression of CCK2 receptors and p-ERK1/2 protein in the L4-L5 spinal dorsal horn increased significantly, while the expression of CCK1 receptors and ERK1/2 protein remained unchanged. Intrathecal injection of the CCK2 receptor antagonist YM-022 or mitogen-activated protein kinase (MAPK) kinase (MEK) inhibitor PD98059 blocked somatic hyperalgesia induced by orofacial inflammation combined with stress. Intrathecal administration of the MEK inhibitor blocked somatic sensitization caused by the CCK receptor agonist CCK8. The CCK2 receptor antagonist YM-022 significantly reduced the expression of p-ERK1/2. These data indicate that upregulation of CCK2 receptors through the MAPK pathway contributes to somatic hyperalgesia in this comorbid pain model. Thus, CCK2 receptors and MAPK pathway may be potential targets for the treatment of TMD comorbid with FMS.
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Affiliation(s)
- Lu-Lu Duan
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, China; Department of Implant Dentistry, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, China
| | - Xin-Yi Qiu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, China
| | - Si-Qi Wei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, China
| | - Han-Yu Su
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, China
| | - Fu-Rong Bai
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, China
| | - Richard J Traub
- Department of Neural and Pain Sciences, UM Center to Advance Chronic Pain Research, University of Maryland School of Dentistry, Baltimore MD, 21201, USA
| | - Qin Zhou
- Department of Implant Dentistry, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, China.
| | - Dong-Yuan Cao
- Department of Implant Dentistry, Xi'an Jiaotong University College of Stomatology, 98 West 5th Road, Xi'an, Shaanxi, 710004, China.
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6
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Chen J, Li Q, Saliuk G, Bazhanov S, Winston JH. Estrogen and serotonin enhance stress-induced visceral hypersensitivity in female rats by up-regulating brain-derived neurotrophic factor in spinal cord. Neurogastroenterol Motil 2021; 33:e14117. [PMID: 33705592 DOI: 10.1111/nmo.14117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND We previously reported that female offspring of dams subjected to chronic prenatal stress (CPS) develop enhanced visceral hypersensitivity (VHS) following exposure to chronic stress in adult life that is mediated by up-regulation of spinal cord BDNF. The aims of this study were to examine the roles of estrogen receptor alpha (ERα) and an increase in spinal serotonin signaling in promoting this enhanced VHS in female rats and up-regulation of spinal cord BDNF transcription. METHODS Pregnant dams were exposed to chronic stress from E11 until delivery. At 8 weeks, a chronic adult stress (CAS) protocol was applied for nine days. KEY RESULTS Ovariectomy before CAS or treatment with letrozole before and during CAS significantly prevented the development of enhanced VHS in female CPS+CAS rats. Intrathecal application of ERα siRNA significantly reduced VHS, decreased lumbar-sacral spinal cord expression of both ERα and BDNF, and reversed pro-transcriptional epigenetic modifications at BDNF promoter lX. Cerebrospinal fluid serotonin levels and 5HT3A receptor expression in the LS spinal cord were both significantly increased in female CPS+CAS rats. During CAS, intrathecal infusion of alosetron significantly decreased VHS, reduced BDNF and ERα expression in the LS spinal cord, and attenuated RNA pol II and ERα binding to the BNDF core promoter IX. CONCLUSIONS & INFERENCES Serotonin-mediated activation of 5HT3A receptors in the spinal cord drives the development of enhanced female-specific VHS in our two hit CPS+CAS through up-regulation of spinal cord ERα.
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Affiliation(s)
- Jinghong Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Qingjie Li
- Division of Gastroenterology and Hepatology, Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Genevieve Saliuk
- Division of Gastroenterology and Hepatology, Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Sonia Bazhanov
- Division of Gastroenterology and Hepatology, Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - John H Winston
- Division of Gastroenterology and Hepatology, Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
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7
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Tramullas M, Collins JM, Fitzgerald P, Dinan TG, O' Mahony SM, Cryan JF. Estrous cycle and ovariectomy-induced changes in visceral pain are microbiota-dependent. iScience 2021; 24:102850. [PMID: 34381975 PMCID: PMC8333168 DOI: 10.1016/j.isci.2021.102850] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/07/2021] [Accepted: 07/09/2021] [Indexed: 12/11/2022] Open
Abstract
Visceral hypersensitivity (VH) is a hallmark of many functional gastrointestinal disorders including irritable bowel syndrome and is categorized by a dull, diffuse sensation of abdominal pain. Recently, the gut microbiota has been implicated in VH in male mice, but the effects in females have yet to be explored fully. To this end, we now show that somewhat surprisingly, female germ-free mice have similar visceral pain responses to colorectal distension (CRD) as their conventional controls. However, we show that although sensitivity to CRD is estrous cycle stage-dependent in conventional mice, it is not in germ-free mice. Further, ovariectomy (OVX) induced VH in conventional but not germ-free mice, and induced weight gain regardless of microbiota status. Finally, we show that estrogen-replacement ameliorated OVX-induced VH. Taken together, this study provides evidence for a major role of female sex hormones and the gut microbiota in sensation of visceral pain in females.
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Affiliation(s)
| | - James M Collins
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | | | - Timothy G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Behavioural Science, University College Cork, Cork, Ireland
| | - Siobhain M O' Mahony
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
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8
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Arbiters of endogenous opioid analgesia: role of CNS estrogenic and glutamatergic systems. Transl Res 2021; 234:31-42. [PMID: 33567346 PMCID: PMC8217383 DOI: 10.1016/j.trsl.2021.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
Nociception and opioid antinociception in females are pliable processes, varying qualitatively and quantitatively over the reproductive cycle. Spinal estrogenic signaling via membrane estrogen receptors (mERs), in combination with multiple other signaling molecules [spinal dynorphin, kappa-opioid receptors (KOR), glutamate and metabotropic glutamate receptor 1 (mGluR1)], appears to function as a master coordinator, parsing functionality between pronociception and antinociception. This provides a window into pharmacologically accessing intrinsic opioid analgesic/anti-allodynic systems. In diestrus, membrane estrogen receptor alpha (mERα) signals via mGluR1 to suppress spinal endomorphin 2 (EM2) analgesia. Strikingly, in the absence of exogenous opioids, interfering with this suppression in a chronic pain model elicits opioid anti-allodynia, revealing contributions of endogenous opioid(s). In proestrus, robust spinal EM2 analgesia is manifest but this requires spinal dynorphin/KOR and glutamate-activated mGluR1. Furthermore, spinal mGluR1 blockade in a proestrus chronic pain animal (eliminating spinal EM2 analgesia) exacerbates mechanical allodynia, revealing tempering by endogenous opioid(s). A complex containing mu-opioid receptor, KOR, aromatase, mGluRs, and mERα are foundational to eliciting endogenous opioid anti-allodynia. Aromatase-mERα oligomers are also plentiful, in a central nervous system region-specific fashion. These can be independently regulated and allow estrogens to act intracellularly within the same signaling complex in which they are synthesized, explaining asynchronous relationships between circulating estrogens and central nervous system estrogen functionalities. Observations with EM2 highlight the translational relevance of extensively characterizing exogenous responsiveness to endogenous opioids and the neuronal circuits that mediate them along with the multiplicity of estrogenic systems that concomitantly function in phase and out-of-phase with the reproductive cycle.
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9
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Acute visceral pain relief mediated by A3AR agonists in rats: involvement of N-type voltage-gated calcium channels. Pain 2021; 161:2179-2190. [PMID: 32379223 DOI: 10.1097/j.pain.0000000000001905] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/14/2020] [Indexed: 02/07/2023]
Abstract
ABSTRACT Pharmacological tools for chronic visceral pain management are still limited and inadequate. A3 adenosine receptor (A3AR) agonists are effective in different models of persistent pain. Recently, their activity has been related to the block of N-type voltage-gated Ca2+ channels (Cav2.2) in dorsal root ganglia (DRG) neurons. The present work aimed to evaluate the efficacy of A3AR agonists in reducing postinflammatory visceral hypersensitivity in both male and female rats. Colitis was induced by the intracolonic instillation of 2,4-dinitrobenzenesulfonic acid (DNBS; 30 mg in 0.25 mL 50% EtOH). Visceral hypersensitivity was assessed by measuring the visceromotor response and the abdominal withdrawal reflex to colorectal distension. The effects of A3AR agonists (MRS5980 and Cl-IB-MECA) were evaluated over time after DNBS injection and compared to that of the selective Cav2.2 blocker PD173212, and the clinically used drug linaclotide. A3AR agonists significantly reduced DNBS-evoked visceral pain both in the postinflammatory (14 and 21 days after DNBS injection) and persistence (28 and 35 days after DNBS) phases. Efficacy was comparable to effects induced by linaclotide. PD173212 fully reduced abdominal hypersensitivity to control values, highlighting the role of Cav2.2. The effects of MRS5980 and Cl-IB-MECA were completely abolished by the selective A3AR antagonist MRS1523. Furthermore, patch-clamp recordings showed that A3AR agonists inhibited Cav2.2 in dorsal root ganglia neurons isolated from either control or DNBS-treated rats. The effect on Ca2+ current was PD173212-sensitive and prevented by MRS1523. A3AR agonists are effective in relieving visceral hypersensitivity induced by DNBS, suggesting a potential therapeutic role against abdominal pain.
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10
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DeLong M, Gil-Silva M, Hong VM, Babyok O, Kolber BJ. Visceral pressure stimulator for exploring hollow organ pain: a pilot study. Biomed Eng Online 2021; 20:30. [PMID: 33766034 PMCID: PMC7993476 DOI: 10.1186/s12938-021-00870-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The regulation and control of pressure stimuli is useful for many studies of pain and nociception especially those in the visceral pain field. In many in vivo experiments, distinct air and liquid stimuli at varying pressures are delivered to hollow organs such as the bladder, vagina, and colon. These stimuli are coupled with behavioral, molecular, or physiological read-outs of the response to the stimulus. Care must be taken to deliver precise timed stimuli during experimentation. For example, stimuli signals can be used online to precisely time-lock the stimulus with a physiological output. Such precision requires the development of specialized hardware to control the stimulus (e.g., air) while providing a precise read-out of pressure and stimulus signal markers. METHODS In this study, we designed a timed pressure regulator [termed visceral pressure stimulator (VPS)] to control air flow, measure pressure (in mmHg), and send stimuli markers to online software. The device was built using a simple circuit and primarily off-the-shelf parts. A separate custom inline analog-to-digital pressure converter was used to validate the real pressure output of the VPS. RESULTS Using commercial physiological software (Spike2, CED), we were able to measure mouse bladder pressure continuously during delivery of unique air stimulus trials in a mouse while simultaneously recording an electromyogram (EMG) of the overlying abdominal muscles. CONCLUSIONS This device will be useful for those who need to (1) deliver distinct pressure stimuli while (2) measuring the pressure in real-time and (3) monitoring stimulus on-off using physiological software.
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Affiliation(s)
- Michael DeLong
- Center for Advanced Pain Studies, Department of Neuroscience, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX, 75080, USA
| | - Mauricio Gil-Silva
- Center for Advanced Pain Studies, Department of Neuroscience, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX, 75080, USA.,Department of Biological Sciences, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA, 15217, USA
| | - Veronica Minsu Hong
- Center for Advanced Pain Studies, Department of Neuroscience, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX, 75080, USA
| | - Olivia Babyok
- Department of Biological Sciences, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA, 15217, USA
| | - Benedict J Kolber
- Center for Advanced Pain Studies, Department of Neuroscience, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX, 75080, USA.
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11
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Linher-Melville K, Shah A, Singh G. Sex differences in neuro(auto)immunity and chronic sciatic nerve pain. Biol Sex Differ 2020; 11:62. [PMID: 33183347 PMCID: PMC7661171 DOI: 10.1186/s13293-020-00339-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/20/2020] [Indexed: 01/13/2023] Open
Abstract
Chronic pain occurs with greater frequency in women, with a parallel sexually dimorphic trend reported in sufferers of many autoimmune diseases. There is a need to continue examining neuro-immune-endocrine crosstalk in the context of sexual dimorphisms in chronic pain. Several phenomena in particular need to be further explored. In patients, autoantibodies to neural antigens have been associated with sensory pathway hyper-excitability, and the role of self-antigens released by damaged nerves remains to be defined. In addition, specific immune cells release pro-nociceptive cytokines that directly influence neural firing, while T lymphocytes activated by specific antigens secrete factors that either support nerve repair or exacerbate the damage. Modulating specific immune cell populations could therefore be a means to promote nerve recovery, with sex-specific outcomes. Understanding biological sex differences that maintain, or fail to maintain, neuroimmune homeostasis may inform the selection of sex-specific treatment regimens, improving chronic pain management by rebalancing neuroimmune feedback. Given the significance of interactions between nerves and immune cells in the generation and maintenance of neuropathic pain, this review focuses on sex differences and possible links with persistent autoimmune activity using sciatica as an example.
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Affiliation(s)
- Katja Linher-Melville
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Anita Shah
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gurmit Singh
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.
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12
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Lenhart A, Naliboff B, Shih W, Gupta A, Tillisch K, Liu C, Mayer EA, Chang L. Postmenopausal women with irritable bowel syndrome (IBS) have more severe symptoms than premenopausal women with IBS. Neurogastroenterol Motil 2020; 32:e13913. [PMID: 32469130 PMCID: PMC7529855 DOI: 10.1111/nmo.13913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/26/2020] [Accepted: 05/11/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although irritable bowel syndrome (IBS) is more common in women, little is known about the role of hormonal changes and menopause in IBS. This study aimed to evaluate for differences in gastrointestinal (GI) and psychological symptoms between pre- and postmenopausal women with IBS compared to age-matched men with IBS. METHODS Patients with Rome-positive IBS were identified. Premenopausal women were <45 years of age with regular menses. Postmenopausal women were ≥45 years without menses for at least 1 year. Younger men were <45 years, and older men were ≥45 years. Questionnaires measured severity of IBS symptoms, somatic symptoms, health-related quality of life (HRQOL), and psychological symptoms. Multivariable linear or logistic regressions evaluating relationships between age and sex were performed. KEY RESULTS 190 premenopausal women (mean age 30.25 years), 52 postmenopausal women (mean age 54.38 years), 190 men <45 years (mean age 30.45 years), and 52 men ≥45 years (mean age 53.37 years) were included. Postmenopausal IBS women had greater severity of IBS symptoms (P = .003) and worse physical HRQOL (P = .048) compared to premenopausal women. No differences were observed between age-matched older and younger IBS men. Constipation increased with age for both sexes but was the principal IBS subtype in women only. CONCLUSIONS AND INFERENCES Postmenopausal women with IBS have more severe IBS symptoms than premenopausal women, while no comparable age-related changes were seen in IBS men. The modulatory effect of female sex hormones on brain-gut interactions which affect visceral perception and GI function likely contributes to these findings.
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Affiliation(s)
- Adrienne Lenhart
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
| | - Bruce Naliboff
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Wendy Shih
- Semel Institute for Neuroscience and Human Behavior,
University of California, Los Angeles, CA, USA
| | - Arpana Gupta
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Kirsten Tillisch
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Cathy Liu
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Emeran A. Mayer
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
| | - Lin Chang
- Vatche and Tamar Manoukian Division of Digestive Diseases,
David Geffen School of Medicine, University of California, Los Angeles, CA,
USA
- G Oppenheimer Center for Neurobiology of Stress and
Resilience, University of California, Los Angeles, CA, USA
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13
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Ji Y, Hu B, Klontz C, Li J, Dessem D, Dorsey SG, Traub RJ. Peripheral mechanisms contribute to comorbid visceral hypersensitivity induced by preexisting orofacial pain and stress in female rats. Neurogastroenterol Motil 2020; 32:e13833. [PMID: 32155308 PMCID: PMC7319894 DOI: 10.1111/nmo.13833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/24/2020] [Accepted: 02/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Stress exacerbates many chronic pain syndromes including irritable bowel syndrome (IBS). Among these patient populations, many suffer from comorbid or chronic overlapping pain conditions and are predominantly female. Nevertheless, basic studies investigating chronic psychological stress-induced changes in pain sensitivity have been mostly carried out in male rodents. Our laboratory developed a model of comorbid pain hypersensitivity (CPH) (stress in the presence of preexisting orofacial pain inducing chronic visceral pain hypersensitivity that significantly outlasts transient stress-induced pain hypersensitivity (SIH)) facilitating the study of pain associated with IBS. Since CPH and SIH are phenotypically similar until SIH resolves and CPH persists, it is unclear if underlying mechanisms are similar. METHODS In the present study, the visceromotor response (VMR) to colorectal distention was recorded in the SIH and CPH models in intact females and ovariectomized rats plus estradiol replacement (OVx + E2). Over several months, rats were determined to be susceptible or resilient to stress and the role of peripheral corticotrophin-releasing factor (CRF) underlying in the pain hypersensitivity was examined. KEY RESULTS Stress alone induced transient (3-4 weeks) visceral hypersensitivity, though some rats were resilient. Comorbid conditions increased susceptibility to stress prolonging hypersensitivity beyond 13 weeks. Both models had robust peripheral components; hypersensitivity was attenuated by the CRF receptor antagonist astressin and the mast cell stabilizer disodium cromoglycate (DSCG). However, DSCG was less effective in the CPH model compared to the SIH model. CONCLUSIONS AND INFERENCES The data indicate many similarities but some differences in mechanisms contributing to comorbid pain conditions compared to transient stress-induced pain.
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Affiliation(s)
- Yaping Ji
- Department of Neural and Pain SciencesSchool of DentistryUniversity of Maryland BaltimoreBaltimoreMDUSA
| | - Bo Hu
- Department of Neural and Pain SciencesSchool of DentistryUniversity of Maryland BaltimoreBaltimoreMDUSA,Present address:
Key laboratory of Shaanxi Province for Craniofacial Precision Medicine ResearchXi’an Jiao Tong University College of StomatologyXi’anShaanxiChina
| | - Charles Klontz
- Department of Neural and Pain SciencesSchool of DentistryUniversity of Maryland BaltimoreBaltimoreMDUSA
| | - Jiyun Li
- Department of Neural and Pain SciencesSchool of DentistryUniversity of Maryland BaltimoreBaltimoreMDUSA
| | - Dean Dessem
- Department of Neural and Pain SciencesSchool of DentistryUniversity of Maryland BaltimoreBaltimoreMDUSA,UM Center to Advance Chronic Pain ResearchUniversity of Maryland BaltimoreBaltimoreMDUSA
| | - Susan G. Dorsey
- UM Center to Advance Chronic Pain ResearchUniversity of Maryland BaltimoreBaltimoreMDUSA,Department of Pain and Translational Symptom ScienceSchool of NursingUniversity of Maryland BaltimoreBaltimoreMDUSA
| | - Richard J. Traub
- Department of Neural and Pain SciencesSchool of DentistryUniversity of Maryland BaltimoreBaltimoreMDUSA,UM Center to Advance Chronic Pain ResearchUniversity of Maryland BaltimoreBaltimoreMDUSA
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14
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Li ZL, Xue Y, Tao ZY, Du WZ, Jiang YG, Cao DY. Spinal 5-HT 3 receptor contributes to somatic hyperalgesia induced by sub-chronic stress. Mol Pain 2020; 15:1744806919859723. [PMID: 31184246 PMCID: PMC6613060 DOI: 10.1177/1744806919859723] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Zhuo-Lin Li
- 1 Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, P. R. China.,2 Department of Endodontics, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, P. R. China
| | - Yang Xue
- 1 Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, P. R. China
| | - Zhuo-Ying Tao
- 1 Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, P. R. China
| | - Wen-Zhi Du
- 1 Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, P. R. China
| | - Yue-Gui Jiang
- 2 Department of Endodontics, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, P. R. China
| | - Dong-Yuan Cao
- 1 Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, P. R. China
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15
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Xu Q, Sun L, Zhang W, Chen S, Wu H, Jiao C, Fu F, Feng Y, Yao H, Chen Q, Chen X. Effect of chronic pretreatment with 17β-estradiol and/or progesterone on the nociceptive response to uterine cervical distension in a rat model. Eur J Pharmacol 2019; 865:172791. [PMID: 31712057 DOI: 10.1016/j.ejphar.2019.172791] [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: 06/19/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
It is widely known that visceral pain is more prevalent in women than in men, and this phenomenon is interpreted as a consequence of the gonadal hormone modulation of pain perception and transduction. Uterine cervical distension might cause obstetric and gynecologic pain with clinical relevance to visceral pain. In this study, we focused on the roles of 17β-estradiol and progesterone in visceral nociception with the use of a rat model of uterine cervical distension. Female ovariectomized rats were injected with 17β-estradiol (E2) or progesterone (P4) for 21 days, after which visceral pain-induced spinal c-fos expression and visceromotor reflex changes were compared between ovariectomized and hormone-substituted groups. We found that uterine cervical distension induced a drastic increase in spinal c-fos expression and visceromotor reflex activity, and ovariectomy inhibited the increase in c-fos expression induced by visceral pain; this inhibition was reversed by estrogen but not progesterone replacement. This study demonstrates that estrogen is involved in uterine cervical nociception, while progesterone plays less of a significant role.
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Affiliation(s)
- Qi Xu
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lihong Sun
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wenxin Zhang
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Sheng Chen
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hui Wu
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cuicui Jiao
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Feng Fu
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Feng
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Huaqi Yao
- Department of Anesthesia, Maternity and Child Care Hospital, Huzhou, China
| | - Qing Chen
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinzhong Chen
- Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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16
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Gintzler AR, Storman EM, Liu NJ. Estrogens as arbiters of sex-specific and reproductive cycle-dependent opioid analgesic mechanisms. VITAMINS AND HORMONES 2019; 111:227-246. [PMID: 31421702 PMCID: PMC7136895 DOI: 10.1016/bs.vh.2019.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The organization of estrogenic signaling in the CNS is exceedingly complex. It is comprised of peripherally and centrally synthesized estrogens, and a plethora of types of estrogen receptor that can localize to both the nucleus and the plasma membrane. Moreover, CNS estrogen receptors can exist independent of aromatase (aka estrogen synthase) as well as oligomerize with it, along with a host of other membrane signaling proteins. This ability of CNS estrogen receptors to either to physically pair or exist separately enables locally produced estrogens to act on multiple spatial levels, with a high degree of gradated regulation and plasticity, signaling either in-phase or out-of phase with circulating estrogens. This complexity explains the numerous contradictory findings regarding sex-dependent pain processing and sexually dimorphic opioid antinociception. This review highlights the increasing awareness that estrogens are major endogenous arbiters of both opioid analgesic actions and the mechanisms used to achieve them. This behooves us to understand, and possibly intercede at, the points of intersection of estrogenic signaling and opioid functionality. Factors that integrate estrogenic actions at subcellular, synaptic, and CNS regional levels are likely to be prime drug targets for novel pharmacotherapies designed to modulate CNS estrogen-dependent opioid functionalities and possibly circumvent the current opioid epidemic.
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MESH Headings
- Analgesia
- Analgesics, Opioid/pharmacology
- Animals
- Aromatase
- Brain/physiology
- Dynorphins/physiology
- Estrogens/physiology
- Female
- Humans
- Male
- Neurosecretory Systems/physiology
- Nociception/drug effects
- Nociception/physiology
- Receptors, Estrogen/physiology
- Receptors, Opioid, kappa/drug effects
- Receptors, Opioid, kappa/physiology
- Receptors, Opioid, mu/drug effects
- Receptors, Opioid, mu/physiology
- Reproduction/physiology
- Sex Characteristics
- Signal Transduction/physiology
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Affiliation(s)
- Alan R Gintzler
- Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, NY, United States.
| | - Emiliya M Storman
- Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, NY, United States
| | - Nai-Jiang Liu
- Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, NY, United States
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17
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Wen X, Yu X, Huo R, Yan QX, Wu D, Feng Y, Li Y, Sun X, Li XY, Sun J, Li KX, Li QY, Han LM, Lu XL, Liu Y, Shou W, Li BY. Serotonin-Mediated Cardiac Analgesia via Ah-Type Baroreceptor Activation Contributes to Silent Angina and Asymptomatic Infarction. Neuroscience 2019; 411:150-163. [DOI: 10.1016/j.neuroscience.2019.05.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 12/14/2022]
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18
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Ovarian Hormone-dependent and Spinal ERK Activation-regulated Nociceptive Hypersensitivity in Female Rats with Acid Injection-induced Chronic Widespread Muscle Pain. Sci Rep 2019; 9:3077. [PMID: 30816240 PMCID: PMC6395742 DOI: 10.1038/s41598-019-39472-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 01/18/2019] [Indexed: 11/18/2022] Open
Abstract
Symptoms of chronic widespread muscle pain (CWP) meet most of the diagnostic criteria for fibromyalgia syndrome, which is prevalent in females. We used an acid injection-induced muscle pain (AIMP) model to mimic CWP. After female rats received an ovariectomy (OVX), acid saline solution was injected into the left gastrocnemius muscle. Time courses of changes in pain behaviours and p-ERK in the spinal cord were compared between groups. Intrathecal injections of oestradiol (E2) to the OVX group before two acid injections and E2 or progesterone (P4) injections in male rats were compared to evaluate hormone effects. We found that repeated acid injections produced mechanical hypersensitivity and enhanced p-ERK expression in the spinal dorsal horn. OVX rats exhibited significantly less tactile allodynia than did the rats in the other groups. The ERK inhibitor U0126 alleviated mechanical allodynia with lower p-ERK expression in the sham females but did not affect the OVX rats. Intrathecal E2 reversed the attenuated mechanical hypersensitivity in the OVX group, and E2 or P4 induced transient hyperalgesia in male rats. Accordingly, our results suggested that ovarian hormones contribute to AIMP through a spinal p-ERK-mediated pathway. These findings may partially explain the higher prevalence of fibromyalgia in females than males.
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19
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Liu NJ, Storman EM, Gintzler AR. Pharmacological Modulation of Endogenous Opioid Activity to Attenuate Neuropathic Pain in Rats. THE JOURNAL OF PAIN 2018; 20:235-243. [PMID: 30366152 DOI: 10.1016/j.jpain.2018.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/12/2018] [Accepted: 10/17/2018] [Indexed: 12/23/2022]
Abstract
We showed previously that spinal metabotropic glutamate receptor 1 (mGluR1) signaling suppresses or facilitates (depending on the stage of estrous cycle) analgesic responsiveness to intrathecal endomorphin 2, a highly mu-opioid receptor-selective endogenous opioid. Spinal endomorphin 2 antinociception is suppressed during diestrus by mGluR1 when it is activated by membrane estrogen receptor alpha (mERα) and is facilitated during proestrus when mGluR1 is activated by glutamate. In the current study, we tested the hypothesis that in female rats subjected to spinal nerve ligation (SNL), the inhibition of spinal estrogen synthesis or blockade of spinal mERα/mGluR1 would be antiallodynic during diestrus, whereas during proestrus, mGluR1 blockade would worsen the mechanical allodynia. As postulated, following SNL, aromatase inhibition or mERα/mGluR1 blockade during diestrus markedly lessened the mechanical allodynia. This was observed only on the paw ipsilateral to SNL and was eliminated by naloxone, implicating endogenous opioid mediation. In contrast, during proestrus, mGluR1 blockade worsened the SNL-induced mechanical allodynia of the ipsilateral paw. Findings suggest menstrual cycle stage-specific drug targets for and the putative clinical utility of harnessing endogenous opioids for chronic pain management in women, as well as the value of, if not the necessity for, considering menstrual cycle stage in clinical trials thereof. PERSPECTIVE: Intrathecal treatments that enhance spinal endomorphin 2 analgesic responsiveness under basal conditions lessen mechanical allodynia in a chronic pain model. Findings provide a foundation for developing drugs that harness endogenous opioid antinociception for chronic pain relief, lessening the need for exogenous opioids and thus prescription opioid abuse.
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Affiliation(s)
- Nai-Jiang Liu
- Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Emiliya M Storman
- Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Alan R Gintzler
- Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York..
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20
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Estrogens synthesized and acting within a spinal oligomer suppress spinal endomorphin 2 antinociception: ebb and flow over the rat reproductive cycle. Pain 2018; 158:1903-1914. [PMID: 28902684 DOI: 10.1097/j.pain.0000000000000991] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The magnitude of antinociception elicited by intrathecal endomorphin 2 (EM2), an endogenous mu-opioid receptor (MOR) ligand, varies across the rat estrous cycle. We now report that phasic changes in analgesic responsiveness to spinal EM2 result from plastic interactions within a novel membrane-bound oligomer containing estrogen receptors (mERs), aromatase (aka estrogen synthase), metabotropic glutamate receptor 1 (mGluR1), and MOR. During diestrus, spinal mERs, activated by locally synthesized estrogens, act with mGluR1 to suppress spinal EM2/MOR antinociception. The emergence of robust spinal EM2 antinociception during proestrus results from the loss of mER-mGluR1 suppression, a consequence of altered interactions within the oligomer. The chemical pairing of aromatase with mERs within the oligomer containing MOR and mGluR1 allows estrogens to function as intracellular messengers whose synthesis and actions are confined to the same signaling oligomer. This form of estrogenic signaling, which we term "oligocrine," enables discrete, highly compartmentalized estrogen/mER-mGluR1 signaling to regulate MOR-mediated antinociception induced by EM2. Finally, spinal neurons were observed not only to coexpress MOR, mERα, aromatase, and mGluR1 but also be apposed by EM2 varicosities. This suggests that modulation of spinal analgesic responsiveness to exogenous EM2 likely reflects changes in its endogenous analgesic activity. Analogous suppression of spinal EM2 antinociception in women (eg, around menses, comparable with diestrus in rats) as well as the (pathological) inability to transition out of that suppressed state at other menstrual cycle stages could underlie, at least in part, the much greater prevalence and severity of chronic pain in women than men.
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21
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Opposing Roles of Estradiol and Testosterone on Stress-Induced Visceral Hypersensitivity in Rats. THE JOURNAL OF PAIN 2018; 19:764-776. [PMID: 29496640 DOI: 10.1016/j.jpain.2018.02.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/30/2018] [Accepted: 02/14/2018] [Indexed: 12/19/2022]
Abstract
Chronic stress produces maladaptive pain responses, manifested as alterations in pain processing and exacerbation of chronic pain conditions including irritable bowel syndrome. Female predominance, especially during reproductive years, strongly suggests a role of gonadal hormones. However, gonadal hormone modulation of stress-induced pain hypersensitivity is not well understood. In the present study, we tested the hypothesis that estradiol is pronociceptive and testosterone is antinociceptive in a model of stress-induced visceral hypersensitivity (SIVH) in rats by recording the visceromotor response to colorectal distention after a 3-day forced swim (FS) stress paradigm. FS induced visceral hypersensitivity that persisted at least 2 weeks in female, but only 2 days in male rats. Ovariectomy blocked and orchiectomy facilitated SIVH. Furthermore, estradiol injection in intact male rats increased SIVH and testosterone in intact female rats attenuated SIVH. Western blot analyses indicated estradiol increased excitatory glutamate ionotropic receptor NMDA type subunit 1 expression and decreased inhibitory metabotropic glutamate receptor 2 expression after FS in male thoracolumbar spinal cord. In addition, the presence of estradiol during stress increased spinal brain-derived neurotrophic factor (BDNF) expression independent of sex. In contrast, testosterone blocked the stress-induced increase in BDNF expression in female rats. These data suggest that estradiol facilitates and testosterone attenuates SIVH by modulating spinal excitatory and inhibitory glutamatergic receptor expression. PERSPECTIVE SIVH is more robust in female rats. Estradiol facilitates whereas testosterone dampens the development of SIVH. This could partially explain the greater prevalence of certain chronic visceral pain conditions in women. An increase in spinal BDNF is concomitant with increased stress-induced pain. Pharmaceutical interventions targeting this molecule could provide promising alleviation of SIVH in women.
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Zhao YJ, Li JH, Hu B, Wang Y, Chang XF, Traub RJ, Cao DY. Extracellular signal-regulated kinase activation in the spinal cord contributes to visceral hypersensitivity induced by craniofacial injury followed by stress. Neurogastroenterol Motil 2018; 30. [PMID: 28730748 DOI: 10.1111/nmo.13161] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/20/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND We previously developed an animal model to examine mechanisms that underlie the emergence of visceral hypersensitivity modeling pain characteristics of temporomandibular disorder (TMD) patients with comorbid irritable bowel syndrome (IBS). In ovariectomized (OVx) rats with estradiol (E2) replacement, visceral hypersensitivity developed subsequent to masseter muscle inflammation followed by repeated forced swim (FS) stress. The purpose of this study was to investigate whether activation of extracellular signal-regulated kinase (ERK) in the spinal cord contributes to visceral hypersensitivity in this overlapping pain model. METHODS In OVx with E2 replacement rats masseter muscle inflammation was followed by 3 day FS (comorbid condition). Depression-like behaviors were assessed by sucrose preference and in the elevated plus maze, and visceral sensitivity was measured by the visceromotor response (VMR) to colorectal distention. The protein level of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in the L6-S2 dorsal spinal cord was analyzed by western blot. KEY RESULTS FS stress decreased sucrose consumption in E2 replaced rats in sucrose preference test. The expression of p-ERK1/2 in the L6-S2 dorsal spinal cord increased significantly in E2 with comorbid rats. Intrathecal injection of mitogen-activated protein kinase (MAPK) kinase (MEK) inhibitor PD98059 blocked the visceral hypersensitivity induced by masseter muscle inflammation combined with FS stress. CONCLUSIONS & INFERENCES These data indicate that ERK1/2 activation contributes to the visceral hypersensitivity evoked by craniofacial inflammation pain combined with stress. The results may provide a new therapeutic avenue for alleviating overlapping pain conditions.
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Affiliation(s)
- Y-J Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - J-H Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - B Hu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - Y Wang
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - X-F Chang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - R J Traub
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, UM Center to Advance Chronic Pain Research, Baltimore, MD, USA
| | - D-Y Cao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
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23
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Zielińska M, Fichna J, Bashashati M, Habibi S, Sibaev A, Timmermans JP, Storr M. G protein-coupled estrogen receptor and estrogen receptor ligands regulate colonic motility and visceral pain. Neurogastroenterol Motil 2017; 29. [PMID: 28191706 DOI: 10.1111/nmo.13025] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/21/2016] [Accepted: 12/08/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Diarrhea-predominant irritable bowel syndrome (IBS-D) is a functional gastrointestinal (GI) disorder, which occurs more frequently in women than men. The aim of our study was to determine the role of activation of classical estrogen receptors (ER) and novel membrane receptor, G protein-coupled estrogen receptor (GPER) in human and mouse tissue and to assess the possible cross talk between these receptors in the GI tract. METHODS Immunohistochemistry was used to determine the expression of GPER in human and mouse intestines. The effect of G-1, a GPER selective agonist, and estradiol, a non-selective ER agonist, on muscle contractility was characterized in isolated preparations of the human and mouse colon. To characterize the effect of G-1 and estradiol in vivo, colonic bead expulsion test was performed. G-1 and estradiol activity on the visceral pain signaling was assessed in the mustard oil-induced abdominal pain model. KEY RESULTS GPER is expressed in the human colon and in the mouse colon and ileum. G-1 and estradiol inhibited muscle contractility in vitro in human and mouse colon. G-1 or estradiol administered intravenously at the dose of 20 mg/kg significantly prolonged the time to bead expulsion in females. Moreover, G-1 prolonged the time to bead expulsion and inhibited GI hypermotility in both genders. The injection of G-1 or estradiol resulted in a significant reduction in the number of pain-induced behaviors in mice. CONCLUSIONS AND INFERENCES GPER and ER receptors are involved in the regulation of GI motility and visceral pain. Both may thus constitute an important pharmacological target in the IBS-D therapy.
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Affiliation(s)
- M Zielińska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - J Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - M Bashashati
- Division of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center/Paul L. Foster School of Medicine, El Paso, TX, USA.,Hotchkiss Brain Institute and Snyder Institute for Chronic Diseases, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - S Habibi
- Hotchkiss Brain Institute and Snyder Institute for Chronic Diseases, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - A Sibaev
- Division of Gastroenterology, Department of Medicine, Ludwig Maximilians University of Munich, Munich, Germany
| | - J-P Timmermans
- Department of Veterinary Sciences, Laboratory of Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
| | - M Storr
- Hotchkiss Brain Institute and Snyder Institute for Chronic Diseases, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,Division of Gastroenterology, Department of Medicine, Ludwig Maximilians University of Munich, Munich, Germany.,Walter Brendel Center of Experimental Medicine, University of Munich, Munich, Germany
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24
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Fukudo S, Matsueda K, Haruma K, Ida M, Hayase H, Akiho H, Nakashima Y, Hongo M. Optimal dose of ramosetron in female patients with irritable bowel syndrome with diarrhea: A randomized, placebo-controlled phase II study. Neurogastroenterol Motil 2017; 29. [PMID: 28205278 DOI: 10.1111/nmo.13023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/17/2016] [Accepted: 12/07/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Previous studies showed that 5 μg of ramosetron, a serotonin (5-hydroxytryptamine: 5-HT)-3 receptor antagonist, is only effective in male patients with irritable bowel syndrome (IBS) with diarrhea (IBS-D). We hypothesized that either dose 1.25, 2.5, or 5 μg of ramosetron would be effective in female patients with IBS-D. METHODS This randomized, double-blind, placebo-controlled, phase II dose-finding exploratory trial included 409 female outpatients with IBS-D treated in Japan. They were administered oral placebo (n=102), or 1.25 μg (n=104), 2.5 μg (n=104), or 5 μg (n=99) of ramosetron once daily for 12 weeks after a 1-week baseline period. The primary endpoint was monthly responder rates of global improvement of IBS symptoms in the first month. Secondary endpoints included global improvement in the other months, abdominal pain/discomfort, weekly mean changes in the Bristol Stool Form Scale (BSFS), and IBS-QOL. KEY RESULTS Middle dose (2.5 μg) of ramosetron significantly improved abdominal pain/discomfort at second month (62.5%, P=.002), third month (60.6%, P=.005), and the last evaluation point (63.5%, P=.002) and weekly BSFS (P<.05) except at Week 8, 11, and 12 than placebo. IBS-QOL did not change. Ramosetron induced more constipation than placebo. CONCLUSIONS & INFERENCES The trial suggested that 2.5 μg of ramosetron is the most effective and least harmful option for treating female patients with IBS-D (Clinicaltrials.gov ID: NCT01274000).
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Affiliation(s)
- S Fukudo
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - K Haruma
- Department of Gastroenterology, Kawasaki Medical University, Kurashiki, Japan
| | - M Ida
- Japan-Asia Planning & Administration, Medical & Development, Astellas Pharma Inc., Tokyo, Japan
| | - H Hayase
- Japan-Asia Clinical Development 2, Development, Astellas Pharma Inc., Tokyo, Japan
| | - H Akiho
- Japan-Asia Clinical Development 2, Development, Astellas Pharma Inc., Tokyo, Japan
| | - Y Nakashima
- Japan-Asia Data Science, Development, Astellas Pharma Inc., Tokyo, Japan
| | - M Hongo
- Kurokawa Hospital, Miyagi, Japan
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25
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Norcini M, Sideris A, Adler SM, Hernandez LAM, Zhang J, Blanck TJJ, Recio-Pinto E. NR2B Expression in Rat DRG Is Differentially Regulated Following Peripheral Nerve Injuries That Lead to Transient or Sustained Stimuli-Evoked Hypersensitivity. Front Mol Neurosci 2016; 9:100. [PMID: 27803647 PMCID: PMC5068091 DOI: 10.3389/fnmol.2016.00100] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 09/26/2016] [Indexed: 12/30/2022] Open
Abstract
Following injury, primary sensory neurons undergo changes that drive central sensitization and contribute to the maintenance of persistent hypersensitivity. NR2B expression in the dorsal root ganglia (DRG) has not been previously examined in neuropathic pain models. Here, we investigated if changes in NR2B expression within the DRG are associated with hypersensitivities that result from peripheral nerve injuries. This was done by comparing the NR2B expression in the DRG derived from two modalities of the spared nerve injury (SNI) model, since each variant produces different neuropathic pain phenotypes. Using the electronic von Frey to stimulate the spared and non-spared regions of the hindpaws, we demonstrated that sural-SNI animals develop sustained neuropathic pain in both regions while the tibial-SNI animals recover. NR2B expression was measured at Day 23 and Day 86 post-injury. At Day 23 and 86 post-injury, sural-SNI animals display strong hypersensitivity, whereas tibial-SNI animals display 50 and 100% recovery from post-injury-induced hypersensitivity, respectively. In tibial-SNI at Day 86, but not at Day 23 the perinuclear region of the neuronal somata displayed an increase in NR2B protein. This retention of NR2B protein within the perinuclear region, which will render them non-functional, correlates with the recovery observed in tibial-SNI. In sural-SNI at Day 86, DRG displayed an increase in NR2B mRNA which correlates with the development of sustained hypersensitivity in this model. The increase in NR2B mRNA was not associated with an increase in NR2B protein within the neuronal somata. The latter may result from a decrease in kinesin Kif17, since Kif17 mediates NR2B transport to the soma’s plasma membrane. In both SNIs, microglia/macrophages showed a transient increase in NR2B protein detected at Day 23 but not at Day 86, which correlates with the initial post-injury induced hypersensitivity in both SNIs. In tibial-SNI at Day 86, but not at Day 23, satellite glia cells (SGCs) displayed an increase in NR2B protein. This study is the first to characterize of cell-specific changes in NR2B expression within the DRG following peripheral nerve injury. We discuss how the observed NR2B changes in DRG can contribute to the different neuropathic pain phenotypes displayed by each SNI variant.
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Affiliation(s)
- Monica Norcini
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Medical Center, New York University, New York NY, USA
| | - Alexandra Sideris
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Medical Center, New York University, New York NY, USA
| | - Samantha M Adler
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Medical Center, New York University, New York NY, USA
| | - Lourdes A M Hernandez
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Medical Center, New York University, New York NY, USA
| | - Jin Zhang
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Medical Center, New York University, New York NY, USA
| | - Thomas J J Blanck
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Medical Center, New York University, New YorkNY, USA; Department of Neuroscience and Physiology, NYU Langone Medical Center, New York University, New YorkNY, USA
| | - Esperanza Recio-Pinto
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Medical Center, New York University, New YorkNY, USA; Department of Biochemistry and Molecular Pharmacology, NYU Langone Medical Center, New York University, New YorkNY, USA
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26
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Knuesel C, Oulevey-Meier M, Flogerzi B, Krayer M, Gschossmann I, Miller J, Tovar L, Janko S, Gschossmann JM. Effect of estrogen on visceral sensory function in a non-inflammatory colonic hypersensitivity rat model. Neurogastroenterol Motil 2016; 28:1570-9. [PMID: 27230266 DOI: 10.1111/nmo.12857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 04/18/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Increased prevalence of functional gastrointestinal disorders in women and perimenstrually accentuated symptoms imply that sexual hormones play a crucial role in the pathogenesis of such syndromes. The aim of this study was to analyze the selective effect of estrogen on visceral sensitivity in gonadectomized female and male Lewis rats with or without prior treatment with butyrate enemas. METHODS Following ovariectomy (OVX) or orchiectomy (ORX) estradiol pellets (E2-P) or sham pellets (Sham-P) were implanted. After treatment with butyrate (BUT) or saline (NaCl) enemas, colorectal distensions (CRD) were performed and the visceromotor reflex (VMR) to CRD was measured by electromyography. KEY RESULTS Gender did not influence VMR to CRD in gonadectomized animals. VMR in E2-P animals compared to Sham-P animals was increased (635 ± 32 μVs vs 470 ± 39 μVs; p = 0.002). Overall, instillation of butyrate enemas did not influence VMR to CRD. A comparison of CRD clusters showed that butyrate enemas in the E2-P animals resulted in a significant sensitization in both OVX and ORX animals. In female rats, sensitization was also caused by estrogen substitution alone. CONCLUSION & INFERENCES In our animal model, estrogen is a strong factor for an increase in visceral sensory function. Surprisingly, the treatment with butyrate alone did not evoke a general rise in VMR to CRD. Rats treated with butyrate enemas and under selective estrogen substitution developed visceral sensitization during the series of CRDs.
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Affiliation(s)
- C Knuesel
- Department of Visceral Surgery and Medicine, Inselspital/University of Berne, Berne, Switzerland.,Department of Clinical Research, Inselspital/University of Berne, Berne, Switzerland
| | - M Oulevey-Meier
- Department of Visceral Surgery and Medicine, Inselspital/University of Berne, Berne, Switzerland.,Department of Clinical Research, Inselspital/University of Berne, Berne, Switzerland
| | - B Flogerzi
- Department of Visceral Surgery and Medicine, Inselspital/University of Berne, Berne, Switzerland.,Department of Clinical Research, Inselspital/University of Berne, Berne, Switzerland
| | - M Krayer
- Department of Visceral Surgery and Medicine, Inselspital/University of Berne, Berne, Switzerland.,Department of Clinical Research, Inselspital/University of Berne, Berne, Switzerland
| | - I Gschossmann
- Department of Visceral Surgery and Medicine, Inselspital/University of Berne, Berne, Switzerland.,Department of Clinical Research, Inselspital/University of Berne, Berne, Switzerland
| | - J Miller
- Department of Visceral Surgery and Medicine, Inselspital/University of Berne, Berne, Switzerland.,Department of Clinical Research, Inselspital/University of Berne, Berne, Switzerland
| | - L Tovar
- Department of Visceral Surgery and Medicine, Inselspital/University of Berne, Berne, Switzerland.,Department of Clinical Research, Inselspital/University of Berne, Berne, Switzerland
| | - S Janko
- Department of Statistics and Econometry, University of Bamberg, Bamberg, Germany
| | - J M Gschossmann
- Department of Visceral Surgery and Medicine, Inselspital/University of Berne, Berne, Switzerland. .,Department of Clinical Research, Inselspital/University of Berne, Berne, Switzerland.
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27
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Sajjad J, Felice VD, Golubeva AV, Cryan JF, O’Mahony SM. Sex-dependent activity of the spinal excitatory amino acid transporter: Role of estrous cycle. Neuroscience 2016; 333:311-9. [DOI: 10.1016/j.neuroscience.2016.07.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/28/2016] [Accepted: 07/20/2016] [Indexed: 02/07/2023]
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28
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Nag S, Mokha SS. Activation of the trigeminal α2-adrenoceptor produces sex-specific, estrogen dependent thermal antinociception and antihyperalgesia using an operant pain assay in the rat. Behav Brain Res 2016; 314:152-8. [PMID: 27506651 DOI: 10.1016/j.bbr.2016.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/03/2016] [Accepted: 08/05/2016] [Indexed: 01/04/2023]
Abstract
Higher prevalence of several pain disorders in women and sexual dimorphism in G-protein coupled receptor-induced analgesia has been reported. We have previously shown that α2-adrenoceptor-induced antinociception is sex-specific and attenuated by estrogen in the female rat. However, this evidence was obtained using reflexive withdrawal-based nociceptive assays conducted on restrained animals that may not involve cerebral processing. Hence, we evaluated whether activation of the trigeminal α2-adrenoceptor produces sex-specific antinociceptive and antihyperalgesic effects in the orofacial region of the rat using a reward conflict-based operant paradigm in which animals must tolerate nociceptive thermal stimulation to be rewarded. Male and ovariectomized (OVX) Sprague-Dawley rats were implanted intracisternally with a PE10 cannula for drug injections. A group of OVX rats (OVX+E) was administered subcutaneously with estradiol 48h before the test. Effect of clonidine, an α2-adrenoceptor agonist, was determined on the operant pain assay using a fully automated Orofacial Pain Assessment Device. Number of spout licks, thermode contacts, and amount of reward intake were automatically recorded by the ANY-maze software. Using acute pain modeling, clonidine produced a dose-dependent increase in all three parameters in male and OVX groups, however, it was ineffective in the OVX+E group. Similarly, using inflammatory pain modeling, clonidine significantly increased these parameters in carrageenan-treated male and OVX groups but not in the OVX+E group. Thus, α2-adrenoceptor activation produces sex-specific antinociception and antihyperalgesia and estrogen attenuates these effects in female rats using an operant pain assay. These findings may help the discovery of effective analgesics for each sex.
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Affiliation(s)
- Subodh Nag
- Department of Neuroscience and Pharmacology, Meharry Medical College, Nashville, TN 37208, United States.
| | - Sukhbir S Mokha
- Department of Neuroscience and Pharmacology, Meharry Medical College, Nashville, TN 37208, United States
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29
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Moloney RD, Sajjad J, Foley T, Felice VD, Dinan TG, Cryan JF, O'Mahony SM. Estrous cycle influences excitatory amino acid transport and visceral pain sensitivity in the rat: effects of early-life stress. Biol Sex Differ 2016; 7:33. [PMID: 27429736 PMCID: PMC4946195 DOI: 10.1186/s13293-016-0086-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/01/2016] [Indexed: 01/26/2023] Open
Abstract
Background Early-life stress (ELS) is a recognized risk factor for chronic pain disorders, and females appear to be more sensitive to the negative effects of stress. Moreover, estrous cycle-related fluctuations in estrogen levels have been linked with alternating pain sensitivity. Aberrant central circuitry involving both the anterior cingulate cortex (ACC) and the lumbosacral spinal cord has also been implicated in the modulation of visceral pain in clinical and preclinical studies. Here we further investigate changes in visceral pain sensitivity and central glutamatergic systems in rats with respect to estrous cycle and ELS. Methods We investigated visceral sensitivity in adult female Sprague-Dawley rats, which had undergone maternal separation (MS) in early life or remained non-separated (NS), by performing colorectal distension (CRD). We also assessed excitatory amino acid uptake through excitatory amino acid transporters (EAATs) in the lumbosacral spinal cord and ACC. Results NS animals in proestrus and estrus exhibited reduced EAAT uptake and decreased threshold to CRD. Moreover, total pain behaviors were increased in these stages. MS rats exhibited lower pain thresholds and higher total pain behaviors to CRD across all stages of the estrous cycle. Interestingly, cortical EAAT function in MS rats was inhibited in the low estrogen state—an effect completely opposite to that seen in NS rats. Conclusions This data confirms that estrous cycle and ELS are significant factors in visceral sensitivity and fluctuations in EAAT function may be a perpetuating factor mediating central sensitization.
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Affiliation(s)
- Rachel D Moloney
- Laboratory of Neurogastroenterology, APC Microbiome Institute, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland.,Present Address: Oklahoma Center for Neuroscience, University of Oklahoma Health Science Center, Oklahoma City, OK USA
| | - Jahangir Sajjad
- Department of Anatomy and Neuroscience, University College Cork, Office 4.113, Western Gateway Building, Cork, Ireland
| | - Tara Foley
- Department of Anatomy and Neuroscience, University College Cork, Office 4.113, Western Gateway Building, Cork, Ireland
| | - Valeria D Felice
- Laboratory of Neurogastroenterology, APC Microbiome Institute, University College Cork, Cork, Ireland
| | - Timothy G Dinan
- Laboratory of Neurogastroenterology, APC Microbiome Institute, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - John F Cryan
- Laboratory of Neurogastroenterology, APC Microbiome Institute, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Office 4.113, Western Gateway Building, Cork, Ireland
| | - Siobhain M O'Mahony
- Laboratory of Neurogastroenterology, APC Microbiome Institute, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Office 4.113, Western Gateway Building, Cork, Ireland
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30
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Hubbard CS, Karpowicz JM, Furman AJ, da Silva JT, Seminowicz DA, Traub RJ. Estrogen-dependent visceral hypersensitivity following stress in rats: An fMRI study. Mol Pain 2016; 12:12/0/1744806916654145. [PMID: 27317579 PMCID: PMC4956385 DOI: 10.1177/1744806916654145] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/11/2016] [Indexed: 12/17/2022] Open
Abstract
We used functional MRI and a longitudinal design to investigate the brain mechanisms in a previously reported estrogen-dependent visceral hypersensitivity model. We hypothesized that noxious visceral stimulation would be associated with activation of the insula, anterior cingulate cortex, and amygdala, and that estrogen-dependent, stress-induced visceral hypersensitivity would both enhance activation of these regions and recruit activation of other brain areas mediating affect and reward processing. Ovariectomized rats were treated with estrogen (17 β-estradiol, E2) or vehicle (n = 5 per group) and scanned in a 7T MRI at three different time points: pre-stress (baseline), 2 days post-stress, and 18 days post-stress. Stress was induced via a forced-swim paradigm. In a separate group of ovariectomized rats, E2 treatment induced visceral hypersensitivity at the 2 days post-stress time point, and this hypersensitivity returned to baseline at the 18 days post-stress time point. Vehicle-treated rats show no hypersensitivity following stress. During the MRI scans, rats were exposed to noxious colorectal distention. Across groups and time points, noxious visceral stimulation led to activations in the insula, anterior cingulate, and left amygdala, parabrachial nuclei, and cerebellum. A group-by-time interaction was seen in the right amygdala, ventral striatum-pallidum, cerebellum, hippocampus, mediodorsal thalamus, and pontine nuclei. Closer inspection of the data revealed that vehicle-treated rats showed consistent activations and deactivations across time, whereas estrogen-treated animals showed minimal deactivation with noxious visceral stimulation. This unexpected finding suggests that E2 may dramatically alter visceral nociceptive processing in the brain following an acute stressor. This study is the first to examine estrogen-stress dependent interactions in response to noxious visceral stimulation using functional MRI. Future studies that include other control groups and larger sample sizes are needed to fully understand the interactions between sex hormones, stress, and noxious stimulation on brain activity.
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Affiliation(s)
- Catherine S Hubbard
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
| | - Jane M Karpowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Andrew J Furman
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Joyce Teixeira da Silva
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Department of Anaesthesia, Harvard Medical School, Boston, MA, USA Department of Anatomy, Institute of Biomedical Science-III, University of Sao Paulo, Sao Paulo, Brazil
| | - David A Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, USA
| | - Richard J Traub
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, USA
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31
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Robinson DL, Nag S, Mokha SS. Estrogen facilitates and the kappa and mu opioid receptors mediate antinociception produced by intrathecal (-)-pentazocine in female rats. Behav Brain Res 2016; 312:163-8. [PMID: 27312267 DOI: 10.1016/j.bbr.2016.06.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 01/01/2023]
Abstract
Pentazocine, a mixed-action kappa opioid receptor (KOR) agonist, has high affinity for both KOR and the mu opioid receptor (MOR), and has been shown clinically to alleviate pain with a pronounced effect in women. However, whether local application of pentazocine in the spinal cord produces antinociception and the contribution of spinal KOR and MOR in mediating the effect of pentazocine in female rats remain unknown. Also, it is not known whether pentazocine-induced antinociception in females is estrogen-dependent. Hence, we investigated whether intrathecal (i.t.) (-)-pentazocine produces thermal antinociception and whether estrogen modulates the drug effect in female rats. Only the highest dose of pentazocine (500 nmol) was effective in producing antinociception in ovariectomized (OVX) rats. In contrast, pentazocine produced antinociception in estradiol-treated ovariectomized females (OVX+E) rats with the lowest effective dose being 250nmol. KOR or MOR mediated the effect of the lowest effective dose in OVX+E rats; however, MOR blockade extended the KOR-mediated effect of 500nmol pentazocine in both groups. In normally cycling females, the 250nmol dose was effective in producing antinociception at the proestrous, but not at the diestrous stage of the estrous cycle. Thus, estrogen facilitates and KOR or MOR mediates. the antinociceptive effect of i.t. (-)-pentazocine in female rats. Selective doses of (-)-pentazocine, with or without MOR blockade, may have a therapeutic benefit.
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MESH Headings
- Analgesics/administration & dosage
- Animals
- Estradiol/administration & dosage
- Estrogen Antagonists/administration & dosage
- Estrous Cycle
- Female
- Hot Temperature
- Injections, Spinal
- Nociception/drug effects
- Ovariectomy
- Pain Measurement
- Pain Threshold/drug effects
- Pentazocine/administration & dosage
- Rats
- Rats, Sprague-Dawley
- Receptors, Opioid, kappa/agonists
- Receptors, Opioid, kappa/physiology
- Receptors, Opioid, mu/agonists
- Receptors, Opioid, mu/physiology
- Spinal Cord/drug effects
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Affiliation(s)
- Douglas L Robinson
- Department of Neuroscience and Pharmacology, Meharry Medical College, Nashville, TN 37208, USA
| | - Subodh Nag
- Department of Neuroscience and Pharmacology, Meharry Medical College, Nashville, TN 37208, USA
| | - Sukhbir S Mokha
- Department of Neuroscience and Pharmacology, Meharry Medical College, Nashville, TN 37208, USA.
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The relationship of bone-tumor-induced spinal cord astrocyte activation and aromatase expression to mechanical hyperalgesia and cold hypersensitivity in intact female and ovariectomized mice. Neuroscience 2016; 324:344-54. [PMID: 26995084 DOI: 10.1016/j.neuroscience.2016.03.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 12/28/2022]
Abstract
Recently, our group established a relationship between tumor-induced spinal cord astrocyte activation and aromatase expression and the development of bone tumor nociception in male mice. As an extension of this work, we now report on the association of tumor-induced mechanical hyperalgesia and cold hypersensitivity to changes in spinal cord dorsal horn GFAP and aromatase expression in intact (INT) female mice and the effect of ovariectomy on these parameters. Implantation of fibrosarcoma cells produced robust mechanical hyperalgesia in INT animals, while ovariectomized (OVX) females had significantly less mechanical hyperalgesia. Cold hypersensitivity was apparent by post-implantation day 7 in INT and OVX females compared to their saline-injected controls and increased throughout the experiment. The decrease in mechanical hyperalgesia in OVX females was mirrored by significant decreases in spinal astrocyte activity in laminae I-II, III-IV, V-VI and X and aromatase expression in laminae V-VI and X in the dorsal horn of tumor-bearing animals. Administration of the aromatase inhibitor letrozole reduced tumor-induced hyperalgesia in INT females only suggesting that the tumor-induced increase in aromatase expression and its associated increase in spinal estrogen play a role in the development of bone tumor-induced hyperalgesia. Finally, intrathecal (i.t.) administration of 17β-estradiol caused a significant increase in tumor-induced hyperalgesia in INT tumor-bearing females. Since i.t. 17β-estradiol increases tumor pain and ovariectomy significantly decreases tumor pain, as well as spinal aromatase, estrogen may play a critical role in the spinal cord response to the changing tumor environment and the development of tumor-induced nociception.
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Moloney RD, Johnson AC, O'Mahony SM, Dinan TG, Greenwood‐Van Meerveld B, Cryan JF. Stress and the Microbiota-Gut-Brain Axis in Visceral Pain: Relevance to Irritable Bowel Syndrome. CNS Neurosci Ther 2016; 22:102-17. [PMID: 26662472 PMCID: PMC6492884 DOI: 10.1111/cns.12490] [Citation(s) in RCA: 214] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 11/05/2015] [Accepted: 11/05/2015] [Indexed: 02/06/2023] Open
Abstract
Visceral pain is a global term used to describe pain originating from the internal organs of the body, which affects a significant proportion of the population and is a common feature of functional gastrointestinal disorders (FGIDs) such as irritable bowel syndrome (IBS). While IBS is multifactorial, with no single etiology to completely explain the disorder, many patients also experience comorbid behavioral disorders, such as anxiety or depression; thus, IBS is described as a disorder of the gut-brain axis. Stress is implicated in the development and exacerbation of visceral pain disorders. Chronic stress can modify central pain circuitry, as well as change motility and permeability throughout the gastrointestinal (GI) tract. More recently, the role of the gut microbiota in the bidirectional communication along the gut-brain axis, and subsequent changes in behavior, has emerged. Thus, stress and the gut microbiota can interact through complementary or opposing factors to influence visceral nociceptive behaviors. This review will highlight the evidence by which stress and the gut microbiota interact in the regulation of visceral nociception. We will focus on the influence of stress on the microbiota and the mechanisms by which microbiota can affect the stress response and behavioral outcomes with an emphasis on visceral pain.
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Affiliation(s)
- Rachel D. Moloney
- Laboratory of NeurogastroenterologyAPC Microbiome InstituteUniversity College CorkCorkIreland
- Present address:
Oklahoma Center for NeuroscienceUniversity of Oklahoma Health Science CenterOklahoma CityOKUSA
| | - Anthony C. Johnson
- Oklahoma Center for NeuroscienceUniversity of Oklahoma Health Science CenterOklahoma CityOKUSA
| | - Siobhain M. O'Mahony
- Laboratory of NeurogastroenterologyAPC Microbiome InstituteUniversity College CorkCorkIreland
- Department of Anatomy and NeuroscienceUniversity College CorkCorkIreland
| | - Timothy G. Dinan
- Laboratory of NeurogastroenterologyAPC Microbiome InstituteUniversity College CorkCorkIreland
- Department of Psychiatry and Neurobehavioural ScienceUniversity College CorkCorkIreland
| | - Beverley Greenwood‐Van Meerveld
- Oklahoma Center for NeuroscienceUniversity of Oklahoma Health Science CenterOklahoma CityOKUSA
- V.A. Medical CenterOklahoma CityOKUSA
| | - John F. Cryan
- Laboratory of NeurogastroenterologyAPC Microbiome InstituteUniversity College CorkCorkIreland
- Department of Anatomy and NeuroscienceUniversity College CorkCorkIreland
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Cao DY, Bai G, Ji Y, Traub RJ. Epigenetic upregulation of metabotropic glutamate receptor 2 in the spinal cord attenuates oestrogen-induced visceral hypersensitivity. Gut 2015; 64:1913-20. [PMID: 25378524 PMCID: PMC4562903 DOI: 10.1136/gutjnl-2014-307748] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 10/16/2014] [Indexed: 12/08/2022]
Abstract
OBJECTIVE Epigenetic mechanisms are potential targets to relieve somatic pain. However, little is known whether epigenetic regulation interferes with visceral pain. Previous studies show that oestrogen facilitates visceral pain. This study aimed to determine whether histone hyperacetylation in the spinal cord could attenuate oestrogen-facilitated visceral pain. DESIGN The effect of the histone deacetylase inhibitor suberoylanilide hydroxamic acid (SAHA) on the magnitude of the visceromotor response (VMR) to colorectal distention was examined in ovariectomised rats with/without oestrogen replacement. An additional interaction with the metabotropic glutamate receptor 2/3 (mGluR2/3) antagonist LY341495 was tested. The levels of acetylated histone and mGluR2 mRNA and protein were analysed. The binding of acetylated H3 and oestrogen receptor α (ERα) to the GRM2 promoter was measured by chromatin immunoprecipitation coupled with qPCR. RESULTS In ovariectomised rats, 17β-estradiol (E2), but not safflower oil, increased the magnitude of the VMR to colorectal distention. SAHA attenuated the E2-facilitated VMR, but had no effect in safflower oil-treated rats. Subsequent spinal administration of LY341495 reversed the antinociceptive effect of SAHA in E2 rats. In addition, SAHA increased mGluR2 mRNA and protein in the spinal dorsal horn following E2, but not vehicle, treatment. In contrast, neither E2 nor SAHA alone altered mGluR2 mRNA. SAHA increased binding of H3K9ac and ERα to the same regions of the GRM2 promoter in E2-SAHA-treated animals. CONCLUSIONS Histone hyperacetylation in the spinal cord attenuates the pronociceptive effects of oestrogen on visceral sensitivity, suggesting that epigenetic regulation may be a potential approach to relieve visceral pain.
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Affiliation(s)
- Dong-Yuan Cao
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, UM Center to Advance Chronic Pain Research, Baltimore, Maryland, USA
| | - Guang Bai
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, UM Center to Advance Chronic Pain Research, Baltimore, Maryland, USA
| | - Yaping Ji
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, UM Center to Advance Chronic Pain Research, Baltimore, Maryland, USA
| | - Richard J Traub
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, UM Center to Advance Chronic Pain Research, Baltimore, Maryland, USA
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Ji Y, Bai G, Cao DY, Traub RJ. Estradiol modulates visceral hyperalgesia by increasing thoracolumbar spinal GluN2B subunit activity in female rats. Neurogastroenterol Motil 2015; 27:775-86. [PMID: 25810326 PMCID: PMC4446246 DOI: 10.1111/nmo.12549] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/21/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND We previously reported estrogen modulates spinal N-methyl-d-aspartate (NMDA) receptor processing of colorectal pain through changes in spinal GluN1 subunit phosphorylation/expression. The purpose of this study was to investigate whether spinal GluN2B containing NMDA receptors are involved in estrogen modulation of visceral pain processing. METHODS Behavioral, molecular, and immunocytochemical techniques were used to determine spinal GluN2B expression/phosphorylation and function 48 h following subcutaneous injection of estradiol (E2) or vehicle (safflower oil, Saff oil) in ovariectomized rats in the absence or presence of colonic inflammation induced by mustard oil. KEY RESULTS E2 increased the magnitude of the visceromotor response (VMR) to colorectal distention compared to Saff oil in non-inflamed rats. Intrathecal injection of the GluN2B subunit antagonist, Ro 25-6981, had no effect on the VMR in non-inflamed E2 or Saff oil rats. Colonic inflammation induced visceral hyperalgesia in E2, but not Saff oil rats. Visceral hyperalgesia in E2 rats was blocked by intrathecal GluN2B subunit selective antagonists. In inflamed rats, E2 increased GluN2B protein and gene expression in the thoracolumbar (TL), but not lumbosacral (LS), dorsal spinal cord. Immunocytochemical labeling showed a significant increase in GluN2B subunit in the superficial dorsal horn of E2 rats compared to Saff oil rats. CONCLUSIONS & INFERENCES These data support the hypothesis that estrogen increases spinal processing of colonic inflammation-induced visceral hyperalgesia by increasing NMDA receptor activity. Specifically, an increase in the activity of GluN2B containing NMDA receptors in the TL spinal cord by estrogen underlies visceral hypersensitivity in the presence of colonic inflammation.
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Affiliation(s)
- Y. Ji
- Department of Neural and Pain Sciences; University of Maryland School of Dentistry; UM Center to Advance Chronic Pain Research; Baltimore MD USA
| | - G. Bai
- Department of Neural and Pain Sciences; University of Maryland School of Dentistry; UM Center to Advance Chronic Pain Research; Baltimore MD USA
| | - D.-Y. Cao
- Department of Neural and Pain Sciences; University of Maryland School of Dentistry; UM Center to Advance Chronic Pain Research; Baltimore MD USA
| | - R. J. Traub
- Department of Neural and Pain Sciences; University of Maryland School of Dentistry; UM Center to Advance Chronic Pain Research; Baltimore MD USA
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36
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Traub RJ, Cao DY, Karpowicz J, Pandya S, Ji Y, Dorsey SG, Dessem D. A clinically relevant animal model of temporomandibular disorder and irritable bowel syndrome comorbidity. THE JOURNAL OF PAIN 2014; 15:956-66. [PMID: 24981128 DOI: 10.1016/j.jpain.2014.06.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/18/2014] [Accepted: 06/19/2014] [Indexed: 12/28/2022]
Abstract
UNLABELLED Temporomandibular disorder and irritable bowel syndrome are comorbid functional chronic pain disorders of unknown etiology that are triggered/exacerbated by stress. Here we present baseline phenotypic characterization of a novel animal model to gain insight into the underlying mechanisms that contribute to such comorbid pain conditions. In this model, chronic visceral hypersensitivity, a defining symptom of irritable bowel syndrome, is dependent on 3 factors: estradiol, existing chronic somatic pain, and stress. In ovariectomized rats, estradiol replacement followed by craniofacial muscle injury and stress induced visceral hypersensitivity that persisted for months. Omission of any 1 factor resulted in a transient (1 week) visceral hypersensitivity from stress alone or no hypersensitivity (no inflammation or estradiol). Maintenance of visceral hypersensitivity was estradiol dependent, resolving when estradiol replacement ceased. Referred cutaneous hypersensitivity was concurrent with visceral hypersensitivity. Increased spinal Fos expression suggests induction of central sensitization. These data demonstrate the development and maintenance of visceral hypersensitivity in estradiol-replaced animals following distal somatic injury and stress that mimics some characteristics reported in patients with temporomandibular disorder and comorbid irritable bowel syndrome. This new animal model is a powerful experimental tool that can be employed to gain further mechanistic insight into overlapping pain conditions. PERSPECTIVE The majority of patients with temporomandibular disorder report symptoms consistent with irritable bowel syndrome. Stress and female prevalence are common to both conditions. In a new experimental paradigm in ovariectomized rats with estradiol replacement, masseter inflammation followed by stress induces visceral hypersensitivity that persists for months, modeling these comorbid pain conditions.
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Affiliation(s)
- Richard J Traub
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland; UMB Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland.
| | - Dong-Yuan Cao
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Jane Karpowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Sangeeta Pandya
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Yaping Ji
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Susan G Dorsey
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, Maryland; UMB Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland
| | - Dean Dessem
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland; UMB Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland
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37
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Loyd DR, Murphy AZ. The neuroanatomy of sexual dimorphism in opioid analgesia. Exp Neurol 2014; 259:57-63. [PMID: 24731947 DOI: 10.1016/j.expneurol.2014.04.004] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 03/11/2014] [Accepted: 04/04/2014] [Indexed: 12/18/2022]
Abstract
The influence of sex has been neglected in clinical studies on pain and analgesia, with the vast majority of research conducted exclusively in males. However, both preclinical and clinical studies indicate that males and females differ in both the anatomical and physiological composition of central nervous system circuits that are involved in pain processing and analgesia. These differences influence not only the response to noxious stimuli, but also the ability of pharmacological agents to modify this response. Morphine is the most widely prescribed opiate for the alleviation of persistent pain in the clinic; however, it is becoming increasingly clear that morphine is less potent in women compared to men. This review highlights recent research identifying neuroanatomical and physiological dimorphisms underlying sex differences in pain and opioid analgesia, focusing on the endogenous descending pain modulatory circuit.
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Affiliation(s)
- Dayna R Loyd
- Pain Management Research Area, United States Army Institute of Surgical Research, Fort Sam Houston, TX 78234, United States
| | - Anne Z Murphy
- Neuroscience Institute, Georgia State University, Atlanta, GA 30303, United States.
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38
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Li LH, Wang ZC, Yu J, Zhang YQ. Ovariectomy results in variable changes in nociception, mood and depression in adult female rats. PLoS One 2014; 9:e94312. [PMID: 24710472 PMCID: PMC3978042 DOI: 10.1371/journal.pone.0094312] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 03/15/2014] [Indexed: 01/08/2023] Open
Abstract
Decline in the ovarian hormones with menopause may influence somatosensory, cognitive, and affective processing. The present study investigated whether hormonal depletion alters the nociceptive, depressive-like and learning behaviors in experimental rats after ovariectomy (OVX), a common method to deplete animals of their gonadal hormones. OVX rats developed thermal hyperalgesia in proximal and distal tail that was established 2 weeks after OVX and lasted the 7 weeks of the experiment. A robust mechanical allodynia was also occurred at 5 weeks after OVX. In the 5th week after OVX, dilute formalin (5%)-induced nociceptive responses (such as elevating and licking or biting) during the second phase were significantly increased as compared to intact and sham-OVX females. However, chronic constriction injury (CCI) of the sciatic nerve-induced mechanical allodynia did not differ as hormonal status (e.g. OVX and ovarian intact). Using formalin-induced conditioned place avoidance (F-CPA), which is believed to reflect the pain-related negative emotion, we further found that OVX significantly attenuated F-CPA scores but did not alter electric foot-shock-induced CPA (S-CPA). In the open field and forced swimming test, there was an increase in depressive-like behaviors in OVX rats. There was no detectable impairment of spatial performance by Morris water maze task in OVX rats up to 5 weeks after surgery. Estrogen replacement retrieved OVX-induced nociceptive hypersensitivity and depressive-like behaviors. This is the first study to investigate the impacts of ovarian removal on nociceptive perception, negative emotion, depressive-like behaviors and spatial learning in adult female rats in a uniform and standard way.
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Affiliation(s)
- Li-Hong Li
- Institute of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Zhe-Chen Wang
- Institute of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jin Yu
- Department of Integrative Medicine and Neurobiology, State Key Laboratory of Medical Neurobiology, Shanghai Medical Colloge, Fudan University, Shanghai, China
| | - Yu-Qiu Zhang
- Institute of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
- * E-mail:
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39
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Yan XJ, Feng CC, Liu Q, Zhang LY, Dong X, Liu ZL, Cao ZJ, Mo JZ, Li Y, Fang JY, Chen SL. Vagal Afferents Mediate Antinociception of Estrogen in a Rat Model of Visceral Pain: The Involvement of Intestinal Mucosal Mast Cells and 5-Hydroxytryptamine 3 Signaling. THE JOURNAL OF PAIN 2014; 15:204-17. [DOI: 10.1016/j.jpain.2013.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 09/14/2013] [Accepted: 10/31/2013] [Indexed: 12/19/2022]
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40
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Traub RJ, Ji Y. Sex differences and hormonal modulation of deep tissue pain. Front Neuroendocrinol 2013; 34:350-66. [PMID: 23872333 PMCID: PMC3830473 DOI: 10.1016/j.yfrne.2013.07.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 07/08/2013] [Accepted: 07/09/2013] [Indexed: 12/11/2022]
Abstract
Women disproportionately suffer from many deep tissue pain conditions. Experimental studies show that women have lower pain thresholds, higher pain ratings and less tolerance to a range of painful stimuli. Most clinical and epidemiological reports suggest female gonadal hormones modulate pain for some, but not all, conditions. Similarly, animal studies support greater nociceptive sensitivity in females in many deep tissue pain models. Gonadal hormones modulate responses in primary afferents, dorsal horn neurons and supraspinal sites, but the direction of modulation is variable. This review will examine sex differences in deep tissue pain in humans and animals focusing on the role of gonadal hormones (mainly estradiol) as an underlying component of the modulation of pain sensitivity.
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Affiliation(s)
- Richard J Traub
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland Baltimore, 650 W. Baltimore St., 8 South, Baltimore, MD 21201, USA; Program in Neuroscience, University of Maryland Baltimore, Baltimore, MD 21201, USA; Center for Pain Studies, University of Maryland Baltimore, Baltimore, MD 21201, USA.
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41
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Amandusson Å, Blomqvist A. Estrogenic influences in pain processing. Front Neuroendocrinol 2013; 34:329-49. [PMID: 23817054 DOI: 10.1016/j.yfrne.2013.06.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/19/2013] [Accepted: 06/20/2013] [Indexed: 12/24/2022]
Abstract
Gonadal hormones not only play a pivotal role in reproductive behavior and sexual differentiation, they also contribute to thermoregulation, feeding, memory, neuronal survival, and the perception of somatosensory stimuli. Numerous studies on both animals and human subjects have also demonstrated the potential effects of gonadal hormones, such as estrogens, on pain transmission. These effects most likely involve multiple neuroanatomical circuits as well as diverse neurochemical systems and they therefore need to be evaluated specifically to determine the localization and intrinsic characteristics of the neurons engaged. The aim of this review is to summarize the morphological as well as biochemical evidence in support for gonadal hormone modulation of nociceptive processing, with particular focus on estrogens and spinal cord mechanisms.
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Affiliation(s)
- Åsa Amandusson
- Department of Clinical Neurophysiology, Uppsala University, 751 85 Uppsala, Sweden.
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42
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Sexually Dimorphic Effects of Unpredictable Early Life Adversity on Visceral Pain Behavior in a Rodent Model. THE JOURNAL OF PAIN 2013; 14:270-80. [DOI: 10.1016/j.jpain.2012.11.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 11/06/2012] [Accepted: 11/15/2012] [Indexed: 12/14/2022]
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43
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Moussa L, Bézirard V, Salvador-Cartier C, Bacquié V, Houdeau E, Théodorou V. A new soy germ fermented ingredient displays estrogenic and protease inhibitor activities able to prevent irritable bowel syndrome-like symptoms in stressed female rats. Clin Nutr 2013; 32:51-8. [PMID: 22727545 DOI: 10.1016/j.clnu.2012.05.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 05/07/2012] [Accepted: 05/08/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Irritable bowel syndrome (IBS) often associated with psychological distress, is characterized by increased gut permeability and visceral sensitivity. In animals, stress increases intestinal paracellular permeability (IPP), visceral sensitivity and colonic proteolytic activity. Estradiol reduces IPP and affects visceral sensitivity in non-stressed ovariectomized rats, but whether estrogens affect stress-induced hyperpermeability and hypersensitivity in cyclic females remains unclear. We aimed to evaluate (i) the effects of a phytoestrogen-rich soy germ fermented ingredient (SG) on visceral hypersensitivity, hyperpermeability and other symptoms in stressed intact female rats, (ii) the mechanisms of action involved on the basis of both estrogenic and protease inhibitor activities of SG. METHODS Female rats received orally for 15-d either SG, 17β-estradiol benzoate (EB), or vehicles, with or without the estrogen receptor (ER) antagonist ICI182.780 before stress. Visceral sensitivity, IPP, faecal proteolytic activity, plasma corticosterone, rat mast cell protease II immunostaining, and occludin expression were assessed. RESULTS Stress increased IPP (concomitantly to a drop in occludin expression), visceral sensitivity, faecal proteolytic activity and plasma corticosterone. Similarly to EB, SG prevented the stress-induced hyperpermeability, and hypersensitivity, without changes in plasma corticosterone. SG inhibited the increase in faecal proteolytic activity, enhanced occludin expression, and reduced the colonic mast cell density. All SG effects, except decrease on faecal proteolytic activity, were blocked by ICI182.780. CONCLUSION A 2-wk oral treatment with SG prevented the stress-induced hyperpermeability and visceral hypersensitivity in cyclic rats through ER activation, and blocked the increase in colonic proteolytic activity, suggesting that SG can be promising in IBS management.
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Affiliation(s)
- Lara Moussa
- Neuro-Gastroenterology & Nutrition Group, Toxalim, UMR 1331 INRA/INPT, 180 chemin de Tournefeuille, BP 93173, 31027 Toulouse Cedex 3, France
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44
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Voß U, Lewerenz A, Nieber K. Treatment of irritable bowel syndrome: sex and gender specific aspects. Handb Exp Pharmacol 2013:473-97. [PMID: 23027463 DOI: 10.1007/978-3-642-30726-3_21] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Patients with functional gastrointestinal disorders constitute the majority of patients seeking healthcare for gastrointestinal symptoms in primary and secondary care. Of these disorders irritable bowel syndrome (IBS) is one of the most common and affects 10-20% in the Western world. IBS is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. Sex and gender aspects are important in understanding differences between men and women in their risk and experience of IBS. Relative to men, women are diagnosed more frequently with IBS. Female patients are more likely to be constipated, complain of abdominal distension and of certain extracolonic symptoms. Given the variability of IBS, the most successful treatment will be comprehensive, involving multiple strategies. Efficacy, safety and tolerability are important in the evaluation of IBS therapies, as patients are likely to require long-term treatment. Laxatives, antidiarrheals or antispasmodics are common in the treatment of IBS but the majority of patients receive antispasmodics followed by prokinetic agents. In treatment of IBS there appears to be a greater clinical response to serotonergic agents developed for IBS in women compared to men. There is an absence of drugs licensed specifically for the treatment of IBS. Further studies with novel agents are needed, to evaluate new approaches to IBS management including gender specific behavioral therapies and better characterization of patient subgroups with regard to drug therapy so that personalized therapy can be tested.
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45
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Gintzler AR, Liu NJ. Importance of sex to pain and its amelioration; relevance of spinal estrogens and its membrane receptors. Front Neuroendocrinol 2012; 33:412-24. [PMID: 23036438 PMCID: PMC3778676 DOI: 10.1016/j.yfrne.2012.09.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 09/13/2012] [Accepted: 09/18/2012] [Indexed: 12/14/2022]
Abstract
Estrogens have a multitude of effects on opioid systems and are thought to play a key role in sexually dimorphic nociception and opioid antinociception. Heretofore, classical genomic actions of estrogens are largely thought to be responsible for the effects of these steroids on nociception and opioid antinociception. The recent discovery that estrogens can also activate estrogen receptors that are located in the plasma membrane, the effects of which are manifest in seconds to minutes instead of hours to days has revolutionized our thinking concerning the ways in which estrogens are likely to modulate pain responsiveness and the dynamic nature of that modulation. This review summarizes parameters of opioid functionality and nociception that are subject to modulation by estrogens, underscoring the added dimensions of such modulation that accrues from rapid membrane estrogen receptor signaling. Implications of this mode of signaling regarding putative sources of estrogens and its degradation are also discussed.
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Affiliation(s)
- Alan R Gintzler
- State University of New York, Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203, USA.
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46
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Ji Y, Tang B, Cao DY, Wang G, Traub RJ. Sex differences in spinal processing of transient and inflammatory colorectal stimuli in the rat. Pain 2012; 153:1965-1973. [PMID: 22819535 DOI: 10.1016/j.pain.2012.06.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 06/14/2012] [Accepted: 06/19/2012] [Indexed: 02/06/2023]
Abstract
Sex differences in the spinal processing of somatic and visceral stimuli contribute to greater female sensitivity in many pain disorders. The present study examined spinal mechanisms that contribute to sex differences in visceral sensitivity. The visceromotor response to colorectal distention (CRD) was more robust in normal female rats and after intracolonic mustard oil compared with that in male rats. No sex difference was observed in the CRD-evoked response of lumbosacral (LS) and thoracolumbar (TL) colonic afferents in normal and mustard oil-treated rats, but there was a sex difference in spontaneous activity that was exacerbated by intracolonic mustard oil. The response of visceroceptive dorsal horn neurons to CRD was greater in normal female rats in the LS and TL spinal segments. The effect of intracolonic mustard oil on the CRD-evoked response of different phenotypes of visceroceptive dorsal horn neurons was dependent on sex and segment. The NMDA receptor antagonist 2-amino-5-phosphonopentanoic acid (APV) dose-dependently attenuated the visceromotor response in normal rats with greater effect in male rats. Correspondingly, there was greater cell membrane expression of the GluN1 subunit in dorsal horn extracts in female rats. After intracolonic mustard oil, there was no longer a sex difference in the effect of APV nor GluN1 expression in LS segments, but greater female expression in TL segments. These data document a sex difference in spinal processing of nociceptive visceral stimuli from the normal and inflamed colon. Differences in dorsal horn neuronal activity and NMDA receptor expression contribute to the sex differences in the visceral sensitivity observed in awake rats.
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Affiliation(s)
- Yaping Ji
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Center for Pain Studies, University of Maryland, Baltimore, MD, USA Program in Neuroscience, University of Maryland, Baltimore, MD, USA
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Xiao X, Yang Y, Zhang Y, Zhang XM, Zhao ZQ, Zhang YQ. Estrogen in the Anterior Cingulate Cortex Contributes to Pain-Related Aversion. Cereb Cortex 2012; 23:2190-203. [DOI: 10.1093/cercor/bhs201] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cao DY, Ji Y, Tang B, Traub RJ. Estrogen receptor β activation is antinociceptive in a model of visceral pain in the rat. THE JOURNAL OF PAIN 2012; 13:685-94. [PMID: 22698981 DOI: 10.1016/j.jpain.2012.04.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 04/19/2012] [Accepted: 04/27/2012] [Indexed: 01/31/2023]
Abstract
UNLABELLED The mechanism underlying estrogen modulation of visceral pain remains unclear. Our previous studies indicate that activation of estrogen receptor α (ERα) enhances visceral pain. The purpose of the present study was to investigate the role of estrogen receptor β (ERβ) activation in spinal processing of visceral stimuli. The effects of selective ERβ agonists on the visceromotor response (VMR) and dorsal horn neuronal responses to colorectal distention (CRD) were tested in ovariectomized and intact female rats. The magnitude of the VMR to CRD was significantly attenuated by ERβ agonists diarylpropionitrile (DPN) and WAY-200070 4 hours after subcutaneous injection. Pretreatment with the estrogen receptor antagonist ICI 182,780 obscured the DPN-evoked attenuation. There was no effect of DPN on the VMR at earlier time points. Subcutaneous and spinal administration of DPN attenuated the response of visceroceptive dorsal horn neurons with a comparable time course. DPN attenuated the VMR in intact rats regardless of estrous cycle stage. The time course of effect of ERβ activation on the visceromotor response and neuronal activity is consistent with transcriptional or translational modulation of neuronal activity. PERSPECTIVE Activation of ERβ is antinociceptive in the colorectal distention model of visceral pain, which may provide a therapeutic target to manage irritable bowel syndrome in the clinic.
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Affiliation(s)
- Dong-Yuan Cao
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland 21201, USA
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Peng HY, Lin TB. Spinal pelvic-urethra reflex potentiation. Biomedicine (Taipei) 2012. [DOI: 10.1016/j.biomed.2012.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Gustafsson JK, Greenwood-Van Meerveld B. Amygdala activation by corticosterone alters visceral and somatic pain in cycling female rats. Am J Physiol Gastrointest Liver Physiol 2011; 300:G1080-5. [PMID: 21454447 DOI: 10.1152/ajpgi.00349.2010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Irritable bowel syndrome (IBS) is often seen in women, and symptom severity is known to vary over the menstrual cycle. In addition, activation of the hypothalamic-pituitary-adrenal (HPA) axis enhances symptomology and patients with IBS have increased activation of the amygdala, a brain region known to facilitate HPA output. However, little is known about the effects of amygdala activation during different stages of the menstrual cycle. We therefore investigated the effects of amygdala activation on somatic and visceral pain perception over the rat estrous cycle. Female Wistar rats were implanted with either corticosterone (Cort) or cholesterol as a control onto the dorsal margin of the central amygdala. Visceral sensitivity was quantified by recording the visceromotor response (VMR) to colorectal distension (CRD) and somatic sensitivity was assessed via the Von Frey test. In cholesterol controls, both visceral and somatic sensitivity varied over the estrous cycle. Rats in proestrus/estrus responded to CRD with an increased VMR compared with rats in metestrus/diestrus. Somatic sensitivity followed a similar pattern with enhanced sensitivity during proestrus/estrus compared with metestrus/diestrus. Elevated amygdala Cort induced visceral hypersensitivity during metestrus/diestrus but had no effect during proestrus/estrus. In contrast, elevated amygdala Cort increased somatic sensitivity during both metestrus/diestrus and proestrus/estrous. These results suggests that amygdala activation by Cort eliminates spontaneously occurring differences in visceral and somatic pain perception, which could explain the lowered pain thresholds and higher incidence of somatic pain observed in women with IBS.
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Affiliation(s)
- Jenny K Gustafsson
- Department of Veterans Affairs Medical Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA
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