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Huerta MÁ, Marcos-Frutos D, Nava JDL, García-Ramos A, Tejada MÁ, Roza C. P2X3 and P2X2/3 Receptors Inhibition Produces a Consistent Analgesic Efficacy: A Systematic Review and Meta-Analysis of Preclinical Studies. Eur J Pharmacol 2024; 984:177052. [PMID: 39393665 DOI: 10.1016/j.ejphar.2024.177052] [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: 06/10/2024] [Revised: 08/29/2024] [Accepted: 10/07/2024] [Indexed: 10/13/2024]
Abstract
BACKGROUND P2X3 and P2X2/3 receptors are promising therapeutic targets for pain treatment and selective inhibitors are under evaluation in ongoing clinical trials. Here we aim to consolidate and quantitatively evaluate the preclinical evidence on P2X3 and P2X2/3 receptors inhibitors for pain treatment. METHODS A literature search was conducted in PubMed, Scopus and Web-of-Science on August 5, 2023. Data was extracted and meta-analyzed using a random-effects model to estimate the analgesic efficacy of the intervention; then several subgroup analyses were performed. RESULTS 67 articles were included. The intervention induced a consistent pain reduction (66.5 [CI95% = 58.5, 74.5]; p < 0.0001), which was highest for visceral pain (114.3), followed by muscle (79.8) and neuropathic pain (71.1), but lower for cancer (64.1), joint (57.5) and inflammatory pain (49.0). Further analysis showed a greater effect for mechanical hypersensitivity (70.4) compared to heat hypersensitivity (64.5) and pain-related behavior (54.1). Sex (male or female) or interspecies (mice or rats) differences were not appreciated (p > 0.05). The most used molecule was A-317491, but other such as gefapixant or eliapixant were also effective (p < 0.0001 for all). The analgesic effect was higher for systemic or peripheral administration than for intrathecal administration. Conversely, intracerebroventricular administration was not analgesic, but potentiated pain. CONCLUSION P2X3 and P2X2/3 receptor inhibitors showed a good analgesic efficacy in preclinical studies, which was dependent on the pain etiology, pain outcome measured, the drug used and its route of administration. Further research is needed to assess the clinical utility of these preclinical findings. PROTOCOL REGISTRATION PROSPERO ID CRD42023450685.
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Affiliation(s)
- Miguel Á Huerta
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, Spain; Biomedical Research Center, Institute of Neuroscience, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Daniel Marcos-Frutos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Javier de la Nava
- Unit for Active Coping Strategies for Pain in Primary Care, East-Valladolid Primary Care Management, Castilla and Leon Public Health System (Sacyl), Valladolid, Spain
| | - Amador García-Ramos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain; Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Miguel Ángel Tejada
- Department of Pharmacology, Faculty of Medicine, University of Granada, Granada, Spain; Biomedical Research Center, Institute of Neuroscience, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.
| | - Carolina Roza
- Department of System's Biology, Medical School, University of Alcala, Alcalá de Henares, 28871, Madrid, Spain
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Patankar VR, Jain AK, Rao RD, Rao PR. Assessment of mechanical allodynia in healthy teeth adjacent and contralateral to endodontically diseased teeth: a clinical study. Restor Dent Endod 2024; 49:e31. [PMID: 39247644 PMCID: PMC11377871 DOI: 10.5395/rde.2024.49.e31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 06/06/2024] [Accepted: 06/25/2024] [Indexed: 09/10/2024] Open
Abstract
Objectives The present study investigated the prevalence of mechanical allodynia (MA) in healthy teeth adjacent and contralateral to endodontically diseased teeth. Materials and Methods This cross-sectional study included 114 patients with symptomatic irreversible pulpitis and apical periodontitis in permanent mandibular first molars who possessed healthy teeth adjacent and contralateral to the endodontically diseased tooth. The mechanical sensitivity of the teeth was determined by percussion testing. The presence or absence of pain on percussion in the teeth adjacent and contralateral to the endodontically diseased tooth and the tooth distal to the contralateral symmetrical tooth was recorded according to coding criteria. The prevalence of MA was computed as a percentage, and binary logistic regression analysis was done. The Fisher exact test and Mann-Whitney U test were used for binary and ordinal data. Results Age and sex did not influence the prevalence of MA. An increased prevalence of MA was found in patients with higher levels of spontaneous pain (p < 0.001). The prevalence of allodynia was 57% in teeth adjacent to endodontically diseased teeth and 10.5% in teeth contralateral to endodontically diseased teeth. In addition, on the ipsilateral side, there were more painful sensations distal to the diseased tooth than mesially. Conclusions Despite being disease-free, teeth adjacent and contralateral to endodontically diseased teeth exhibited pain on percussion. There was a direct association between the severity of the patient's pain and the presence of MA.
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Affiliation(s)
- Vaishnavi Ratnakar Patankar
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College, Navi Mumbai, Maharashtra, India
| | - Ashish K Jain
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College, Navi Mumbai, Maharashtra, India
| | - Rahul D Rao
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College, Navi Mumbai, Maharashtra, India
| | - Prajakta R Rao
- Department of Periodontics and Implantology, Bharati Vidyapeeth Dental College, Navi Mumbai, Maharashtra, India
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3
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Chen Y, Chen L, Ji T, Yu Y, Zhang T, Wang L. The purinergic receptor P2X3 promotes facial pain by activating neurons and cytokines in the trigeminal ganglion. Int Immunopharmacol 2024; 130:111801. [PMID: 38442578 DOI: 10.1016/j.intimp.2024.111801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/18/2024] [Accepted: 03/02/2024] [Indexed: 03/07/2024]
Abstract
The mechanism underlying allodynia/hyperalgesia caused by dental pulpitis has remained enigmatic. This investigation endeavored to characterize the influence of the purinergic receptor P2X3 on pain caused by experimental pulpitis and the mechanism involved. An experimental model of irreversible pulpitis was produced by the drilling and exposure of the dental pulp of the left upper first and second molars in rats, followed by measuring nociceptive responses in the oral and maxillofacial regions. Subsequently, neuronal activity and the expression of P2X3 and pertinent cytokines in the trigeminal ganglion (TG) were meticulously examined and analyzed. Histological evidence corroborated that significant pulpitis was produced in this model, which led to a distinct escalation in nociceptive responses in rats. The activation of neurons, coupled with the upregulated expression of c-fos, P2X3, p-p38, TNF-α and IL-1β, was identified subsequent to the pulpitis surgery within the TG. The selective inhibition of P2X3 with A-317491 effectively restrained the abnormal allodynia/hyperalgesia following the pulpitis surgery and concurrently inhibited the upregulation of p-p38, TNF-α and IL-1β within the TG. These findings suggest that the P2X3 signaling pathway plays a pivotal role in instigating and perpetuating pain subsequent to the induction of pulpitis in rats, implicating its association with the p38 MAPK signaling pathway and inflammatory factors.
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Affiliation(s)
- Yangxi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China; Department of Emergency and General Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Liangyu Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China; Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Tuo Ji
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China; Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Yuan Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China; Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Tiejun Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China; Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
| | - Li Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China; Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
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4
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Chen Y, Hu J, Qi F, Kang Y, Zhang T, Wang L. Acute pulpitis promotes purinergic signaling to induce pain in rats via P38MAPK/NF-κB signaling pathway. Mol Pain 2024; 20:17448069241234451. [PMID: 38325814 PMCID: PMC10868473 DOI: 10.1177/17448069241234451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/01/2024] [Accepted: 02/01/2024] [Indexed: 02/09/2024] Open
Abstract
Toothache is one of the most common types of pain, but the mechanisms underlying pulpitis-induced pain remain unknown. The ionotropic purinergic receptor family (P2X) is reported to mediate nociception in the nervous system. This study aims to investigate the involvement of P2X3 in the sensitisation of the trigeminal ganglion (TG) and the inflammation caused by acute pulpitis. An acute tooth inflammation model was established by applying LPS to the pulp of SD rats. We found that the increased expression of P2X3 was induced by acute pulpitis. A selective P2X3 inhibitor (A-317491) reduced pain-like behavior in the maxillofacial region of rats and depressed the activation of neurons in the trigeminal ganglion induced by pulpitis. The upregulated MAPK signaling (p-p38, p-ERK1/2) expression in the ipsilateral TG induced by pulpitis could also be depressed by the application of the P2X3 inhibitor. Furthermore, the expression of markers of inflammatory processes, such as NF-κB, TNF-α and IL-1β, could be induced by acute pulpitis and deduced by the intraperitoneal injection of P2X3 antagonists. Our findings demonstrate that purinergic P2X3 receptor signaling in TG neurons contributes to pulpitis-induced pain in rats and that P2X3 signaling may be a potential therapeutic target for tooth pain.
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Affiliation(s)
- Yangxi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Emergency and General Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jun Hu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Emergency and General Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Qi
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yiqun Kang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tiejun Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Anesthesiology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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5
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Jin T, Liu X, Li Y, Li PC, Wan MM, Li LJ, Shi L, Fu ZY, Gao WP. Electroacupuncture Reduces Ocular Surface Neuralgia in Dry-Eyed Guinea Pigs by Inhibiting the Trigeminal Ganglion and Spinal Trigeminal Nucleus Caudalis P2X 3R-PKC Signaling Pathway. Curr Eye Res 2023; 48:546-556. [PMID: 36803321 DOI: 10.1080/02713683.2023.2176886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
PURPOSE To observe the effects of electroacupuncture on ocular surface neuralgia and the P2X3R-PKC signaling pathway in guinea pigs with dry eye. METHODS A dry eye guinea pig model was established by subcutaneous injection of scopolamine hydrobromide. Guinea pigs were monitored for body weight, palpebral fissure height, number of blinks, corneal fluorescein staining score, phenol red thread test, and corneal mechanical perception threshold. Histopathological changes and mRNA expression of P2X3R and protein kinase C in the trigeminal ganglion and spinal trigeminal nucleus caudalis were observed. We performed a second part of the experiment, which involved the P2X3R-specific antagonist A317491 and the P2X3R agonist ATP in dry-eyed guinea pigs to further validate the involvement of the P2X3R-protein kinase C signaling pathway in the regulation of ocular surface neuralgia in dry eye. The number of blinks and corneal mechanical perception threshold were monitored before and 5 min after subconjunctival injection and the protein expression of P2X3R and protein kinase C was detected in the trigeminal ganglion and spinal trigeminal nucleus caudalis of guinea pigs. RESULTS Dry-eyed guinea pigs showed pain-related manifestations and the expression of P2X3R and protein kinase C in the trigeminal ganglion and spinal trigeminal nucleus caudalis was upregulated. Electroacupuncture reduced pain-related manifestations and inhibited the expression of P2X3R and protein kinase C in the trigeminal ganglion and spinal trigeminal nucleus caudalis. Subconjunctival injection of A317491 attenuated corneal mechanoreceptive nociceptive sensitization in dry-eyed guinea pigs, while ATP blocked the analgesic effect of electroacupuncture. CONCLUSIONS Electroacupuncture reduced ocular surface sensory neuralgia in dry-eyed guinea pigs, and the mechanism of action may be associated with the inhibition of the P2X3R-protein kinase C signaling pathway in the trigeminal ganglion and spinal trigeminal nucleus caudalis by electroacupuncture.
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Affiliation(s)
- Tuo Jin
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue Liu
- Department of Ophthalmology, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
| | - Ying Li
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Pei-Chen Li
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Mi-Mi Wan
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Liu-Jiao Li
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Li Shi
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhang-Yitian Fu
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wei-Ping Gao
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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6
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Dong CR, Zhang WJ, Luo HL. Association between P2X3 receptors and neuropathic pain: As a potential therapeutic target for therapy. Biomed Pharmacother 2022; 150:113029. [PMID: 35489283 DOI: 10.1016/j.biopha.2022.113029] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 11/02/2022] Open
Abstract
Neuropathic pain is a common clinical symptom of various diseases, and it seriously affects the physical and mental health of patients. Owing to the complex pathological mechanism of neuropathic pain, clinical treatment of pain is challenging. Therefore, there is growing interest among researchers to explore potential therapeutic strategies for neuropathic pain. A large number of studies have shown that development of neuropathic pain is related to nerve conduction and related signaling molecules. P2X3 receptors (P2X3R) are ATP-dependent ion channels that participate in the transmission of neural information and related signaling pathways, sensitize the central nervous system, and play a key role in the development of neuropathic pain. In this paper, we summarized the structure and biological characteristics of the P2X3R gene and discussed the role of P2X3R in the nervous system. Moreover, we outlined the related pathological mechanisms of pain and described the relationship between P2X3R and chronic pain to provide valuable information for development of novel treatment strategies for pain.
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Affiliation(s)
- Cai-Rong Dong
- The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi 343000, China
| | - Wen-Jun Zhang
- The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi 343000, China.
| | - Hong-Liang Luo
- The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi 343000, China
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7
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Okamoto K, Hasegawa M, Piriyaprasath K, Kakihara Y, Saeki M, Yamamura K. Preclinical models of deep craniofacial nociception and temporomandibular disorder pain. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:231-241. [PMID: 34815817 PMCID: PMC8593658 DOI: 10.1016/j.jdsr.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 01/06/2023] Open
Abstract
Chronic pain in temporomandibular disorder (TMD) is a common health problem. Cumulating evidence indicates that the etiology of TMD pain is complex with multifactorial experience that could hamper the developments of treatments. Preclinical research is a resource to understand the mechanism for TMD pain, whereas limitations are present as a disease-specific model. It is difficult to incorporate multiple risk factors associated with the etiology that could increase pain responses into a single animal. This article introduces several rodent models which are often employed in the preclinical studies and discusses their validities for TMD pain after the elucidations of the neural mechanisms based on the clinical reports. First, rodent models were classified into two groups with or without inflammation in the deep craniofacial tissues. Next, the characteristics of each model and the procedures to identify deep craniofacial pain were discussed. Emphasis was directed on the findings of the effects of chronic psychological stress, a major risk factor for chronic pain, on the deep craniofacial nociception. Preclinical models have provided clinically relevant information, which could contribute to better understand the basis for TMD pain, while efforts are still required to bridge the gap between animal and human studies.
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Affiliation(s)
- Keiichiro Okamoto
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata City, 951-8514, Japan
| | - Mana Hasegawa
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata City, 951-8514, Japan.,Division of Dental Clinical Education, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata City, 951-8514, Japan
| | - Kajita Piriyaprasath
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata City, 951-8514, Japan
| | - Yoshito Kakihara
- Division of Dental Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata City, 951-8514, Japan
| | - Makio Saeki
- Division of Dental Pharmacology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata City, 951-8514, Japan
| | - Kensuke Yamamura
- Division of Oral Physiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata City, 951-8514, Japan
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8
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Tariba Knežević P, Vukman R, Uhač M, Illeš D, Kovačević Pavičić D, Simonić-Kocijan S. P 2Y 2 Receptors Mediate Masseter Muscle Mechanical Hypersensitivity in Rats. J Pain Res 2020; 13:1323-1333. [PMID: 32581574 PMCID: PMC7280063 DOI: 10.2147/jpr.s239831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/07/2020] [Indexed: 01/18/2023] Open
Abstract
Purpose P2Y2 receptors (P2Y2Rs) are among the various receptors that play an important role in nociception. The goal of this research was to investigate possible P2Y2R expression changes in the trigeminal ganglion (TRG) in bilateral masseter muscle (MM) hypersensitivity following unilateral MM inflammation. The impact of unilateral intramasseteric administration of P2Y2R antagonist on bilateral MM hypersensitivity was also explored. Materials and Methods Bilateral MM hypersensitivity was provoked by unilateral intramasseteric injection of complete Freund’s adjuvant (CFA). The head withdrawal threshold (HWT) was assessed bilaterally 4 days later. Bilateral TRG and MM isolation were followed, and quantitative real-time polymerase chain reaction (qRT-PCR) and histopathological analysis were carried out on these tissues, respectively. The involvement of P2Y2Rs in nocifensive behavior was evaluated by administering two doses of P2Y2R antagonist AR-C118925 (0.2 or 1 mg/100 μL) in inflamed MM 4 days post-CFA administration. Bilateral HWT was assessed at different time points following antagonist injection. Results qRT-PCR analysis demonstrated P2Y2R up-regulation in TRG ipsilateral to the site of CFA administration. Compared to the controls, both doses of AR-C118925 injected ipsilateral to the TRG increased the bilateral HWT at 30, 60, 90, and 120 minutes after antagonist administration. Conclusion The findings suggest that P2Y2Rs may affect MM inflammatory hypersensitivity owing to its up-regulation in the TRG in MM inflammatory pain states.
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Affiliation(s)
- Petra Tariba Knežević
- Department of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia.,Department of Prosthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Robert Vukman
- Department of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia.,Department of Prosthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Mia Uhač
- Department of Orthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Davor Illeš
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Daniela Kovačević Pavičić
- Department of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia.,Department of Prosthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Sunčana Simonić-Kocijan
- Department of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia.,Department of Prosthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia
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9
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Kayaoglu G, Ekici M, Altunkaynak B. Mechanical Allodynia in Healthy Teeth Adjacent and Contralateral to Endodontically Diseased Teeth: A Clinical Study. J Endod 2020; 46:611-618. [DOI: 10.1016/j.joen.2020.01.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/24/2020] [Accepted: 01/31/2020] [Indexed: 11/26/2022]
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10
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Electroacupuncture Stimulation Alleviates CFA-Induced Inflammatory Pain Via Suppressing P2X3 Expression. Int J Mol Sci 2019; 20:ijms20133248. [PMID: 31269659 PMCID: PMC6651287 DOI: 10.3390/ijms20133248] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 06/25/2019] [Accepted: 06/28/2019] [Indexed: 12/13/2022] Open
Abstract
Chronic inflammatory pain is one of the most common complaints that seriously affects patients’ quality of life. Previous studies have demonstrated that the analgesic effect of electroacupuncture (EA) stimulation on inflammatory pain is related to its frequency. In this study, we focused on whether the analgesic effects of EA are related to the period of stimulation. Purinergic receptor P2X3 (P2X3) is involved in the pathological process underlying chronic inflammatory pain and neuropathic pain. We hypothesized that 100 Hz EA stimulation alleviated Freund’s complete adjuvant (CFA) induced inflammatory pain via regulating P2X3 expression in the dorsal root ganglion (DRG) and/or spinal cord dorsal horn (SCDH). We also assumed that the analgesic effect of EA might be related to the period of stimulation. We found that both short-term (three day) and long-term (14 day) 100 Hz EA stimulation effectively increased the paw withdrawal threshold (PWT) and reversed the elevation of P2X3 in the DRG and SCDH of CFA rats. However, the analgesic effects of 100 Hz EA were not dependent on the period of stimulation. Moreover, P2X3 inhibition or activation may contribute to or attenuate the analgesic effects of 100 Hz EA on CFA-induced inflammatory pain. This result indicated that EA reduced pain hypersensitivity through P2X3 modulation.
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11
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de Melo Aquino B, da Silva Dos Santos DF, Jorge CO, Marques ACS, Teixeira JM, Parada CA, Oliveira-Fusaro MCG. P2X3 receptors contribute to muscle pain induced by static contraction by a mechanism dependent on neutrophil migration. Purinergic Signal 2019; 15:167-175. [PMID: 31115830 DOI: 10.1007/s11302-019-09659-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 05/13/2019] [Indexed: 01/02/2023] Open
Abstract
P2X3 receptors are involved with several pain conditions. Muscle pain induced by static contraction has an important socioeconomic impact. Here, we evaluated the involvement of P2X3 receptors on mechanical muscle hyperalgesia and neutrophil migration induced by static contraction in rats. Also, we evaluated whether static contraction would be able to increase muscle levels of TNF-α and IL-1β. Male Wistar rats were pretreated with the selective P2X3 receptor antagonist, A-317491, by intramuscular or intrathecal injection and the static contraction-induced mechanical muscle hyperalgesia was evaluated using the Randall-Selitto test. Neutrophil migration was evaluated by measurement of myeloperoxidase (MPO) kinetic-colorimetric assay and the cytokines TNF-α and IL-1β by enzyme-linked immunosorbent assay. Intramuscular or intrathecal pretreatment with A-317491 prevented static contraction-induced mechanical muscle hyperalgesia. In addition, A-317491 reduced static contraction-induced mechanical muscle hyperalgesia when administered 30 and 60 min of the beginning of static contraction, but not after 30 and 60 min of the end of static contraction. Intramuscular A-317491 also prevented static contraction-induced neutrophil migration. In a period of 24 h, static contraction did not increase muscle levels of TNF-α and IL-1β. These findings demonstrated that mechanical muscle hyperalgesia and neutrophil migration induced by static contraction are modulated by P2X3 receptors expressed on the gastrocnemius muscle and spinal cord dorsal horn. Also, we suggest that P2X3 receptors are important to the development but not to maintenance of muscle hyperalgesia. Therefore, P2X3 receptors can be pointed out as a target to musculoskeletal pain conditions induced by daily or work-related activities.
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Affiliation(s)
- Bruna de Melo Aquino
- Laboratory of Pain and Inflammation Research, School of Applied Sciences, State University of Campinas, Pedro Zaccaria 1300, Limeira, Sao Paulo, Brazil
| | - Diogo Francisco da Silva Dos Santos
- Laboratory of Pain and Inflammation Research, School of Applied Sciences, State University of Campinas, Pedro Zaccaria 1300, Limeira, Sao Paulo, Brazil
| | - Carolina Ocanha Jorge
- Laboratory of Pain and Inflammation Research, School of Applied Sciences, State University of Campinas, Pedro Zaccaria 1300, Limeira, Sao Paulo, Brazil
| | - Aline Carolina Salgado Marques
- Laboratory of Pain and Inflammation Research, School of Applied Sciences, State University of Campinas, Pedro Zaccaria 1300, Limeira, Sao Paulo, Brazil
| | - Juliana Maia Teixeira
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Monteiro Lobato 255, Campinas, Sao Paulo, Brazil
| | - Carlos Amilcar Parada
- Department of Structural and Functional Biology, Institute of Biology, State University of Campinas, Monteiro Lobato 255, Campinas, Sao Paulo, Brazil
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Queme LF, Ross JL, Jankowski MP. Peripheral Mechanisms of Ischemic Myalgia. Front Cell Neurosci 2017; 11:419. [PMID: 29311839 PMCID: PMC5743676 DOI: 10.3389/fncel.2017.00419] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 12/13/2017] [Indexed: 12/18/2022] Open
Abstract
Musculoskeletal pain due to ischemia is present in a variety of clinical conditions including peripheral vascular disease (PVD), sickle cell disease (SCD), complex regional pain syndrome (CRPS), and even fibromyalgia (FM). The clinical features associated with deep tissue ischemia are unique because although the subjective description of pain is common to other forms of myalgia, patients with ischemic muscle pain often respond poorly to conventional analgesic therapies. Moreover, these patients also display increased cardiovascular responses to muscle contraction, which often leads to exercise intolerance or exacerbation of underlying cardiovascular conditions. This suggests that the mechanisms of myalgia development and the role of altered cardiovascular function under conditions of ischemia may be distinct compared to other injuries/diseases of the muscles. It is widely accepted that group III and IV muscle afferents play an important role in the development of pain due to ischemia. These same muscle afferents also form the sensory component of the exercise pressor reflex (EPR), which is the increase in heart rate and blood pressure (BP) experienced after muscle contraction. Studies suggest that afferent sensitization after ischemia depends on interactions between purinergic (P2X and P2Y) receptors, transient receptor potential (TRP) channels, and acid sensing ion channels (ASICs) in individual populations of peripheral sensory neurons. Specific alterations in primary afferent function through these receptor mechanisms correlate with increased pain related behaviors and altered EPRs. Recent evidence suggests that factors within the muscles during ischemic conditions including upregulation of growth factors and cytokines, and microvascular changes may be linked to the overexpression of these different receptor molecules in the dorsal root ganglia (DRG) that in turn modulate pain and sympathetic reflexes. In this review article, we will discuss the peripheral mechanisms involved in the development of ischemic myalgia and the role that primary sensory neurons play in EPR modulation.
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Affiliation(s)
- Luis F Queme
- Department of Anesthesia, Division of Pain Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Jessica L Ross
- Department of Anesthesia, Division of Pain Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Michael P Jankowski
- Department of Anesthesia, Division of Pain Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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