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Madhusudanan P, Jerard C, Raju G, Katiyar N, Shankarappa SA. Nerve terminals in the tumor microenvironment as targets for local infiltration analgesia. Neurosci Res 2023; 196:40-51. [PMID: 37336292 DOI: 10.1016/j.neures.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/19/2023] [Accepted: 06/16/2023] [Indexed: 06/21/2023]
Abstract
Nerve terminals within the tumor microenvironment as potential pain-mitigating targets for local infiltration analgesia is relatively less explored. In this study, we examine the role of key analgesics administered as local infiltration analgesia in a model of cancer-induced bone pain (CIBP). CIBP was induced by administration of allogenic MRMT1 breast cancer cells in the proximal tibia of rats, and tumor mass characterized using radiogram, micro-CT, and histological analysis. In vitro responsiveness to key analgesics δ-opioid receptor agonist (DOPr), Ca2+ channel and TRPV1 antagonists was assessed using ratiometric Ca2+ imaging in sensory neurons innervating the tumor site. Effectiveness of locally infiltrated analgesics administered independently or in combination was assessed by quantifying evoked limb withdrawal thresholds at two distinct sites for up to 14 days. CIBP animals demonstrated DOPr, N-, and L-type and TRPV1 expression in lumbar dorsal root ganglion neurons (DRG), comparable to controls. Evoked Ca2+ transients in DRG neurons from CIBP animals were significantly reduced in response to treatment with compounds targeting DOPr, N-, L-type Ca2+ channels and TRPV1 proteins. Behaviourally, evoked hyperalgesia at the tumor site was strongly mitigated by peritumoral injection of the DOPr agonist and T-type calcium antagonist, via its activity on bone afferents. Results from this study suggest that nerve terminals at tumor site could be utilized as targets for specific analgesics, using local infiltration analgesia.
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Affiliation(s)
- Pallavi Madhusudanan
- Amrita School of Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences & Research Center, Amrita Vishwa Vidyapeetham, Kochi, Kerala 682041, India
| | - Chinnu Jerard
- Amrita School of Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences & Research Center, Amrita Vishwa Vidyapeetham, Kochi, Kerala 682041, India
| | - Gayathri Raju
- Amrita School of Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences & Research Center, Amrita Vishwa Vidyapeetham, Kochi, Kerala 682041, India
| | - Neeraj Katiyar
- Biomedical Engineering Division, Department of Materials Science and Engineering, Uppsala University, Lagerhyddsvagen 1, 752 37 Uppsala, Sweden
| | - Sahadev A Shankarappa
- Amrita School of Nanosciences & Molecular Medicine, Amrita Institute of Medical Sciences & Research Center, Amrita Vishwa Vidyapeetham, Kochi, Kerala 682041, India.
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Haroun R, Wood JN, Sikandar S. Mechanisms of cancer pain. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2023; 3:1030899. [PMID: 36688083 PMCID: PMC9845956 DOI: 10.3389/fpain.2022.1030899] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/14/2022] [Indexed: 01/05/2023]
Abstract
Personalised and targeted interventions have revolutionised cancer treatment and dramatically improved survival rates in recent decades. Nonetheless, effective pain management remains a problem for patients diagnosed with cancer, who continue to suffer from the painful side effects of cancer itself, as well as treatments for the disease. This problem of cancer pain will continue to grow with an ageing population and the rapid advent of more effective therapeutics to treat the disease. Current pain management guidelines from the World Health Organisation are generalised for different pain severities, but fail to address the heterogeneity of mechanisms in patients with varying cancer types, stages of disease and treatment plans. Pain is the most common complaint leading to emergency unit visits by patients with cancer and over one-third of patients that have been diagnosed with cancer will experience under-treated pain. This review summarises preclinical models of cancer pain states, with a particular focus on cancer-induced bone pain and chemotherapy-associated pain. We provide an overview of how preclinical models can recapitulate aspects of pain and sensory dysfunction that is observed in patients with persistent cancer-induced bone pain or neuropathic pain following chemotherapy. Peripheral and central nervous system mechanisms of cancer pain are discussed, along with key cellular and molecular mediators that have been highlighted in animal models of cancer pain. These include interactions between neuronal cells, cancer cells and non-neuronal cells in the tumour microenvironment. Therapeutic targets beyond opioid-based management are reviewed for the treatment of cancer pain.
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Affiliation(s)
- Rayan Haroun
- Division of Medicine, Wolfson Institute of Biomedical Research, University College London, London, UnitedKingdom
| | - John N Wood
- Division of Medicine, Wolfson Institute of Biomedical Research, University College London, London, UnitedKingdom
| | - Shafaq Sikandar
- William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom,Correspondence: Shafaq Sikandar
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Singla RK, Guimarães AG, Zengin G. Editorial: Application of plant secondary metabolites to pain neuromodulation, volume II. Front Pharmacol 2022; 13:1013063. [PMID: 36225584 PMCID: PMC9549320 DOI: 10.3389/fphar.2022.1013063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/15/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rajeev K. Singla
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
- *Correspondence: Rajeev K. Singla, ; Adriana Gibara Guimarães, ; Gokhan Zengin,
| | - Adriana Gibara Guimarães
- Federal University of Sergipe, São Cristóvão, Brazil
- *Correspondence: Rajeev K. Singla, ; Adriana Gibara Guimarães, ; Gokhan Zengin,
| | - Gokhan Zengin
- Selçuk University, Konya, Turkey
- *Correspondence: Rajeev K. Singla, ; Adriana Gibara Guimarães, ; Gokhan Zengin,
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Yuan ZL, Liu XD, Zhang ZX, Li S, Tian Y, Xi K, Cai J, Yang XM, Liu M, Xing GG. Activation of GDNF-ERK-Runx1 signaling contributes to P2X3R gene transcription and bone cancer pain. iScience 2022; 25:104936. [PMID: 36072549 PMCID: PMC9441333 DOI: 10.1016/j.isci.2022.104936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/15/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
Bone cancer pain is a common symptom in cancer patients with bone metastases and its underlying mechanisms remain unknown. Here, we report that Runx1 directly upregulates the transcriptional activity of P2X3 receptor (P2X3R) gene promoter in PC12 cells. Knocking down Runx1 in dorsal root ganglion (DRG) neurons suppresses the functional upregulation of P2X3R, attenuates neuronal hyperexcitability and pain hypersensitivity in tumor-bearing rats, whereas overexpressing Runx1 promotes P2X3R gene transcription in DRG neurons, induces neuronal hyperexcitability and pain hypersensitivity in naïve rats. Activation of GDNF-GFRα1-Ret-ERK signaling is required for Runx1-mediated P2X3R gene transcription in DRG neurons, and contributes to neuronal hyperexcitability and pain hypersensitivity in tumor-bearing rats. These findings indicate that the Runx1-mediated P2X3R gene transcription resulted from activation of GDNF-GFRα1-Ret-ERK signaling contributes to the sensitization of DRG neurons and pathogenesis of bone cancer pain. Our findings identify a potentially targetable mechanism that may cause bone metastasis-associated pain in cancer patients. Runx1 directly upregulates the transcriptional activity of P2X3R gene promoter Upregulation of Runx1-mediated P2X3R gene transcription underlies bone cancer pain Involvement of GDNF-Ret-ERK signaling in Runx1-mediated P2X3R gene transcription
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Qian HY, Zhou F, Wu R, Cao XJ, Zhu T, Yuan HD, Chen YN, Zhang PA. Metformin Attenuates Bone Cancer Pain by Reducing TRPV1 and ASIC3 Expression. Front Pharmacol 2021; 12:713944. [PMID: 34421611 PMCID: PMC8371459 DOI: 10.3389/fphar.2021.713944] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Bone cancer pain (BCP) is a common pathologic pain associated with destruction of bone and pathological reconstruction of nervous system. Current treatment strategies in clinical is inadequate and have unacceptable side effects due to the unclear pathology mechanism. In the present study, we showed that transplantation of Walker 256 cells aggravated mechanical allodynia of BCP rats (**p < 0.01 vs. Sham), and the expression of ASIC3 (Acid-sensitive ion channel 3) and TRPV1 was obviously enhanced in L4-6 dorsal root ganglions (DRGs) of BCP rats (**p < 0.01 vs. Sham). ASIC3 and TRPV1 was mainly expressed in CGRP and IB4 positive neurons of L4-6 DRGs. While, TRPV1 but not ASIC3 was markedly upregulated in L4-6 spinal dorsal horn (SDH) of BCP rats (**p < 0.01 vs. Sham). Importantly, intrathecal injection of CPZ (a TRPV1 inhibitor) or Amiloride (an ASICs antagonist) markedly increased the paw withdraw threshold (PWT) of BCP rats response to Von Frey filaments (**p < 0.01 vs. BCP + NS). What’s more, intraperitoneally injection of Metformin or Vinorelbine markedly elevated the PWT of BCP rats, but reduced the expression of TRPV1 and ASIC3 in L4-6 DRGs and decreased the TRPV1 expression in SDH (*p < 0.05, **p < 0.01 vs. BCP + NS). Collectively, these results suggest an effective analgesic effect of Metformin on mechanical allodynia of BCP rats, which may be mediated by the downregulation of ASIC3 and TRPV1.
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Affiliation(s)
- He-Ya Qian
- Department of Oncology, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China.,Center for Translational Medicine, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China
| | - Fang Zhou
- Department of Oncology, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China
| | - Rui Wu
- Center for Translational Medicine, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China
| | - Xiao-Jun Cao
- Center for Translational Medicine, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China
| | - Tao Zhu
- Department of Laboratory, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China
| | - Hao-Dong Yuan
- Department of Laboratory, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China
| | - Ya-Nan Chen
- Department of Oncology, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China
| | - Ping-An Zhang
- Center for Translational Medicine, Affiliated Zhangjiagang Hospital of Soochow University, Zhangjiagang, China.,Center for Translational Pain Medicine, Institute of Neuroscience, Soochow University, Suzhou, China
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Kucharczyk MW, Derrien D, Dickenson AH, Bannister K. The Stage-Specific Plasticity of Descending Modulatory Controls in a Rodent Model of Cancer-Induced Bone Pain. Cancers (Basel) 2020; 12:cancers12113286. [PMID: 33172040 PMCID: PMC7716240 DOI: 10.3390/cancers12113286] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/25/2020] [Accepted: 11/03/2020] [Indexed: 12/31/2022] Open
Abstract
Simple Summary The mechanisms that underlie pain resulting from metastatic bone disease remain elusive. This translates to a clinical and socioeconomic burden—targeted therapy is not possible, and patients do not receive adequate analgesic relief. The heterogeneous nature of metastatic bone disease complicates matters. Early stage cancers are molecularly very different to their late stage counterparts and so is the pain associated with early stage and advanced tumours. Thus, analgesic approaches should differ according to disease stage. In this article, we demonstrate that a unique form of brain inhibitory control responsible for the modulation of incoming pain signals at the level of the spinal cord changes with the progression of bone tumours. This corresponds with the degree of damage to the primary afferents innervating the cancerous tissue. Plasticity in the modulation of spinal neuronal activity by descending control pathways reveals a novel opportunity for targeting bone cancer pain in a stage-specific manner. Abstract Pain resulting from metastatic bone disease is a major unmet clinical need. Studying spinal processing in rodent models of cancer pain is desirable since the percept of pain is influenced in part by modulation at the level of the transmission system in the dorsal horn of the spinal cord. Here, a rodent model of cancer-induced bone pain (CIBP) was generated following syngeneic rat mammary gland adenocarcinoma cell injection in the tibia of male Sprague Dawley rats. Disease progression was classified as “early” or “late” stage according to bone destruction. Even though wakeful CIBP rats showed progressive mechanical hypersensitivity, subsequent in vivo electrophysiological measurement of mechanically evoked deep dorsal horn spinal neuronal responses revealed no change. Rather, a dynamic reorganization of spinal neuronal modulation by descending controls was observed, and this was maladaptive only in the early stage of CIBP. Interestingly, this latter observation corresponded with the degree of damage to the primary afferents innervating the cancerous tissue. Plasticity in the modulation of spinal neuronal activity by descending control pathways reveals a novel opportunity for targeting CIBP in a stage-specific manner. Finally, the data herein have translational potential since the descending control pathways measured are present also in humans.
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Affiliation(s)
- Mateusz Wojciech Kucharczyk
- Central Modulation of Pain Group, Wolfson Centre for Age-Related Diseases, King’s College London, London SE1 1UL, UK;
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, UK; (D.D.); (A.H.D.)
- Correspondence: ; Tel.: +44-20-7848-4617; Fax: +44-20-7848-6806
| | - Diane Derrien
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, UK; (D.D.); (A.H.D.)
| | - Anthony Henry Dickenson
- Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, London WC1E 6BT, UK; (D.D.); (A.H.D.)
| | - Kirsty Bannister
- Central Modulation of Pain Group, Wolfson Centre for Age-Related Diseases, King’s College London, London SE1 1UL, UK;
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