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Apostolova D, Apostolov G, Moten D, Batsalova T, Dzhambazov B. Claudin-12: guardian of the tissue barrier or friend of tumor cells. Tissue Barriers 2024:2387408. [PMID: 39087432 DOI: 10.1080/21688370.2024.2387408] [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: 05/04/2024] [Revised: 07/28/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024] Open
Abstract
Tight junctions (TJs) are an important component of cellular connectivity. Claudin family proteins, as a constituent of TJs, determine their barrier properties, cell polarity and paracellular permeability. Claudin-12 is an atypical member of the claudin family, as it belongs to the group of non-classical claudins that lack a PDZ-binding domain. It has been shown that claudin-12 is involved in paracellular Ca2+ transients and it is present in normal and hyperplastic tissues in addition to neoplastic tissues. Dysregulation of claudin-12 expression has been reported in various cancers, suggesting that this protein may play an important role in cancer cell migration, invasion, and metastasis. Some studies have shown that claudin-12 gene functions as a tumor suppressor, but others have reported that overexpression of claudin-12 significantly increases the metastatic properties of various tumor cells. Investigating this dual role of claudin-12 is of utmost importance and should therefore be studied in detail. The aim of this review is to provide an overview of the information available to date on claudin-12, including its structure, expression in various tissues and substances that may affect it, with a final focus on its role in cancer.
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Affiliation(s)
- Desislava Apostolova
- Department of Developmental Biology, Faculty of Biology, Paisii Hilendarski University of Plovdiv, Plovdiv, Bulgaria
| | - Georgi Apostolov
- Department of Neurosurgery, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Dzhemal Moten
- Department of Developmental Biology, Faculty of Biology, Paisii Hilendarski University of Plovdiv, Plovdiv, Bulgaria
| | - Tsvetelina Batsalova
- Department of Developmental Biology, Faculty of Biology, Paisii Hilendarski University of Plovdiv, Plovdiv, Bulgaria
| | - Balik Dzhambazov
- Department of Developmental Biology, Faculty of Biology, Paisii Hilendarski University of Plovdiv, Plovdiv, Bulgaria
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Gutiérrez-Galicia JK, Drago-Serrano ME, Oros-Pantoja R, Godínez-Victoria M, Guzmán-Mejía F. Effect of chronic stress on gel-forming mucins in the small intestine of BALB/c mice. J Med Life 2024; 17:326-333. [PMID: 39044931 PMCID: PMC11262609 DOI: 10.25122/jml-2023-0473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/16/2024] [Indexed: 07/25/2024] Open
Abstract
Intestinal homeostasis involves the collaboration of gut barrier components, such as goblet cells and IgA-microbiota complexes, that are under the control of stress that promotes inflammatory responses addressed primarily in the colon. The aim of this study was to evaluate the effect of stress on mucins, goblet cells, and proinflammatory parameters in the proximal and distal regions of the small intestine. A group (n = 6) of female 8-week-old BALB/c mice underwent board immobilization stress (2 h per day for 4 days) and were sacrificed with isoflurane. Samples from proximal and distal small segments were collected to analyze the following: 1) goblet cells stained with periodic acid-Schiff (PAS) and with alcian blue (AB) to visualize histologically neutral and acidic mucins, respectively; 2) IgA-microbiota complexes identified by flow cytometry in intestinal lavages; and 3) MUC2, MUC5AC, and IL-18 mRNA levels in whole mucosal scrapings by reverse transcription-qPCR. Regarding the unstressed group, in the proximal region of small intestine both PAS+ and AB+ goblet cells were unchanged; however, MUC5AC and IL-18 mRNA levels were increased, and the percentage of IgA-microbiota complexes was reduced. In the distal segment, the number of PAS+ goblet cells was increased, whereas the number of AB+ goblet cells was reduced and did not affect the remaining parameters. The data suggest that stress induces inflammation in the proximal small intestine; these findings may provide an experimental reference for human diseases that may affect the proximal small intestine, such as Crohn's disease, in which stress contributes to the progression of intestinal inflammation or relapse.
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Affiliation(s)
- Jennifer Karume Gutiérrez-Galicia
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México
| | - Maria Elisa Drago-Serrano
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana Unidad Xochimilco, Ciudad de México, México
| | - Rigoberto Oros-Pantoja
- Facultad de Medicina, Universidad Autónoma del Estado de México, Toluca de Lerdo, México
| | - Marycarmen Godínez-Victoria
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México
| | - Fabiola Guzmán-Mejía
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana Unidad Xochimilco, Ciudad de México, México
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Ilderbayev O, Okassova A, Rakhyzhanova S, Ilderbayeva G, Zhazykbayeva L. The levels of oxidative stress in a combination of stress factors. J Med Life 2022; 15:927-931. [PMID: 36188645 PMCID: PMC9514812 DOI: 10.25122/jml-2021-0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 02/18/2022] [Indexed: 11/05/2022] Open
Abstract
We studied the effect of the combined action of ionizing radiation and induced immobilization stress on the lipid peroxidation process and antioxidant protection of organs (mesenteric lymph nodes, spleen, adrenal glands, thymus, and liver) and immune cels - the blood lymphocytes. Results were obtained on the role of free-radical oxidation in combination with exposure to ionizing radiation and immobilization stress at an early stage in the experiment. Gamma radiation in the acute period resulted in significant changes in lipoperoxidation and antioxidant systems. The first period of immobilization stress was marked by the imbalance of LPO-AOS systems disturbance with an accumulation of toxic compounds in tissues which had affected their function. The combined sublethal gamma radiation and immobilization stress disturbed the functional activity of adaptive systems of the body in the early stage of adaptation syndrome. Furthermore, the results show the dominant role of ionizing radiation in it.
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Affiliation(s)
- Oralbek Ilderbayev
- Department of General Biology and Genomics, Faculty of Natural Sciences, L.N. Gumilyov Eurasian National University, Nur-Sultan, Kazakhstan,Corresponding Author: Oralbek Ilderbayev, Department of General Biology and Genomics, Faculty of Natural Sciences, L.N. Gumilyov Eurasian National University, Nur-Sultan, Kazakhstan. E-mail:
| | - Assem Okassova
- Department of General Biology and Genomics, Faculty of Natural Sciences, L.N. Gumilyov Eurasian National University, Nur-Sultan, Kazakhstan
| | - Saule Rakhyzhanova
- Department of Physiological Disciplines, Semey Medical University, Semey, Kazakhstan
| | - Gulzhan Ilderbayeva
- Department of Biotechnology and Microbiology, Natural Science Faculty, NCJSC L.N. Gumilyov Eurasian National University, Nur-Sultan, Kazakhstan
| | - Lashyn Zhazykbayeva
- Department of Physiological Disciplines, Semey Medical University, Semey, Kazakhstan
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Mocci E, Goto T, Chen J, Ament S, Traub RJ, Dorsey SG. Early and Late Transcriptional Changes in Blood, Neural, and Colon Tissues in Rat Models of Stress-Induced and Comorbid Pain Hypersensitivity Reveal Regulatory Roles in Neurological Disease. FRONTIERS IN PAIN RESEARCH 2022; 3:886042. [PMID: 35655748 PMCID: PMC9152010 DOI: 10.3389/fpain.2022.886042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) and temporomandibular disorder (TMD) are two chronic pain conditions that frequently overlap in the same individual, more commonly in women. Stress is a significant risk factor, exacerbating or triggering one or both conditions. However, the mechanisms underlying IBS–TMD co-morbidity are mostly unknown. Aim To detect both specific and common stress-induced visceral hypersensitivity (SIH) and comorbid TMD–IBS pain hypersensitivity (CPH) genetic signatures over time. Method Twenty-four female rats were randomly assigned to one of three experimental groups: naïve, SIH, and CPH (orofacial pain plus stress). RNA was extracted from blood, colon, spinal cord, and dorsal root ganglion 1 or 7 weeks after the stress paradigm. We combined differential gene expression and co-expression network analyses to define both SIH and CPH expression profiles across tissues and time. Results The transcriptomic profile in blood and colon showed increased expression of genes enriched in inflammatory and neurological biological processes in CPH compared to SIH rats, both at 1 and 7 weeks after stress. In lumbosacral spinal tissue, both SIH and CPH rats compared to naïve revealed decreased expression of genes related to synaptic activity and increased expression of genes enriched in “angiogenesis,” “Neurotrophin,” and “PI3K-Akt” pathways. Compared to SIH, CPH rats showed increased expression of angiogenesis-related genes 1 week after exposure to stress, while 7 weeks post-stress the expression of these genes was higher in SIH rats. In dorsal root ganglia (DRG), CPH rats showed decreased expression of immune response genes at week 1 and inhibition of nerve myelination genes at 7 weeks compared to naïve. For all tissues, we observed higher expression of genes involved in ATP production in SIH compared to CPH at 1 week and this was reversed 7 weeks after the induction of stress. Conclusion Our study highlights an increased inflammatory response in CPH compared to SIH rats in the blood and colon. DRG and spinal transcriptomic profiles of both CPH and SIH rats showed inhibition of synaptic activity along with activation of angiogenesis. Targeting these biological processes may lead to a more profound understanding of the mechanisms underlying IBS–TMD comorbidities and new diagnostic and therapeutic strategies.
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Affiliation(s)
- Evelina Mocci
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States
- Institute for Genome Sciences, University of Maryland School of Medicine, University of Maryland Baltimore, Baltimore, MD, United States
| | - Taichi Goto
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States
| | - Jie Chen
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States
| | - Seth Ament
- Institute for Genome Sciences, University of Maryland School of Medicine, University of Maryland Baltimore, Baltimore, MD, United States
| | - Richard J. Traub
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, University of Maryland Baltimore, Baltimore, MD, United States
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
| | - Susan G. Dorsey
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
- *Correspondence: Susan G. Dorsey
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Morphofunctional Changes in Colon after Cold Stress in Male C57BL/6 Mice Susceptible and Tolerant to Hypoxia. Bull Exp Biol Med 2021; 171:499-503. [PMID: 34542767 DOI: 10.1007/s10517-021-05259-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Indexed: 10/20/2022]
Abstract
There are individual differences in the tolerance to hypoxia and stress. Stress can contribute to the development of various diseases, including inflammatory bowel disease. It was found that inflammatory bowel diseases in animals susceptible to hypoxia runs more severe course than in tolerant animals. We studied morphofunctional changes in the colon under conditions of modeled cold stress in male C57BL/6 mice susceptible and tolerant to hypoxia. The animals were daily subjected to cold stress (20 min at -20°C) for 2 weeks. Cold stress was followed by an increase in the volume fraction of goblet cells in the colon and production of mucins by these cells in mice tolerant to hypoxia and an increase in cell content in the lamina propria of the colon mucous membrane in animals susceptible to hypoxia. The number of serotoninproducing endocrine cells increased in both groups, but these changes were more pronounced in mice susceptible to hypoxia.
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Guzmán-Mejía F, Godínez-Victoria M, Vega-Bautista A, Pacheco-Yépez J, Drago-Serrano ME. Intestinal Homeostasis under Stress Siege. Int J Mol Sci 2021; 22:ijms22105095. [PMID: 34065791 PMCID: PMC8150578 DOI: 10.3390/ijms22105095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 01/15/2023] Open
Abstract
Intestinal homeostasis encompasses a complex and balanced interplay among a wide array of components that collaborate to maintain gut barrier integrity. The appropriate function of the gut barrier requires the mucus layer, a sticky cushion of mucopolysaccharides that overlays the epithelial cell surface. Mucus plays a critical anti-inflammatory role by preventing direct contact between luminal microbiota and the surface of the epithelial cell monolayer. Moreover, mucus is enriched with pivotal effectors of intestinal immunity, such as immunoglobulin A (IgA). A fragile and delicate equilibrium that supports proper barrier function can be disturbed by stress. The impact of stress upon intestinal homeostasis results from neuroendocrine mediators of the brain-gut axis (BGA), which comprises a nervous branch that includes the enteric nervous system (ENS) and the sympathetic and parasympathetic nervous systems, as well as an endocrine branch of the hypothalamic-pituitary-adrenal axis. This review is the first to discuss the experimental animal models that address the impact of stress on components of intestinal homeostasis, with special emphasis on intestinal mucus and IgA. Basic knowledge from animal models provides the foundations of pharmacologic and immunological interventions to control disturbances associated with conditions that are exacerbated by emotional stress, such as irritable bowel syndrome.
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Affiliation(s)
- Fabiola Guzmán-Mejía
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana Unidad Xochimilco, Calzada del Hueso No. 1100, CP 04960 Mexico City, Mexico; (F.G.-M.); (A.V.-B.)
| | - Marycarmen Godínez-Victoria
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, CP 11340 Mexico City, Mexico;
- Correspondence: (M.G.-V.); (M.E.D.-S.); Tel.: +52-55-5729-6000 (ext. 62743) (M.G.-V.); +52-55-5483-7000 (ext. 3624) (M.E.D.-S.)
| | - Alan Vega-Bautista
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana Unidad Xochimilco, Calzada del Hueso No. 1100, CP 04960 Mexico City, Mexico; (F.G.-M.); (A.V.-B.)
| | - Judith Pacheco-Yépez
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, CP 11340 Mexico City, Mexico;
| | - Maria Elisa Drago-Serrano
- Departamento de Sistemas Biológicos, Universidad Autónoma Metropolitana Unidad Xochimilco, Calzada del Hueso No. 1100, CP 04960 Mexico City, Mexico; (F.G.-M.); (A.V.-B.)
- Correspondence: (M.G.-V.); (M.E.D.-S.); Tel.: +52-55-5729-6000 (ext. 62743) (M.G.-V.); +52-55-5483-7000 (ext. 3624) (M.E.D.-S.)
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Rana MN, Lu J, Xue E, Ruan J, Liu Y, Zhang L, Dhar R, Li Y, Hu Z, Zhou J, Ma W, Tang H. PDE9 Inhibitor PF-04447943 Attenuates DSS-Induced Colitis by Suppressing Oxidative Stress, Inflammation, and Regulating T-Cell Polarization. Front Pharmacol 2021; 12:643215. [PMID: 33967779 PMCID: PMC8098793 DOI: 10.3389/fphar.2021.643215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/12/2021] [Indexed: 12/24/2022] Open
Abstract
Ulcerative colitis (UC) is a form of inflammatory bowel disease, which manifests as irritation or swelling and sores in the large intestine in a relapsing and remitting manner. In a dextran sulfate sodium sulfate (DSS)-induced UC model in female mice, we found that the levels of cyclic guanosine monophosphate (cGMP) are reduced, while the expression of phosphodiesterase 9A (PDE9A) is highest among all phosphodiesterase (PDEs). Since PDE9 has the highest affinity toward cGMP, we evaluated the selective PDE9 inhibitor PF-04447943 (PF) as a potential candidate for UC treatment. PF has been extensively studies in cognitive function and in sickle cell disease, but not in models for inflammatory bowel disease (IBD). Therefore, we used female C57BL/6 mice treated with 3% DSS alone or co-treated with PF or sulfasalazine (SASP) to study the body weight, colon length, histopathology, and measure superoxide dismutase (SOD), malondialdehyde (MDA), and cGMP level, as well as cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-17 (IL-17), interleukin-12/23 (IL-12/23), interleukin-10 (IL-10), and pathways including nuclear factor kappa B (NF-κB), signal transducer and activator of transcription 3 (STAT3), and inflammasome activation. In addition, the number of dendritic cells (DC) and regulatory T cells (Treg cell) was assessed in the spleen, lymph node, and colon using flow cytometry. DSS reduced the number of goblet cells, decreased colon lengths and body weights, all of them were attenuated by PF treatment. It also suppressed the elevated level of inflammatory cytokines and increased level the anti-inflammatory cytokine, IL-10. PF treatment also reduced the DSS-induced inflammation by suppressing oxidative stress, NF-κB, STAT3, and inflammasome activation, by upregulating nuclear factor erythroid 2-related factor 2 (Nrf-2) and its downstream proteins via extracellular signal-regulated kinase (ERK) phosphorylation. Importantly, PF reversed imbalance in Treg/T helper 17 cells (Th17) cells ratio, possibly by regulating dendritic cells and Treg developmental process. In summary, this study shows the protective effect of a PDE9A inhibitor in ulcerative colitis by suppressing oxidative stress and inflammation as well as reversing the Treg/Th17 cells imbalance.
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Affiliation(s)
- Mohammad Nasiruddin Rana
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Jie Lu
- Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Enfu Xue
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Jingjing Ruan
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Yuting Liu
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Lejun Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Rana Dhar
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Yajun Li
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Zhengqiang Hu
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
| | - Jie Zhou
- Department of Anesthesiology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Wangqian Ma
- Department of Gastroenterology, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China
| | - Huifang Tang
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, China
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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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