1
|
Huang ACW, Shih HC, Shyu BC. The P2X7 Hypothesis of Central Post-Stroke Pain. Int J Mol Sci 2024; 25:6577. [PMID: 38928280 PMCID: PMC11204365 DOI: 10.3390/ijms25126577] [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: 04/04/2024] [Revised: 06/02/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
The present study examined how P2X7 receptor knockout (KO) modulates central post-stroke pain (CPSP) induced by lesions of the ventrobasal complex (VBC) of the thalamus in behaviors, molecular levels, and electrical recording tests. Following the experimental procedure, the wild-type and P2X7 receptor KO mice were injected with 10 mU/0.2 μL type IV collagenase in the VBC of the thalamus to induce an animal model of stroke-like thalamic hemorrhage. Behavioral data showed that the CPSP group induced thermal and mechanical pain. The P2X7 receptor KO group showed reduced thermal and mechanical pain responses compared to the CPSP group. Molecular assessments revealed that the CPSP group had lower expression of NeuN and KCC2 and higher expression of GFAP, IBA1, and BDNF. The P2X7 KO group showed lower expression of GFAP, IBA1, and BDNF but nonsignificant differences in KCC2 expression than the CPSP group. The expression of NKCC1, GABAa receptor, and TrkB did not differ significantly between the control, CPSP, and P2X7 receptor KO groups. Muscimol, a GABAa agonist, application increased multiunit numbers for monitoring many neurons and [Cl-] outflux in the cytosol in the CPSP group, while P2X7 receptor KO reduced multiunit activity and increased [Cl-] influx compared to the CPSP group. P2X4 receptor expression was significantly decreased in the 100 kDa but not the 50 kDa site in the P2X7 receptor KO group. Altogether, the P2X7 hypothesis of CPSP was proposed, wherein P2X7 receptor KO altered the CPSP pain responses, numbers of astrocytes and microglia, CSD amplitude of the anterior cingulate cortex and the medial dorsal thalamus, BDNF expression, [Cl-] influx, and P2X4 expression in 100 kDa with P2X7 receptors. The present findings have implications for the clinical treatment of CPSP symptoms.
Collapse
Affiliation(s)
| | - Hsi-Chien Shih
- Institute of Biomedical Sciences, Academia Sinica, Taipei 11529, Taiwan;
| | - Bai Chuang Shyu
- Institute of Biomedical Sciences, Academia Sinica, Taipei 11529, Taiwan;
| |
Collapse
|
2
|
Nasirinezhad F, Zarepour L, Hadjighassem M, Gharaylou Z, Majedi H, Ramezani F. Analgesic Effect of Bumetanide on Neuropathic Pain in Patients With Spinal Cord Injury. Basic Clin Neurosci 2021; 12:409-420. [PMID: 34917299 PMCID: PMC8666921 DOI: 10.32598/bcn.12.3.2049.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/15/2019] [Accepted: 01/21/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction The current study evaluated the analgesic effects of bumetanide as an adjunctive in the management of neuropathic pain following Spinal Cord Injury (SCI). The peripheral expression of Na-K-Cl Cotransporter-1 (NKCC1) and K-Cl Cotransporter-2 (KCC2) genes in polymorphonuclear lymphocytes (PMLs) was assessed as a possible biomarker indicating central mechanisms underlying the observed response. Methods Through an open-label, single-arm, pilot trial of bumetanide (2 mg/d), an add-on treatment was conducted on 14 SCI patients for 19 weeks. This study consisted of 3 phases: pre-treatment (1 month), titration (3 weeks), and active treatment (4 months). Ultimately, 9 patients completed the study. The primary outcome variables were the endpoint pain score using the Numeric Rating Scale (NRS), and also the short-form of the McGill pain questionnaire. Secondary endpoints included the short-form of the health survey that assesses the quality of life. Blood samples were collected and used for determining the expression of NKCC1 and KCC2 genes in transcription and translation levels. Results Bumetanide treatment significantly decreased average pain intensity according to the NRS and the short-form of the McGill pain questionnaire scores. Baseline expression of KCC2 protein was low between groups and increased significantly following treatment (P<0.05). In the current study, pain improvement was accompanied by the greater mean change from the baseline (improvement) for the overall quality of life. Conclusion These data highlighted the analgesic effect of bumetanide on neuropathic pain and indicated the potential role of the upregulation of KCC2 protein and involvement of GABAergic disinhibition in producing neuropathic pain.
Collapse
Affiliation(s)
- Farinaz Nasirinezhad
- Department of Physiology, Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Zarepour
- Department of Physiology, Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoudreza Hadjighassem
- Brain and Spinal cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Gharaylou
- Brain and Spinal cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossin Majedi
- Brain and Spinal cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ramezani
- Department of Physiology, Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Bista P, Imlach WL. Pathological Mechanisms and Therapeutic Targets for Trigeminal Neuropathic Pain. MEDICINES (BASEL, SWITZERLAND) 2019; 6:E91. [PMID: 31443547 PMCID: PMC6789505 DOI: 10.3390/medicines6030091] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 12/31/2022]
Abstract
Trigeminal neuropathic pain is a chronic pain condition caused by damage or inflammation of the trigeminal nerve or its branches, with both peripheral and central nervous system dysfunction contributing to the disorder. Trigeminal pain conditions present with diagnostic and therapeutic challenges to healthcare providers and often require multiple therapeutic approaches for pain reduction. This review will provide the overview of pathophysiology in peripheral and central nociceptive circuits that are involved in neuropathic pain conditions involving the trigeminal nerve and the current therapeutics that are used to treat these disorders. Recent advances in treatment of trigeminal pain, including novel therapeutics that target ion channels and receptors, gene therapy and monoclonal antibodies that have shown great promise in preclinical studies and clinical trials will also be described.
Collapse
Affiliation(s)
- Pawan Bista
- Department of Physiology & Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Wendy L Imlach
- Department of Physiology & Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia.
| |
Collapse
|
4
|
Dehkordi FM, Kaboutari J, Zendehdel M, Javdani M. The antinociceptive effect of artemisinin on the inflammatory pain and role of GABAergic and opioidergic systems. Korean J Pain 2019; 32:160-167. [PMID: 31257824 PMCID: PMC6615442 DOI: 10.3344/kjp.2019.32.3.160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/11/2019] [Accepted: 03/19/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Pain is a complex mechanism which involves different systems, including the opioidergic and GABAergic systems. Due to the side effects of chemical analgesic agents, attention toward natural agents have been increased. Artemisinin is an herbal compound with widespread modern and traditional therapeutic indications, which its interaction with the GABAergic system and antinoniceptive effects on neuropathic pain have shown. Therefore, this study was designed to evaluate the antinociceptive effects of artemisinin during inflammatory pain and interaction with the GABAergic and opioidergic systems by using a writhing response test. METHODS On the whole, 198 adult male albino mice were used in 4 experiments, including 9 groups (n = 6) each with three replicates, by intraperitoneal (i.p.) administration of artemisinin (2.5, 5, and 10 mg/kg), naloxone (2 mg/kg), bicuculline (2 mg/kg), saclofen (2 mg/kg), indomethacin (5 mg/kg), and ethanol (10 mL/kg). Writhing test responses were induced by i.p. injection of 10 mL/kg of 0.6% acetic acid, and the percentage of writhing inhibition was recorded. RESULTS Results showed significant dose dependent anti-nociceptive effects from artemisinin which, at a 10 mg/kg dose, was statistically similar to indomethacin. Neither saclofen nor naloxone had antinociceptive effects and did not antagonize antinociceptive effects of artemisinin, whereas bicuculline significantly inhibited the antinocicptive effect of artemisinin. CONCLUSIONS It seems that antinocicptive effects of artemisinin are mediated by GABAA receptors.
Collapse
Affiliation(s)
- Faraz Mahdian Dehkordi
- Department of Basic Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord,
Iran
| | - Jahangir Kaboutari
- Department of Basic Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord,
Iran
| | - Morteza Zendehdel
- Department of Physiology, Faculty of Veterinary Medicine, University of Tehran, Tehran,
Iran
| | - Moosa Javdani
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord,
Iran
| |
Collapse
|
5
|
Lima MPD, Lopes EM, Gomes LDS, França ARDS, Acha BT, Carvalho ALM, Almeida FRDC. Technological development of microemulsions with perspectives for pain treatment: a patent review. Expert Opin Ther Pat 2018; 28:691-702. [PMID: 30175633 DOI: 10.1080/13543776.2018.1519025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Microemulsions are thermodynamically stable translucent systems widely used for systemic delivery of drugs. The present study is the first to analyze the biotechnological potential of microemulsion systems for therapeutic purposes, through transdermal route, for pain treatment. AREAS COVERED Patents were searched in the World Intellectual Property Organization (WIPO), European Patent Office (Espacenet), United States Patent and Trademark Office (USPTO) and National Institute of Intellectual Property (INPI). The inclusion criteria were published patents containing the keywords; 'microemulsion' and 'transdermal' in their title or abstract. 208 patents were found. However, only those patents which mentioned in their abstract or in their description the use of microemulsion system (object of invention) for pain treatment were selected. Were excluded duplicate patents and those that did not report pharmacological use of MEs specifically for pain treatment. Thus, sixteen patents were selected and described in the present study. EXPERT OPINION Patents were found that focused specifically on the development process of microemulsion systems, the inclusion of essential oils in microemulsions, which place microemulsions as delivery systems for NSAIDs and other substances, as well as microemulsions for transdermal administration. These studies reinforce the therapeutic applicability of MEs in the treatment of acute and chronic pain.
Collapse
Affiliation(s)
| | - Everton Moraes Lopes
- a Medicinal Plants Research nucleus, Center of Health Sciences , Federal University of Piauí , Teresina , Brazil
| | - Laércio da Silva Gomes
- a Medicinal Plants Research nucleus, Center of Health Sciences , Federal University of Piauí , Teresina , Brazil
| | - Ana Rita de Sousa França
- a Medicinal Plants Research nucleus, Center of Health Sciences , Federal University of Piauí , Teresina , Brazil
| | - Boris Timah Acha
- a Medicinal Plants Research nucleus, Center of Health Sciences , Federal University of Piauí , Teresina , Brazil
| | | | | |
Collapse
|
6
|
Yoon JH, Son JY, Kim MJ, Kang SH, Ju JS, Bae YC, Ahn DK. Preemptive application of QX-314 attenuates trigeminal neuropathic mechanical allodynia in rats. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2018; 22:331-341. [PMID: 29719455 PMCID: PMC5928346 DOI: 10.4196/kjpp.2018.22.3.331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/09/2018] [Accepted: 02/19/2018] [Indexed: 12/19/2022]
Abstract
The aim of the present study was to examine the effects of preemptive analgesia on the development of trigeminal neuropathic pain. For this purpose, mechanical allodynia was evaluated in male Sprague-Dawley rats using chronic constriction injury of the infraorbital nerve (CCI-ION) and perineural application of 2% QX-314 to the infraorbital nerve. CCI-ION produced severe mechanical allodynia, which was maintained until postoperative day (POD) 30. An immediate single application of 2% QX-314 to the infraorbital nerve following CCI-ION significantly reduced neuropathic mechanical allodynia. Immediate double application of QX-314 produced a greater attenuation of mechanical allodynia than a single application of QX-314. Immediate double application of 2% QX-314 reduced the CCI-ION-induced upregulation of GFAP and p-p38 expression in the trigeminal ganglion. The upregulated p-p38 expression was co-localized with NeuN, a neuronal cell marker. We also investigated the role of voltage-gated sodium channels (Navs) in the antinociception produced by preemptive application of QX-314 through analysis of the changes in Nav expression in the trigeminal ganglion following CCI-ION. Preemptive application of QX-314 significantly reduced the upregulation of Nav1.3, 1.7, and 1.9 produced by CCI-ION. These results suggest that long-lasting blockade of the transmission of pain signaling inhibits the development of neuropathic pain through the regulation of Nav isoform expression in the trigeminal ganglion. Importantly, these results provide a potential preemptive therapeutic strategy for the treatment of neuropathic pain after nerve injury.
Collapse
Affiliation(s)
- Jeong-Ho Yoon
- Department of Oral Physiology School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Jo-Young Son
- Department of Oral Physiology School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Min-Ji Kim
- Department of Oral Physiology School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Song-Hee Kang
- Department of Oral Physiology School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Jin-Sook Ju
- Department of Oral Physiology School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Yong-Chul Bae
- Department of Oral Anatomy, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Dong-Kuk Ahn
- Department of Oral Physiology School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| |
Collapse
|
7
|
Association of inflammatory mediators with pain perception. Biomed Pharmacother 2017; 96:1445-1452. [DOI: 10.1016/j.biopha.2017.12.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 12/31/2022] Open
|