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Galik E, Resnick B, Mocci E, Renn CL, Song Y, Dorsey SG. Differential Gene Expression in Pain-Related Genes are not Affected by the Presence of Dementia. Pain Manag Nurs 2024; 25:145-151. [PMID: 38135606 PMCID: PMC11016462 DOI: 10.1016/j.pmn.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 09/24/2023] [Accepted: 11/03/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Prior work has demonstrated differences in the transcriptome between those with and without chronic musculoskeletal pain. AIMS The aim of this study was to explore whether pain-related gene expression is similar between individuals with and without dementia. DESIGN This was a descriptive study using a one-time assessment. SETTINGS PARTICIPANTS/SUBJECTS: A total of 20 older adults living in a continuing care retirement community, 50% of whom had dementia were inlcuded in this study. All were female and the mean age of participants was 89 (SD = 6). METHODS Pain was evaluated based on the PROMIS Pain Intensity Short Form 3a. Whole blood was collected by venipuncture into Tempus vacutainer tubes (3 ml) and the RNA was extracted at the Translational Genomics Laboratory at the University of Maryland Baltimore. Analyses included a differential expression analysis, a weighted gene co-expression network analysis, and a pathway enrichment analysis. RESULTS Eighty-three genes were differentially expressed between individuals with and without pain (p <.05). After normalizing gene counts and removing the low expressed genes, 18,028 genes were left in the final analysis. There was no clustering of the samples related to study variables of pain or dementia. CONCLUSION The findings from this study provided some preliminary support that pain-related gene expression is similar between individuals with and without dementia.
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Affiliation(s)
- Elizabeth Galik
- From the University of Maryland School of Nursing, Baltimore, Maryland.
| | - Barbara Resnick
- From the University of Maryland School of Nursing, Baltimore, Maryland
| | - Evelina Mocci
- From the University of Maryland School of Nursing, Baltimore, Maryland
| | - Cynthia L Renn
- From the University of Maryland School of Nursing, Baltimore, Maryland
| | - Yang Song
- University of Maryland School of Medicine, Baltimore, Maryland
| | - Susan G Dorsey
- From the University of Maryland School of Nursing, Baltimore, Maryland
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Weiss MN, Mocci E, Zhu S, Davenport MJ, English E, Renn CL, Dorsey SG. Nociceptive and Transcriptomic Responses in a Swine Diabetic Wound Model Treated With a Topical Angiotensin 1 Receptor Antagonist. Nurs Res 2024; 73:118-125. [PMID: 37916845 PMCID: PMC10922245 DOI: 10.1097/nnr.0000000000000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND Painful, treatment-resistant wounds are prevalent among diabetic patients and significantly affect health-related quality of life (HRQOL). Topical treatments may help alleviate pain without risk of dependence or side effects. However, there is a lack of topical wound compounds targeting pain-specific receptors. One possible target is proinflammatory angiotensin 1 receptor (AT1R), which is upregulated in diabetic skin and has been implicated in nociception. OBJECTIVES We investigated the effects of topical valsartan, an AT1R antagonist, on pain (nociceptive thresholds) and gene expression changes (transcriptomics) in a swine model of diabetic wounds. METHODS Eight wounds were surgically induced in diabetic, hyperglycemic Yucatan miniature swine ( n = 4). Topical AT1R antagonist was applied to wounds on one side and vehicle on the other side. Nocifensive testing was conducted at baseline and then weekly, beginning 7 days after wound induction. Mechanical and thermal stimuli were applied to the wound margins until a nocifensive reaction was elicited or a predetermined cutoff was reached. After 7 weeks of testing, tissue from the dorsal horn, dorsal root ganglion, and wounds were sequenced and analyzed with DESeq2. Unbiased pathway analyses using Metascape were conducted on differentially expressed genes. RESULTS There was no significant difference in mechanical tolerance threshold between AT1R antagonist-treated and vehicle-treated wounds ( p = .106). Thermal tolerance was significantly higher in AT1R antagonist-treated wounds compared to vehicle-treated ( p = .015). Analysis of differentially expressed genes revealed enriched pathways of interest: interleukin-18 signaling in dorsal horn laminae IV-V and sensory perception of mechanical stimulus in wound tissue. DISCUSSION In this study, wounds modeling diabetic ulcers were created in hyperglycemic swine and treated with a topical AT1R antagonist. AT1R-antagonist-treated wounds had a higher tolerance threshold than vehicle-treated wounds for thermal hyperalgesia, but not mechanical allodynia. Pathway analyses of differentially expressed genes revealed several pathways of interest for future pain research. Although further studies are needed to confirm the findings, this study can improve nursing care by providing information about a potential future treatment that may be used to decrease pain and improve HRQOL in patients with diabetic wounds.
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Kleckner AS, Kleckner IR, Renn CL, Rosenblatt PY, Ryan AS, Zhu S. Dietary Composition, Meal Timing, and Cancer-Related Fatigue: Insights From the Women's Healthy Eating and Living Study. Cancer Nurs 2023:00002820-990000000-00198. [PMID: 38032743 DOI: 10.1097/ncc.0000000000001305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Cancer-related fatigue is difficult to treat, and dietary interventions are promising yet underused. OBJECTIVE We explored associations between dietary patterns and fatigue, and the effect of a dietary intervention versus control on fatigue using Women's Healthy Eating and Living study data, plus mediators and moderators of the intervention effect. METHODS The Women's Healthy Eating and Living study was a randomized controlled trial among early-stage breast cancer survivors. The 4-year intervention encouraged fruits, vegetables, fiber, and 15% to 20% calories from fat. Fatigue outcomes included a 9-item energy scale and a single-item tiredness question. Dietary quality was estimated using a modified Healthy Eating Index (24-hour dietary recall) and serum carotenoid concentrations. Nutrient timing was obtained from 4-day food logs. RESULTS Among 2914 total participants, lower body mass index was associated with less tiredness and more energy at baseline (P < .001 for both). Earlier start and end times for daily eating windows were associated with less tiredness (P = .014 and P = .027, respectively) and greater energy (P = .006 and P = .102, respectively). The intervention did not lead to improvements in fatigue on average (P > .125). However, the intervention was more effective for participants who were younger, had fewer comorbidities, and did not have radiation treatment. Mediators included increases in serum carotenoids, increases in the modified Healthy Eating Index, and weight loss/maintenance. CONCLUSION Diet quality and earlier eating windows were associated with less fatigue. IMPLICATIONS FOR PRACTICE Programs that encourage high diet quality and a morning meal and discourage nighttime eating should be tested for efficacy in reducing cancer-related fatigue in survivorship.
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Affiliation(s)
- Amber S Kleckner
- Author Affiliations: Department of Pain and Translational Symptom Science (Drs A. Kleckner, I. Kleckner, and Renn) and Department of Organizational Systems and Adult Health (Dr Zhu), University of Maryland School of Nursing; Department of Hematology and Oncology (Dr Rosenblatt) and Department of Medicine (Dr Ryan), University of Maryland School of Medicine; Baltimore Geriatric Research Education Clinical Center (Dr Ryan); and Greenebaum Comprehensive Cancer Center (Drs A. Kleckner, I. Kleckner, Rosenblatt, and Ryan), Baltimore, Maryland
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Weaver-Toedtman KR, Walch M, Kiracofe L, Bedingfield A, Cook L, Resnick B, Renn CL, Dorsey SG. Feasibility and Acceptability of an Online Yoga Study Among Individuals with Irritable Bowel Syndrome (IBS). Int J Yoga Therap 2023; 33:Article 8. [PMID: 37798803 DOI: 10.17761/2023-d-22-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain that is often comorbid with psychiatric disorders and other pain-related conditions. The practice of yoga improves symptoms among patients with IBS, although the virtual delivery of yoga in this patient population remains understudied. The purpose of this article is to report feasibility and acceptability of a 6-week pilot yoga intervention among IBS and healthy control participants, which was transitioned to an online format in response to the COVID-19 pandemic. Participants attended 3 virtual study visits and received 60-minute private yoga sessions twice weekly for 6 weeks via Zoom. Sixteen females (n = 8 in IBS group, n = 8 in control group) with a mean age of 34.7 identified as White (87.5%) and Asian (12.5%). All participants attended all 3 study visits; 14 participants attended 12 yoga sessions, 1 attended 11, and 1 attended 9. At the end of the study, 81.3% of participants strongly agreed that participating in the online study was beneficial and convenient, and 87.5% strongly agreed that participating in the online yoga program was beneficial. Our online study and yoga intervention was feasible and acceptable; future studies with larger and more diverse populations will be conducted to investigate health effects among individuals with IBS.
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Affiliation(s)
- Kristen Ronn Weaver-Toedtman
- Assistant Professor, University of South Carolina, College of Nursing, Columbia, S.C.; and University of Maryland School of Nursing; and Center to Advance Chronic Pain Research, University of Maryland, Baltimore
| | - Marissa Walch
- Pain and Translational Symptom Science Department, University of Maryland, School of Nursing, Baltimore
| | - Lindsay Kiracofe
- Pain and Translational Symptom Science Department, University of Maryland, School of Nursing, Baltimore
| | - Alexa Bedingfield
- Pain and Translational Symptom Science Department, University of Maryland, School of Nursing, Baltimore
| | - Lindsay Cook
- Pain and Translational Symptom Science Department, University of Maryland, School of Nursing, Baltimore
| | - Barbara Resnick
- Organizational Systems and Adult Health Department, University of Maryland, School of Nursing; and Center to Advance Chronic Pain Research, University of Maryland, Baltimore
| | - Cynthia L Renn
- Pain and Translational Symptom Science Department, University of Maryland, School of Nursing; and Center to Advance Chronic Pain Research, University of Maryland, Baltimore
| | - Susan G Dorsey
- Pain and Translational Symptom Science Department, University of Maryland, School of Nursing; and Center to Advance Chronic Pain Research, University of Maryland, Baltimore
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Resnick B, Van Haitsma K, Kolanowski A, Galik E, Boltz M, Ellis J, Behrens L, Eshraghi K, Renn CL, Dorsey SG. Invariance of the PAINAD Scale Between the Black and White Residents Living With Dementia. Front Pain Res (Lausanne) 2022; 2:757654. [PMID: 35295523 PMCID: PMC8915686 DOI: 10.3389/fpain.2021.757654] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to test the reliability and validity of the Pain Assessment in Advanced Dementia (PAINAD) and particularly consider whether or not this measure was invariant when used among the Black and White residents. Baseline data from an implementation study testing that included a sample of 553 residents, 30% of who were Black, from 55 nursing were included in this study. The Winsteps statistical program was used to perform the Rasch analysis and evaluate the reliability and validity of the measure based on internal consistency, infit and outfit statistics, mapping, and a differential item functioning (DIF) analysis. The AMOS statistical program was used for confirmatory factor analysis. The findings supported the reliability and validity of the PAINAD when used with these individuals and demonstrated that there was no evidence of invariance between the Black and White residents. All the items fit the model, but there was not a good spread of the items across the pain level of the participants. The majority of the participants (75%) were so low in pain signs or symptoms that they could not be differentiated. Based on the clinical practice and observations, it is recommended that additional items can be added to the measure such as observing the individual for evidence of resisting care, retropulsion when trying to stand, hitting or kicking when turning in bed, hitting or kicking when transferring from bed to chair, hitting or kicking when ambulating, or hitting or kicking when raising arms, less engagement with others, and decreased participation in the activities previously enjoyed.
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Affiliation(s)
- Barbara Resnick
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
| | | | - Ann Kolanowski
- Pennsylvania State University, University Park, PA, United States
| | - Elizabeth Galik
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Marie Boltz
- Pennsylvania State University, University Park, PA, United States
| | - Jeanette Ellis
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Liza Behrens
- Pennsylvania State University, University Park, PA, United States
| | - Karen Eshraghi
- Pennsylvania State University, University Park, PA, United States
| | - Cynthia L Renn
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Susan G Dorsey
- Pain & Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, United States
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Starkweather A, Ward K, Eze B, Gavin A, Renn CL, Dorsey SG. Neurophysiological and transcriptomic predictors of chronic low back pain: Study protocol for a longitudinal inception cohort study. Res Nurs Health 2022; 45:11-22. [PMID: 34866207 PMCID: PMC8792278 DOI: 10.1002/nur.22200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/09/2021] [Accepted: 11/20/2021] [Indexed: 02/03/2023]
Abstract
Chronic low back pain is one of the most common, costly, and debilitating pain conditions worldwide. Increased mechanistic understanding of the transition from acute to chronic low back and identification of predictive biomarkers could enhance the clinical assessment performed by healthcare providers and enable the development of targeted treatment to prevent and/or better manage chronic low back pain. This study protocol was designed to identify the neurological and transcriptomic biomarkers predictive of chronic low back pain at low back pain onset. This is a prospective descriptive longitudinal inception cohort study that will follow 340 individuals with acute low back pain and 40 healthy controls over 2 years. To analyze the neurophysiological and transcriptomic biomarkers of low back pain, the protocol includes psychological and pain-related survey data that will be collected beginning within 6 weeks of low back pain onset (baseline, 6, 12, 24, 52 weeks, and 2 years) and remotely at five additional time points (8, 10, 16, 20 weeks, and 18 months). Quantitative sensory testing and collection of blood samples for RNA sequencing will occur during the six in-person visits. The study results will describe variations in the neurophysiological and transcriptomic profiles of healthy pain-free controls and individuals with low back pain who either recover to pain-free status or develop chronic low back pain.
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Affiliation(s)
- Angela Starkweather
- University of Connecticut School of Nursing, Professor, Institute for Genome Sciences, 231 Glenbrook Road, Storrs, CT 06269, USA
| | - Kathryn Ward
- University of Maryland, Baltimore School of Nursing, 655 West Lombard Street, Baltimore, MD, 21201
| | - Bright Eze
- University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT 06269, USA
| | - Ahleah Gavin
- University of Maryland, Baltimore School of Nursing, 655 West Lombard Street, Baltimore, MD, 21201
| | - Cynthia L. Renn
- University of Maryland, Baltimore School of Nursing, 655 West Lombard Street, Baltimore, MD, 21201
| | - Susan G. Dorsey
- University of Maryland, Baltimore School of Nursing, Professor, Department of Anesthesiology, School of Medicine, Professor, Department of Neural and Pain Sciences, School of Dentistry, 655 West Lombard Street, Baltimore, MD, 21201
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Weaver KR, Griffioen MA, Klinedinst NJ, Galik E, Duarte AC, Colloca L, Resnick B, Dorsey SG, Renn CL. Quantitative Sensory Testing Across Chronic Pain Conditions and Use in Special Populations. Front Pain Res (Lausanne) 2022; 2:779068. [PMID: 35295425 PMCID: PMC8915716 DOI: 10.3389/fpain.2021.779068] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/07/2021] [Indexed: 02/01/2023]
Abstract
Chronic pain imposes a significant burden to the healthcare system and adversely affects patients' quality of life. Traditional subjective assessments, however, do not adequately capture the complex phenomenon of pain, which is influenced by a multitude of factors including environmental, developmental, genetic, and psychological. Quantitative sensory testing (QST), established as a protocol to examine thermal and mechanical sensory function, offers insight on potential mechanisms contributing to an individual's experience of pain, by assessing their perceived response to standardized delivery of stimuli. Although the use of QST as a research methodology has been described in the literature in reference to specific pain populations, this manuscript details application of QST across a variety of chronic pain conditions. Specific conditions include lower extremity chronic pain, knee osteoarthritis, chronic low back pain, temporomandibular joint disorder, and irritable bowel syndrome. Furthermore, we describe the use of QST in placebo/nocebo research, and discuss the use of QST in vulnerable populations such as those with dementia. We illustrate how the evaluation of peripheral sensory nerve function holds clinical promise in targeting interventions, and how using QST can enhance patient education regarding prognostic outcomes with particular treatments. Incorporation of QST methodology in research investigations may facilitate the identification of common mechanisms underlying chronic pain conditions, guide the development of non-pharmacological behavioral interventions to reduce pain and pain-related morbidity, and enhance our efforts toward reducing the burden of chronic pain.
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Affiliation(s)
- Kristen R. Weaver
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States,Center to Advance Chronic Pain Research (CACPR), University of Maryland, Baltimore, MD, United States,*Correspondence: Kristen R. Weaver
| | - Mari A. Griffioen
- Center to Advance Chronic Pain Research (CACPR), University of Maryland, Baltimore, MD, United States,College of Health Sciences, School of Nursing, University of Delaware, Newark, DE, United States
| | - N. Jennifer Klinedinst
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Elizabeth Galik
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Ana C. Duarte
- Department of Family and Community Health, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Luana Colloca
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States,Center to Advance Chronic Pain Research (CACPR), University of Maryland, Baltimore, MD, United States
| | - Barbara Resnick
- Center to Advance Chronic Pain Research (CACPR), University of Maryland, Baltimore, MD, United States,Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, MD, United States
| | - Susan G. Dorsey
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States,Center to Advance Chronic Pain Research (CACPR), University of Maryland, Baltimore, MD, United States
| | - Cynthia L. Renn
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States,Center to Advance Chronic Pain Research (CACPR), University of Maryland, Baltimore, MD, United States
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Cavaletti G, Marmiroli P, Renn CL, Dorsey SG, Serra MP, Quartu M, Meregalli C. Cannabinoids: an Effective Treatment for Chemotherapy-Induced Peripheral Neurotoxicity? Neurotherapeutics 2021; 18:2324-2336. [PMID: 34668147 PMCID: PMC8804126 DOI: 10.1007/s13311-021-01127-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 12/23/2022] Open
Abstract
Chemotherapy-induced peripheral neurotoxicity (CIPN) is one of the most frequent side effects of antineoplastic treatment, particularly of lung, breast, prostate, gastrointestinal, and germinal cancers, as well as of different forms of leukemia, lymphoma, and multiple myeloma. Currently, no effective therapies are available for CIPN prevention, and symptomatic treatment is frequently ineffective; thus, several clinical trials are addressing this unmet clinical need. Among possible pharmacological treatments of CIPN, modulation of the endocannabinoid system might be particularly promising, especially in those CIPN types where analgesia and neuroinflammation modulation might be beneficial. In fact, several clinical trials are ongoing with the specific aim to better investigate the changes in endocannabinoid levels induced by systemic chemotherapy and the possible role of endocannabinoid system modulation to provide relief from CIPN symptoms, a hypothesis supported by preclinical evidence but never consistently demonstrated in patients. Interestingly, endocannabinoid system modulation might be one of the mechanisms at the basis of the reported efficacy of exercise and physical therapy in CIPN patients. This possible virtuous interplay will be discussed in this review.
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Affiliation(s)
- Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, Monza, Italy.
- Milan Center for Neuroscience, University of Milano Bicocca, Piazza Ateneo Nuovo 1, Milano, Italy.
| | - Paola Marmiroli
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza, 2, Milano, Italy
- Milan Center for Neuroscience, University of Milano Bicocca, Piazza Ateneo Nuovo 1, Milano, Italy
| | - Cynthia L Renn
- Department of Pain and Translational Science, School of Nursing, University of Maryland, 655 West Lombard Street, Baltimore, MD, 21201, USA
| | - Susan G Dorsey
- Department of Pain and Translational Science, School of Nursing, University of Maryland, 655 West Lombard Street, Baltimore, MD, 21201, USA
| | - Maria Pina Serra
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Italy
| | - Marina Quartu
- Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, 09042, Monserrato, Italy
| | - Cristina Meregalli
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano Bicocca, via Cadore 48, Monza, Italy
- Milan Center for Neuroscience, University of Milano Bicocca, Piazza Ateneo Nuovo 1, Milano, Italy
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Griffioen MA, Bowen ME, Resnick B, Renn CL, Ji X. Prior Night Sleep Affects Next-Day Pain Interference Among Community-Dwelling Older Adults With Lower Extremity Chronic Pain. Res Gerontol Nurs 2021; 14:173-179. [PMID: 34288781 DOI: 10.3928/19404921-20210526-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Emergent work suggests that sleep is a robust biobehavioral predictor of pain; however, it remains unclear how sleep is prospectively linked to pain on a day-to-day basis among older adults. The current prospective study examined how sleep duration (total sleep time), quality (sleep efficiency, wake after sleep onset), and late and irregular sleep timing influenced next-day pain perception among community-dwelling older adults (N = 10; 65 matched observations) with lower extremity chronic pain over 1 week. Multilevel modeling estimated the association between sleep (Actigraph GT9X Link) and pain perception (Brief Pain Inventory Short Form). Increased wake after sleep onset (B = 0.19, p = 0.04), sleep variability (B = 0.02, p = 0.01), and later midsleep time (B = 0.40, p < 0.05) were associated with increased pain interference the following day. Findings support the idea that timely sleep interventions may reduce the effect of poor sleep on next-day pain in older adults. [Research in Gerontological Nursing, 14(4), 173-179.].
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Cao T, Matyas JJ, Renn CL, Faden AI, Dorsey SG, Wu J. Function and Mechanisms of Truncated BDNF Receptor TrkB.T1 in Neuropathic Pain. Cells 2020; 9:cells9051194. [PMID: 32403409 PMCID: PMC7290366 DOI: 10.3390/cells9051194] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 12/11/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF), a major focus for regenerative therapeutics, has been lauded for its pro-survival characteristics and involvement in both development and recovery of function within the central nervous system (CNS). However, studies of tyrosine receptor kinase B (TrkB), a major receptor for BDNF, indicate that certain effects of the TrkB receptor in response to disease or injury may be maladaptive. More specifically, imbalance among TrkB receptor isoforms appears to contribute to aberrant signaling and hyperpathic pain. A truncated isoform of the receptor, TrkB.T1, lacks the intracellular kinase domain of the full length receptor and is up-regulated in multiple CNS injury models. Such up-regulation is associated with hyperpathic pain, and TrkB.T1 inhibition reduces neuropathic pain in various experimental paradigms. Deletion of TrkB.T1 also limits astrocyte changes in vitro, including proliferation, migration, and activation. Mechanistically, TrkB.T1 is believed to act through release of intracellular calcium in astrocytes, as well as through interactions with neurotrophins, leading to cell cycle activation. Together, these studies support a potential role for astrocytic TrkB.T1 in hyperpathic pain and suggest that targeted strategies directed at this receptor may have therapeutic potential.
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Affiliation(s)
- Tuoxin Cao
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD 21201, USA; (T.C.); (J.J.M.); (A.I.F.)
| | - Jessica J. Matyas
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD 21201, USA; (T.C.); (J.J.M.); (A.I.F.)
| | - Cynthia L. Renn
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD 21201, USA; (C.L.R.); (S.G.D.)
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA
| | - Alan I. Faden
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD 21201, USA; (T.C.); (J.J.M.); (A.I.F.)
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA
| | - Susan G. Dorsey
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD 21201, USA; (C.L.R.); (S.G.D.)
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA
| | - Junfang Wu
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, Baltimore, MD 21201, USA; (T.C.); (J.J.M.); (A.I.F.)
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA
- Correspondence: ; Tel.: +1-410-706-5189
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11
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Hickey KT, Bakken S, Byrne MW, Bailey DCE, Demiris G, Docherty SL, Dorsey SG, Guthrie BJ, Heitkemper MM, Jacelon CS, Kelechi TJ, Moore SM, Redeker NS, Renn CL, Resnick B, Starkweather A, Thompson H, Ward TM, McCloskey DJ, Austin JK, Grady PA. Corrigendum to Precision health: Advancing symptom and self-management science. Nurs Outlook 2020; 68:139-140. [PMID: 32046859 DOI: 10.1016/j.outlook.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- K T Hickey
- Cardiac Electrophysiology, Columbia University School of Nursing, Columbia University Medical Center, New York, NY
| | - S Bakken
- School of Nursing and Department of Biomedical Informatics, Columbia University, New York, NY.
| | - M W Byrne
- Department of Anesthesiology, Columbia University School of Nursing, Columbia University College of Physicians and Surgeons, New York, NY; Center for Children and Families, Columbia University School of Nursing, Columbia University College of Physicians and Surgeons, New York, NY
| | | | - G Demiris
- University of Pennsylvania, School of Nursing, Philadelphia, PA
| | | | - S G Dorsey
- Department of Pain and Translational Symptom Science, School of Medicine, University of Maryland Baltimore, Baltimore, MD; Department of Anesthesiology, School of Medicine, University of Maryland Baltimore, Baltimore, MD
| | - B J Guthrie
- Bouve College of Health Sciences, Northeastern University School of Nursing, Boston, MA
| | - M M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA
| | - C S Jacelon
- University of Massachusetts Amherst College of Nursing, Amherst, MA
| | - T J Kelechi
- Medical University of South Carolina, College of Nursing, Charleston, SC
| | - S M Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - N S Redeker
- Section of Pulmonary, Critical Care and Sleep Medicine, Yale University, New Haven, CT
| | - C L Renn
- Department of Pain and Translational Symptom Science, University of Maryland Baltimore, Baltimore, MD
| | - B Resnick
- Organizational Systems and Adult Health Nursing Department, University of Maryland Baltimore, Baltimore, MD
| | | | - H Thompson
- University of Washington School of Nursing, Seattle, WA
| | - T M Ward
- University of Washington School of Nursing, Seattle, WA
| | - D J McCloskey
- National Institute of Nursing Research, Bethesda, MD
| | - J K Austin
- National Institute of Nursing Research, Bethesda, MD; Indiana University School of Nursing, Bloomington, IN
| | - P A Grady
- National Institute of Nursing Research, Bethesda, MD
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12
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Hickey KT, Bakken S, Byrne MW, Bailey DCE, Demiris G, Docherty SL, Dorsey SG, Guthrie BJ, Heitkemper MM, Jacelon CS, Kelechi TJ, Moore SM, Redeker NS, Renn CL, Resnick B, Starkweather A, Thompson H, Ward TM, McCloskey DJ, Austin JK, Grady PA. Precision health: Advancing symptom and self-management science. Nurs Outlook 2019; 67:462-475. [PMID: 30795850 PMCID: PMC6688754 DOI: 10.1016/j.outlook.2019.01.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Precision health considers individual lifestyle, genetics, behaviors, and environment context and facilitates interventions aimed at helping individuals achieve well-being and optimal health. PURPOSE To present the Nursing Science Precision Health (NSPH) Model and describe the integration of precision health concepts within the domains of symptom and self-management science as reflected in the National Institute of Nursing Research P30 Centers of Excellence and P20 Exploratory Centers. METHODS Center members developed the NSPH Model and the manuscript based on presentations and discussions at the annual NINR Center Directors Meeting and in follow-up telephone meetings. DISCUSSION The NSPH Model comprises four precision components (measurement; characterization of phenotype including lifestyle and environment; characterization of genotype and other biomarkers; and intervention target discovery, design, and delivery) that are underpinned by an information and data science infrastructure. CONCLUSION Nurse scientist leadership is necessary to realize the vision of precision health as reflected in the NSPH Model.
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Affiliation(s)
- Kathleen T Hickey
- Cardiac Electrophysiology, Columbia University School of Nursing, Columbia University Medical Center, New York, NY
| | - Suzanne Bakken
- School of Nursing and Department of Biomedical Informatics, Columbia University, New York, NY.
| | - Mary W Byrne
- Department of Anesthesiology, Columbia University School of Nursing, Columbia University College of Physicians and Surgeons, New York, NY; Center for Children and Families, Columbia University School of Nursing, Columbia University College of Physicians and Surgeons, New York, NY
| | | | - George Demiris
- University of Pennsylvania, School of Nursing, Philadelphia, PA
| | | | - Susan G Dorsey
- Department of Pain and Translational Symptom Science, School of Medicine, University of Maryland Baltimore, Baltimore, MD; Department of Anesthesiology, School of Medicine, University of Maryland Baltimore, Baltimore, MD
| | - Barbara J Guthrie
- Bouve College of Health Sciences, Northeastern University School of Nursing, Boston, MA
| | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA
| | | | - Teresa J Kelechi
- Medical University of South Carolina, College of Nursing, Charleston, SC
| | - Shirley M Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Nancy S Redeker
- Section of Pulmonary, Critical Care and Sleep Medicine, Yale University, New Haven, CT
| | - Cynthia L Renn
- Department of Pain and Translational Symptom Science, University of Maryland Baltimore, Baltimore, MD
| | - Barbara Resnick
- Organizational Systems and Adult Health Nursing Department, University of Maryland Baltimore, Baltimore, MD
| | | | | | - Teresa M Ward
- University of Washington School of Nursing, Seattle, WA
| | | | - Joan K Austin
- National Institute of Nursing Research, Bethesda, MD; Indiana University School of Nursing, Bloomington, IN
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Abstract
Chronic pain has become a public health epidemic based on the number of Americans affected and its associated health care costs. Unfortunately, there are few efficacious treatments to manage chronic pain and as the population of older adults and centenarians who are at high risk for chronic pain continues to grow, the chronic pain epidemic will continue to worsen unless new therapeutic strategies are discovered. In the current era of precision medicine, there is a major emphasis being placed on the use of self-management and omics to discover new therapeutic targets and design treatment strategies that are tailored to the individual patient. This commentary discusses the current state of the science related to omics and self-management of chronic pain in older adults, the role of gerontological nurses in this process, and future directions. [Res Gerontol Nurs. 2018; 11(1):7-13.].
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Page GG, Corwin EJ, Dorsey SG, Redeker NS, McCloskey DJ, Austin JK, Guthrie BJ, Moore SM, Barton D, Kim MT, Docherty SL, Waldrop-Valverde D, Bailey DE, Schiffman RF, Starkweather A, Ward TM, Bakken S, Hickey KT, Renn CL, Grady P. Biomarkers as Common Data Elements for Symptom and Self-Management Science. J Nurs Scholarsh 2018; 50:276-286. [PMID: 29575635 DOI: 10.1111/jnu.12378] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE Biomarkers as common data elements (CDEs) are important for the characterization of biobehavioral symptoms given that once a biologic moderator or mediator is identified, biologically based strategies can be investigated for treatment efforts. Just as a symptom inventory reflects a symptom experience, a biomarker is an indicator of the symptom, though not the symptom per se. The purposes of this position paper are to (a) identify a "minimum set" of biomarkers for consideration as CDEs in symptom and self-management science, specifically biochemical biomarkers; (b) evaluate the benefits and limitations of such a limited array of biomarkers with implications for symptom science; (c) propose a strategy for the collection of the endorsed minimum set of biologic samples to be employed as CDEs for symptom science; and (d) conceptualize this minimum set of biomarkers consistent with National Institute of Nursing Research (NINR) symptoms of fatigue, depression, cognition, pain, and sleep disturbance. DESIGN AND METHODS From May 2016 through January 2017, a working group consisting of a subset of the Directors of the NINR Centers of Excellence funded by P20 or P30 mechanisms and NINR staff met bimonthly via telephone to develop this position paper suggesting the addition of biomarkers as CDEs. The full group of Directors reviewed drafts, provided critiques and suggestions, recommended the minimum set of biomarkers, and approved the completed document. Best practices for selecting, identifying, and using biological CDEs as well as challenges to the use of biological CDEs for symptom and self-management science are described. Current platforms for sample outcome sharing are presented. Finally, biological CDEs for symptom and self-management science are proposed along with implications for future research and use of CDEs in these areas. FINDINGS The recommended minimum set of biomarker CDEs include pro- and anti-inflammatory cytokines, a hypothalamic-pituitary-adrenal axis marker, cortisol, the neuropeptide brain-derived neurotrophic factor, and DNA polymorphisms. CONCLUSIONS It is anticipated that this minimum set of biomarker CDEs will be refined as knowledge regarding biologic mechanisms underlying symptom and self-management science further develop. The incorporation of biological CDEs may provide insights into mechanisms of symptoms, effectiveness of proposed interventions, and applicability of chosen theoretical frameworks. Similarly, as for the previously suggested NINR CDEs for behavioral symptoms and self-management of chronic conditions, biological CDEs offer the potential for collaborative efforts that will strengthen symptom and self-management science. CLINICAL RELEVANCE The use of biomarker CDEs in biobehavioral symptoms research will facilitate the reproducibility and generalizability of research findings and benefit symptom and self-management science.
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Affiliation(s)
- Gayle G Page
- Nu Beta, Professor and Independence Foundation Chair in Nursing Education, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Elizabeth J Corwin
- Alpha Epsilon, Professor and Associate Dean for Research, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Susan G Dorsey
- Pi, Professor and Chair, Department of Pain and Translational Symptom Science, University of Maryland Baltimore, Baltimore, MD, USA
| | - Nancy S Redeker
- Delta Mu, Beatrice Renfield Term Professor of Nursing, Professor, Section of Pulmonary, Critical Care and Sleep Medicine, Yale University, New Haven, CT
| | - Donna Jo McCloskey
- Clinical Advisor, Contractor, National Institute of Nursing Research, NIH, Bethesda, MD, USA
| | - Joan K Austin
- Alpha, Distinguished Professor Emerita, Indiana University School of Nursing, Indianapolis, IN and National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Barbara J Guthrie
- Professor, Director of the PhD Program, Northeastern University, Boston, MA, USA
| | - Shirley M Moore
- Delta Xi, Edward J. and Louise Mellen Professor of Nursing, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Debra Barton
- Mary Lou Willard French Professor of Oncology Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Miyong T Kim
- Epsilon Theta, Professor, Associate Vice President for Community Health Engagement, University of Texas at Austin, Austin, TX, USA
| | - Sharron L Docherty
- Iota Omicron, Associate Professor, School of Nursing; Associate Professor, Department of Pediatrics, School of Medicine, Duke University, Durham, NC, USA
| | - Drenna Waldrop-Valverde
- Associate Professor and Assistant Dean for Research, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Donald E Bailey
- Beta Epsilon and Theta Iota, Associate Professor, Duke University, Durham, NC, USA
| | - Rachel F Schiffman
- Alpha Chi and Eta Nu, Professor and Associate Dean for Research, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | | | - Teresa M Ward
- Psi-at-Large, Associate Professor, University of Washington School of Nursing, Seattle, WA, USA
| | - Suzanne Bakken
- Alpha Eta, The Alumni Professor of Nursing and Professor of Biomedical Informatics Director, Columbia University, New York, NY, USA
| | - Kathleen T Hickey
- Alpha Eta, Professor of Nursing at Columbia University Medical Center, Columbia University, New York, NY, USA
| | - Cynthia L Renn
- Pi, Associate Professor Department of Pain and Translational Symptom Science, University of Maryland Baltimore, Baltimore, MD, USA
| | - Patricia Grady
- Tau, Director, National Institute of Nursing Research, National Institutes or Health, Bethesda, MD, USA
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Griffioen MA, Greenspan JD, Johantgen M, Von Rueden K, O’Toole RV, Dorsey SG, Renn CL. Quantitative Sensory Testing and Current Perception Threshold Testing in Patients With Chronic Pain Following Lower Extremity Fracture. Biol Res Nurs 2018; 20:16-24. [PMID: 28735556 PMCID: PMC5942497 DOI: 10.1177/1099800417720725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronic pain is a significant problem for patients with lower extremity injuries. While pain hypersensitivity has been identified in many chronic pain conditions, it is not known whether patients with chronic pain following lower extremity fracture report pain hypersensitivity in the injured leg. PURPOSE To quantify and compare peripheral somatosensory function and sensory nerve activation thresholds in persons with chronic pain following lower extremity fractures with a cohort of persons with no history of lower extremity fractures. METHOD This was a cross-sectional study where quantitative sensory testing and current perception threshold testing were conducted on the injured and noninjured legs of cases and both legs of controls. RESULTS A total of 14 cases and 28 controls participated in the study. Mean time since injury at the time of testing for cases was 22.3 (standard deviation = 12.1) months. The warmth detection threshold ( p = .024) and nerve activation thresholds at 2,000 Hz ( p < .001) and 250 Hz ( p = .002), respectively, were significantly higher in cases compared to controls. CONCLUSION This study suggests that patients with chronic pain following lower extremity fractures may experience hypoesthesia in the injured leg, which contrasts with the finding of hyperesthesia previously observed in other chronic pain conditions but is in accord with patients with nerve injuries and surgeries. This is the first study to examine peripheral sensory nerve function at the site of injury in patients with chronic pain following lower extremity fractures using quantitative sensory testing and current perception threshold testing.
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Affiliation(s)
| | | | - Meg Johantgen
- School of Nursing, University of Maryland, Baltimore, MD, USA
| | | | | | - Susan G. Dorsey
- School of Nursing, University of Maryland, Baltimore, MD, USA
| | - Cynthia L. Renn
- School of Nursing, University of Maryland, Baltimore, MD, USA
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16
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Marmiroli P, Riva B, Pozzi E, Ballarini E, Lim D, Chiorazzi A, Meregalli C, Distasi C, Renn CL, Semperboni S, Morosi L, Ruffinatti FA, Zucchetti M, Dorsey SG, Cavaletti G, Genazzani A, Carozzi VA. Susceptibility of different mouse strains to oxaliplatin peripheral neurotoxicity: Phenotypic and genotypic insights. PLoS One 2017; 12:e0186250. [PMID: 29020118 PMCID: PMC5636145 DOI: 10.1371/journal.pone.0186250] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/27/2017] [Indexed: 12/18/2022] Open
Abstract
Peripheral neurotoxicity is one of the most distressing side effects of oxaliplatin therapy for cancer. Indeed, most patients that received oxaliplatin experience acute and/or chronic severe sensory peripheral neuropathy. However, despite similar co-morbidities, cancer stage, demographics and treatment schedule, patients develop oxaliplatin-induced peripheral neurotoxicity with remarkably different severity. This suggests individual genetic variability, which might be used to glean the mechanistic insights into oxaliplatin neurotoxicity. We characterized the susceptibility of different mice strains to oxaliplatin neurotoxicity investigating the phenotypic features of neuropathy and gene expression profiles in dorsal root ganglia of six genetically different mice strains (Balb-c, C57BL6, DBA/2J, AJ, FVB and CD1) exposed to the same oxaliplatin schedule. Differential gene expression in dorsal root ganglia from each mice strain were assayed using a genome-wide expression analysis and selected genes were validated by RT-PCR analysis. The demonstration of consistent differences in the phenotypic response to oxaliplatin across different strains is interesting to allow the selection of the appropriate strain based on the pre-defined read-out parameters. Further investigation of the correlation between gene expression changes and oxaliplatin-induced neurotoxicity phenotype in each strain will be useful to deeper investigate the molecular mechanisms of oxaliplatin neurotoxicity.
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Affiliation(s)
- Paola Marmiroli
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- * E-mail:
| | - Beatrice Riva
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy
| | - Eleonora Pozzi
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Elisa Ballarini
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Dmitry Lim
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy
| | - Alessia Chiorazzi
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristina Meregalli
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carla Distasi
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy
| | - Cynthia L. Renn
- School of Nursing, Department of Pain and Translational Symptom Science, University of Maryland, Baltimore, Maryland, United States of America
| | - Sara Semperboni
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Lavinia Morosi
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Massimo Zucchetti
- Department of Oncology, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Susan G. Dorsey
- School of Nursing, Department of Pain and Translational Symptom Science, University of Maryland, Baltimore, Maryland, United States of America
| | - Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Armando Genazzani
- Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy
| | - Valentina A. Carozzi
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
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17
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Griffioen MA, Greenspan JD, Johantgen M, Von Rueden K, O'Toole RV, Dorsey SG, Renn CL. Acute Pain Characteristics in Patients with and without Chronic Pain following Lower Extremity Injury. Pain Manag Nurs 2016; 18:33-41. [PMID: 27964911 DOI: 10.1016/j.pmn.2016.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/04/2016] [Accepted: 10/05/2016] [Indexed: 11/16/2022]
Abstract
Many patients with injuries to lower extremities report chronic pain. High pain intensity at time of admission for injury is a risk factor for chronic pain, but it is not clear whether specific acute pain patterns following injury influence the development of chronic pain. To examine the relationship between the pain trajectory, the mean pain score, and the frequency of pain documentation during the immediate hospitalization following injury, with the report of chronic pain. This was a descriptive, retrospective cohort study of adults admitted with lower extremity fractures to an academic urban trauma center. Participants, 6-45 months postinjury, rated their current pain, worst pain, and average pain over the last 3 months. Pain scores from hospitalization associated with the injury were obtained through a retrospective chart review. The pain trajectory, mean pain score, and frequency of pain documentation was compared between patients with and without chronic pain. A total of 129 patients were enrolled in this study and 78% reported chronic pain at the site of injury. The mean pain score (5.1 vs. 4.2) and first pain score (5.6 vs. 3.4) were higher for patients with chronic pain compared to patients with no chronic pain. Consistent with other studies, high pain intensity at time of injury was associated with chronic pain. The findings contribute valuable information about acute pain characteristics associated with chronic pain and provide insight into the importance of early and adequate acute pain treatment.
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Affiliation(s)
- Mari A Griffioen
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland.
| | - Joel D Greenspan
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, Maryland
| | - Meg Johantgen
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland
| | - Kathryn Von Rueden
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland
| | | | - Susan G Dorsey
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland
| | - Cynthia L Renn
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland
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18
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Resnick B, Galik E, Wells CL, Boltz M, Renn CL, Dorsey SG. The Impact of Pain Management with Opioids among Older Adults Post Orthopedic Trauma. Pain Manag Nurs 2016; 17:302-10. [DOI: 10.1016/j.pmn.2016.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 03/26/2016] [Accepted: 05/18/2016] [Indexed: 10/21/2022]
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Hertz DL, Owzar K, Lessans S, Wing C, Jiang C, Kelly WK, Patel J, Halabi S, Furukawa Y, Wheeler HE, Sibley AB, Lassiter C, Weisman L, Watson D, Krens SD, Mulkey F, Renn CL, Small EJ, Febbo PG, Shterev I, Kroetz DL, Friedman PN, Mahoney JF, Carducci MA, Kelley MJ, Nakamura Y, Kubo M, Dorsey SG, Dolan ME, Morris MJ, Ratain MJ, McLeod HL. Pharmacogenetic Discovery in CALGB (Alliance) 90401 and Mechanistic Validation of a VAC14 Polymorphism that Increases Risk of Docetaxel-Induced Neuropathy. Clin Cancer Res 2016; 22:4890-4900. [PMID: 27143689 DOI: 10.1158/1078-0432.ccr-15-2823] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 04/04/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE Discovery of SNPs that predict a patient's risk of docetaxel-induced neuropathy would enable treatment individualization to maximize efficacy and avoid unnecessary toxicity. The objectives of this analysis were to discover SNPs associated with docetaxel-induced neuropathy and mechanistically validate these associations in preclinical models of drug-induced neuropathy. EXPERIMENTAL DESIGN A genome-wide association study was conducted in metastatic castrate-resistant prostate cancer patients treated with docetaxel, prednisone and randomized to bevacizumab or placebo on CALGB 90401. SNPs were genotyped on the Illumina HumanHap610-Quad platform followed by rigorous quality control. The inference was conducted on the cumulative dose at occurrence of grade 3+ sensory neuropathy using a cause-specific hazard model that accounted for early treatment discontinuation. Genes with SNPs significantly associated with neuropathy were knocked down in cellular and mouse models of drug-induced neuropathy. RESULTS A total of 498,081 SNPs were analyzed in 623 Caucasian patients, 50 (8%) of whom experienced grade 3+ neuropathy. The 1,000 SNPs most associated with neuropathy clustered in relevant pathways including neuropathic pain and axonal guidance. An SNP in VAC14 (rs875858) surpassed genome-wide significance (P = 2.12 × 10-8, adjusted P = 5.88 × 10-7). siRNA knockdown of VAC14 in stem cell-derived peripheral neuronal cells increased docetaxel sensitivity as measured by decreased neurite processes (P = 0.0015) and branches (P < 0.0001). Prior to docetaxel treatment, VAC14 heterozygous mice had greater nociceptive sensitivity than wild-type litter mate controls (P = 0.001). CONCLUSIONS VAC14 should be prioritized for further validation of its potential role as a predictor of docetaxel-induced neuropathy and biomarker for treatment individualization. Clin Cancer Res; 22(19); 4890-900. ©2016 AACR.
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Affiliation(s)
- Daniel L Hertz
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan. UNC Institute for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kouros Owzar
- Duke Cancer Institute, Durham, North Carolina. Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | - Sherrie Lessans
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland
| | - Claudia Wing
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Chen Jiang
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | | | - Jai Patel
- UNC Institute for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
| | - Susan Halabi
- Duke Cancer Institute, Durham, North Carolina. Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | - Yoichi Furukawa
- Division of Clinical Genome Research, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | | | | | - Cameron Lassiter
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland
| | - Lois Weisman
- Life Sciences Institute, University of Michigan, Ann Arbor, Michigan
| | - Dorothy Watson
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | - Stefanie D Krens
- UNC Institute for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Utrecht University, Faculty of Science, Department of Pharmaceutical Sciences, Utrecht, the Netherlands
| | - Flora Mulkey
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina
| | - Cynthia L Renn
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland
| | - Eric J Small
- Department of Medicine, UCSF, San Francisco, California
| | | | - Ivo Shterev
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
| | - Deanna L Kroetz
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California
| | - Paula N Friedman
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - John F Mahoney
- Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina
| | - Michael A Carducci
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, Maryland
| | - Michael J Kelley
- Durham VA Medical Center, Duke University Medical Center, Durham, North Carolina
| | - Yusuke Nakamura
- Department of Medicine, University of Chicago, Chicago, Illinois. Division of Clinical Genome Research, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Michiaki Kubo
- Lab for Genotyping Development, Riken Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Susan G Dorsey
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland
| | - M Eileen Dolan
- Department of Medicine, University of Chicago, Chicago, Illinois
| | | | - Mark J Ratain
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Howard L McLeod
- UNC Institute for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Personalized Medicine Institute, Moffitt Cancer Center, Tampa, Florida.
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20
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Griffith KA, Dorsey SG, Renn CL, Zhu S, Johantgen ME, Cornblath DR, Argyriou AA, Cavaletti G, Merkies ISJ, Alberti P, Postma TJ, Rossi E, Frigeni B, Bruna J, Velasco R, Kalofonos HP, Psimaras D, Ricard D, Pace A, Galie E, Briani C, Dalla Torre C, Faber CG, Lalisang RI, Boogerd W, Brandsma D, Koeppen S, Hense J, Storey DJ, Kerrigan S, Schenone A, Fabbri S, Valsecchi MG. Correspondence between neurophysiological and clinical measurements of chemotherapy-induced peripheral neuropathy: secondary analysis of data from the CI-PeriNomS study. J Peripher Nerv Syst 2015; 19:127-35. [PMID: 24814100 DOI: 10.1111/jns5.12064] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/19/2014] [Accepted: 03/19/2014] [Indexed: 12/01/2022]
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) lacks standardized clinical measurement. The objective of the current secondary analysis was to examine data from the CIPN Outcomes Standardization (CI-PeriNomS) study for associations between clinical examinations and neurophysiological abnormalities. Logistic regression estimated the strength of associations of vibration, pin, and monofilament examinations with lower limb sensory and motor amplitudes. Examinations were classified as normal (0), moderately abnormal (1), or severely abnormal (2). Among 218 participants, those with class 1 upper extremity (UE) and classes 1 or 2 lower extremity (LE) monofilament abnormality were 2.79 (95% confidence interval [CI]: 1.28-6.07), 3.49 (95%CI: 1.61-7.55), and 4.42 (95%CI: 1.35-14.46) times more likely to have abnormal sural nerve amplitudes, respectively, compared to individuals with normal examinations. Likewise, those with class 2 UE and classes 1 or 2 LE vibration abnormality were 8.65 (95%CI: 1.81-41.42), 2.54 (95%CI: 1.19-5.41), and 7.47 (95%CI: 2.49-22.40) times more likely to have abnormal sural nerve amplitudes, respectively, compared to participants with normal examinations. Abnormalities in vibration and monofilament examinations are associated with abnormal sural nerve amplitudes and are useful in identifying CIPN.
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Affiliation(s)
- Kathleen A Griffith
- Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, MD, USA
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21
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Abstract
BACKGROUND Animal models in pain research have suggested that inclusion of both evoked and nonevoked behavioral measures is needed to better reflect the human pain experience. Individuals with chronic pain are known to experience spontaneous pain, in addition to pain after exposure to an external stimulus. Recently, the dynamic weight bearing (DWB) apparatus was developed to assess for nonevoked hyperalgesia by capturing weight bearing and surface distribution in the paws of mice after acute inflammation. OBJECTIVES The aim of this study was to evaluate the DWB test as a measure of nonevoked hyperalgesia. METHODS The experimental group received an intraplantar injection in the left hind paw of the inflammatory agent--complete Freund's adjuvant (CFA)--whereas the vehicle control group received a saline injection and the naive control group had no treatment. Calipers and a plethysmometer were used to verify inflammation and the hot-plate test was used as a measure for stimulus-evoked hyperalgesia. Data were collected at baseline; 3 hours; and 1, 3, and 7 days after injection. RESULTS Mice injected with CFA showed a statistically significant higher mean paw thickness and volume displacement compared with the vehicle and naive control groups. In the hot-plate testing, CFA-treated mice showed lower response temperature at 7 days compared with the other groups. On the DWB test, CFA-treated mice showed a reduction in the ipsilateral paw load and surface area compared with the contralateral paw load at Days 1, 3, and 7. DISCUSSION Mice with inflammation showed alterations in weight bearing as well as increased thermal hyperalgesia in comparison with control groups. These findings support the use of the DWB test as a tool for measuring nonevoked inflammatory hyperalgesia in a mouse model.
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Affiliation(s)
- Mari A Griffioen
- Mari A. Griffioen, MS, RN, is PhD Student; Valerie H. Dernetz, MA, RN, is PhD Student; Gee Su Yang, MS, RN, is PhD Student; Kathleen A. Griffith, PhD, MPH, CRNP, is Assistant Professor; Susan G. Dorsey, PhD, RN, FAAN, is Associate Professor and Cynthia L. Renn, PhD, RN, is Associate Professor, Department of Pain & Translational Symptom Science, School of Nursing, University of Maryland, Baltimore
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22
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Carozzi VA, Renn CL, Bardini M, Fazio G, Chiorazzi A, Meregalli C, Oggioni N, Shanks K, Quartu M, Serra MP, Sala B, Cavaletti G, Dorsey SG. Bortezomib-induced painful peripheral neuropathy: an electrophysiological, behavioral, morphological and mechanistic study in the mouse. PLoS One 2013; 8:e72995. [PMID: 24069168 PMCID: PMC3772181 DOI: 10.1371/journal.pone.0072995] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/23/2013] [Indexed: 11/18/2022] Open
Abstract
Bortezomib is the first proteasome inhibitor with significant antineoplastic activity for the treatment of relapsed/refractory multiple myeloma as well as other hematological and solid neoplasms. Peripheral neurological complications manifesting with paresthesias, burning sensations, dysesthesias, numbness, sensory loss, reduced proprioception and vibratory sensitivity are among the major limiting side effects associated with bortezomib therapy. Although bortezomib-induced painful peripheral neuropathy is clinically easy to diagnose and reliable models are available, its pathophysiology remains partly unclear. In this study we used well-characterized immune-competent and immune-compromised mouse models of bortezomib-induced painful peripheral neuropathy. To characterize the drug-induced pathological changes in the peripheral nervous system, we examined the involvement of spinal cord neuronal function in the development of neuropathic pain and investigated the relevance of the immune response in painful peripheral neuropathy induced by bortezomib. We found that bortezomib treatment induced morphological changes in the spinal cord, dorsal roots, dorsal root ganglia (DRG) and peripheral nerves. Neurophysiological abnormalities and specific functional alterations in Aδ and C fibers were also observed in peripheral nerve fibers. Mice developed mechanical allodynia and functional abnormalities of wide dynamic range neurons in the dorsal horn of spinal cord. Bortezomib induced increased expression of the neuronal stress marker activating transcription factor-3 in most DRG. Moreover, the immunodeficient animals treated with bortezomib developed a painful peripheral neuropathy with the same features observed in the immunocompetent mice. In conclusion, this study extends the knowledge of the sites of damage induced in the nervous system by bortezomib administration. Moreover, a selective functional vulnerability of peripheral nerve fiber subpopulations was found as well as a change in the electrical activity of wide dynamic range neurons of dorsal horn of spinal cord. Finally, the immune response is not a key factor in the development of morphological and functional damage induced by bortezomib in the peripheral nervous system.
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Affiliation(s)
- Valentina A. Carozzi
- Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza, Italy
- * E-mail: (VAC)
| | - Cynthia L. Renn
- School of Nursing, Center for Pain Studies, University of Maryland, Baltimore, Maryland, United States of America
| | - Michela Bardini
- “M. Tettamanti” Research Center, Department of Health Sciences, University of Milan Bicocca, Monza, Italy
| | - Grazia Fazio
- “M. Tettamanti” Research Center, Department of Health Sciences, University of Milan Bicocca, Monza, Italy
| | - Alessia Chiorazzi
- Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza, Italy
| | - Cristina Meregalli
- Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza, Italy
| | - Norberto Oggioni
- Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza, Italy
| | - Kathleen Shanks
- School of Nursing, Center for Pain Studies, University of Maryland, Baltimore, Maryland, United States of America
| | - Marina Quartu
- Department of Biomedical Sciences, Section of Cytomorphology, University of Cagliari, Monserrato, Italy
| | - Maria Pina Serra
- Department of Biomedical Sciences, Section of Cytomorphology, University of Cagliari, Monserrato, Italy
| | - Barbara Sala
- Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza, Italy
| | - Guido Cavaletti
- Department of Surgery and Translational Medicine, University of Milan Bicocca, Monza, Italy
| | - Susan G. Dorsey
- School of Nursing, Center for Pain Studies, University of Maryland, Baltimore, Maryland, United States of America
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Dorsey SG, Lovering RM, Renn CL, Leitch CC, Liu X, Tallon LJ, Sadzewicz LD, Pratap A, Ott S, Sengamalay N, Jones KM, Barrick C, Fulgenzi G, Becker J, Voelker K, Talmadge R, Harvey BK, Wyatt RM, Vernon-Pitts E, Zhang C, Shokat K, Fraser-Liggett C, Balice-Gordon RJ, Tessarollo L, Ward CW. Genetic deletion of trkB.T1 increases neuromuscular function. Am J Physiol Cell Physiol 2011; 302:C141-53. [PMID: 21865582 DOI: 10.1152/ajpcell.00469.2010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Neurotrophin-dependent activation of the tyrosine kinase receptor trkB.FL modulates neuromuscular synapse maintenance and function; however, it is unclear what role the alternative splice variant, truncated trkB (trkB.T1), may have in the peripheral neuromuscular axis. We examined this question in trkB.T1 null mice and demonstrate that in vivo neuromuscular performance and nerve-evoked muscle tension are significantly increased. In vitro assays indicated that the gain-in-function in trkB.T1(-/-) animals resulted specifically from an increased muscle contractility, and increased electrically evoked calcium release. In the trkB.T1 null muscle, we identified an increase in Akt activation in resting muscle as well as a significant increase in trkB.FL and Akt activation in response to contractile activity. On the basis of these findings, we conclude that the trkB signaling pathway might represent a novel target for intervention across diseases characterized by deficits in neuromuscular function.
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Affiliation(s)
- Susan G Dorsey
- University of Maryland Baltimore School of Nursing, Baltimore, Maryland 21201, USA.
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Renn CL, Leitch CC, Lessans S, Rhee P, McGuire WC, Smith BA, Traub RJ, Dorsey SG. Brain-derived neurotrophic factor modulates antiretroviral-induced mechanical allodynia in the mouse. J Neurosci Res 2011; 89:1551-65. [PMID: 21647939 DOI: 10.1002/jnr.22685] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Revised: 04/06/2011] [Accepted: 04/12/2011] [Indexed: 01/12/2023]
Abstract
Nucleoside reverse transcriptase inhibitors (NRTIs) are key components of HIV/AIDS treatment to reduce viral load. However, these drugs can induce chronic neuropathic pain, leading to increased morbidity in HIV patients. This study examines the role of brain-derived neurotrophic factor (BDNF) in the spinal dorsal horn (SDH) in development of mechanical allodynia in male C57BL/6J mice treated with the NRTI stavudine (d4T). After d4T administration, mice developed increased neuronal activity and BDNF expression in the SDH and hind paw mechanical allodynia that was exacerbated by intrathecal BDNF administration. Intrathecal BDNF alone also increased neuronal activity and caused mechanical allodynia. Because excess BDNF amplified d4T-induced mechanical allodynia and neuronal activity, the impact of decreasing BDNF in the SDH was investigated. After d4T, BDNF heterozygous mice were less allodynic than wild-type littermates, which was negated by intrathecal BDNF administration. Finally, pretreatment with intrathecal trkB-Fc chimera prior to d4T or administration of the tyrosine kinase inhibitor K252a 3 days after d4T blocked BDNF-mediated signaling, significantly attenuated the development of mechanical allodynia (trkB-Fc), and decreased neuronal activity (trkB-Fc and K252a). Taken together, these findings provide evidence that BDNF in the SDH contributes to the development of NRTI-induced painful peripheral neuropathy and may represent a new therapeutic opportunity.
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Affiliation(s)
- Cynthia L Renn
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, Maryland 21201-1579, USA.
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25
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Abstract
Animal models are a critical component of biomedical and biobehavioral research and have contributed to the exponential expansion of our understanding of human disease. Now, as we move onward into the era of genetics and genomics research, the importance of animal models to the research process will become even more acute as we explore the significance of genetic differences that are found in the presence and absence of disease. The decision to use an animal model is not one that can be taken lightly; but, rather, requires careful thought and consideration. In this review, we will address (a) why we should consider using animal models, (b) several caveats that are associated with using animals for research, and (c) some of the common genetic tools that are used in animal research.
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Affiliation(s)
- Cynthia L Renn
- University of Maryland School of Nursing, Department of Organizational Systems & Adult Health, Baltimore, MD, USA
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26
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Abstract
Brain-Derived Neurotrophic Factor (BDNF) is a central nervous system modulator of nociception. In animal models of chronic pain, BDNF exerts its effects on nociceptive processing by binding to the full-length receptor tropomyosin-related kinase B (trkB.FL) and transducing intracellular signaling to produce nocifensive behaviors. In addition to trkB.FL, the trkB locus also produces a widely-expressed alternatively-spliced truncated isoform, trkB.T1. TrkB.T1 binds BDNF with high affinity; however the unique 11 amino acid intracellular cytoplasmic tail lacks the kinase domain of trkB.FL. Recently, trkB.T1 was shown to be specifically up-regulated in a model of HIV-associated neuropathic pain, potentially implicating trkB.T1 as a modulator of nociception. Here, we report that trkB.T1 mRNA and protein is up-regulated in the spinal dorsal horn at times following antiretroviral drug treatment and hind paw inflammation in which nocifensive behaviors develop. While genetic depletion of trkB.T1 did not affect baseline mechanical and thermal thresholds, the absence of trkB.T1 resulted in significant attenuation of inflammation- and antiretroviral-induced nocifensive behaviors. Our results suggest that trkB.T1 up-regulation following antiretroviral treatment and tissue inflammation participates in the development and maintenance of nocifensive behavior and may represent a novel therapeutic target for pain treatment.
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Affiliation(s)
- Cynthia L Renn
- School of Nursing, University of Maryland, Baltimore, MD 21201, USA.
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Dorsey SG, Leitch CC, Renn CL, Lessans S, Smith BA, Wang XM, Dionne RA. Genome-wide screen identifies drug-induced regulation of the gene giant axonal neuropathy (Gan) in a mouse model of antiretroviral-induced painful peripheral neuropathy. Biol Res Nurs 2009; 11:7-16. [PMID: 19398414 DOI: 10.1177/1099800409332726] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Painful peripheral neuropathy is a debilitating complication of the treatment of HIV with nucleoside reverse transcriptase inhibitors (NRTIs). Patients are living longer with these drugs; however many develop excruciating, unremitting, and often treatment-limiting neuropathy that is resistant to conventional pain management therapies. Improving patient comfort and quality of life is paramount and depends on a clearer understanding of this devastating side effect. The mechanisms underlying the development of NRTI-induced neuropathy, however, remain unclear. Using a mouse model of NRTI-induced neuropathy, the authors conducted an unbiased whole-genome microarray screen to identify molecular targets in the spinal dorsal horn, which is the location where integration of ascending sensory transmission and descending modulatory effects occur. Analysis of the microarray data identified a change in the gene giant axonal neuropathy 1 (Gan1). Mutation of this gene has been linked to the development of giant axonal neuropathy (GAN), a rare autosomal recessive condition characterized by a progressive sensorimotor neuropathy. Gan1 has not been previously linked to nerve pathologies in other populations. In this study, downregulation of the Gan1 gene and the gene protein product, gigaxonin, was validated via quantitative polymerase chain reaction ([qPCR] gene expression) and Western blot analyses (protein level). Our report is the first to suggest that Gan1 might be a novel molecular target in the development of NRTI-induced peripheral neuropathy with implications for new therapeutic approaches to preventing or reducing a significant side effect of HIV treatment.
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Affiliation(s)
- Susan G Dorsey
- University of Maryland School of Nursing, Baltimore, MD 21201, USA.
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28
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Abstract
Supraspinal descending pathways from the periaqueductal gray and rostral ventromedial medulla dynamically modulate nociceptive transmission in the spinal dorsal horn. We examined the expression of the brain-derived neurotrophic factor receptor trkB in response to inflammation. No difference was observed in the number of neurons expressing trkB in the periaqueductal gray or rostral ventromedial medulla 3 h after inflammation; however, by 24 h, there was a significant increase in trkB expression in the periaqueductal gray (P < 0.05) and rostral ventromedial medulla (P < 0.05), compared with naïve levels, which persisted to 7 days and returned to naïve levels by 21 days. These results demonstrate a temporal increase in the number of cells expressing trkB in response to persistent inflammation, suggesting a role for trkB signaling in activity-dependent plasticity in the pain modulatory circuitry.
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Affiliation(s)
- Cynthia L Renn
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, Maryland 21201-1579, USA
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29
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Dorsey SG, Renn CL, Carim-Todd L, Barrick CA, Bambrick L, Krueger BK, Ward CW, Tessarollo L. In vivo restoration of physiological levels of truncated TrkB.T1 receptor rescues neuronal cell death in a trisomic mouse model. Neuron 2006; 51:21-8. [PMID: 16815329 DOI: 10.1016/j.neuron.2006.06.009] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2005] [Revised: 01/13/2006] [Accepted: 06/09/2006] [Indexed: 01/02/2023]
Abstract
Imbalances in neurotrophins or their high-affinity Trk receptors have long been reported in neurodegenerative diseases. However, a molecular link between these gene products and neuronal cell death has not been established. In the trisomy 16 (Ts16) mouse there is increased apoptosis in the cortex, and hippocampal neurons undergo accelerated cell death that cannot be rescued by administration of brain-derived neurotrophic factor (BDNF). Ts16 neurons have normal levels of the TrkB tyrosine kinase receptor but an upregulation of the TrkB.T1 truncated receptor isoform. Here we show that restoration of the physiological level of the TrkB.T1 receptor by gene targeting rescues Ts16 cortical cell and hippocampal neuronal death. Moreover, it corrects resting Ca2+ levels and restores BDNF-induced intracellular signaling mediated by full-length TrkB in Ts16 hippocampal neurons. These data provide a direct link between neuronal cell death and abnormalities in Trk neurotrophin receptor levels.
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Affiliation(s)
- Susan G Dorsey
- Neural Development Group, Mouse Cancer Genetics Program, Center for Cancer Research, National Cancer Institute, Frederick, Maryland 21702, USA.
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30
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Abstract
Despite the many advances in our understanding of the mechanisms underlying pain processing, pain continues to be a major healthcare problem in the United States. Each day, millions of Americans are affected by both acute and chronic pain conditions, costing in excess of $100 billion for treatment-related costs and lost work productivity. Thus, it is imperative that better treatment strategies be developed. One step toward improving pain management is through increased knowledge of pain physiology. Within the nervous system, there are several pathways that transmit information about pain from the periphery to the brain. There is also a network of pathways that carry modulatory signals from the brain and brainstem that alter the incoming flow of pain information. This article provides a review to the physiology and processing of pain.
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Affiliation(s)
- Cynthia L Renn
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, Maryland 21201-1579, USA.
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