Sara Kelly

Inhibitory effects of CB1 and CB2 receptor agonists on responses of DRG neurons and dorsal horn neurons in neuropathic rats

Cannabinoid 2 (CB2) receptor mediated antinociception and increased levels of spinal CB2 receptor mRNA are reported in neuropathic Sprague–Dawley rats. The aim of this study was to provide functional evidence for a role of peripheral, vs. spinal, CB2 and cannabinoid 1 (CB1) receptors in neuropathic rats. Effects of the CB2 receptor agonist, JWH‐133, and the CB1 receptor agonist, arachidonyl‐2‐chloroethylamide (ACEA), on primary afferent fibres were determined by calcium imaging studies of adult dorsal root ganglion (DRG) neurons taken from neuropathic and sham‐operated rats. Capsaicin (100 nm) increased [Ca2+]i in DRG neurons from sham and neuropathic rats. JWH‐133 (3 µm) or ACEA (1 µm) significantly (P < 0.001) attenuated capsaicin‐evoked calcium responses in DRG neurons in neuropathic and sham‐operated rats. The CB2 receptor antagonist, SR144528, (1 µm) significantly inhibited the effects of JWH‐133. Effects of ACEA were significantly inhibited by the CB1 receptor antagonist SR141716A (1 µm). In vivo experiments evaluated the effects of spinal administration of JWH‐133 (8–486 ng/50 µL) and ACEA (0.005–500 ng/50 µL) on mechanically evoked responses of neuropathic and sham‐operated rats. Spinal JWH‐133 attenuated mechanically evoked responses of spinal neurons in neuropathic, but not sham‐operated rats. These inhibitory effects were blocked by SR144528 (0.001 µg/50 µL). Spinal ACEA inhibited mechanically evoked responses of neuropathic and sham‐operated rats, these effects were blocked by SR141716A (0.01 µg/50 µL). Our data provide evidence for a functional role of CB2, as well as CB1 receptors on DRG neurons in sham and neuropathic rats. At the level of the spinal cord, CB2 receptors have inhibitory effects in neuropathic, but not sham‐operated rats suggesting that spinal CB2 may be an important analgesic target.

Activation of peripheral cannabinoid CB1 receptors inhibits mechanically evoked responses of spinal neurons in noninflamed rats and rats with hindpaw inflammation

The presence of cannabinoid1 (CB1) receptors on primary afferent fibres may provide a novel target for cannabinoid analgesics. The present study investigated the ability of peripheral CB1 receptors to modulate innocuous and noxious transmission in noninflamed rats and rats with peripheral carrageenan inflammation. Effects of peripheral injection of arachidonyl‐2‐choroethylamide (ACEA; 10 and 30 µg in 50 µL), a selective CB1 receptor agonist, on mechanically evoked responses of dorsal horn neurons were studied in noninflamed rats and rats with peripheral carrageenan inflammation. Peripheral injection of ACEA (30 µg in 50 µL) significantly inhibited innocuous (12 g) mechanically evoked responses of spinal neurons in noninflamed (27 ± 4% of control; P < 0.01) and inflamed (12 ± 8% of control; P < 0.05) rats. Similarly, noxious (80 g) mechanically evoked responses of spinal neurons were inhibited by peripheral injection of ACEA (30 µg in 50 µL) in noninflamed rats (51 ± 9% of control; P < 0.01) and rats with peripheral carrageenan inflammation (21 ± 8% of control; P < 0.01). Inhibitory effects of ACEA were significantly greater in rats with peripheral carrageenan inflammation than in noninflamed rats (P < 0.05). Inhibitory effects of ACEA were significantly blocked by coadministration of the CB1 receptor antagonist SR141716A in both groups of rats. Peripheral injection of SR141716A alone did not alter mechanically evoked responses of spinal neurons in either group of rats. These data demonstrate that activation of peripheral CB1 receptors can inhibit innocuous and noxious somatosensory processing. Furthermore, following peripheral inflammation there is an enhanced inhibitory effect of a peripherally administered CB1 receptor agonist on both innocuous and noxious mechanically evoked responses of spinal neurons.

Increased function of pronociceptive TRPV1 at the level of the joint in a rat model of osteoarthritis pain

Objectives Blockade of transient receptor potential vanilloid 1 (TRPV1) with systemic antagonists attenuates osteoarthritis (OA) pain behaviour in rat models, but on-target-mediated hyperthermia has halted clinical trials. The present study investigated the potential for targeting TRPV1 receptors within the OA joint in order to produce analgesia. Methods The presence of TRPV1 receptors in human synovium was detected using western blotting and immunohistochemistry. In a rat model of OA, joint levels of an endogenous ligand for TRPV1, 12-hydroxy-eicosatetraenoic acid (12-HETE), were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Effects of peripheral administration of the TRPV1 receptor antagonist JNJ-17203212 on afferent fibre activity, pain behaviour and core body temperature were investigated. Effects of a spinal administration of JNJ-17203212 on dorsal horn neuronal responses were studied. Results We demonstrate increased TRPV1 immunoreactivity in human OA synovium, confirming the diseased joint as a potential therapeutic target for TRPV1-mediated analgesia. In a model of OA pain, we report increased joint levels of 12-HETE, and the sensitisation of joint afferent neurones to mechanical stimulation of the knee. Local administration of JNJ-17203212 reversed this sensitisation of joint afferents and inhibited pain behaviour (weight-bearing asymmetry), to a comparable extent as systemic JNJ-17203212, in this model of OA pain, but did not alter core body temperature. There was no evidence for increased TRPV1 function in the spinal cord in this model of OA pain. Conclusions Our data provide a clinical and mechanistic rationale for the future investigation of the therapeutic benefits of intra-articular administration of TRPV1 antagonists for the treatment of OA pain.

Inflammation reduces mechanical thresholds in a population of transient receptor potential channel A1-expressing nociceptors in the rat.

Inflammatory hypersensitivity is characterized by behavioural reductions in withdrawal thresholds to noxious stimuli. Although cutaneous primary afferent neurones are known to have lowered thermal thresholds in inflammation, whether their mechanical thresholds are altered remains controversial. The transient receptor potential channel A1 (TRPA1) is a receptor localized to putative nociceptive neurones and is implicated in mechanical and thermal nociception. Herein, we examined changes in the properties of single primary afferents in normal and acutely inflamed rats and determined whether specific nociceptive properties, particularly mechanical thresholds, are altered in the subpopulation of afferents that responded to the TRPA1 agonist cinnamaldehyde (TRPA1‐positive afferents). TRPA1‐positive afferents in normal animals belonged to the mechanonociceptive populations, many of which also responded to heat or capsaicin but only a few of which responded to cold. In acute inflammation, a greater proportion of afferents responded to cinnamaldehyde and an increased proportion of dorsal root ganglion neurones expressed TRPA1 protein. Functionally, in inflammation, TRPA1‐positive afferents showed significantly reduced mechanical thresholds and enhanced activity to agonist stimulation. Inflammation altered thermal thresholds in both TRPA1‐positive and TRPA1‐negative afferents. Our data show that a subset of afferents is sensitized to mechanical stimulation by inflammation and that these afferents are defined by expression of TRPA1.

Sensory nerves have altered function contralateral to a monoarthritis and may contribute to the symmetrical spread of inflammation

Rheumatoid arthritis (RA) and rat models of RA exhibit symmetrical mirror‐image spread. Many studies have sought to understand the underlying mechanisms and have reported contralateral effects that are manifested in many different forms. It is now well accepted that neurogenic mechanisms contribute to the symmetrical spread of inflammation. However, very few investigators have directly assessed changes in contralateral nerve function and there is a paucity of data. In the present study our aim was to investigate whether there are changes, in particular in the nervous system but also in the vascular system contralateral to an inflamed rat knee joint, that might precede overt inflammation and symmetrical spread. Three to five days following Complete Freunds Adjuvant (CFA) injection we found spontaneous antidromic (away from the CNS) activity in the homologous sensory nerve contralateral to the inflamed joint. Antidromic activity of this nature is known to result in the peripheral release of pro‐inflammatory and vasoactive neuropeptides. Importantly, this activity was modulated by systemic analgesic treatment. Furthermore, levels of Evans blue dye extravasation were significantly increased in the joint contralateral to inflammation, indicating altered vascular function. These data suggest that contralateral increases in sensory neural activity and vascular function may account for the symmetrical spread of RA, and that early analgesic treatment may prevent or delay the spread of this debilitating disease.

Spinal administration of capsazepine inhibits noxious evoked responses of dorsal horn neurons in non-inflamed and carrageenan inflamed rats

Vanilloid VR1 receptors are located in the dorsal horn of the spinal cord. The aim of the present study was to determine the role of spinal vanilloid receptors (VR1) during nociceptive processing in control and inflamed rats. Effects of spinal administration of capsazepine (0.5-30 microM/50 microl), a competitive VR1 antagonist, on innocuous and noxious evoked responses of spinal neurones were studied in halothane anaesthetised rats. Transcutaneous electrical-evoked neuronal responses of spinal neurones were recorded in control and carrageenan (2%, 3 h) inflamed rats. Spinal application of capsazepine did not significantly alter Abeta-fibre evoked responses of neurones, however Adelta-fibre evoked responses were significantly inhibited by capsazepine in both non-inflamed and carrageenan inflamed rats (30 microM: non-inflamed 31+/-8% of control, P<0.01: carrageenan-inflamed 43+/-6% of control, P<0.01). Similarly, the evoked C-fibre mediated post-discharge responses of spinal neurones in non-inflamed and carrageenan inflamed rats were reduced by capsazepine (30 microM: non-inflamed 41+/-14% of control, P<0.01: carrageenan-inflamed 31+/-9% of control, P<0.01). These results demonstrate a role of spinal VR1 receptors during noxious, but not innocuous transmission, at the level of the spinal cord. The degree of effect of capsazepine on evoked neuronal responses was similar in control and inflamed rats, suggesting that the role of spinal VR1 receptors is not altered following short-term peripheral inflammation. Our data suggest that following noxious peripheral stimulation, spinal VR1 receptors are activated, but the endogenous ligands mediating this effect remain to be elucidated.

Peripheral Calcitonin Gene-Related Peptide Receptor Activation and Mechanical Sensitization of the Joint in Rat Models of Osteoarthritis Pain

To investigate the role of the sensory neuropeptide calcitonin gene‐related peptide (CGRP) in peripheral sensitization in experimental models of osteoarthritis (OA) pain.

Spontaneous firing in C-fibers and increased mechanical sensitivity in A-fibers of knee joint-associated mechanoreceptive primary afferent neurones during MIA-induced osteoarthritis in the rat

OBJECTIVE Osteoarthritis (OA) pain mechanisms are poorly understood. We used the monosodium iodoacetate (MIA) model of knee OA to characterize changes in excitability during the course of OA in different classes of mechanosensitive afferents projecting to joint-associated tissues, and examine whether these afferent responses and pain behavior are correlated. METHODS Rats were injected intra-articularly with MIA (1mg in 50 μl). Hind-limb weight bearing was studied 3 (MIA3) and 14 (MIA14) days after MIA, followed by deep anesthesia and teased-nerve-fiber recordings. Spontaneous activity (SA) and mechanically evoked responses of A- and C-mechanosensitive fibers (AM and CM respectively, probably nociceptive) innervating tissues associated with the ipsilateral knee joint were examined. RESULTS MIA3 and MIA14 rats exhibited reduced ipsilateral weight bearing. SA (>0.02 impulses/s) occurred in ∼50% of CMs from MIA rats vs 0% in normals. SA firing rates in CMs were significantly higher than normal; decreased weight bearing was correlated with increased CM SA rates. Neither percentages of AMs with SA (20%) nor their firing rates (0-0.01 impulses/s) significantly increased after MIA. In contrast, in MIA rats AMs, but not CMs, exhibited decreased mechanical thresholds and increased firing rates in response to suprathreshold mechanical stimulation. CONCLUSIONS These findings of increased SA firing rate in CMs but not AMs and increased mechanical sensitivity of AMs, but not CMs, have not previously been reported. These are two distinct important physiological mechanisms that may underpin spontaneous pain (CMs) and stimulus-evoked pain (AMs) in OA. Our data contribute to a mechanism-based understanding of OA pain.

Spinal nociceptive reflexes are sensitized in the monosodium iodoacetate model of osteoarthritis pain in the rat

OBJECTIVE Evidence suggests that osteoarthritis (OA) is associated with altered central pain processing. We assessed the effects of experimentally induced OA on the excitability of spinal nociceptive withdrawal reflexes (NWRs), and their supraspinal control in a preclinical OA model. DESIGN Experimental OA was induced in rats with knee injection of monosodium iodoacetate (MIA) and pain behaviour was assessed. 14/28 days post-MIA or saline injection, rats were anaesthetised for spinal NWR recording from tibialis anterior (TA) and biceps femoris (BF) hind limb muscles during plantar hind paw stimulation. Thresholds, receptive field sizes and wind up (incremental increase to repetitive stimulation) were measured in intact (d14/28) and spinalised (severed spinal cord; d28) MIA- and saline-injected rats. RESULTS MIA reduced BF mechanical thresholds at day 28. Spinalisation of MIA rats did not prevent this hyperexcitability, and failed to produce the reduction in reflex receptive field (RRF) size observed in saline rats. These data indicate that MIA induces a hyperexcitability of BF NWR circuits that is maintained at the spinal level. In contrast, MIA appeared to have no effect on NWRs evoked by mechanical stimuli in the ankle flexor TA in intact rats, however spinalisation revealed hyperexcitability. Thus, 28 days following MIA-treatment, descending supraspinal inhibition normalised TA NWRs and was only overcome following repetitive noxious stimulation during wind up. CONCLUSIONS We demonstrate that spinal nociceptive reflex pathways are sensitized following the development of OA, suggesting the presence of central sensitization. Further, our data reflect OA-induced alterations in the descending control of reflex responses. Our findings contribute to a mechanism-based understanding of OA pain.

Calcitonin gene‐related peptide in the joint: contributions to pain and inflammation

Arthritis is the commonest cause of disabling chronic pain, and both osteoarthritis (OA) and rheumatoid arthritis (RA) remain major burdens on both individuals and society. Peripheral release of calcitonin gene‐related peptide (CGRP) contributes to the vasodilation of acute neurogenic inflammation. Contributions of CGRP to the pain and inflammation of chronic arthritis, however, are only recently being elucidated. Animal models of arthritis are revealing the molecular and pathophysiological events that accompany and lead to progression of both arthritis and pain. Peripheral actions of CGRP in the joint might contribute to both inflammation and joint afferent sensitization. CGRP and its specific receptors are expressed in joint afferents and up‐regulated following arthritis induction. Peripheral CGRP release results in activation of synovial vascular cells, through which acute vasodilatation is followed by endothelial cell proliferation and angiogenesis, key features of chronic inflammation. Local administration of CGRP to the knee also increases mechanosensitivity of joint afferents, mimicking peripheral sensitization seen in arthritic joints. Increased mechanosensitivity in OA knees and pain behaviour can be reduced by peripherally acting CGRP receptor antagonists. Effects of CGRP pathway blockade on arthritic joint afferents, but not in normal joints, suggest contributions to sensitization rather than normal joint nociception. CGRP therefore might make key contributions to the transition from normal to persistent synovitis, and the progression from nociception to sensitization. Targeting CGRP or its receptors within joint tissues to prevent these undesirable transitions during early arthritis, or suppress them in established disease, might prevent persistent inflammation and relieve arthritis pain.