Response to pregabalin and progesterone differs in male and female rat models of neuropathic and cancer pain.

Background: Cancer pain involves nervous system damage and pathological neurogenesis. Neuropathic pain arises from damage to the nervous system and is driven by ectopic signaling. Both progesterone and pregabalin are neuroprotective in animal models, and there is evidence that both drugs bind to and inhibit voltage-gated calcium channels. Aims: This study was designed to characterize the effects of progesterone and pregabalin in preclinical models of cancer and neuropathic pain in both sexes. Methods: We measured peripheral sensory signaling by intracellular in vivo electrophysiology and behavioral indicators of pain in rat models of cancer-induced bone pain and neuropathic pain. Results: Female but not male models of cancer pain showed a behavioral response to treatment and pregabalin reduced excitability in C and A high-threshold but not low-threshold sensory neurons of both sexes. Male models of neuropathic pain treated with pregabalin demonstrated higher signaling thresholds only in A high-threshold neurons, and behavioral data indicated a clear recovery to baseline mechanical withdrawal thresholds in all treatment groups. Female rat treatment groups did not show excitability changes in sensory neurons, but all demonstrated higher mechanical withdrawal thresholds than vehicle-treated females, although not to baseline levels. Athymic female rat models of neuropathic pain showed no behavioral or electrophysiological responses to treatment. Conclusions: Both pregabalin and progesterone showed evidence of efficacy in male models of neuropathic pain. These results add to the evidence demonstrating differential effects of treatments for pain in male and female animals and widely differing responses in models of cancer and neuropathic pain.

Contexte: La douleur cancéreuse implique des lésions du système nerveux et une neurogenèse pathologique. La douleur neuropathique résulte d'une lésion du système nerveux et est provoquée par une signalisation ectopique. La progestérone et la prégabaline sont toutes deux neuroprotectrices dans les modèles animaux et il est prouvé que ces deux médicaments se lient aux canaux calciques à tension contrôlée et les inhibent.Objectifs: Cette étude visait à caractériser les effets de la progestérone et de la prégabaline dans des modèles précliniques de cancer et de douleur neuropathique chez les deux sexes.Méthodes: Nous avons mesuré la signalisation sensorielle périphérique par électrophysiologie intracellulaire in vivo, ainsi que les indicateurs comportementaux de la douleur dans des modèles de rats atteints de douleurs osseuses et de douleurs neuropathiques induites par le cancer.Résultats: Contrairement aux modèles masculins, les modèles féminins atteints de douleur cancéreuse ont montré une réponse comportementale au traitement, tandis que la prégabaline a réduit l'excitabilité des neurones sensoriels C et A à seuil élevé mais non à seuil bas chez les deux sexes. Les modèles masculins atteints de douleur neuropathique traités à la prégabaline ont montré des seuils de signalisation plus élevés uniquement dans les neurones A à seuil élevé, tandis que les données comportementales ont indiqué un net retour aux seuils de retrait mécanique de départ dans tous les groupes de traitement. Les groupes de rats femelles traités n'ont pas montré de changements d'excitabilité dans les neurones sensoriels, mais tous ont montré des seuils de retrait mécanique plus élevés que les femelles traitées avec le vecteur, sans toutefois atteindre les niveaux de départ. Les modèles atteints de douleur neuropathique parmi les rats femelles athymiques n'ont montré aucune réponse comportementale ou électrophysiologique au traitement.Conclusions: La prégabaline et la progestérone ont toutes deux démontré leur efficacité dans les modèles masculins atteints de douleur neuropathique. Ces résultats s'ajoutent aux données probantes démontrant les effets différentiels des traitements de la douleur chez les animaux mâles et femelles, et les réponses très différentes dans les modèles atteints de cancer et de douleur neuropathique.

Inhibiting STAT3 in a murine model of human breast cancer-induced bone pain delays the onset of nociception.

Aggressive breast cancer subtypes utilize system xc-, a membrane antiporter, to import cystine for glutathione synthesis and maintenance of redox homeostasis, in turn releasing glutamate as a metabolic pro-nociceptive by-product. Metastatic breast cancers establish themselves at distal sites including bone, where changes in extracellular glutamate levels contribute to cancer-induced bone pain. We previously established that stearically blocking system xc- activity with sulfasalazine delays the onset of nociceptive behaviours and that xCT, the functional antiporter subunit, is positively regulated by signal transducer and activator of transcription 3 (STAT3). In the current investigation, a murine xenograft cancer-induced bone pain model was applied to examine whether pharmacological inhibition of phosphorylated STAT3 (pSTAT3) induces changes in nociception. A high glutamate-releasing, xCT/pSTAT3 over-expressing human breast cancer cell line was selected for injection into the distal epiphysis of the right femur of female nude mice. A 14-day regimen of intraperitoneal injections with either vehicle or the novel STAT3 inhibitor DR-1-55 commenced three weeks after initial intrafemoral bone injection. Nociceptive behaviours were temporally monitored by automated von Frey, dynamic weight bearing and open-field testing for the duration of the study, beginning at the baseline. Prior to sacrifice and at ethical end point, tumour-induced osteolytic lesions were radiographically assessed. Treatment with DR-1-55 significantly delayed the onset and severity of spontaneous and induced nociceptive behaviours, also decreasing human SLC7A11 ( xCT) mRNA levels in tumour-bearing limbs without altering osteolysis. In addition, two pro-inflammatory cytokines released by this cell line, interleukin 6 and interleukin 1ß, were also down-regulated at the mRNA level in response to DR-1-55 treatment in vivo, with lower human interleukin 6 levels detected in the host circulation. This study demonstrates that targeting pSTAT3 may be a viable therapeutic means to manage cancer-induced bone pain, alone or in combination with stearic system xc- blockers.

Spontaneous regression of chronic lymphocytic leukemia to a monoclonal B-lymphocytosis or to a normal phenotype.

Spontaneous remission of chronic lymphocytic leukemia (CLL) is an unusual and poorly characterized event. We performed a search for spontaneous remission in patients with CLL. Cases must have had a pathological diagnosis of CLL with disease duration > 6 months. Spontaneous remission was defined as absence of lymphadenopathy or splenomegaly with lymphocyte counts < 5 × 10(9)/L for > 9 months without therapy. We identified 20 cases and included one additional case from our institution. Fourteen cases (67%) showed remission into monoclonal B lymphocytosis (MBL) and seven (33%) into a normal phenotype. There was no difference in age distribution, lymphocyte count or stage between groups. There was a significant difference in the median duration of CLL prior to remission, 13 years in the MBL versus 3 years in the normal phenotype group (p = 0.03). This difference in the duration of CLL prior to remission could be due to a possible distinct pathophysiology for these events.