Chronic pain affects the life of millions of people. Current treatments have deleterious side effects. We have advanced a strategy for targeting protein interactions which regulate the N-type voltage-gated calcium (CaV2.2) channel as an alternative to direct channel block. Peptides uncoupling CaV2.2 interactions with the axonal collapsin response mediator protein 2 (CRMP2) were antinociceptive without effects on memory, depression, and reward/addiction. A search for small molecules that could recapitulate uncoupling of the CaV2.2-CRMP2 interaction identified (S)-lacosamide [(S)-LCM], the inactive enantiomer of the Food and Drug Administration-approved antiepileptic drug (R)-lacosamide [(R)-LCM, Vimpat]. We show that (S)-LCM, but not (R)-LCM, inhibits CRMP2 phosphorylation by cyclin dependent kinase 5, a step necessary for driving CaV2.2 activity, in sensory neurons. (S)-lacosamide inhibited depolarization-induced Ca influx with a low micromolar IC50. Voltage-clamp electrophysiology experiments demonstrated a commensurate reduction in Ca currents in sensory neurons after an acute application of (S)-LCM. Using constellation pharmacology, a recently described high content phenotypic screening platform for functional fingerprinting of neurons that uses subtype-selective pharmacological agents to elucidate cell-specific combinations (constellations) of key signaling proteins that define specific cell types, we investigated if (S)-LCM preferentially acts on certain types of neurons. (S)-lacosamide decreased the dorsal root ganglion neurons responding to mustard oil, and increased the number of cells responding to menthol. Finally, (S)-LCM reversed thermal hypersensitivity and mechanical allodynia in a model of postoperative pain, and 2 models of neuropathic pain. Thus, using (S)-LCM to inhibit CRMP2 phosphorylation is a novel and efficient strategy to treat pain, which works by targeting specific sensory neuron populations.

Les douleurs neuropathiques ayant une origine à la suite de blessures traumatiques du SNC ou du SNP sont particulièrement difficiles à traiter en utilisant les moyens thérapeutiques actuellement disponibles. Il est donc nécessaire d'identifier de nouvelles stratégies thérapeutiques. Notre objectif était donc de définir les mécanismes impliqués dans ces douleurs neuropathiques. LIMK1 est l'un des acteurs possibles de la réorganisation épinière qui caractérise les lésions nerveuses. Une fonction très caractérisé de cette protéine, est la phosphorylation d'une famille de protéines appelées « cofilines ». Sa phosphorylation, ce qui induit la réorganisation du cytosquelette d'actine. Récemment, il a été montré qu’un microARN (miARNs) nomé miR-134 régule l'expression de LIMK1 en se liant au messager de LIMK1 (ARNm), inhibant sa traduction en protéine physiologiquement active. Notre hypothèse était que la régulation de LIMK1 par miR-134 pourrait jouer un rôle essentiel dans la sensibilisation à la douleur. Cette régulation pourrait ainsi être liée non seulement à la modulation neurochimique neuronale mais aussi à la plasticité fonctionnelle associée. Au cours de cette thèse, l’HIS a montré une diminution de miR-134 chez des rats SNL (neuropathique), cette sous-expression était concomitante à une augmentation de LIMK1 illustrée par l’IHC. Il est important de noter ici que l'ISH est une méthode de détection connue récemment et qui a été identifiée pour visualiser les miARNs. Des différents protocoles de l’HIS ont également été discutés dans le cadre de cette thèse. Ce résultat a été confirmé par Le qRT-PCR . Par la suite, afin de vérifier les changements comportementaux douloureux induits par miR-134 et LIMK1. Nous avons effectués des injections intrathécales de siRNA anti-LIMK1 pour inhiber l'expression endogène de LIMK1 chez les SNL. C’était intéressant de ne pas avoir trouvé aucun changement comportemenal chez les SNL après ce type d’injection. Une surexpression artificielle de miR-134 en utilisant un précurseur de miR-134 (premiR-134) chez les SNL a montré le même effet. Ensuite, nous avons essayé d'effectuer les mêmes injections chez les Sham (control), et c’était plus intéressant de trouver que ces injections (siRNA LIMK1 et premiR-134) ont provoqué une hypersensibilité douleureuse chez les sham. Cela a été illustré au moyen de deux tests de comportement; le Von Frey (VF) et la distribution pondérale dynamique (DWB). Pour etudier l'effet inverse, nous avons inhibé miR-134 en utilisant une sonde spécifique KD (Knock-Down); une diminution significative inattendue dans le seuil de retrait a été observée avec VF et DWB. qRT-PCR dans la plupart de ces cas, a confirmé la corrélation in vivo entre miR-134 et LIMK1. Enfin, nous avons cherché un mécanisme d'action possible qui pourrait réguler cette modulation. Des données récentes publiées ont montré une implication de l'ADF/cofiline sur le trafic des récepteurs AMPA (AMPAR). En accord avec les résultats mentionnés ci-dessus, la transfection du KD de miR-134 a montré une diminution dans AMPAR adressés à la membrane plasmique. Tout ensemble ces données suggèrent que l'effet antinociceptif de KD de miR-134 et la surexpression de LIMK1 sont indirectement régulé par l'insertion des AMPAR à la membrane plasmique.Il semble que miR-134 exerce un effet différent sur la douleur neuropathique que miR-103, discuté aussi dans le cadre de cette thèse. Il était demontré comme un régulateur de plusieurs cibles, les trois sous-unités formant les canaux calciques de type-L « Cav1.2 LTC ». MiR-103 a été trouvé également réprimés chez les SNL. La surexpression de miR-103 soulage la douleur neuropathique. Contrairement au miR-134, miR-103 exerce un rôle pronociceptive pendant la douleur neuropathique. / Pains having a neuropathic origin following CNS or PNS traumatic injury are particularly difficult to treat using the actually available therapeutic means. It is thus necessary to identify new therapeutic strategies. Hence, our aim was to define the mechanisms implicated in these neuropathic pains. Nervous lesions are characterised by an anatomical reorganization of the neuronal network of the dorsal horn. Neurochemical alterations are also involved. Some of the molecular mechanisms underlying the neuronal plasticity (a main feature of neuropathic pain) have been emphasized here by a variety of complementary technical approaches. LIMK1 is one of the possible actors of this reorganization. Among this protein’s known functions, and the most characterized is the phosphorylation of a family of proteins known as cofilins. Their phosphorylation induces the reorganization of actin cytoskeleton. Recently, it has been shown that a miR-134 miRNA regulates LIMK1 expression by binding to the LIMK1 messenger, inhibiting its translation into physiologically active protein. Our hypothesis is that LIMK1 regulation by miR-134 might play an essential role in pain sensitization by modulating neuron neurochemical reorganization and the associated functional neuronal plasticity. Firstly, by means of IHC and ISH, we studied miR-134/LIMK1 distribution within the dorsal horn of the spinal cord in sham animal (control group) and in neuropathic pain model (SNL model). Important to note here that ISH is a known detection method recently identified to visualize miRNA. Different protocols of ISH were discussed in a part of this thesis. ISH showed a decrease in miR-134 expression in SNL rats concomitantly with an increase in LIMK1 illustrated by IHC. This finding has been confirmed by qRT-PCR techniques. Afterward, in order to check for the possible behavioural-induced changes of miR-134 and LIMK1. We intrathecally injected an anti-LIMK1 siRNA to inhibit endogenous LIMK1 expression in SNL rats. Interestingly no significant changes in pain behaviour have been observed. Artificial overexpression of miR-134 using a PremiR-134, showed the same effect. Then we tried to perform the same injections on sham rats, and more interestingly, siRNA LIMK1 and premiR-134 evoked pain hypersensitivity in shams rats. This was illustrated by means of two behaviour tests; Von Frey (VF) and the Dynamic Weight bearing (DWB). To explore the reverse effect, we inhibited miR-134 using a specific KD probe in SNL rats; unexpectedly a significant decrease in pain withdrawal threshold was observed with VF and DWB. qRT-PCR in most cases confirmed the in vivo correlation between miR-134 and LIMK1. Finally, we searched for the possible mechanism of action that could regulate this modulation. Recent published data showed an involvement of ADF/cofilin on AMPAR trafficking. In line with the above mentioned findings, miR-134 KD transfection showed a decrease in AMPAR addressed to the plasma membrane. Altogether suggest that the antinociceptive effect of miR-134 KD and LIMK1 overexpression are mediated by AMPAR insertion at the plasma membrane. It seems that miR-134 exerts a different effect on neuropathic pain than miR-103 another miRNA discussed within the frame of this thesis. MiR-103 has been proved to regulate multiple targets, the three subunits forming Cav1.2 LTC. Pain sensitization involves Cav1.2 activation which consequently alters gene expression during this form of plasticity. MiR-103 was found downregulated also in the SNL model. Conversely to miR-134, overexpression of miR-103 partially alleviates pain. It decreases pain withdrawal threshold of the Von Frey test. Unlike miR-134, miR-103 exerts a pronociceptive role during neuropathic pain.

Le système somato-sensoriel permet à l'organisme de percevoir une large palette de stimuli externes/internes, qui peuvent être soit agréables, soit nocifs. Le corps cellulaire des neurones somato-sensoriels, responsables de ces processus et qui innervent tous les organes du corps, est situé dans les ganglions de la racine dorsale. La douleur est perçue par les nocicepteurs qui constituent un ensemble hétérogène de neurones, aussi bien d'un point de vue fonctionnel, électrophysiologique que moléculaire. Afin de mieux comprendre la spécialisation fonctionnelle des nocicepteurs, une des stratégies de l'équipe a été d'identifier de nouveaux marqueurs moléculaires exprimés par des sous-populations des neurones du DRG et de mettre en place des outils génétiques pour étudier leur fonction spécifique. Nous avons mis en évidence un nouveau gène, qui définit une sous-population de nocicepteurs. Suite à mes travaux de thèse, qui ont révélés la fonction moléculaire de la protéine associée à ce gène, nous l'avons nommé GINIP pour Galpha INhibitory Interacting Protein. Au cours de ma thèse, j'ai montré que : - GINIP interagit physiquement avec les protéines G-alpha inhibitrices- la perte de fonction de GINIP (souris GINIP KO) amplifie les douleurs de type neuropathique- le mécanisme sous-jacent fait intervenir la signalisation GABAergique Les douleurs pathologiques sont, entre autres, dues à un disfonctionnement des nocicepteurs, et leurs mécanismes restent mal connus. Dans ce contexte, l'ensemble de mes résultats met en évidence une nouvelle voie impliquée dans la régulation négative des nocicepteurs, qui pourra à l'avenir être la cible de stratégies thérapeutiques. / The somato-sensory system allows our organism to detect a myriad of external and internal stimuli that can range from innocuous stimuli (pleasant touch,etc) to noxious ones (burns, tissue injury, etc). The somato-sensory neurons involved in these processes innervate the entire organism and have their cell bodies clustered within the dorsal root ganglion. Pain is a modality of the somatosensory system, sensed through nociceptors. Nociceptors represent a heterogeneous class of somato-sensory neurons with respect to functional, electrophysiological and molecular criteria. In order to expand the knowledge of the functional specialization of nociceptors, our team's strategy aimed at identifying new molecular markers of nociceptors subsets. Subsequent design of the corresponding genetic tools allowed us investigating their specific function. Therefore, we found a gene that was never described before and that marks a specific subset of nociceptors. We named it GINIP (Gaplha Inhibitory Interacting Protein) as during my thesis I showed that:- GINIP physically interacts with inhibitory G-proteins- GINIP loss of function (GINIP knock out mouse) leads to the amplification of neuropathic pain- the associated mechanism involves GABAergic signalingPathological pain (chronic inflammatory pain and neuropathic pain) is, among others, a consequence of nociceptor dysfunction. Importantly, the mechanisms leading to this aberrant function are still not totally understood. Altogether, my results underscore a new pathway involved in the negative control of nociceptors under neuropathic pain conditions, and this opens a path for new therapeutic strategies.

The incidence of mild blast traumatic brain injuryhas risen due tothe increased use of improvised explosive devices (IEDs) in militaryconflicts. Mild blast TBI (mbTBI) is especially relevant due to its lack of acutely observable symptoms, and to its association with long-term neurodegenerative and neuropsychiatric disorders. Predominantly, TBI patients often suffer from chronic stress, neuropathic pain and headaches, which greatly compromise the health and quality of life of these individuals. Treatments for neuropathic pain have been empirically found and produce little effect in lessening neuropathic pain, likely due to the lack of targeted therapies. This highlights the need for better understanding of the molecular mechanisms underlying neuropathicpain, TBI and chronic stress that could lead to mechanistic therapeutic targets. Oxidative stress is an important mechanism of the pathophysiology of neuropathic pain, TBI and chronic stress. We hypothesize that acrolein, an endogenously formed neurotoxin, is able to stay active in the body for up to 10 days, is involved in the pathophysiology of neuropathic pain in TBI and chronic stress. This study aims to correlate acrolein elevation in the body with neuropathic pain, deepen the understanding of underlying mechanisms of pain in TBI and chronic stress, and mitigate this pain with acrolein scavenging. The ultimate goal of this research is to provide therapies for TBI and chronic stress patients that can eliminate pain and significantly improve their healthand quality of life

No description available.

Introdução: Um fator que pode contribuir para o desenvolvimento da dor neuropática é a modulação negativa da via descendente da dor pelo aumento da degradação do triptofano pela ativação da enzima indoleamina 2,3-dioxigenase 1 (IDO1) ou a ativação da via descendente facilitatória da dor por um agonista glutamatérgicos produzido pela enzima quinurenina 3 monoxigenase (KMO). Objetivo: Foi avaliar a participação das enzimas IDO1 e a KMO presente na substância cinzenta periaquedutal (PAG) e no bulbo rostral ventromedial (RVM) no desenvolvimento da dor neuropática em camundongos induzida pelo modelo SNI. Metodologia: A indução da neuropatia experimental foi realizada de acordo com (Bourquin et al., 2006). A expressão da IDO1 e KMO foi realizada pela técnica de Western blotting. A administração de drogas foi realizada por via oral, intraperitoneal, intratecal e intracerebroventricular (i.c.v.). Resultados: Foi observado o aumento da expressão da enzima IDO1 no RVM (7 dias) e PAG (3, 7, 14 e 21 dias) após SNI. A microinjeção de Norharmane no espaço i.c.v. reduziu a hipersensibilidade mecânica no 7, 14 e 21 dias após SNI. Corroborando com esses achados, animais deficientes para a enzima IDO1 submetidos a SNI não desenvolvem a hipersensibilidade mecânica. Além disso, a expressão da enzima KMO aumenta significativamente no 7 e 14 dias no RVM e 7 dias na PAG após SNI. Por conseguinte, a administração oral de JM6, pró-droga de liberação lenta do Ro61-8048, ou Ro61-8048 (inibidor da KMO) no espaço i.c.v. reduziu significativamente a hipersensibilidade mecânica nos dias 7, 14 ou 21 após SNI. Sabendo que a expressão da enzima IDO1 é modulada pela citocina IFN-, verificamos que os animais deficientes para a citocina IFN- apresentam hipersensibilidade mecânica reduzida. Ainda, os animais IFN- KO possuem expressão reduzida da IDO1 no RVM 7 dias e na PAG 14 dias após a SNI. Em adição, a microinjeção de doses crescentes de IFN- no espaço i.c.v. induz uma hipernocicepção mecânica em camundongos naives. Constatamos também que animais CD4+ KO, mas não os animais CD8+ KO apresentam reduzida expressão da enzima IDO1 no RVM e na PAG e consequentemente menor hipersensibilidade mecânica após SNI. A microinjeção dos metabolitos da via das quinureninas, no espaço i.c.v. de camundongos causou hipersensibilidade mecânica, sendo o QUIN o mais potente. Sugerimos que a ativação da via das quinureninas seja dependente da ativação do receptor NMDA, visto que o pré-tratamento local com o MK801 (antagonista seletivos dos receptores NMDA) reverte os efeitos nociceptivos induzidos pelos metabólitos. Além disso, o efeito nociceptivo induzido por QUIN depende ativação da via descendente facilitatória. Constatamos que os animais neuropáticos exibem um comportamento do tipo depressivo e esse comportamento não é observado em animais IFN- KO e CD4KO. Por último, avaliamos a participação da via das quinureninas no desenvolvimento do comportamento depressivo associado à SNI e constatamos que esse comportamento depende da ativação das enzimas IDO1 e KMO. Conclusão: Os resultados sugerem que as enzimas IDO1 e KMO, localizadas em regiões supraespinais desempenham um importante papel no desenvolvimento da dor neuropática, assim como da comorbidade depressão. Além disso, a expressão da IDO1 é dependente da sinalização via citocina IFN- e células CD4+. O mecanismo responsável pelo desenvolvimento da hipersensibilidade neuropática deve-se tanto a redução dos níveis de triptofano/5-HT, diminuição da eficiência da via descendente inibitória, quanto ao aumento dos níveis de QUIN, que ativa a via descendente facilitatória da dor. / Introduction: One factor that may contribute to the development of neuropathic pain is the negative modulation of the descending pain pathway by increased degradation of the activation of tryptophan by enzyme indoleamine 2,3-dioxygenase1 (IDO1) or activation of the descending facilitatory pain pathway for a glutamate agonist produced by the enzyme kynurenine 3 monooxygenase (KMO). Aim: We evaluate the role of IDO1 and KMO in the periaqueductal gray (PAG) and the rostral ventromedial medulla (RVM) in the development of neuropathic pain in mice induced by SNI model. Methods: Induction of experimental neuropathy was performed according to (Bourquin et al. 2006). The expression of IDO1 and KMO was carried out by Western blotting technique. The drug administration was performed orally, intraperitoneally and intracerebroventricularly (i.c.v) Results. We observed increased IDO1 expression in the RVM (7 days) and PAG (3, 7, 14 and 21 days) after SNI. The microinjection Norharmane in i.c.v. space reduced mechanical hypersensitivity in the 7, 14 and 21 days after SNI. Corroborating these findings, mice deficient for the enzyme IDO1 undergoing SNI did not develop mechanical hypersensitivity. Furthermore, the KMO expression was significantly increased in the 7 and 14 days in the RVM and 7 days in PAG after SNI. Therefore, oral administration of JM6, prodrug slow release from Ro61-8048 or Ro61-8048 (KMO inhibitors) within i.c.v. significantly reduced the mechanical hypersensitivity at day 7, 14 or 21 after SNI. Knowing that the expression of IDO1 enzyme is modulated by IFN- cytokine, it was found that animals deficient for IFN- cytokine have reduced mechanical hypersensitivity. Moreover, IFN- ko animals have reduced expression of IDO1 RVM 7 days and 14 days after SNI in the PAG. In addition, microinjection of increasing doses of IFN- in i.c.v. induced mechanical hyperalgesia. We also found that CD4 + KO animals, but not CD8 + KO animals showed reduced expression of the enzyme IDO1 RVM and PAG and consequently lower mechanical hypersensitivity after SNI. The microinjection of the main metabolites of kynurenine pathway into the i.c.v. spaces induced mechanical hypersensitivity, QUIN being the most potent. We suggest that the activation of the kynurenine pathway was dependent of NMDA receptor activation, whereas the spot pre-treatment with MK801 (selective NMDA receptor antagonist) reverses the effects induced by noxious metabolites. After that, the microinjection into i.c.v. spaces of MK801 reduced mechanical hypersensitivity after SNI. Furthermore, nociceptive effect induced by QUIN depends activation of the descending facilitatory. We found that the neuropathic animals exhibit depressive-like behavior and this behavior is not observed in IFN- KO and CD4KO mice. Finally, we evaluate the participation of kynurenine pathway in the development of depressive-like behavior associated with SNI and found that this behavior depends on the activation of IDO1 and KMO Conclusion: These results suggest that IDO1 and KMO enzyme, located in supraspinal regions play a role in the development of neuropathic pain as well as comorbidity depression. Furthermore, the expression of IDO1 are dependent on signaling via cytokine IFN- and CD4+ cells. The mechanism responsible for the development of neuropathic hypersensitivity is due to both reduced levels of tryptophan/5-HT decrease the descending inhibitory pain pathway efficiency, as the increased levels of QUIN, which activates the descending facilitatory pain pathway.

A dor associada ao câncer pode ser causada não somente pelos efeitos diretos ou indiretos da patologia primária, mas também pelo tratamento quimioterápico. A Cisplatina é um dos medicamentos anti-neoplásicos mais efetivos e mais comumente usados no tratamento de tumores sólidos. Entretanto, um de seus principais efeitos colaterais é a neurotoxicidade periférica. Os mecanismos celulares e moleculares da dor crônica induzida por quimioterápico são ainda bastante obscuros. Investigamos o papel da proteína quinase dependente de RNA (PKR) nos diferentes mecanismos neurobiológicos associados à dor crônica induzida pelo quimioterápico Cisplatina. O presente estudo avaliou: (1) O desenvolvimento de alodínia mecânica e hipernocicepção térmica em camundongos PKR-/- e PKR+/+ submetidos à administração do quimioterápico Cisplatina; (2) O estado de fosforilação das MAPKs (Erk1,2, p38 e JNK/SAP) e o fator de transcrição STAT-3 nas células do gânglio da raiz dorsal de animais tratados com Cisplatina; (3) Alterações na resistência e força muscular dos camundongos PKR-/- e PKR+/+ submetidos a administração do quimioterápico Cisplatina; (4) A proteólise muscular em músculos EDL (glicolíticos) e soleus (oxidativos) de camundongos PKR-/- e PKR+/+ após tratamento com Cisplatina (5) A síntese proteica através de Western Blot das proteínas Akt, FoxO 1 e FoxO 4, S6k1 e a S6 em células C2C12 analisando temporalmente o efeito da Cisplatina (6h, 12h e 24h); (6) O estresse oxidativo mitocondrial em células do gânglio da raiz dorsal e do músculo Soleus de camundongos PKR-/- e PKR+/+ após tratamento com Cisplatina. Os resultados obtidos foram: (1) Que com o tratamento com cisplatina produziu hipernocicepção térmica e alodínia mecânica nos animais PKR+/+; (2) A reduz da fosforilação do p38 não justifica o quadro de hipernocicepção e a hipernocicepção pode ocorrer a partir do aumento da fosforilação de STAT 3; (3) Animais que não tem a PKR são menos vulneráveis à ação deletéria da cisplatina sobre o músculo pois todos os testes comportamentais para atividade motora; (4) Não houve diferença na proteólise total mas sim na síntese proteica em animais PKR tratados com cisplatina; (5) Há alteração na via Akt quando analisa temporalmente a ação da cisplatina; (6) animais PKR -/- apresentaram índices mais altos da respiração mitocondrial comparados aos PKR +/+. Este estudo combinou métodos de biologia celular e molecular com paradigmas comportamentais a fim de investigar os possíveis mecanismos de ação da PKR no desenvolvimento de hipersensibilidade sensorial após o tratamento com quimioterápico. Os resultados deste trabalho devem evidenciar novos mecanismos neurobiológicos que contribuam para o entendimento da fisiopatologia da dor crônica de origem neurotóxica e apontar novas estratégias terapêuticas para o tratamento da dor crônica causada por quimioterapia / Pain associated with cancer can be caused by only direct or indirect products of the primary pathology, but also by chemotherapeutic treatment. Cisplatin is one of the most effective and most common anti-neoplastic drugs without the treatment of solid tumors. However, one of its major side effects is peripheral neurotoxicity. The cellular and molecular mechanisms of chronic pain induced by chemotherapy are still rather obscure. Investigators of role of RNA-dependent protein kinase (PKR) in the different neurobiological mechanisms associated with chronic pain induced by the chemotherapeutic Cisplatin. The present study evaluated: (1) the development of mechanical allodynia and thermal hypernociception in mice PKR - / - and PKR + / + submitted to chemotherapy Cisplatin; (2) The state of phosphorylation of the MAPKs (Erk1,2, p38 and JNK / SAP) and the transcription factor STAT-3 in the cells dorsal root ganglion of Cisplatin-treated animals; (3) Changes in muscle strength and strength of mice PKR - / - and PKR + / + submitted to the administration of the chemotherapeutic Cisplatin; (4) Muscle protein in EDL (glycolytic) and soleus (oxidative) muscles of mice PKR - / - and PKR + / + after treatment with Cisplatin (5) Western Blot Synthesis Protein of Akt, FoxO 1 and FoxO 4 S6k1 proteins and S6 in C2C12 cells by temporarily analyzing the effect of Cisplatin (6h, 12h and 24h); (6) Mitochondrial oxidative stress in dorsal root ganglion and Soleil muscle cells of PKR - / - and PKR + / + mice after treatment with Cisplatin. The results obtained were: (1) That with the treatment with cisplatin produced thermal hypernociception and mechanical allodynia in the animals PKR + / +; (2) The reduced phosphorylation of p38 does not justify the hyperencouragement and hypernociception can occur from increased STAT 3 phosphorylation; (3) Animals that do not have a PKR are less vulnerable to the deleterious action of cisplatin on muscle for all behavioral tests for motor activities; (4) There was no difference in total proteolysis but in protein synthesis in PKR animals treated with cisplatin; (5) There is alteration in the Akt pathway when the action of cisplatin is temporarily analyzed; (6) Animals PKR - / - had higher mitochondrial respiration rates compared to PKR + / +. This study combined methods of cellular and molecular biology with behavioral paradigms to investigate the possible mechanisms of action of PKR in the development of sensory hypersensitivity after treatment with chemotherapy. The results of this program are mandatory, which are responsible for the development of medicines for health and human health

Odontalgia Atípica (OA) é uma condição dolorosa orofacial crônica de intensidade moderada a severa, que ocorre nas estruturas dentoalveolares e na mucosa oral. É considerada de difícil diagnóstico por estar associada com a ausência de alterações clínicas e radiográficas perceptíveis. Seus aspectos patofisiológicos sensoriais e de manutenção e perpetuação da dor ainda são mal compreendidos. Os objetivos deste estudo foram: (1) avaliar as alterações somatossensoriais em pacientes com OA através dos testes sensoriais quantitativos (QST); (2) ampliar o conhecimento disponível sobre os mecanismos de modulação da dor através do teste de controle de modulação da dor (CPM); e (3) avaliar as condições psicológicas como ansiedade e depressão, qualidade do sono e qualidade de vida através de questionários auto-aplicáveis. Um total de 50 indivíduos foram incluídos, sendo 25 sujeitos do grupo sintomático com OA (19 mulheres, 58,25 +- 12,17 anos de idade) e 25 sujeitos saudáveis do grupo controle (19 mulheres, 58,92 +- 7,39 anos)(p>0.05). Os QSTs englobaram os testes de Limiar de Detecção Mecânica (MDT), Limiar de Sensibilidade Dolorosa Mecânica (PDT), Teste Mecânico de Alodinia com cotonete (DMA1) e escova dental (DMA2), Testes de Detecção Dolorosa do tipo quente (HPD) e gelado (CPD) e o Teste de Somação Temporal (WUR). O controle de modulação da dor foi feito através do teste CPM e as avaliações psicológicas através do Inventário de Ansiedade e Depressão de Beck, o Índice de Qualidade do Sono de Pittsburg e o Questionário de Qualidade de Vida SF-36. Os QSTs foram repetidos após a aplicação de uma pomada anestésica de Benzocaína 2%. A análise estatística foi feita através dos testes t pareado, teste t e o teste não paramétrico de Mann-Whitney, considerando-se um nível de significância de 5%. Os resultados indicaram que sujeitos com OA apresentam ganho sensorial por meio de estímulos térmicos do tipo quente (HPD) e gelado (CPD) e estímulos mecânicos dinâmicos (DMA1, DMA2 e WUR), e perda sensorial à estímulos mecânicos (MDT, PDT). Ainda, o teste CPM reduziu a intensidade da dor significativamente somente para o grupo controle. A aplicação tópica de anestesia indicou uma redução significativa na intensidade da dor nos indivíduos afetados. Além disso, sujeitos com OA apresentaram sintomas de maior depressão e ansiedade, qualidade do sono ruim e baixa qualidade de vida comparados à pacientes saudáveis. Este estudo enfatizou que alterações somatossensoriais significativas são encontradas em sujeitos com OA, onde envolve uma participação de processos periféricos de sensitização e condução da dor, associado à fenômenos de alodínia e hiperalgesia, o que sugere alterações em nível de sensitização central. O sistema modulátorio de dor mostra-se deficiente e as condições psicológicas estão afetadas em sujeitos com OA. / Atypical Odontalgia (AO) is a chronic orofacial painful condition, which occurs in dentoalveolar structures and oral mucosa. AO is difficult to diagnose because it is associated with the absence of any clinical and radiographic alterations. Repetitive dental procedures are made, with the aim to relief pain. Sensory pathophysiological aspects and pain maintenance and perpetuation are still poorly understood. The aim of this study were: (1) evaluate somatosensory abnormalities in AO patients through quantitative sensory testing (QST), (2) evaluate mechanisms of pain modulation through the controlled pain modulation test (CPM), and (3) assess the psychological features such as anxiety, depression, sleep quality and quality of life through selfreported questionnaires. A total of 50 subjects were included, consisting of 25 subjects with symptomatic AO (19 women, 58.25 +- 12.17 years old) and 25 subjects in the control group (19 women, 58.92 +- 7.39 years old)(p>0.05). QST encompassed Mechanical Detection Threshold (MDT), Pain Detection Threshold (PDT), Dynamical Mechanical Allodynia with a cotton swab (DMA1) and with a toothbrush (DMA2), Cold Pain Detection (CPD), Heat Pain Detection (HPD) and Wind-up Ratio (WUR). Pain modulation was performed by CPM and psychological evaluations through Anxiety Inventory and Beck Depression Index, the Pittsburgh Sleep Quality and Quality of Life Questionnaire SF-36. QSTs were repeated after the administration of an anesthetic cream (2% Benzocaine). Statistical analysis was performed using the \"t\" test, paired t test and nonparametric Mann-Whitney test considering a significance level of 5%. Results indicated that AO subjects showed sensory gain through heat (HPD) and cold (CPD) stimuli and dynamic mechanical stimuli (DMA1, DMA2 and WUR), and sensory loss to mechanical stimuli (MDT, PDT). Moreover, CPM reduced pain intensity significantly only in the control group. A topical anesthesia showed a significant reduction in pain intensity in affected subjects. Furthermore, subjects with AO had symptoms of depression and anxiety, poor sleep quality and poor quality of life compared to healthy individuals. This study emphasized that somatosensory abnormalities are found in subjects with AO, which involves participation of peripheral sensitization associated with allodynia and hyperalgesia, suggesting central sensitization abnormalities. Pain modulation system proves deficient and psychological conditions are affected in subjects with AO.

O enriquecimento ambiental (EA) é capaz de alterar a percepção a estímulos nociceptivos, bem como de aumentar a resposta analgésica induzida por opioides. Considerando que a dor neuropática é um grave problema de saúde pública e o tratamento para esta condição ainda é insatisfatório e acarreta efeitos adversos severos, os objetivos deste trabalho foram avaliar a interferência do bem-estar animal na sensibilidade dolorosa de ratos frente a diferentes estímulos nociceptivos e investigar possíveis mecanismos envolvidos neste efeito. Os animais foram submetidos à avaliação da ansiedade e da sensibilidade dolorosa, em modelo de neuropática, frente a estímulos nociceptivos mecânicos e térmicos. Foi verificado que um protocolo de EA elaborado e iniciado desde o nascimento foi capaz de reverter totalmente a dor neuropática de animais submetidos à constrição crônica do nervo isquiático (CCI). Este efeito foi completamente abolido quando os animais enriquecidos foram tratados com naloxona, um antagonista opioide não seletivo. Análises de Western Blot não mostraram diferenças na expressão de receptores opioides em regiões relacionadas ao processamento e controle da dor, porém os níveis circulantes de beta-endorfina e met-encefalina aumentaram na presença de dor crônica nos animais enriquecidos. Os níveis séricos de corticosterona também se apresentaram aumentados nos animais com EA, independentemente da neuropatia, mas o tratamento com mifepristona, um antagonista de receptores de glicocorticoides, não alterou a analgesia dos animais operados. Ainda, o EA também reduziu a imunorreatividade para serotonina na medula espinal de animais com CCI. Além do efeito analgésico, o EA também reduziu o marcador de lesão neuronal ATF-3 no gânglio da raiz dorsal e, no local da constrição, reduziu a degeneração neuronal característica do modelo, induzindo ainda, a presença predominantemente de macrófagos do tipo M2. Este trabalho reforça a importância do bem-estar na prevenção do desenvolvimento da dor neuropática e mostra uma abordagem não farmacológica que pode aumentar a resiliência de animais contra estímulos nocivos. / Environmental enrichment (EE) is capable of altering the perception of nociceptive stimuli, as well as increasing the analgesic response induced by opioids. Considering that neuropathic pain is a serious public health problem and the treatment for this condition is still unsatisfactory and induces severe side effects, the aims of this study were to evaluate the interference of animal welfare in the sensitivity to different nociceptive stimuli and to investigate possible mechanisms involved in this effect. Animals were submitted to the evaluation of anxiety and pain sensitivity in a model of neuropathic pain, against mechanical and thermal nociceptive stimuli. It was seen that an elaborated EE starting from birth was able to totally reverse the neuropathic pain of animals submitted to chronic constriction injury of the sciatic nerve (CCI). This effect was completely abolished when enriched animals were treated with naloxone, a nonselective opioid antagonist. Western blot analysis did not show differences in opioid receptor expression in regions related to pain processing and control, however, circulating levels of beta-endorphin and met-enkephalin were increased in the presence of chronic pain in enriched animals. Serum corticosterone levels were also increased in animals with EE regardless of neuropathy, but treatment with mifepristone, a nonselective glucocorticoid receptor antagonist, did not alter the analgesia of operated animals. Moreover, EE reduced serotonin immunoreactivity in the spinal cord of CCI animals. In addition to analgesic effect, EE also reduced the neuronal injury marker ATF-3 at the dorsal root ganglia and, at the site of constriction, decreased the neuronal degeneration characteristic of the model, inducing the presence of M2 macrophages subtype predominantly. This work reinforces the importance of well-being in preventing the development of neuropathic pain and shows a non-pharmacological approach that may increase animal resilience against noxious stimuli.

O tramadol é um analgésico de ação central eficaz na atenuação de dores agudas e crônicas, entre elas a dor neuropática em pacientes diabéticos. Encontra-se disponível na clínica como mistura de (+)-tramadol e (-)-tramadol. O tramadol é metabolizado pelo CYP2D6 em O-desmetiltramadol (M1) e pelo CYP3A4 e CYP2B6 em N-desmetiltramadol (M2). Ambos enantiômeros do tramadol e o (+)-M1 contribuem para a atividade analgésica: o (+)-tramadol e o (+)-M1 agem como agonistas do receptor -opióide; o (+)-tramadol inibe a recaptação de serotonina; e o (-)-tramadol inibe a recaptação de noradrenalina. O estudo investiga a influência do diabetes mellitus (DM) tipo 1 e tipo 2 descompensados na disposição cinética, metabolismo e farmacocinética-farmacodinâmica dos enantiômeros tramadol em pacientes com dor neuropática. Os pacientes não diabéticos (Grupo Controle, n=12), os pacientes com DM tipo 1 (n=9) e os pacientes com DM tipo 2 (n=9), todos portadores de dor neuropática e fenotipados como metabolizadores extensivos do CYP2D6, receberam dose única oral de 100 mg de tramadol racêmico. Amostras seriadas de sangue foram coletadas até 24 h após a administração do tramadol para o estudo farmacocinético e para a avaliação das concentrações de noradrenalina. A dor dos pacientes foi avaliada através da escala analógica visual de dor nos mesmos tempos de coleta de sangue. Os pacientes foram avaliados quanto à atividade in vivo do CYP3A utilizando midazolam como fármaco marcador e genotipados para o CYP2B6. As concentrações plasmáticas total e livre dos enantiômeros do tramadol, M1 e M2 foram analisadas por LC-MS/MS usando a coluna Chiralpak® AD. A disposição cinética do tramadol é enantiosseletiva nos pacientes dos Grupos Controle e DM tipo 1, com acúmulo plasmático do (+)-tramadol. O DM tipo 1, mas não o DM tipo 2, reduz a AUC do metabólito ativo (+)-M1 e simultaneamente aumenta sua fração livre. Portanto, a concentração plasmática livre do eutômero (+)-M1 permanece inalterada nos pacientes portadores de DM tipo 1 e DM tipo 2. Não foram observadas diferenças entre os Grupos Controle, DM tipo 1 e DM tipo 2 quanto às razões metabólicas plasmáticas e urinárias do metoprolol/-hidroximetoprolol e quanto ao clearance do midazolam. Correlações significativas entre as razões metabólicas de AUC (+)-tramadol/(+)-M1 ou (-)-tramadol/(-)-M1 e a atividade in vivo do CYP2D6 avaliada em plasma ou urina empregando o metoprolol como fármaco marcador sugerem a aplicação do tramadol como fármaco marcador do CYP2D6. Os dados também mostram uma tendência de aumento do clearance do (+)-tramadol e do (-)-tramadol em virtude da presença do alelo mutante T no polimorfismo 516G>T do CYP2B6. O modelo sigmóide de efeito máximo fracional foi empregado para descrever a relação farmacocinética-farmacodinâmica do tramadol em pacientes com dor neuropática, relacionando as concentrações plasmáticas livre do (+)-M1 com o efeito analgésico do tramadol. O presente estudo mostra a importância da análise da concentração livre dos enantiômeros individuais do tramadol e seus metabólitos nos estudos de farmacocinética-farmacodinâmica. / Tramadol is a centrally acting analgesic that effectively relieves acute and chronic pain, including neuropathic pain in diabetic patients. The drug is available in clinical practice as a mixture of the (+)-tramadol and (-)-tramadol enantiomers. Tramadol is metabolized by CYP2D6 to O-desmethyltramadol (M1) and by CYP3A4 and CYP2B6 to N-desmethyltramadol (M2). Both tramadol enantiomers and (+)-M1 contribute to the analgesic activity of the drug: (+)-tramadol and the (+)-M1 metabolite act as -opioid receptor agonists; (+)-tramadol inhibits serotonin reuptake; and (-)-tramadol inhibits the reuptake of norepinephrine. This study investigated the influence of uncontrolled type 1 and type 2 diabetes mellitus (DM) on the kinetic disposition, metabolism and pharmacokinetics-pharmacodynamics of tramadol enantiomers in patients with neuropathic pain. Nondiabetic patients (control group, n = 12), patients with type 1 DM (n = 9), and patients with type 2 DM (n = 9), all with neuropathic pain and phenotyped as extensive metabolizers of CYP2D6, received a single oral dose of 100 mg racemic tramadol. Serial blood samples were collected up to 24 h after administration of the drug for pharmacokinetic study and for the analysis of noradrenaline in plasma. Pain was rated on a visual analog pain scale at the same time as blood sampling. The patients were evaluated for in vivo CYP3A activity using midazolam as a probe drug and genotyped for CYP2B6. Total and unbound plasma concentrations of the tramadol, M1 and M2 enantiomers were analyzed by LC-MS/MS using a Chiralpak® AD column. The kinetic disposition of tramadol was enantioselective in the control and type 1 DM groups, with the accumulation of (+)-tramadol. Type 1, but not type 2, DM reduced the AUC of the active (+)-M1 metabolite and simultaneously increased its unbound fraction. Therefore, unbound plasma concentrations of the (+)-M1 eutomer remain unchanged in patients with type 1 and type 2 DM. No differences in the plasma and urinary metabolic ratios of metoprolol/-hydroxymetoprolol or in midazolam clearance were observed between the control, type 1 and type 2 DM groups. The significant correlations seen between (+)-tramadol/(+)-M1 or (-)-tramadol/(-)-M1 AUC metabolic ratios and in vivo CYP2D6 activity evaluated in plasma or urine using metoprolol as a probe drug suggest the application of tramadol as a marker for CYP2D6. The data also showed a trend towards increased clearance of (+)-tramadol and (-)-tramadol as a result of the presence of mutant allele T in the 516G>T polymorphism of the CYP2B6 gene. The fractional sigmoid maximum drug effect model was used to describe the pharmacokinetic-pharmacodynamic relationship of tramadol in patients with neuropathic pain, associating the unbound plasma concentrations of (+)-M1 with the analgesic effect of tramadol. The present study highlights the importance of analyzing unbound concentrations of the individual tramadol enantiomers and its metabolites in pharmacokinetic-pharmacodynamic studies.