PAIN®Pub Date : 2025-04-01Epub Date: 2024-09-18DOI: 10.1097/j.pain.0000000000003410
Rocco Giordano, Lars Arendt-Nielsen, Maria Carla Gerra, Andreas Kappel, Svend Erik Østergaard, Camila Capriotti, Cristina Dallabona, Kristian Kjær-Staal Petersen
{"title":"Pain mechanistic networks: the development using supervised multivariate data analysis and implications for chronic pain.","authors":"Rocco Giordano, Lars Arendt-Nielsen, Maria Carla Gerra, Andreas Kappel, Svend Erik Østergaard, Camila Capriotti, Cristina Dallabona, Kristian Kjær-Staal Petersen","doi":"10.1097/j.pain.0000000000003410","DOIUrl":"10.1097/j.pain.0000000000003410","url":null,"abstract":"<p><strong>Abstract: </strong>Chronic postoperative pain is present in approximately 20% of patients undergoing total knee arthroplasty. Studies indicate that pain mechanisms are associated with development and maintenance of chronic postoperative pain. The current study assessed pain sensitivity, inflammation, microRNAs, and psychological factors and combined these in a network to describe chronic postoperative pain. This study involved 75 patients with and without chronic postoperative pain after total knee arthroplasty. Clinical pain intensity, Oxford Knee Score, and pain catastrophizing were assessed as clinical parameters. Quantitative sensory testing was assessed to evaluate pain sensitivity and microRNAs, and inflammatory markers were likewise analyzed. Supervised multivariate data analysis with \"Data Integration Analysis for Biomarker Discovery\" using Latent cOmponents (DIABLO) was used to describe the chronic postoperative pain intensity. Two DIABLO models were constructed by dividing the patients into 3 groups or 2 defined by clinical pain intensities. Data Integration Analysis for Biomarker discovery using Latent cOmponents model explained chronic postoperative pain and identified factors involved in pain mechanistic networks among assessments included in the analysis. Developing models of 3 or 2 patient groups using the assessments and the networks could explain 81% and 69% of the variability in clinical postoperative pain intensity. The reduction of the number of parameters stabilized the models and reduced the explanatory value to 69% and 51%. This is the first study to use the DIABLO model for chronic postoperative pain and to demonstrate how different pain mechanisms form a pain mechanistic network. The complex model explained 81% of the variability of clinical pain intensity, whereas the less complex model explained 51% of the variability of clinical pain intensity.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"847-857"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PAIN®Pub Date : 2025-04-01Epub Date: 2024-10-01DOI: 10.1097/j.pain.0000000000003418
Rachel M Schafer, Luigino A Giancotti, John C Chrivia, Ying Li, Fatma Mufti, Thomas A Kufer, Jinsong Zhang, Timothy M Doyle, Daniela Salvemini
{"title":"CARTp/GPR160 mediates behavioral hypersensitivities in mice through NOD2.","authors":"Rachel M Schafer, Luigino A Giancotti, John C Chrivia, Ying Li, Fatma Mufti, Thomas A Kufer, Jinsong Zhang, Timothy M Doyle, Daniela Salvemini","doi":"10.1097/j.pain.0000000000003418","DOIUrl":"10.1097/j.pain.0000000000003418","url":null,"abstract":"<p><strong>Abstract: </strong>Neuropathic pain is a debilitating chronic condition that remains difficult to treat. More efficacious and safer therapeutics are needed. A potential target for therapeutic intervention recently identified by our group is the G-protein coupled receptor 160 (GPR160) and the cocaine- and amphetamine-regulated transcript peptide (CARTp) as a ligand for GPR160. Intrathecal administration of CARTp in rodents causes GPR160-dependent behavioral hypersensitivities. However, the molecular and biochemical mechanisms underpinning GPR160/CARTp-induced behavioral hypersensitivities in the spinal cord remain poorly understood. Therefore, we performed an unbiased RNA transcriptomics screen of dorsal horn spinal cord (DH-SC) tissues harvested at the time of peak CARTp-induced hypersensitivities and identified nucleotide-binding oligomerization domain-containing protein 2 ( Nod2 ) as a gene that is significantly upregulated. Nucleotide-binding oligomerization domain-containing protein 2 is a cytosolic pattern-recognition receptor involved in activating the immune system in response to bacterial pathogens. While NOD2 is well studied under pathogenic conditions, the role of NOD2-mediated responses in nonpathogenic settings is still not well characterized. Genetic and pharmacological approaches reveal that CARTp-induced behavioral hypersensitivities are driven by NOD2, with co-immunoprecipitation studies indicating an interaction between GPR160 and NOD2. Cocaine- and amphetamine-regulated transcript peptide-induced behavioral hypersensitivities are independent of receptor-interacting protein kinase 2 (RIPK2), a common adaptor protein to NOD2. Immunofluorescence studies found NOD2 co-expressed with endothelial cells rather than glial cells, implicating potential roles for CARTp/NOD2 signaling in these cells. While these findings are based only on studies with male mice, our results identify a novel pathway by which CARTp causes behavioral hypersensitivities in the DH-SC through NOD2 and highlights the importance of NOD2-mediated responses in nonpathogenic settings.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"902-915"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PAIN®Pub Date : 2025-04-01Epub Date: 2024-12-13DOI: 10.1097/j.pain.0000000000003449
Steven P Cohen
{"title":"The effects of gabapentin and antidepressants on opioid-related mortality rates: physicians who can \"see and hear,\" must also \"look and listen\".","authors":"Steven P Cohen","doi":"10.1097/j.pain.0000000000003449","DOIUrl":"10.1097/j.pain.0000000000003449","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"715-716"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PAIN®Pub Date : 2025-04-01Epub Date: 2024-10-15DOI: 10.1097/j.pain.0000000000003433
Xuejiao Chen, Wenli Mi, Tianchi Gao, Fengfei Ding, Wei Wang
{"title":"Astrocytes in the rostral ventromedial medulla mediate the analgesic effect of electroacupuncture in a rodent model of chemotherapy-induced peripheral neuropathic pain.","authors":"Xuejiao Chen, Wenli Mi, Tianchi Gao, Fengfei Ding, Wei Wang","doi":"10.1097/j.pain.0000000000003433","DOIUrl":"10.1097/j.pain.0000000000003433","url":null,"abstract":"<p><strong>Abstract: </strong>Chemotherapy-induced peripheral neuropathic pain aggravates cancer survivors' life burden. Electroacupuncture (EA) has exhibited promising analgesic effects on neuropathic pain in previous studies. We investigated whether EA was effective in a paclitaxel-induced neuropathic pain mouse model. We further explored the functional role of astrocytes in the rostral ventromedial medulla (RVM), a well-established pain modulation center, in the process of neuropathic pain as well as the analgesic effect of EA. We found that paclitaxel induced mechanical allodynia, astrocytic calcium signaling, and neuronal activation in the RVM and spinal cord, which could be suppressed by EA treatment. Electroacupuncture effectively alleviated paclitaxel-induced mechanical allodynia, and the effect was attenuated by the chemogenetic activation of astrocytes in the RVM. In addition, inhibiting astrocytic calcium activity by using either IP 3 R2 knockout (IP 3 R2 KO) mice or microinjection of AAV-mediated hPMCA2 w/b into the RVM to reduce non-IP 3 R2-dependent Ca 2+ signaling in astrocytes exhibited an analgesic effect on neuropathic pain, which mimicked the EA effect. The current study revealed the pivotal role of the RVM astrocytes in mediating the analgesic effects of EA on chemotherapy-induced peripheral neuropathic pain.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"916-926"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PAIN®Pub Date : 2025-04-01Epub Date: 2025-02-19DOI: 10.1097/j.pain.0000000000003541
Eleonora Galosi, Pietro Falco, Giuseppe Di Pietro, Nicoletta Esposito, Gianfranco De Stefano, Enrico Evangelisti, Caterina Leone, Daniel Litewczuk, Lorenzo Tramontana, Giulia Di Stefano, Andrea Truini
{"title":"Epidermal Transient Receptor Potential Vanilloid 1 innervation is increased in patients with painful diabetic polyneuropathy experiencing ongoing burning pain.","authors":"Eleonora Galosi, Pietro Falco, Giuseppe Di Pietro, Nicoletta Esposito, Gianfranco De Stefano, Enrico Evangelisti, Caterina Leone, Daniel Litewczuk, Lorenzo Tramontana, Giulia Di Stefano, Andrea Truini","doi":"10.1097/j.pain.0000000000003541","DOIUrl":"10.1097/j.pain.0000000000003541","url":null,"abstract":"<p><strong>Abstract: </strong>Preclinical studies suggested that Transient Receptor Potential Vanilloid 1 (TRPV1) channels contribute to neuropathic pain in animal models of diabetic polyneuropathy. Patients with painful diabetic polyneuropathy commonly experience ongoing burning pain. This study aimed at evaluating the association between this specific type of pain and TRPV1 intraepidermal nerve fibers in patients with painful diabetic polyneuropathy. We consecutively enrolled 70 patients with diabetic polyneuropathy. Each patient completed the Neuropathic Pain Symptom Inventory (NPSI) to identify the various types of neuropathic pain. All patients underwent a distal leg skin biopsy, with immunostaining of skin nerve fibers using antibodies for the pan-axonal marker Protein Gene Product 9.5 (PGP9.5), TRPV1, Calcitonin Gene-Related Peptide (CGRP), and Substance P. We found that 57% of patients (n = 40) had neuropathic pain symptoms, with ongoing burning pain being the most frequently reported type of pain at the NPSI (70% of patients with pain, n = 28). Patients with ongoing burning pain had higher TRPV1 intraepidermal nerve fiber density and TRPV1/PGP9.5 ratio compared with those with painless polyneuropathy ( P = 0.014, P = 0.013) and painful polyneuropathy with other types of pain ( P < 0.0001, P = 0.024); they also had increased CGRP dermal nerve fiber density compared with patients with painless polyneuropathy ( P = 0.005). Our study showed that ongoing burning pain is associated with an increased expression of intraepidermal TRPV1 fibers, as well as an increased dermal representation of CGRP fibers. These findings suggest that TRPV1 contributes to ongoing burning pain, possibly in conjunction with elevated CGRP expression, highlighting its significance as a therapeutic target for patients with painful diabetic polyneuropathy.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"824-834"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Activation of GABAergic neurons in the dorsal raphe nucleus alleviates hyperalgesia induced by ovarian hormone withdrawal.","authors":"Hui Wu, Linghua Xie, Qing Chen, Fang Xu, Ange Dai, Xiaolin Ma, Shulan Xie, Hua Li, Fangfang Zhu, Cuicui Jiao, Lihong Sun, Qi Xu, Yudong Zhou, Yi Shen, Xinzhong Chen","doi":"10.1097/j.pain.0000000000003362","DOIUrl":"10.1097/j.pain.0000000000003362","url":null,"abstract":"<p><strong>Abstract: </strong>Menopausal and postmenopausal women, characterized by a significant reduction in ovarian hormones, have a high prevalence of chronic pain with great pain intensity. However, the underlying mechanism of hyperalgesia induced by ovarian hormone withdrawal remains poorly understood. Here, we report that decreases in the activity and excitability of GABAergic neurons in the dorsal raphe nucleus (DRN) are associated with hyperalgesia induced by ovariectomy in mice. Supplementation with 17β-estradiol, but not progesterone, is sufficient to increase the mechanical pain threshold in ovariectomized (OVX) mice and the excitability of DRN GABAergic (DRN GABA ) neurons. Moreover, activation of the DRN GABA neurons projecting to the lateral parabrachial nucleus was critical for alleviating hyperalgesia in OVX mice. These findings show the essential role of DRN GABA neurons and their modulation by estrogen in regulating hyperalgesia induced by ovarian hormone withdrawal, providing therapeutic basis for the treatment of chronic pain in physiological or surgical menopausal women.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"759-772"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PAIN®Pub Date : 2025-04-01Epub Date: 2024-10-11DOI: 10.1097/j.pain.0000000000003448
Laura S Gold, Patrick J Heagerty, Ryan N Hansen, Janna L Friedly, Sandra K Johnston, Richard A Deyo, Michele Curatolo, Judith A Turner, Sean D Rundell, Katherine Wysham, Jeffrey G Jarvik, Pradeep Suri
{"title":"Mortality after concurrent treatment with gabapentin and opioids in older adults with spine diagnoses.","authors":"Laura S Gold, Patrick J Heagerty, Ryan N Hansen, Janna L Friedly, Sandra K Johnston, Richard A Deyo, Michele Curatolo, Judith A Turner, Sean D Rundell, Katherine Wysham, Jeffrey G Jarvik, Pradeep Suri","doi":"10.1097/j.pain.0000000000003448","DOIUrl":"10.1097/j.pain.0000000000003448","url":null,"abstract":"<p><strong>Abstract: </strong>Given the negative impact of opioid use on population health, prescriptions for alternative pain-relieving medications, including gabapentin, have increased. We wanted to determine whether people who filled gabapentin and opioid prescriptions concurrently (\"gabapentin + opioids\") had greater mortality than those who filled an active control medication (tricyclic antidepressants [TCAs] or duloxetine) and opioids concurrently (\"TCAs/duloxetine + opioids\"). In this population-based, propensity score-matched cohort study, we identified Medicare beneficiaries with spine-related diagnoses from 2017 to 2019. We compared people treated with gabapentin + opioids (n = 67,133) to people treated with TCAs/duloxetine + opioids (n = 67,133) who were matched on demographic and clinical factors. The primary outcome was mortality at any time, and a secondary outcome was occurrence of a major medical complication at any time. Among 134,266 participants (median age 73.4 years; 66.7% female), 2360 died before the end of follow-up. No difference in mortality was observed between groups (adjusted hazard ratio and 95% confidence interval for gabapentin + opioids 0.98 [0.90-1.06]; P = 0.63). However, people treated with gabapentin + opioids were at slightly increased risk of a major medical complication (1.02 [1.00-1.04]; P = 0.03) compared to those treated with TCAs/duloxetine + opioids. Results were similar in analyses (1) restricted to ≤30-day follow-up and (2) that required ≥2 fills of each prescription. When treating pain in older adults taking opioids, the addition of gabapentin did not increase mortality risk relative to addition of TCAs or duloxetine.</p>","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"e51-e59"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PAIN®Pub Date : 2025-04-01Epub Date: 2025-01-23DOI: 10.1097/j.pain.0000000000003532
Brian Key, Deborah Brown
{"title":"Thoughts explain but do not cause pain.","authors":"Brian Key, Deborah Brown","doi":"10.1097/j.pain.0000000000003532","DOIUrl":"https://doi.org/10.1097/j.pain.0000000000003532","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":"166 4","pages":"960"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PAIN®Pub Date : 2025-04-01Epub Date: 2024-10-15DOI: 10.1097/j.pain.0000000000003441
Chloe-Emily Eather, Michele Sterling, Clair Sullivan, Rachel A Elphinston
{"title":"Leveraging value-based health principles to improve translation and impact of digital psychological interventions for people with chronic pain.","authors":"Chloe-Emily Eather, Michele Sterling, Clair Sullivan, Rachel A Elphinston","doi":"10.1097/j.pain.0000000000003441","DOIUrl":"10.1097/j.pain.0000000000003441","url":null,"abstract":"","PeriodicalId":19921,"journal":{"name":"PAIN®","volume":" ","pages":"755-758"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}