Marked sexual dimorphism in neuroendocrine mechanisms for the exacerbation of paclitaxel-induced painful peripheral neuropathy by stress

被引:35
作者
Ferrari, Luiz F. [1 ,2 ,3 ]
Araldi, Dioneia [1 ,2 ]
Green, Paul G. [4 ,5 ]
Levine, Jon D. [1 ,2 ]
机构
[1] Univ Calif San Francisco, Dept Med, Div Neurosci, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Oral Surg, Div Neurosci, San Francisco, CA 94143 USA
[3] Univ Utah, Dept Anesthesiol, Salt Lake City, UT USA
[4] Univ Calif San Francisco, Dept Oral & Maxillofacial Surg, San Francisco, CA 94143 USA
[5] Univ Calif San Francisco, Dept Prevent & Restorat Dent Sci, San Francisco, CA 94143 USA
关键词
CIPN; Chemotherapy; Hyperalgesia; Glucocorticoid receptors; beta(2)-adrenergic receptors; Early life stress; Neonatal handling; Neonatal limited bedding; Sex dimorphism; PITUITARY-ADRENAL AXIS; DORSAL-ROOT GANGLIA; EARLY-LIFE STRESS; P-GLYCOPROTEIN; PROTEIN-KINASE; BREAST-CANCER; FEMALE RATS; ADULT-RATS; EXPRESSION; MODEL;
D O I
10.1097/j.pain.0000000000001798
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Chemotherapy-induced neuropathic pain is a serious adverse effect of chemotherapeutic agents. Clinical evidence suggests that stress is a risk factor for development and/or worsening of chemotherapy-induced peripheral neuropathy (CIPN). We evaluated the impact of stress and stress axis mediators on paclitaxel CIPN in male and female rats. Paclitaxel produced mechanical hyperalgesia, over the 4-day course of administration, peaking by day 7, and still present by day 28, with no significant difference between male and female rats. Paclitaxel hyperalgesia was enhanced in male and female rats previously exposed to unpredictable sound stress, but not in rats that were exposed to sound stress after developing paclitaxel CIPN. We evaluated the role of the neuroendocrine stress axes: in adrenalectomized rats, paclitaxel did not produce hyperalgesia. Intrathecal administration of antisense oligodeoxynucleotides (ODN) reduced expression of beta(2)-adrenergic receptors on nociceptors, and paclitaxel-induced hyperalgesia was slightly attenuated in males, but markedly attenuated in females. By contrast, after intrathecal administration of antisense ODN to decrease expression of glucocorticoid receptors, hyperalgesia was markedly attenuated in males, but unaffected in females. Both ODNs together markedly attenuated paclitaxel-induced hyperalgesia in both males and females. We evaluated paclitaxel-induced CIPN in stress-resilient (produced by neonatal handling) and stress-sensitive (produced by neonatal limited bedding). Neonatal handling significantly attenuated paclitaxel-induced CIPN in adult male, but not in adult female rats. Neonatal limited bedding did not affect the magnitude of paclitaxel-induced CIPN in either male or female. This study provides evidence that neuroendocrine stress axis activity has a marked, sexually dimorphic, effect on paclitaxel-induced painful CIPN.
引用
收藏
页码:865 / 874
页数:10
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