Wednesday, October 19, 2016

Neuroscience: Why mole rats don't feel the heat

Neuroscience: Why mole rats don't feel the heat

Nature 538, 7625 (2016). doi:10.1038/538293c

A gene variant could explain why naked mole rats are impervious to certain types of pain that most mammals experience when exposed to heat.In the nervous system, a peptide called nerve growth factor (NGF) mediates hypersensitivity to pain caused by heat. Gary Lewin at



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A mass on the spine indicating Pott’s disease

A 24 year old student was admitted with a three month history of right sided back pain radiating to the right iliac fossa. He had ongoing weight loss of 15 kg during this period, and had experienced...


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Tuesday, October 18, 2016

Quiet dissent: The attitudes, beliefs and behaviours of UK osteopaths who reject low back pain guidance – A qualitative study

Our central theme was a ‘Precedence of Osteopathy’ over medicine and other manual therapies. Three subthemes were: 1) beliefs about self; 2) perceptions of others; 3) attitudes to guidelines and research.

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Authors’ reply to Hawkins

Impacted ear wax is an important and common presentation in primary care and may be associated with pain, as Hawkins has pointed out.1 2 Wax is apparent on examination and should be removed not only...


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Ear wax can cause extraordinary pain

Thanks to Finnikin and Mitchell-Innes for their article on recurrent otalgia.1 In today’s fragmented practice a patient with otitis externa that does not resolve might be given one set of drops after...


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Monday, October 17, 2016

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Identification of patient characteristics influencing treatment outcomes is a top low back pain (LBP) research priority. Results from the STarT Back Trial support the effectiveness of prognostic stratified care for LBP compared to current best care, however patient characteristics associated with treatment response have not yet been explored. The purpose of this secondary analysis was to identify treatment-effect modifiers within the STarT Back Trial at 4 months follow-up (n=688). Treatment response was dichotomized using back-specific physical disability measured by the Roland-Morris Disability Questionnaire (≥7).

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Mu and delta opioid receptor knockout mice show increased colonic sensitivity

Abstract

Background

Opiates act through opioid receptors to diminish pain. Here, we investigated whether mu (MOR) and delta (DOR) receptor endogenous activity assessed in the whole mouse body or in particular at peripheral receptors on primary nociceptive neurons, control colonic pain.

Methods

We compared global MOR and DOR receptor knockout (KO) mice, mice with a conditional deletion of MOR and DOR in Nav1.8-positive nociceptive primary afferent neurons (cKO), and control floxed mice of both genders for visceral sensitivity. Visceromotor responses to colorectal distension (CRD) and macroscopic colon scores were recorded on naïve mice and mice with acute colitis induced by 3% dextran sodium sulphate (DSS) for 5 days. Transcript expression for opioid genes and cytokines was measured by quantitative RT-PCR.

Results

Naïve MOR and DOR global KO mice show increased visceral sensitivity that was not observed in cKO mice. MOR and preproenkephalin (Penk) were the most expressed opioid genes in colon. MOR KO mice had augmented kappa opioid receptor and Tumour-Necrosis-Factor-α and diminished Penk transcript levels while DOR, preprodynorphin and Interleukin-1β were unchanged. Global MOR KO females had a thicker colon than floxed females. No alteration was detected in DOR mutant animals. A 5-day DSS treatment led to comparable hypersensitivity in the different mouse lines.

Conclusion

Our results suggest that mu and delta opioid receptor global endogenous activity but not activity at the peripheral Nav1.8 neurons contribute to visceral sensitivity in naïve mice, and that endogenous MOR and DOR tones were insufficient to elicit analgesia after 5-day DSS-induced colitis.

Significance

Knockout mice for mu and delta opioid receptor have augmented colon sensitivity in the CRD assay. It shows endogenous mu and delta opioid analgesia that may be explored as potential targets for alleviating chronic intestinal pain.



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