ABSTRACT
Intrathecal (IT) gene transfer using adeno-associated virus (AAV) may be clinically promising as a treatment for chronic pain if it can produce sufficiently high levels of a transgene product in the cerebrospinal fluid (CSF). Although this strategy was developed in rodents, no studies investigating CSF levels of an analgesic or antiallodynic protein delivered by IT AAV have been performed in large animals. Interleukin-10 (IL-10) is an antiallodynic cytokine for which target therapeutic levels have been established in rats. The present study tested IT AAV8 encoding either human IL-10 (hIL-10) or enhanced green fluorescent protein (EGFP) in a dog model of IT drug delivery. AAV8/hIL-10 at a dose of 3.5 × 10(12) genome copies induced high hIL-10 levels in the CSF, exceeding the target concentration previously found to be antiallodynic in rodents by >1000-fold. AAV8/EGFP targeted the primary sensory and motor neurons and the meninges. hIL-10, a xenogeneic protein in dogs, induced anti-hIL-10 antibodies detectable in the CSF and serum of dogs. The high hIL-10 levels demonstrate the efficacy of AAV for delivery of secreted transgenes into the IT space of large animals, suggesting a strong case for further development toward clinical testing.
Subject(s)
Chronic Pain/therapy , Dependovirus/genetics , Interleukin-10/cerebrospinal fluid , Animals , Dogs , Genetic Therapy , Green Fluorescent Proteins/biosynthesis , Green Fluorescent Proteins/genetics , Humans , Injections, Spinal , Interleukin-10/genetics , Interleukin-10/immunology , Male , Transduction, Genetic , Viral TropismABSTRACT
Evidence suggests that galanin and its receptors including GalR1 are involved in the modulation of nociception. To understand the contributions of this galanin receptor subtype to the analgesic effect of galanin, we systematically examined the nociception phenotype of the GalR1 knockout (KO) mice. (1) Baseline thresholds: Thermal escape latencies and tactile thresholds of the hind paws were not different between the GalR1 KO and wild type (WT) mice. (2) Thermal injury evoked hyperalgesia: Thermal injury (52 degrees C, 45 s) to one hind paw resulted in a reduction in the thermal escape latency as compared to the uninjured paw. The right/left difference score was significantly greater in the KO (5.9 +/- 0.8 s) than for the WT (2.8 +/- 0.7 s) indicating a greater hyperalgesia. (3) Formalin-induced flinching: Formalin paw injection (2.5%/20 microl) produced a two-phase flinching in both GalR1 KO and WT groups, that was detected by an automated flinching sensor device. Phase II flinching of KO (1510 +/- 90) was slightly greater than that observed for WT (1290 +/- 126), but the difference is not statistically significant. (4) Nerve injury evoked allodynia: Tactile thresholds were assessed prior to and at intervals up to 21 days after left L5 spinal nerve ligation and transection. In both GalR1 KO and WT mice, nerve injury caused thresholds to fall to 0.2-0.3g though 11 days. On days 14-21, GalR1 KO animals showed a significant recovery as compared to WT. In summary, GalR1 KO mice showed no difference from WT with respect to acute nociception, but showed a modest tendency towards increased hyperalgesia after tissue injury and inflammation. These results are consistent with a regulatory effect of galanin at GalR1 receptors on nociceptive processing.
Subject(s)
Hyperalgesia/physiopathology , Nociceptors/physiology , Receptor, Galanin, Type 1/genetics , Recovery of Function/physiology , Acute Disease , Animals , Female , Hyperalgesia/genetics , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , Neurons, Afferent/physiology , Pain Measurement , Pain Threshold/physiology , Spinal Nerves/injuries , Spinal Nerves/physiopathologyABSTRACT
Protein kinase C isoforms including the alpha isozyme have been implicated in morphine tolerance. In the present study, we examined the effect of intrathecal delivery of an antisense oligonucleotide targeting rat protein kinase Calpha mRNA on the expression of spinal protein kinase Calpha isozyme and spinal morphine tolerance. Continuous intrathecal infusion of rats with morphine produced an increase in paw withdrawal threshold to thermal stimulation on day 1, which disappeared by day 5. On day 6, a bolus intrathecal injection of morphine (a probe dose) produced significantly less analgesia in morphine-infused rats than in saline-infused rats, suggesting tolerance. Intrathecal treatment with the protein kinase Calpha antisense concurrent with spinal morphine infusion not only maintained the analgesic effect of morphine during the 5-day infusion, it also significantly increased responsiveness to the probe morphine dose on day 6. In comparison, the missense used in the same treatment paradigm had no effect. The inhibitory effect of protein kinase Calpha antisense on spinal morphine tolerance was dose-dependent, and reversible. Intrathecal treatment with the antisense, but not the missense, in rats decreased expression of spinal protein kinase Calpha mRNA and protein, as revealed by real-time quantitative reverse transcription-polymerase chain reaction and western blots. Expression of the gamma isozyme was not affected by the oligonucleotides. The antisense also attenuated protein kinase C-mediated phosphorylation in spinal cord. These results demonstrate that selective reduction in the expression of the spinal protein kinase Calpha isozyme followed by a decrease of local protein kinase C-mediated phosphorylation will reverse spinal morphine infusion-induced tolerance. This finding is consistent with the view that tolerance produced by morphine infusion is dependent upon an increase in phosphorylation by protein kinase C, and also it emphasizes that the protein kinase Calpha isozyme and its activation in spinal cord may specifically participate in the phenomenon of opiate tolerance.
Subject(s)
Isoenzymes/antagonists & inhibitors , Morphine/pharmacology , Narcotics/pharmacology , Oligonucleotides, Antisense/pharmacology , Protein Kinase C/antagonists & inhibitors , Spinal Cord/metabolism , Animals , Drug Tolerance , Injections, Spinal , Isoenzymes/genetics , Isoenzymes/metabolism , Male , Protein Kinase C/genetics , Protein Kinase C/metabolism , Protein Kinase C-alpha , Rats , Rats, Sprague-Dawley , Spinal Cord/drug effects , Spinal Cord/enzymologyABSTRACT
The biphasic display of paw-flinch behavior in the rat after injection of formalin into the dorsum of the hind paw is used for the screening of anti-hyperalgesic agents. Described and characterized here is a less labor-intensive system for counting flinch activity by detecting movement of a small metal band placed on the formalin-injected paw. A signal is generated as the band breaks the electromagnetic field of a loop antenna located under the rat and processed through an algorithm that determines flinch activity using 1) amplitude, 2) zero-voltage crossing, and 3) signal duration. Flinches are summed and stored over a selected collection interval throughout the assay for later analysis. Studies have validated the measures with respect to 1) system stability over time; 2) system-to-"practiced observer" correlation on flinch detection, r2 = 0.94; 3) system variables including time of day, sex, age, and body weight; and 4) 50% effective dose values similar to those previously reported for intrathecal morphine and the NMDA antagonist MK-801.
Subject(s)
Formaldehyde , Pain Measurement/instrumentation , Analgesics/pharmacology , Animals , Automation , Behavior, Animal/drug effects , Body Weight/drug effects , Data Collection , Dose-Response Relationship, Drug , Electromagnetic Fields , Electromyography , Female , Injections , Injections, Spinal , Male , Models, Biological , Rats , Rats, Sprague-Dawley , Signal Processing, Computer-AssistedABSTRACT
The physiological significance of RNA editing of transcripts that code for kainate-preferring glutamate receptor subunits is unknown, despite the fact that the functional consequences of this molecular modification have been well characterized in cloned receptor subunits. RNA editing of the codon that encodes the glutamine/arginine (Q/R) site in the second membrane domain (MD2) of glutamate receptor 5 (GluR5) and GluR6 kainate receptor subunits produces receptors with reduced calcium permeabilities and single-channel conductances. Approximately 50% of the GluR5 subunit transcripts from adult rat brain are edited at the Q/R site in MD2. To address the role of glutamate receptor mRNA editing in the brain, we have made two strains of mice with mutations at amino acid 636, the Q/R-editing site in GluR5, using embryonic stem cell-mediated transgenesis. GluR5(RloxP/RloxP) mice encode an arginine at the Q/R site of the GluR5 subunit, whereas GluR5(wt(loxP)/wt(loxP)) mice encode a glutamine at this site, similar to wild-type mice. Mutant animals do not exhibit developmental abnormalities, nor do they show deficits in the behavioral paradigms tested in this study. Kainate receptor current densities were reduced by a factor of six in acutely isolated sensory neurons of dorsal root ganglia from GluR5(RloxP/RloxP) mice compared with neurons from wild-type mice. However, the editing mutant mice did not exhibit altered responses to thermal and chemical pain stimuli. Our investigations with the GluR5-editing mutant mice have therefore defined a set of physiological processes in which editing of the GluR5 subunit is unlikely to play an important role.
Subject(s)
Mice, Mutant Strains/genetics , Receptors, Kainic Acid/metabolism , Animals , Behavior, Animal , Electrophysiology , Ganglia, Spinal/cytology , Ganglia, Spinal/metabolism , Kainic Acid , Mice , Mice, Mutant Strains/physiology , Mice, Mutant Strains/psychology , Neurons/metabolism , Pain/psychology , Recombination, Genetic , Reference Values , Seizures/chemically inducedABSTRACT
The distribution, metabolism, and excretion of dioleoylphosphatidylcholine (DOPC), the predominant phospholipid component of DepoFoam (DF) drug delivery matrix, was determined after lumbar intrathecal injection of double-radiolabeled ((14)CDOPC, (3)H-cytarabine) sustained-release encapsulated cytarabine (DF-cytarabine) in rats prepared with chronic spinal catheters. Radioactivity was quantitated in central nervous system (CNS) and peripheral tissues, cerebrospinal fluid (CSF), blood, urine, and feces at various time points up to 504 h. The distribution of (14)C radiolabel among lipid classes was also determined in selected body fluid samples. Both radiolabels distributed rapidly throughout the neuraxis after injection. Levels of both labels declined in a biphasic manner from CSF and plasma, with an initial rapid decline over the first 96 h, followed by a much slower rate of decline out to 504 h. Greater than 90% of the (3)H (drug) label was estimated to be excreted in urine. In contrast, the data suggest that most of the (14)C (phospholipid) label was expired as (14)CO(2); small percentages of the dose remained incorporated in CNS (7%) and peripheral tissues (8%) or were excreted in urine (6%). Characterization of lipidic (14)C in plasma confirmed metabolism of the parent lipid. The data confirm the sustained-release nature of the DF-cytarabine multivesicular liposomal preparation. Moreover, the results indicate that the DOPC lipid component enters standard catabolic path-ways after breakdown of the DF particles in the intrathecal space. Similar CSF and plasma kinetic profiles of drug and lipid radio-labels support the hypothesis that release of drug is related directly to breakdown of the lipid particles.
ABSTRACT
To define the kinetics and safety of spinally infused recombinant-methionyl human brain-derived neurotrophic factor (r-metHuBDNF), beagle dogs were prepared with lumbar intrathecal catheters passed through the cisternal membrane to the L1-L4 lumbar level. For kinetic studies, r-metHuBDNF was delivered by bolus or infusion through one catheter and lumbar CSF was sampled periodically through a second. As a lumbar bolus, r-metHuBDNF displayed a biphasic clearance with t(1/2)a = 0.7 hr and t(1/2)b = 7. 9 hr. Lumbar to cisternal concentrations after bolus delivery were approximately 60:1. For safety studies, dogs received continuous intrathecal infusion (2.4 ml/day) for 28 days of saline (n = 6), r-metHuBDNF at 200 (n = 6), 800 (n = 6), or 2000 (n = 7) microg/day. Control dogs showed no changes. Intrathecally infused r-metHuBDNF produced a dose-dependent increase in muscle tone and decreased coordination. Low-dose r-metHuBDNF was associated with moderate increases in muscle tone after 22-28 days of infusion. No clinically important changes were noted in rectal temperature, arterial pressure, respiration and heart rate, body weight, food consumption, stool or urine output, or change in blood chemistries measured throughout the study. Cisternal CSF protein and glucose sampled at 28 days were not different between dose groups and all cultures were negative. Histopathological examination of the spinal cord typically revealed some degree of chronic inflammation around the catheter, including fibrotic adhesions and focal accumulations of lymphoid and plasma cells, but these effects were not dose dependent. In other dogs receiving r-metHuBDNF (2000 or 4000 microg/day), termination of infusion resulted in significant recovery.
Subject(s)
Brain-Derived Neurotrophic Factor/pharmacokinetics , Muscle Tonus/drug effects , Spinal Cord/drug effects , Animals , Behavior, Animal/drug effects , Brain/drug effects , Brain/pathology , Brain-Derived Neurotrophic Factor/administration & dosage , Brain-Derived Neurotrophic Factor/cerebrospinal fluid , Brain-Derived Neurotrophic Factor/toxicity , Dogs , Dose-Response Relationship, Drug , Hindlimb , Humans , Infusions, Parenteral , Inulin/administration & dosage , Inulin/cerebrospinal fluid , Locomotion/drug effects , Male , Muscle, Skeletal/drug effects , Random Allocation , Recombinant Proteins/administration & dosage , Recombinant Proteins/cerebrospinal fluid , Recombinant Proteins/pharmacokinetics , Recombinant Proteins/toxicity , Spinal Cord/metabolism , Spinal Cord/pathologyABSTRACT
BACKGROUND: The spinal delivery of the cholinesterase inhibitor neostigmine yields analgesia in rats and augments the analgesic effects of alpha 2 agonists in sheep. To assess its activity in humans, preclinical toxicology studies to define its safety were required in two species. METHODS: Rats with chronic intrathecal catheters received daily injections of saline (vehicle) or 5 micrograms/10 microliters or 10 micrograms/10 microliters neostigmine HCl (n = 6/group) for 4 days and were observed for general behavior and nociception (52.5 degrees C hot plate). On day 6, rats were anesthetized and submitted to whole body perfusion/fixation. For dog studies, male beagles were prepared following rigid aseptic precautions with catheters passed from the cisterna magna to the lumbar intrathecal space. Catheters were connected to an external vest-mounted pump. Based on preliminary studies, ten implanted dogs were randomly assigned to receive infusions of neostigmine for 28 days (4 mg/4 ml/day; n = 6) or saline (4 ml/day; n = 4). At 28 days, dogs were anesthetized, cisternal cerebrospinal fluid was obtained, and dogs were submitted to perfusion-fixation. Rat and dog spinal cords were embedded, sectioned, stained, and assessed by the pathologist without knowledge of treatment. RESULTS: In rats, neostigmine produced a dose-dependent increase in hot plate latency, and no tolerance was observed. Mild tremor was observed but was not debilitating. Histopathology revealed a mild fibrotic reaction to the catheter with mixed signs of moderate, acute, and chronic inflammation with no differences between saline or drug groups. In dogs, neostigmine had no effect on blood pressure or on the skin twitch response but produced bradycardia and an increase in muscle tone. At sacrifice, cerebrospinal fluid protein, specific gravity, and glucose were elevated in both saline and neostigmine groups. Histopathology displayed a local reaction to the spinal catheter and a mixed acute and chronic inflammatory reaction. No group differences were observed. These results suggest that, at the neostigmine concentration of 1 mg/ml in the rat and dog and in doses up to 4 mg/day in the dog, there is no evidence of spinal tissue toxicity that can be attributed to the drug. This result, observed in two species, suggests that intrathecal neostigmine given in this manner is without distinguishable toxicity in these two models.