P2X receptors in sensory neurons co-cultured with cancer cells exhibit a decrease in opioid sensitivity.

Opioids are known to control the activity of P2X receptors in the sensory neurons of rats. These receptors are important in persistent pain signaling. However, there are extremely severe pain states, such as those associated with metastatic diseases, that are refractory to opioid treatment. We have tested the possibility that cancer cells affect the sensitivity of P2X(2/3) and P2X(2) receptors to opiates. The sensitivity of ATP-activated currents to the selective mu-opioid receptor agonist endomorphin-1 was evaluated in rat nodose neurons co-cultured (on separate coverslips) with fibrosarcoma cells (NCTC 2472) using whole-cell patch-clamp recordings. Both in control and in co-cultured neurons, P2X-mediated responses exhibited highly variable biphasic desensitization kinetics with fast and slow components. However, ATP-activated currents in co-cultured neurons acquired a new feature: the degree of their inhibition by endomorphin-1 demonstrated strong dependence on their desensitization kinetics. The neurons with 'slower' responses were subject to a smaller inhibitory effect of the opioid. The 'ultra-slow' responses completely lost their sensitivity to the opioid. The occurrence of such responses, rarely observed in the control neurons, was considerably increased with the duration of co-culturing. Application of endomorphin-1 to nodose neurons, co-cultured with rapidly proliferating but non-malignant cells (fibroblasts), resulted in data similar to those for the control. In summary, fibrosarcoma cells release diffusible factors altering the properties of desensitization kinetics of P2X receptors and, in particular, decrease their sensitivity to opioid inhibitory control. These phenomena may increase neuronal excitability initiated by peripheral ATP release and thereby contribute to the decreased sensitivity of cancer pain to opioids.

Opioids inhibit purinergic nociceptors in the sensory neurons and fibres of rat via a G protein-dependent mechanism.

We have found that opioid and P2X receptors are functionally coupled in the sensory nerve fibres and neurons of rat. When examined in the skin-nerve preparation, the ATP-evoked discharges of nerve fibres belonging to n. saphenous were inhibited by various opiates in a naloxone-dependent manner. The functional coupling between opioid and purinergic receptors was studied in the neuronal cell bodies isolated from dorsal root and nodose ganglia. Both fast (mediated by P2X(3) receptors) and slow (P2X(2/3) heteromeric receptors) responses of sensory neurons to ATP were inhibited by opioids. The inhibition of slow responses developed in a characteristic biphasic manner: an initial short phase of potentiation (lasting for 300-400 s) was followed by long-lasting inhibition of the response (for about 50% when saturated). Both phases of the response were initiated by the application of the highly selective ligand for mu-receptors, endomorphin 1 (30 nM). Intracellular GTPgammaS caused a partial inhibition of the ATP responses and opioids were not effective against the residual response. Intracellular GDP eliminated the effects of opioids, while pertussis toxin (PTX) abolished only the inhibition phase. Thus, P2X receptors in the sensory neurons are affected by opioids via multiple G protein-dependent pathways.