Abstract

BackgroundThe endocannabinoid system has been shown to reduce inflammatory flares and pain in rodent models of arthritis. A limitation of endocannabinoids is that they are rapidly denatured by hydrolysing enzymes such as fatty acid amide hydrolase (FAAH) which renders them physiologically inert. Osteoarthritis (OA) is primarily a degenerative joint disease; however, it can incorporate mild inflammation and peripheral neuropathy. The aim of this study was to determine whether early blockade of FAAH bioactivity could reduce OA-associated inflammation and joint neuropathy. The ability of this treatment to prevent end-stage OA pain development was also tested.MethodsPhysiological saline or sodium monoiodoacetate (MIA; 0.3 mg) was injected into the right knee of male C57Bl/6 mice (20–42 g) and joint inflammation (oedema, blood flow and leukocyte trafficking) was measured over 14 days. Joint inflammation was also measured in a separate cohort of animals treated on day 1 with either saline or the FAAH inhibitor URB597 (0.03–0.3 mg/kg topical onto the knee joint). In other experiments, von Frey hair tactile sensitivity was determined on days 1 and 14 in MIA-injected mice treated prophylactically with URB597 (0.3 mg/kg s.c. over the knee joint on days 0–3). Saphenous nerve myelination was also assessed in these animals on day 14 by G-ratio analysis.ResultsIntra-articular injection of MIA caused an increase in joint oedema (P < 0.0001), blood flow (P < 0.05), leukocyte rolling (P < 0.05) and adherence (P < 0.001) on day 1 after treatment which subsequently resolved over later time points. This acute inflammatory response was ameliorated by local URB597 treatment. Prophylactic local administration of URB597 prevented MIA-induced saphenous nerve demyelination, and chronic joint pain was also attenuated.ConclusionsThese data indicate that local inhibition of FAAH in MIA-injected knees can reduce acute inflammatory changes associated with the model. Prophylactic treatment of OA mice with the endocannabinoid hydrolysis inhibitor URB597 was also shown to be neuroprotective and prevented the development of joint pain at later time points.

Highlights

  • The endocannabinoid system has been shown to reduce inflammatory flares and pain in rodent models of arthritis

  • Time course of MIA-induced inflammation When compared with saline-injected controls, intraarticular MIA (0.3 mg) significantly increased the knee joint diameter 1 day (P < 0.0001; n = 14–28; Fig. 1a) and 3 days (P < 0.0001; n = 6–11; Fig. 1a) after injection

  • Intra-articular injection of MIA increased synovial vascular conductance on day 1 when compared with saline-injected controls (P < 0.05; n = 5–27; Fig. 1b). This hyperemic response was transient with blood flow returning to control levels from day 3 onwards

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Summary

Introduction

The endocannabinoid system has been shown to reduce inflammatory flares and pain in rodent models of arthritis. The aim of this study was to determine whether early blockade of FAAH bioactivity could reduce OA-associated inflammation and joint neuropathy The ability of this treatment to prevent end-stage OA pain development was tested. Patient-reported pain does not match the radiographic severity of joint disease [1] while objective pre-clinical studies have confirmed that nociceptor activity does not correlate with joint damage scores [2, 3]. This disconnect between joint destruction and symptom development makes pain management a complicated proposition for arthritis patients. Safer approaches to ameliorate any inflammatory component of OA are required for long-term treatments

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