Abstract

In the majority of patients with advanced breast cancer, there is metastatic spread to bones resulting in pain. Clinically available drug treatments for alleviation of breast cancer-induced bone pain (BCIBP) often produce inadequate pain relief due to dose-limiting side-effects. A major impediment to the discovery of novel well-tolerated analgesic agents for the relief of pain due to bony metastases is the fact that most cancer-induced bone pain models in rodents relied on the systemic injection of cancer cells, causing widespread formation of cancer metastases and poor general animal health. Herein, we have established an optimized, clinically relevant Wistar Han female rat model of breast cancer induced bone pain which was characterized using behavioral assessments, radiology, histology, immunohistochemistry and pharmacological methods. In this model that is based on unilateral intra-tibial injection (ITI) of Walker 256 carcinoma cells, animals maintained good health for at least 66 days post-ITI. The temporal development of hindpaw hypersensitivity depended on the initial number of Walker 256 cells inoculated in the tibiae. Hindpaw hypersensitivity resolved after approximately 25 days, in the continued presence of bone tumors as evidenced by ex vivo histology, micro-computed tomography scans and immunohistochemical assessments of tibiae. A possible role for the endogenous opioid system as an internal factor mediating the self-resolving nature of BCIBP was identified based upon the observation that naloxone, a non-selective opioid antagonist, caused the re-emergence of hindpaw hypersensitivity. Bolus dose injections of morphine, gabapentin, amitriptyline and meloxicam all alleviated hindpaw hypersensitivity in a dose-dependent manner. This is a first systematic pharmacological profiling of this model by testing standard analgesic drugs from four important diverse classes, which are used to treat cancer induced bone pain in the clinical setting. Our refined rat model more closely mimics the pathophysiology of this condition in humans and hence is well-suited for probing the mechanisms underpinning breast cancer induced bone pain. In addition, the model may be suitable for efficacy profiling of new molecules from drug discovery programs with potential to be developed as novel agents for alleviation of intractable pain associated with disseminated breast cancer induced bony metastases.

Highlights

  • Unrelenting pain in patients with advanced cancer significantly reduces quality of life (Bu et al, 2014)

  • Our findings show for the first time, that the severity and nature of mechanical pain hypersensitivity behaviors developed in the hindpaws of female Wistar Han rats depend on the initial number of Walker 256

  • There were no significant differences in between body weights of animals given an intra-tibial injection (ITI) of DPBS and age-matched control female Wistar Han rats in experiment 4 (p > 0.05)

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Summary

Introduction

Unrelenting pain in patients with advanced cancer significantly reduces quality of life (Bu et al, 2014). Knowledge on the precise mechanisms by which breast and other cancers metastasize to bone and produce pain is incomplete (Zhu et al, 2015). It is somewhat counter-intuitive that primary breast tumors at the original site cause less or no pain, yet once these cells have metastasized to bone, patients may suffer excruciating pain (Lozano-Ondoua et al, 2013). Until the late 20th century, CIBP models in animals were initiated by systemically injecting the cancer cells, causing poor animal health due to tumor in the liver and lungs as well as random and multi-sited bone deposits (Urch, 2004). Models involving local injection of breast cancer cells within a single bone have proven successful, avoiding the spread of tumors systemically to the highly perfused organs or neighboring soft tissue (Schwei et al, 1999)

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