Abstract

Radiotherapy is one of the major clinical approaches for treatment of bone cancer pain. Activation of cAMP-PKA signaling pathway plays important roles in bone cancer pain. Here, we examined the effects of radiotherapy on bone cancer pain and accompanying abnormal activation of cAMP-PKA signaling. Female Sprague-Dawley rats were used and received tumor cell implantation (TCI) in rat tibia (TCI cancer pain model). Some of the rats that previously received TCI treatment were treated with X-ray radiation (radiotherapy). Thermal hyperalgesia and mechanical allodynia were measured and used for evaluating level of pain caused by TCI treatment. PKA mRNA expression in dorsal root ganglion (DRG) was detected by RT-PCR. Concentrations of cAMP, IL-1β, and TNF-α as well as PKA activity in DRG and the spinal cord were measured by ELISA. The results showed that radiotherapy significantly suppressed TCI-induced thermal hyperalgesia and mechanical allodynia. The level of PKA mRNA in DRG, cAMP concentration and PKA activity in DRG and in the spinal cord, and concentrations of IL-1β and TNF-α in the spinal cord were significantly reduced by radiotherapy. In addition, radiotherapy also reduced TCI-induced bone loss. These findings suggest that radiotherapy may suppress bone cancer pain through inhibition of activation of cAMP-PKA signaling pathway in DRG and the spinal cord.

Highlights

  • Pain is one of the most prevalent symptoms in patients with primary bone sarcomas and with the distant metastases of nonbone primary tumors [1, 2]

  • We have recently demonstrated that the cAMPPKA pathway is crucial for the maintenance of dorsal root ganglia (DRG) neuronal hyperexcitability and behaviorally expressed hyperalgesia, in an in vivo neuropathic pain animal model of chronic compression of the dorsal root ganglion (DRG) (CCD model), as well as in an in vitro model of acute DRG dissociation [15, 16, 18]

  • This study provides evidence supporting an idea that radiotherapy may suppress bone cancer pain through inhibition of abnormal activation of cAMP-PKA signaling pathway in DRG and the spinal cord

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Summary

Introduction

Pain is one of the most prevalent symptoms in patients with primary bone sarcomas and with the distant metastases of nonbone primary tumors [1, 2]. Studies have indicated that bone cancer pain has complex and unique mechanisms that may involve both inflammatory and neuropathic pain [3]. Most patients with bone cancer have already passed the optimal time for radical surgery and multidisciplinary therapies. With radiotherapy, majority of these patients experience pain relief, control of tumor growth, and prolonged survival. Radiotherapy is an effective method in the clinical treatment of bone cancer, and an important approach for treatment of the severe pain associated with bone cancer. Mechanisms underlying radiotherapy for bone cancer pain have not been well investigated and remain elusive

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