2021 journal article

Early radiation-induced oral pain signaling responses are reduced with pentoxifylline treatment

VETERINARY RADIOLOGY & ULTRASOUND, 62(2), 255–263.

By: M. Price n, Y. Lai n, K. Marcus n, J. Robertson n, B. Lascelles n & M. Nolan n

co-author countries: United States of America 🇺🇸
author keywords: glossitis; mucositis; TNF‐ α TRPV1; TRPV4
MeSH headings : Animals; Capsaicin / pharmacology; Histamine / pharmacology; Mice; Pain / prevention & control; Pain / veterinary; Pentoxifylline / therapeutic use; Pilot Projects; Prospective Studies; Radiation-Protective Agents / therapeutic use; Radiotherapy / adverse effects; Sensory System Agents / pharmacology; Signal Transduction / drug effects; Stomatitis / complications; Stomatitis / drug therapy; Stomatitis / etiology; Tumor Necrosis Factor-alpha / analysis; Tumor Necrosis Factor-alpha / metabolism
Source: Web Of Science
Added: January 11, 2021

Abstract Radiation‐induced acute oral mucositis is associated with inflammation and pain. In other realms of pain research, nociceptors are known to be activated by inflammatory cytokines; for example, tumor necrosis factor alpha (TNF‐α) can activate transient receptor potential ion channels on sensory neurons. But there is an unclear relationship between inflammatory cytokines and molecular mediators of pain in radiation‐induced mucositis (RIM) and radiation‐associated pain (RAP). In this prospective, analytical, experimental pilot study, a common drug (pentoxifylline [PTX]) was used with the goal of inhibiting TNF‐α signaling in mice that underwent lingual irradiation to induce severe acute oral RIM/RAP. Body weight and glossitis scores were recorded daily. Eye wiping behaviors were assayed as a surrogate measure of oral discomfort (which is possible due to cross‐sensitization of the mandibular and ophthalmic branches of the trigeminal nerve). Quantitative real‐time reverse transcription polymerase chain reaction was performed on irradiated tongue tissue to measure changes in expression of TNF‐α, its receptor, nuclear factor kappa‐light‐chain‐enhancer of activated B cells, transient receptor potential vanilloid type 1 (TRPV1), and transient receptor potential vanilloid type 4 (TRPV4). Responsiveness of afferent sensory trigeminal neurons to TNF‐α, a TRPV1 agonist (capsaicin), and a partial TRPV4 agonist (histamine) was measured via calcium imaging. Although PTX treatment did not reduce glossitis severity or mitigate weight loss in mice with RIM/RAP, it did inhibit the upregulation of TNF‐α’s receptor that normally accompanies RIM, and it also reduced neuronal responsiveness to each of the aforementioned chemical stimuli. These results provide provisional evidence that inhibition of TNF‐α signaling with PTX treatment may serve as a useful tool for reducing pain in head and neck cancer patients.