The impact of opioid treatment on regional gastrointestinal transit

The impact of opioid treatment on regional gastrointestinal transit 126Abstracts / Scandinavian Journal of Pain 12 (2016) 125–127(VAS; 0–10 cm). Participants performed standardised arm movements, from a seated position, while wearing 1 kg wrist weights.Six arm abduction movements (30◦ to frontal plane, 3 per side)were performed to an angle of 140◦ . Each movement consisted oftwo 3 s phases (up/down) and was separated by a 6 s break, beforemoving the opposite arm. Surface electromyography (EMG) wasrecoded from 8 bilateral muscles. Recordings were done before,immediately after, and 5 min after the experimental pain. Rootmean-square (RMS) of the EMG signals were extracted for eachmuscle and averaged for the 3 trials. Data was compared betweensides and no differences were identified after which data waspooled for further analysis.Results: During the painful condition for the slow upwardmovement, a reduced RMS-EMG activity was found for the ipsilateral upper trapezius (P < 0.01). In addition, increased RMS-EMGwas found bilaterally for the erector spinae muscle (P < 0.01).Conclusion: Bilateral experimental neck reorganise axioscapular and trunk muscle activity during resisted, slow upwardmovement. The results of this supports previous studies on neckpain patients suggesting neck pain is linked to axioscapular function and underpins the necessity to include the shoulder girdle inassessment and rehabilitation of neck pain patients.http://dx.doi.org/10.1016/j.sjpain.2016.05.027Mast cell proteases protect againsthistaminergic itch and attenuate tissue injurypain responsesE.I. Magnúsdóttir a,∗ , M. Grujic b , G. Pejler b , M.C.Lagerström aaDepartment of Neuroscience, DevelopmentalGenetics Unit, Uppsala University, Uppsala, Swedenb Department of Medical Biochemistry andMicrobiology, Uppsala University, Uppsala, SwedenE-mail address: elin.magnusdottir@neuro.uu.se (E.I. Magnúsdóttir).Aims: Mast cell proteases comprise up to 25% of the total protein content within mast cells and have various functions thatare still poorly understood but can be either protective or proinflammatory. Three of those proteases in mice have been identifiedas the closest functional homologues to human mast cell proteases,and in this currently ongoing study we are investigating if they playa role in itch and tissue injury pain, and if they do, what the possiblemechanism behind that could be.Methods: Knock-out mice were generated, lacking either oneor multiple proteases. To evaluate itch, the animals (n = 8–10)were injected intradermally with histaminergic (histamine, compound 48/80) and non-histaminergic (protease activated receptor2 (PAR2) agonist, chloroquine) pruritic substances and their itchbehavior over 1 h scored. Formalin injection (n = 20) in the hindpaw was used as a model for tissue injury pain, where the micewere monitored for pain behavior for 1 h following the injection.Age and gender matched C57BL/6 mice were used as controls.Results: Mice lacking three of the proteases had twice asmany scratching episodes in response to histamine (P = 0.016) andcompound 48/80 (P = 0.034) than controls. The non-histaminergicsubstances chloroqine and PAR2 are more potent pruritogens butdifference was not seen in itch levels between genotypes. Furthermore, the protease-deficient mice exhibited a more pronouncedpain response during the inflammatory stage (10–60 min after formalin injection, P = 0.025) of the tissue injury test.Conclusions: The mouse mast cell proteases have a protectiverole against histaminergic itch and in acute inflammation followinga tissue injury. The exact mechanism remains unclear at present asthe proteases cleave a variety of different pro-inflammatory substrates and can act in complimentary fashion by cleaving the samesubstrates but at different sites.http://dx.doi.org/10.1016/j.sjpain.2016.05.028The impact of opioid treatment on regionalgastrointestinal transitD. Jørgensen a,∗ , J.L. Poulsen a , A.E. Olesen a,b , C.Brock a,b , T.H. Sandberg a , K. Krogh c , A.M.Drewes a,daMech-Sense, Department of Gastroenterology andHepatology, Aalborg University Hospital, Aalborg,Denmarkb Department of Drug Design and Pharmacology,University of Copenhagen, Copenhagen, Denmarkc Neurogastroenterology Unit, Department ofHepatology and Gastroenterology, Aarhus UniversityHospital, Aarhus, Denmarkd Department of Clinical Medicine, AalborgUniversity, Aalborg, DenmarkE-mail address: Debbie.joergensen@rn.dk (D. Jørgensen).Aims: To employ a human experimental model of opioidinduced bowel dysfunction (OIBD) in healthy volunteers, andevaluate the impact of opioid treatment compared to placebo ongastrointestinal (GI) symptoms and motility, assessed by questionnaires and regional GI transit times.Methods: Twenty-five healthy males were randomly assignedto oxycodone or placebo for five days in a double-blind, crossoverdesign. Adverse GI effects were measured with bowel functionindex, gastrointestinal symptom rating scale, patient assessment ofconstipation symptoms questionnaire, and bristol stool form scale.Regional GI transit times were determined using the 3D-Transitsystem and segmental colonic transit times were determined usinga custom Matlab® graphical user interface.Results: GI symptom scores increased significantly acrossall applied questionnaires during opioid treatment. Oxycodoneincreased median total GI transit time from 22.2 to 43.9 h (P < 0.01),segmental transit times in the cecum and ascending colon from5.7 to 9.9 h (P < 0.05), rectosigmoid transit time from 2.7 to 9.0 h(P < 0.05), and colorectal transit time from 18.6 to 38.6 h (P < 0.01).No association between questionnaire scores and segmental transittimes were detected.Conclusions: Self-assessed adverse GI effects and increased GItransit times in different segments were induced during oxycodonetreatment. This detailed information about segmental changes inmotility has great potential for future interventional head-to-headtrials of different laxative regimes for prevention and treatment ofOIBD.http://dx.doi.org/10.1016/j.sjpain.2016.05.029 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

The impact of opioid treatment on regional gastrointestinal transit

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© 2016 Scandinavian Association for the Study of Pain
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1877-8860
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Abstract

126Abstracts / Scandinavian Journal of Pain 12 (2016) 125–127(VAS; 0–10 cm). Participants performed standardised arm movements, from a seated position, while wearing 1 kg wrist weights.Six arm abduction movements (30◦ to frontal plane, 3 per side)were performed to an angle of 140◦ . Each movement consisted oftwo 3 s phases (up/down) and was separated by a 6 s break, beforemoving the opposite arm. Surface electromyography (EMG) wasrecoded from 8 bilateral muscles. Recordings were done before,immediately after, and 5 min after the experimental pain. Rootmean-square (RMS) of the EMG signals were extracted for eachmuscle and averaged for the 3 trials. Data was compared betweensides and no differences were identified after which data waspooled for further analysis.Results: During the painful condition for the slow upwardmovement, a reduced RMS-EMG activity was found for the ipsilateral upper trapezius (P < 0.01). In addition, increased RMS-EMGwas found bilaterally for the erector spinae muscle (P < 0.01).Conclusion: Bilateral experimental neck reorganise axioscapular and trunk muscle activity during resisted, slow upwardmovement. The results of this supports previous studies on neckpain patients suggesting neck pain is linked to axioscapular function and underpins the necessity to include the shoulder girdle inassessment and rehabilitation of neck pain patients.http://dx.doi.org/10.1016/j.sjpain.2016.05.027Mast cell proteases protect againsthistaminergic itch and attenuate tissue injurypain responsesE.I. Magnúsdóttir a,∗ , M. Grujic b , G. Pejler b , M.C.Lagerström aaDepartment of Neuroscience, DevelopmentalGenetics Unit, Uppsala University, Uppsala, Swedenb Department of Medical Biochemistry andMicrobiology, Uppsala University, Uppsala, SwedenE-mail address: elin.magnusdottir@neuro.uu.se (E.I. Magnúsdóttir).Aims: Mast cell proteases comprise up to 25% of the total protein content within mast cells and have various functions thatare still poorly understood but can be either protective or proinflammatory. Three of those proteases in mice have been identifiedas the closest functional homologues to human mast cell proteases,and in this currently ongoing study we are investigating if they playa role in itch and tissue injury pain, and if they do, what the possiblemechanism behind that could be.Methods: Knock-out mice were generated, lacking either oneor multiple proteases. To evaluate itch, the animals (n = 8–10)were injected intradermally with histaminergic (histamine, compound 48/80) and non-histaminergic (protease activated receptor2 (PAR2) agonist, chloroquine) pruritic substances and their itchbehavior over 1 h scored. Formalin injection (n = 20) in the hindpaw was used as a model for tissue injury pain, where the micewere monitored for pain behavior for 1 h following the injection.Age and gender matched C57BL/6 mice were used as controls.Results: Mice lacking three of the proteases had twice asmany scratching episodes in response to histamine (P = 0.016) andcompound 48/80 (P = 0.034) than controls. The non-histaminergicsubstances chloroqine and PAR2 are more potent pruritogens butdifference was not seen in itch levels between genotypes. Furthermore, the protease-deficient mice exhibited a more pronouncedpain response during the inflammatory stage (10–60 min after formalin injection, P = 0.025) of the tissue injury test.Conclusions: The mouse mast cell proteases have a protectiverole against histaminergic itch and in acute inflammation followinga tissue injury. The exact mechanism remains unclear at present asthe proteases cleave a variety of different pro-inflammatory substrates and can act in complimentary fashion by cleaving the samesubstrates but at different sites.http://dx.doi.org/10.1016/j.sjpain.2016.05.028The impact of opioid treatment on regionalgastrointestinal transitD. Jørgensen a,∗ , J.L. Poulsen a , A.E. Olesen a,b , C.Brock a,b , T.H. Sandberg a , K. Krogh c , A.M.Drewes a,daMech-Sense, Department of Gastroenterology andHepatology, Aalborg University Hospital, Aalborg,Denmarkb Department of Drug Design and Pharmacology,University of Copenhagen, Copenhagen, Denmarkc Neurogastroenterology Unit, Department ofHepatology and Gastroenterology, Aarhus UniversityHospital, Aarhus, Denmarkd Department of Clinical Medicine, AalborgUniversity, Aalborg, DenmarkE-mail address: Debbie.joergensen@rn.dk (D. Jørgensen).Aims: To employ a human experimental model of opioidinduced bowel dysfunction (OIBD) in healthy volunteers, andevaluate the impact of opioid treatment compared to placebo ongastrointestinal (GI) symptoms and motility, assessed by questionnaires and regional GI transit times.Methods: Twenty-five healthy males were randomly assignedto oxycodone or placebo for five days in a double-blind, crossoverdesign. Adverse GI effects were measured with bowel functionindex, gastrointestinal symptom rating scale, patient assessment ofconstipation symptoms questionnaire, and bristol stool form scale.Regional GI transit times were determined using the 3D-Transitsystem and segmental colonic transit times were determined usinga custom Matlab® graphical user interface.Results: GI symptom scores increased significantly acrossall applied questionnaires during opioid treatment. Oxycodoneincreased median total GI transit time from 22.2 to 43.9 h (P < 0.01),segmental transit times in the cecum and ascending colon from5.7 to 9.9 h (P < 0.05), rectosigmoid transit time from 2.7 to 9.0 h(P < 0.05), and colorectal transit time from 18.6 to 38.6 h (P < 0.01).No association between questionnaire scores and segmental transittimes were detected.Conclusions: Self-assessed adverse GI effects and increased GItransit times in different segments were induced during oxycodonetreatment. This detailed information about segmental changes inmotility has great potential for future interventional head-to-headtrials of different laxative regimes for prevention and treatment ofOIBD.http://dx.doi.org/10.1016/j.sjpain.2016.05.029

Journal

Scandinavian Journal of Painde Gruyter

Published: Dec 29, 2017

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