Mechanisms of acute and chronic pain after surgery: update from findings in experimental animal models

Purpose of review Management of postoperative pain is still a major issue and relevant mechanisms need to be investigated. In preclinical research, substantial progress has been made, for example, by establishing specific rodent models of postoperative pain. By reviewing most recent preclinical studies in animals related to postoperative, incisional pain, we outline the currently available surgical-related pain models, discuss assessment methods for pain-relevant behavior and their shortcomings to reflect the clinical situation, delineate some novel clinical-relevant mechanisms for postoperative pain, and point toward future needs. Recent findings Since the development of the first rodent model of postoperative, incisional pain almost 20 years ago, numerous variations and some procedure-specific models have been emerged including some conceivably relevant for investigating prolonged, chronic pain after surgery. Many mechanisms have been investigated by using these models; most recent studies focussed on endogenous descending inhibition and opioid-induced hyperalgesia. However, surgical models beyond the classical incision model have so far been used only in exceptional cases, and clinical relevant behavioral pain assays are still rarely utilized. Summary Pathophysiological mechanisms of pain after surgery are increasingly discovered, but utilization of pain behavior assays are only sparsely able to reflect clinical-relevant aspects of acute and chronic postoperative pain in patients. Correspondence to Esther Pogatzki-Zahn, Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, A1, 48149 Münster, Germany. Tel: +49 251 8347261; fax: +49 251 88704; e-mail: pogatzki@anit.uni-muenster.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Mise en ligne du N° 4, volume 63 (juillet 2018) de la revue 'Annales de chirurgie plastique esthétique'

Vol 63 - N°4 - juillet 2018 P. 277-362 © 2018, Elsevier Masson SAS

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Prostate cancer imaging: when the game gets tough, the hard one gets done!

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Glycine Protects the Liver from Reperfusion Injury following Pneumoperitoneum

Background: Experimental pneumoperitoneum induces ischemia/reperfusion injury (IRI) in the liver, most likely via Kupffer cell (KC)-dependent mechanisms. Glycine has been shown to ameliorate IRI in various animal models. Thus, this study was performed to assess the effects of glycine on the liver after pneumoperitoneum. Materials and Methods: Sprague-Dawley rats (220–250 g in weight) underwent CO₂ pneumoperitoneum (12 mm Hg) for 90 min. Some rats received i.v. glycine (1.5 mL, 300 mM) 10 min before pneumoperitoneum. Controls were given the same volume of Ringer's solution. Transaminases, hepatic microcirculation, and phagocytosis of latex beads indexing both liver injury and KC activation were examined following pneumoperitoneum. Analysis of variance (ANOVA), plus a subsequent t test or χ² test (or Fisher's exact test) were carried out as appropriate. Results are presented as mean ± SEM. Results: Glycine significantly decreased lactate dehydrogenase at 1 h and both aspartate aminotransferase and alanine aminotransferase at 2 h after pneumoperitoneum from 477 ± 43, 154 ± 17, and 60 ± 6 U/L in controls to 348 ± 25, 101 ± 11, and 34 ± 3 U/L, respectively (p #x3c; 0.05). In parallel, glycine significantly decreased both the rate of permanent adherence of leukocytes to the endothelium by up to 35% and the rate of phagocytosis by #x3e; 50% compared to the control group. Conclusion: Glycine decreased IRI after pneumoperitoneum, most likely via KC-dependent mechanisms.
Eur Surg Res 2018;59:91–99

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LUMBAR INTERBODY FUSION: A NEW APPROACH UTILIZING KAMBIN'S TRIANGLE

Publication date: Available online 19 July 2018

Source: Seminars in Spine Surgery

Author(s): William Tally

ABSTRACT

With advances of surgical techniques, a major focus is being directed to less traumatic delivery system for fusion hardware. The goal is to minimize the drawbacks of traditional open lumbar fusion by adopting less invasive approaches. However minimally invasive transforaminal, lateral transpsoas, and anterior lumbar fusion techniques are notorious for surgical complications that can be devastating and catastrophic.

In an attempt to find a safer access to the disc space, we have been utilizing the Kambin's triangle, which can be approached using muscle-preserving plane. This manuscript will further describe this technique, its advantages and limitations.

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Lumbar Interbody Fusion for Adjacent Segment Disease: An illustrative case of Anterolateral Retroperitoneal Psoas-Sparing (Anterior To Psoas; ATP) Approach

Publication date: Available online 19 July 2018

Source: Seminars in Spine Surgery

Author(s): Chadi Tannoury

ABSTRACT

Following prior lumbar arthrodesis, surgery for adjacent segment disease (ASD) is not uncommon. Many challenges exist due to scarring, laminectomy defects, retained hardware, and increased risks of various surgical morbidities. These include iatrogenic durotomy, neurologic injuries, wound infections, and ASD recurrence. The minimally invasive retroperitoneal anterolateral psoas-sparing (ATP) approach, unlike the transpsoas and transforaminal techniques, allows access to the T12-S1 segments, enabling unobstructed corridor to discectomy, endplate preparation, anterior column release, direct lumbar decompression, intervertebral height restoration, and sagittal lordosis correction. Despite the promising attributes of the ATP in managing ASD, high quality data is still lacking.

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CRISPR-Cas13 Precision Transcriptome Engineering in Cancer.

Related Articles

CRISPR-Cas13 Precision Transcriptome Engineering in Cancer.

Cancer Res. 2018 Jul 18;:

Authors: Granados-Riveron JT, Aquino-Jarquin G

Abstract
The clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated genes (Cas) system has been rapidly harnessed to perform various genomic engineering tasks. Recently, it has been demonstrated that a novel RNA-targeting CRISPR effector protein, called Cas13, binds and cleaves RNA rather than DNA substrates analogously to the eukaryotic RNA interference system. The known Cas13a-Cas13d effectors are able to efficiently cleave complementary target single-stranded RNAs, which represent a potentially safer alternative to deoxyribonuclease Cas9, because it induces loss-of-function phenotypes without genomic loss of the targeted gene. Furthermore, through the improvement in Cas13 effector functionalities, a system called REPAIR has been developed to edit full-length transcripts containing pathogenic mutations, thus providing a promising opportunity for precise base editing. Moreover, advanced engineering of this CRISPR effector also permits nucleic acid detection, allowing the identification of mutations in cell-free tumor DNA through a platform termed Specific High Sensitivity Enzymatic Reporter Unlocking. All of these properties give us a glimpse about the potential of the CRISPR toolkit for precise transcriptome engineering, possibly leading to an expansion of CRISPR technologies for cancer therapeutics and diagnostics. Here, we examine previously unaddressed aspects of the CRISPR-based RNA-targeting approach as a feasible strategy for globally interrogating gene function in cancer in a programmable manner. Cancer Res; 78(15); 1-7. ©2018 AACR.

PMID: 30021724 [PubMed - as supplied by publisher]

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