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Gene Therapy for Chronic Pain

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Biobehavioral Approaches to Pain

Abstract

Gene therapy shows great potential to assist numerous patients with inadequate relief of inflammatory or neuropathic pain, or intractable pain associated with advanced cancer. A brief overview is provided of the methods of gene therapy and of preclinical findings in animal models of prolonged inflammatory, neuropathic and cancer pain. Preclinical findings demonstrate no efficacy of gene therapy on basal thermal nociception and mechanical sensitivity, and almost universal effects on pathological nociception and hypersensitivity models. The status of human trials is provided with recommendations for future directions and precautions. This early stage of development of gene therapy for chronic pain will likely be followed by an increased number of human clinical trials aimed specifically at the relief of chronic, unrelenting pain.

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References

  • Berto, E., Bozac, A. and Marconi, P. (2005) Development and application of replication-incompetent HSV-1-based vectors. Gene Ther 12, S98–S102

    Article  CAS  PubMed  Google Scholar 

  • Beutler, A.S., Banck, M.S., Walsh, C.E. and Milligan, E.D. (2005) Intrathecal gene transfer by adeno-associated virus for pain. Curr Opin Mol Ther 7, 431–439

    CAS  PubMed  Google Scholar 

  • Braz, J., Beaufour, C., Coutaux, A., Epstein, A.L., Cesselin, F., Hamon, M. and Pohl, M. (2001) Therapeutic efficacy in experimental polyarthritis of viral-driven enkephalin overproduction in sensory neurons. J Neurosci 21, 7881–7888

    CAS  PubMed  Google Scholar 

  • Castro, M., Hurtado-Lorenzo, A., Umana, P., Smith-Arica, J.R., Zermansky, A., Abordo-Adesida, E. and Lowenstein, P.R. (2001) Regulatable and cell-type specific transgene expression in glial cells: prospects for gene therapy for neurological disorders. Prog Brain Res 132, 655–681

    Article  CAS  PubMed  Google Scholar 

  • Chuang, Y.C., Chou, A.K., Wu, P.C., Chiang, P.H., Yu, T.J., Yang, L.C., Yoshimura, N. and Chancellor, M.B. (2003) Gene therapy for bladder pain with gene gun particle encoding pro-opiomelanocortin cDNA. J Urol 170, 2044–2048

    Article  CAS  PubMed  Google Scholar 

  • Chuang, Y.C., Yang, L.C., Chiang, P.H., Kang, H.Y., Ma, W.L., Wu, P.C., DeMiguel, F., Chancellor, M.B. and Yoshimura, N. (2005) Gene gun particle encoding preproenkephalin cDNA produces analgesia against capsaicin-induced bladder pain in rats. Urology 65, 804–810

    Article  PubMed  Google Scholar 

  • Dray, A. (2004) Future pharmacologic management of neuropathic pain. J Orofac Pain 18, 381–385

    PubMed  Google Scholar 

  • Dubuisson, D. and Dennis, S.G. (1977) The formalin test: a quantitative study of the analgesic effects of morphine, meperidine, and brain stem stimulation in rats and cats. Pain 4, 161–174

    Article  CAS  PubMed  Google Scholar 

  • Dworkin, R.H., Backonja, M., Rowbotham, M.C., Allen, R.R., Argoff, C.R., Bennett, G.J., Bushnell, M.C., Farrar, J.T., Galer, B.S., Haythornthwaite, J.A., Hewitt, D.J., Loeser, J.D., Max, M.B., Saltarelli, M., Schmader, K.E., Stein, C., Thompson, D., Turk, D.C., Wallace, M.S., Watkins, L.R. and Weinstein, S.M. (2003) Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol 60, 1524–1534

    Article  PubMed  Google Scholar 

  • Eaton, M.J., Blits, B., Ruitenberg, M.J., Verhaagen, J. and Oudega, M. (2002) Amelioration of chronic neuropathic pain after partial nerve injury by adeno-associated viral (AAV) vector-mediated over-expression of BDNF in the rat spinal cord. Gene Ther 9, 1387–1395

    Article  CAS  PubMed  Google Scholar 

  • Finegold, A.A., Mannes, A.J. and Iadarola, M.J. (1999) A paracrine paradigm for in vivo gene therapy in the central nervous system: treatment of chronic pain. Hum Gene Ther 10, 1251–1257

    Article  CAS  PubMed  Google Scholar 

  • Freytag, S.O., Khil, M. Stricker, H., Peabody, J., Menon, M., DePeralta-Venturina, M., Nafziger, D., Pegg, J., Paielli, D., Brown, S., Barton, K., Lu, M., Aguilar-Cordova, E. and Kim, J.H. (2002) Phase I study of replication-competent adenovirus-mediated double suicide gene therapy for the treatment of locally recurrent prostate cancer. Cancer Res 62, 4968–4976

    CAS  PubMed  Google Scholar 

  • Freytag, S.O., Stricker, H., Movsas, B. and Kim, J.H. (2007) Prostate cancer gene therapy clinical trials. Mol Ther 15, 1042–1052

    CAS  PubMed  Google Scholar 

  • Garry, M.G., Malik, S., Yu, J., Davis, M.A. and Yang, J. (2000) Knock down of spinal NMDA receptors reduces NMDA and formalin evoked behaviors in rat. Neuroreport 11, 49–55

    Article  CAS  PubMed  Google Scholar 

  • Glorioso, J.C. and Fink, D.J. (2004) Herpes vector-mediated gene transfer in treatment of diseases of the nervous system. Annu Rev Microbiol 58, 253–271.

    Google Scholar 

  • Glorioso, J.C., Mata, M. and Fink, D.J. (2003) Gene therapy for chronic pain. Curr Opin Mol Ther 5, 483–488

    CAS  PubMed  Google Scholar 

  • Goss, J.R. (2007) The therapeutic potential of gene transfer for the treatment of peripheral neuropathies. Expert Rev Mol Med 9, 1–20

    Article  PubMed  Google Scholar 

  • Goss, J.R., Harley, C.F., Mata, M., O'Malley, M.E., Goins, W.F., Hu, X., Glorioso, J.C. and Fink, D.J. (2002) Herpes vector-mediated expression of proenkephalin reduces bone cancer pain. Ann Neurol 52, 662–665

    Article  CAS  PubMed  Google Scholar 

  • Goss, J.R., Mata, M., Goins, W.F., Wu, H.H., Glorioso, J.C. and Fink, D.J. (2001) Antinociceptive effect of a genomic herpes simplex virus-based vector expressing human proenkephalin in rat dorsal root ganglion. Gene Ther 8, 551–556

    Article  CAS  PubMed  Google Scholar 

  • Gu, Y., Xu, Y., Li, G.W. and Huang, L.Y. (2005) Remote nerve injection of mu opioid receptor adeno-associated viral vector increases antinociception of intrathecal morphine. J Pain 6, 447–454

    Article  CAS  PubMed  Google Scholar 

  • Gudmundsson, G., Bosch, A., Davidson, B.L., Berg, D.J. and Hunninghake, G.W. (1998) Interleukin-10 modulates the severity of hypersensitivity pneumonitis in mice. Am J Respir Cell Mol Biol 19, 812–818

    CAS  PubMed  Google Scholar 

  • Hao, S., Mata, M., Fink, D.J. (2007) Viral vector-based gene transfer for treatment of chronic pain. Int Anesthesiol Clin 45, 59–71

    Article  PubMed  Google Scholar 

  • Hao, S., Mata, M., Glorioso, J.C. and Fink, D.J. (2006) HSV-mediated expression of interleukin-4 in dorsal root ganglion neurons reduces neuropathic pain. Mol Pain 2, 6

    Article  PubMed  Google Scholar 

  • Hao, S., Mata, M., Goins, W., Glorioso, J.C. and Fink, D.J. (2003a) Transgene-mediated enkephalin release enhances the effect of morphine and evades tolerance to produce a sustained antiallodynic effect in neuropathic pain. Pain 102, 135–142

    Google Scholar 

  • Hao, S., Mata, M., Wolfe, D., Huang, S., Glorioso, J.C. and Fink, D.J. (2003b) HSV-mediated gene transfer of the glial cell-derived neurotrophic factor provides an antiallodynic effect on neuropathic pain. Mol Ther 8, 367–375

    Google Scholar 

  • Hao, S., Mata, M., Wolfe, D., Huang, S., Glorioso, J.C. and Fink, D.J. (2005) Gene transfer of glutamic acid decarboxylase reduces neuropathic pain. Ann Neurol 57, 914–918

    Article  CAS  PubMed  Google Scholar 

  • Hughes, V. (2007) Therapy on trial. Nature Med 13, 1008–1009

    Article  CAS  PubMed  Google Scholar 

  • Kang, W., Wilson, M.A., Bender, M.A., Glorioso, J.C. and Wilson, S.P. (1998) Herpes virus-mediated preproenkephalin gene transfer to the amygdala is antinociceptive. Brain Res 792, 133–135

    Article  CAS  PubMed  Google Scholar 

  • Kurreck, J. (2004) Antisense and RNA interference approaches to target validation in pain research. Curr Opin Drug Discov Devel 7, 179–187

    CAS  PubMed  Google Scholar 

  • Lariviere, W.R., Wilson, S.G., Laughlin, T.M., Kokayeff, A., West, E.E., Adhikari, S.M., Wan, Y. and Mogil, J.S. (2002) Heritability of nociception. III. Genetic relationships among commonly used assays of nociception and hypersensitivity. Pain 97, 75–86

    PubMed  Google Scholar 

  • Lin, C.R., Yang, L.C., Lee, T.H., Lee, C.T., Huang, H.T., Sun, W.Z. and Cheng, J.T. (2002) Electroporation-mediated pain-killer gene therapy for mononeuropathic rats. Gene Ther 9, 1247–1253

    Article  CAS  PubMed  Google Scholar 

  • Liu, J., Wolfe, D., Hao, S., Huang, S., Glorioso, J.C., Mata, M. and Fink, D.J. (2004) Peripherally delivered glutamic acid decarboxylase gene therapy for spinal cord injury pain. Mol Ther 10, 57–66

    Article  CAS  PubMed  Google Scholar 

  • Lu, C.Y., Chou, A.K., Wu, C.L., Yang, C.H., Chen, J.T., Wu, P.C., Lin, S.H., Muhammad, R. and Yang, L.C. (2002) Gene-gun particle with pro-opiomelanocortin cDNA produces analgesia against formalin-induced pain in rats. Gene Ther 9, 1008–1014

    Article  CAS  PubMed  Google Scholar 

  • Mata, M. and Fink, D.J. (2007) Gene therapy for pain. Anesthesiology 106, 1079–1080

    Article  PubMed  Google Scholar 

  • Mata, M., Glorioso, J. and Fink, D.J. (2003) Development of HSV-mediated gene transfer for the treatment of chronic pain. Exp Neurol 184 Suppl 1, S25–29

    Article  CAS  PubMed  Google Scholar 

  • Mannes, A.J., Caudle, R.M., O'Connell, B.C. and Iadarola, M.J. (1998) Adenoviral gene transfer to spinal-cord neurons: intrathecal vs. intraparenchymal administration. Brain Res 793, 1–6

    Article  CAS  PubMed  Google Scholar 

  • Meunier, A., Braz, J., Cesselin, F., Hamon, M. and Pohl, M. (2004) [From inflammation to pain: experimental gene therapy]. Med Sci (Paris) 20, 325–330

    Google Scholar 

  • Meunier, A., Latremoliere, A., Mauborgne, A., Bourgoin, S., Kayser, V., Cesselin, F., Hamon, M. and Pohl, M. (2005) Attenuation of pain-related behavior in a rat model of trigeminal neuropathic pain by viral-driven enkephalin overproduction in trigeminal ganglion neurons. Mol Ther 11, 608–616

    Article  CAS  PubMed  Google Scholar 

  • Milligan, E.D., Langer, S.J., Sloane, E.M., He, L., Wieseler-Frank, J., O'Connor, K., Martin, D., Forsayeth, J.R., Maier, S.F., Johnson, K., Chavez, R.A., Leinwand, L.A. and Watkins, L.R. (2005a) Controlling pathological pain by adenovirally driven spinal production of the anti-inflammatory cytokine, interleukin-10. Eur J Neurosci 21, 2136–2148

    Google Scholar 

  • Milligan, E.D., Sloane, E.M., Langer, S.J., Cruz, P.E., Chacur, M., Spataro, L., Wieseler-Frank, J., Hammack, S.E., Maier, S.F., Flotte, T.R., Forsayeth, J.R., Leinwand, L.A., Chavez, R. and Watkins, L.R. (2005b) Controlling neuropathic pain by adeno-associated virus driven production of the anti-inflammatory cytokine, interleukin-10. Mol Pain 1, 9

    Google Scholar 

  • Noureddini, S.C., Krendelshchikov, A., Simonenko, V., Hedley, S.J., Douglas, J.T., Curiel, D.T. and Korokhov, N. (2006) Generation and selection of targeted adenoviruses embodying optimized vector properties. Virus Res 116, 185–195

    Article  CAS  PubMed  Google Scholar 

  • Pohl, M. and Braz, J. (2001) Gene therapy of pain: emerging strategies and future directions. Eur J Pharmacol 429, 39–48

    Article  CAS  PubMed  Google Scholar 

  • Pohl, M., Meunier, A., Hamon, M. and Braz, J. (2003) Gene therapy of chronic pain. Curr Gene Ther 3, 223–238

    Article  CAS  PubMed  Google Scholar 

  • Pradat, P.F., Finiels, F., Kennel, P., Naimi, S., Orsini, C., Delaere, P., Revah, F. and Mallet, J. (2001a) Partial prevention of cisplatin-induced neuropathy by electroporation-mediated nonviral gene transfer. Hum Gene Ther 12, 367–375

    Google Scholar 

  • Pradat, P.F., Kennel, P., Naimi-Sadaoui, S., Finiels, F., Orsini, C., Revah, F., Delaere, P. and Mallet, J. (2001b) Continuous delivery of neurotrophin 3 by gene therapy has a neuroprotective effect in experimental models of diabetic and acrylamide neuropathies. Hum Gene Ther 12, 2237–2249

    Google Scholar 

  • Pradat, P.F., Kennel, P., Naimi-Sadaoui, S., Finiels, F., Scherman, D., Orsini, C., Delaere, P., Mallet, J. and Revah, F. (2002) Viral and non-viral gene therapy partially prevents experimental cisplatin-induced neuropathy. Gene Ther 9, 1333–1337

    Article  CAS  PubMed  Google Scholar 

  • Reilly, J.P., Grise, M.A., Fortuin, F.D., Vale, P.R., Schaer, G.L., Lopez, J., Van Camp, J.R., Henry, T., Richenbacher, W.E., Losordo, D.W., Schatz, R.A. and Isner, J.M. (2005) Long-term (2-year) clinical events following transthoracic intramyocardial gene transfer of VEGF-2 in no-option patients. J Interven Cardiol 18, 27–31

    Article  Google Scholar 

  • Shiota, M., Ikeda, Y., Kaul, Z., Itadani, J., Kaul, S.C. and Wadhwa, R. (2007) Internalizing antibody-based targeted gene delivery for human cancer cells. Hum Gene Ther 18, 1153–1160

    Article  CAS  PubMed  Google Scholar 

  • Smith, A.E. (1999) Gene therapy – where are we? Lancet 354 Suppl 1, SI1–4

    PubMed  Google Scholar 

  • Tan, P.H., Yang, L.C., Shih, H.C., Lan, K.C. and Cheng, J.T. (2005) Gene knockdown with intrathecal siRNA of NMDA receptor NR2B subunit reduces formalin-induced nociception in the rat. Gene Ther 12, 59–66

    Article  CAS  PubMed  Google Scholar 

  • Tsai, S.Y., Schillinger, K. and Ye, X. (2000) Adenovirus-mediated transfer of regulable gene expression. Curr Opin Mol Ther 2, 515–523

    CAS  PubMed  Google Scholar 

  • Touitou, I., Notarnicola, C., and Grandemange, S. (2004) Identifying mutations in autoinflammatory diseases: towards novel genetic tests and therapies? Am J Pharmacogenomics 4, 109–118

    Article  PubMed  Google Scholar 

  • Weichselbaum, R.R. and Kufe, D. (1997) Gene therapy of cancer. Lancet 349 Suppl 2, SII10–12

    PubMed  Google Scholar 

  • Wilson, S.P. and Yeomans, D.C. (2002) Virally mediated delivery of enkephalin and other neuropeptide transgenes in experimental pain models. Ann NY Acad Sci 971, 515–521

    Article  CAS  PubMed  Google Scholar 

  • Wilson, S.P., Yeomans, D.C., Bender, M.A., Lu, Y., Goins, W.F. and Glorioso, J.C. (1999) Antihyperalgesic effects of infection with a preproenkephalin-encoding herpes virus. Proc Natl Acad Sci USA 96, 3211–3216

    Google Scholar 

  • Wirtz, S. and Neurath, M.F. (2003) Inflammatory bowel disorders: gene therapy solutions. Curr Opin Mol Ther 5, 495–502

    CAS  PubMed  Google Scholar 

  • Woolf, C.J. and Salter, M.W. (2000) Neuronal plasticity: increasing the gain in pain. Science 288, 1765–1769.

    Article  CAS  PubMed  Google Scholar 

  • Yanez-Munoz, R.J., Balaggan, K.S., Macneil, A., Howe, S.J., Schmidt, M., Smith, A.J., Buch, P., Maclaren, R.E., Anderson, P.N., Barker, S.E., Duran, Y., Bartholomae, C., von Kalle, C., Heckenlively, J.R., Kinnon, C., Ali, R.R. and Thrasher, A.J. (2006) Effective gene therapy with nonintegrating lentiviral vectors. Nat Med 12, 348–353

    Article  CAS  PubMed  Google Scholar 

  • Yao, M.Z., Gu, J.F., Wang, J.H., Sun, L.Y., Lang, M.F., Liu, J., Zhao, Z.Q. and Liu, X.Y. (2002b) Interleukin-2 gene therapy of chronic neuropathic pain. Neuroscience 112, 409–416

    Google Scholar 

  • Yao, M.Z., Gu, J.F., Wang, J.H., Sun, L.Y., Liu, H. and Liu, X.Y. (2003) Adenovirus-mediated interleukin-2 gene therapy of nociception. Gene Ther 10, 1392–1399

    Article  CAS  PubMed  Google Scholar 

  • Yao, M.Z., Wang, J.H., Gu, J.F., Sun, L.Y., Liu, H., Zhao, Z.Q. and Liu, X.Y. (2002b) Interleukin-2 gene has superior antinociceptive effects when delivered intrathecally. Neuroreport 13, 791–794

    Google Scholar 

  • Yeomans, D.C., Jones, T., Laurito, C.E., Lu, Y. and Wilson, S.P. (2004) Reversal of ongoing thermal hyperalgesia in mice by a recombinant herpesvirus that encodes human preproenkephalin. Mol Ther 9, 24–29

    Article  CAS  PubMed  Google Scholar 

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Lariviere, W.R., Cope, D.K. (2009). Gene Therapy for Chronic Pain. In: Biobehavioral Approaches to Pain. Springer, New York, NY. https://doi.org/10.1007/978-0-387-78323-9_19

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  • DOI: https://doi.org/10.1007/978-0-387-78323-9_19

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