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Oxidized Lipids in Persistent Pain States

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Review

Oxidized Lipids in Persistent Pain States

Tabea Osthues et al. Front Pharmacol.

Abstract

Chemotherapy, nerve injuries, or diseases like multiple sclerosis can cause pathophysiological processes of persistent and neuropathic pain. Thereby, the activation threshold of ion channels is reduced in peripheral sensory neurons to normally noxious stimuli like heat, cold, acid, or mechanical due to sensitization processes. This leads to enhanced neuronal activity, which can result in mechanical allodynia, cold allodynia, thermal hyperalgesia, spontaneous pain, and may initiate persistent and neuropathic pain. The treatment options for persistent and neuropathic pain patients are limited; for about 50% of them, current medication is not efficient due to severe side effects or low response to the treatment. Therefore, it is of special interest to find additional treatment strategies. One approach is the control of neuronal sensitization processes. Herein, signaling lipids are crucial mediators and play an important role during the onset and maintenance of pain. As preclinical studies demonstrate, lipids may act as endogenous ligands or may sensitize transient receptor potential (TRP)-channels. Likewise, they can cause enhanced activity of sensory neurons by mechanisms involving G-protein coupled receptors and activation of intracellular protein kinases. In this regard, oxidized metabolites of the essential fatty acid linoleic acid, 9- and 13-hydroxyoctadecadienoic acid (HODE), their dihydroxy-metabolites (DiHOMEs), as well as epoxides of linoleic acid (EpOMEs) and of arachidonic acid (EETs), as well as lysophospholipids, sphingolipids, and specialized pro-resolving mediators (SPMs) have been reported to play distinct roles in pain transmission or inhibition. Here, we discuss the underlying molecular mechanisms of the oxidized linoleic acid metabolites and eicosanoids. Furthermore, we critically evaluate their role as potential targets for the development of novel analgesics and for the treatment of persistent or neuropathic pain.

Keywords: HODE; eicosanoids; linoleic acid metabolites; lipids inflammatory pain; neuropathic pain; pain; transient receptor potential channels.

Figures

Figure 1
Figure 1
Metabolic pathway of linoleic and arachidonic acid. In the cell, linoleic acid (LA) is rapidly metabolized via different enzymes into various bioactive metabolites. Lipoxygenases (LOX) can generate 13- and 9-HODE at the perinuclear membrane of the nucleus, whereas the cytochrome-P450- enzymes (CYP) metabolize LA into EpOMEs. These are further metabolized to DiHOMEs via soluble epoxide hydrolase (sEH). In the endoplasmatic reticulum (ER), AA is the precursor of the cyclooxygenase (COX) products prostaglandins (e.g. PGE2). AA can also be metabolized to the epoxyeicosatrienoic acids (EETs), which are further metabolized by sEH to DHETs in the cytosol. At the plasma membrane, phospholipase A liberates either AA out of the phospholipids or generates lysophophatidylcholine (LPC). LPC is then metabolized through the extracellular phospholipase D (PLD) autotaxin to lysophosphatidic acid (LPA). Abbreviations: LTA, leukotriene A; LTB, leukotriene B; LTC, leukotriene C; LOX, lipoxygenase; 5-HPETE, arachidonic acid 5-hydroperoxide; 5-HETE, 5-Hydroxyeicosatetraenoic acid; 13-/9-HODE, 13-/9-Hydroxyoctadecadienoic acid; EET, epoxyeicosatrienoic acid; PG, prostaglandin; COX, cyclooxygenase; CYP, cytochrome enzymes; DHET, Dihydroxy eicosatrienoic acid; EpOME, Epoxy octadecenoic acid; DiHOME, Dihydroxy-octadecenoic acid; LPC, lysophosphatidylcholine, LPA, lysophosphatidic acid; PLD, phospholipase D; sEH, soluble epoxide hydrolase; ER, endoplasmatic reticulum. Source structural formula: http://lipidmaps.org/.
Figure 2
Figure 2
Proteins of lipid release, synthesis and metabolism in the pathology of persistent and/or neuropathic pain states. Shown are the proteins involved in release of lysophospholipids (in beige background), synthesis and metabolism of linoleic acid metabolites (in white background) or arachidonic acid metabolites (in grey background) and the respective pain state that each protein is connected with. White arrows indicate unknown synthesis or metabolism pathway. PLA, phospholipase; LA, linoleic acid; AA, arachidonic acid; LPC, lysophosphatidylcholine; CYP, cytochrome-P450-epoxygenase; LOX, lipoxygnease; sEH, soluble epoxide hydrolase; EET, epoxyeicosatrienoic acid; EpOME, epoxyoctadecadienoic acid; HODE, hydroxyotadecadienoic acid; DHET, dihydroxy-eicosatrienoic acid; DiHOME, dihydroxy-octadecenoic acid.
Figure 3
Figure 3
Lipid GPCRs in the pathology of persistent and/or neuropathic pain states. Shown are the six lipid GPCRs that are discussed in the manuscript with an exemplary lipid ligand and their respective intracellular signaling pathways, their cellular distributions and signaling functions in persistent pain states at the interface of the peripheral and central nervous system. LPA, lysophosphatidic acid; LPAR, lysophosphatidic acid receptor; PLC, phospholipase C; BDNF, brain-derived neurotrophic factor; DHA, docosahexaenoic acid; FFAR, free fatty acid receptor; GPR, G-protein coupled receptor; sEPSCs, spontaneous excitatory postsynaptic currents; TNF-α, tumor necrose factor-alpha; IL-1β, interleukin-1-beta; S1P, sphingosine-1-phosphate; S1P1R, sphingosine-1-phosphate receptor; NFκB, nuclear factor kappa-light-chain-enhancer of activated B-cells; HODE, hydroxyotadecadienoic acid; G2A, G2-accumulating GPCR; LTB4, leukotriene B4; BLT, B-leukotriene receptor; PKC, protein kinase C; TRPV1, transient receptor potential vanilloid 1 channel; NPD1, neuroprotectin D1; TGF, transforming growth factor-beta; IL-10, Interleukin-10.

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