Prostate cancer is unique among cancers as although it is highly metastatic, bone is frequently the only clinically detectable site of metastasis. Fortunately, patients with metastatic prostate cancer usually have a long survival time. Unfortunately, prostate metastasis to bone frequently causes a severe, chronic pain that reduces quality of life, functional status, and greatly increases health care utilization. The goals of this application are to understand the mechanisms that drive prostate cancer-induced bone pain and use this information to develop therapies that can better prevent and/or treat this chronic pain. In preliminary studies, we have refined a mouse model of prostate cancer bone pain so that it closely mirrors many of the pathological features observed in humans with prostate metastasis to bone in terms of: the tumor being primarily osteoblastic, the pattern of tumor colonization in bone, the individual tumor colonies forming sclerotic bone lesions, the robust vascularization, and viability of the tumor. While these prostate cancer cells do not express nerve growth factor (NGF), preliminary data suggest their associated stromal cells release NGF that induces dramatic sprouting of tropomyosin receptor kinase A (TrkA)+ sensory and sympathetic nerve fibers in the tumor-bearing bone that may play a major role in driving chronic prostate cancer-induced bone pain. Based on these observations, we hypothesize that: (1) NGF released from specific populations of stromal cells induces marked sprouting and neuroma formation by TrkA+, but not TrkA-, sensory and sympathetic nerve fibers in the tumor-bearing bone and that the extent of this pathological reorganization will predict the severity of prostate-induced pain behaviors;(2) newly sprouted sensory and sympathetic nerve fibers have a distinct morphology and express pathologically high levels of pro-algesic neurotransmitters, channels/receptors, and mitogen-activated protein kinases that are never observed in nerve fibers that innervate the normal bone;and (3) early preventive administration of anti-NGF or anti-TrkA attenuates the tumor-induced nerve sprouting, the pro-algesic phenotype of sensory and sympathetic nerve fibers, and bone cancer pain. In contrast, late administration of anti-NGF or anti-TrkA will only partially reverse the pro-algesic phenotype of the nerve fibers and have little or no effect on the pathological sprouting or neuroma formation that has already occurred. The overarching hypothesis is that the earlier preventive blockade of the NGF/TrkA pathway is initiated, the more effectively the pathological nerve changes and pain can be controlled. If correct, data from this project may fundamentally change our understanding and treatment of prostate cancer-induced bone pain.

Public Health Relevance

Prostate cancer is unique among cancers as although it is spreads to different organs, bone is frequently the only clinically detectable site of metastasis. Fortunately, patients with metastatic prostate cancer usually have a long survival time. Unfortunately, prostate metastasis to bone frequently causes a severe, chronic pain that reduces quality of life, functional status and greatly increases health care utilization. The goals of this application are to understand the mechanisms that drive prostate cancer-induced bone pain and to use this information to develop therapies that can better treat this chronic pain.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA157449-04
Application #
8677794
Study Section
Tumor Microenvironment Study Section (TME)
Program Officer
O'Mara, Ann M
Project Start
2011-07-01
Project End
2016-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Arizona
Department
Pharmacology
Type
Schools of Medicine
DUNS #
City
Tucson
State
AZ
Country
United States
Zip Code
85721
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Chartier, Stephane R; Mitchell, Stefanie At; Majuta, Lisa A et al. (2017) Immunohistochemical localization of nerve growth factor, tropomyosin receptor kinase A, and p75 in the bone and articular cartilage of the mouse femur. Mol Pain 13:1744806917745465
Majuta, Lisa A; Guedon, Jean-Marc G; Mitchell, Stefanie A T et al. (2017) Anti-nerve growth factor therapy increases spontaneous day/night activity in mice with orthopedic surgery-induced pain. Pain 158:605-617
Majuta, Lisa A; Guedon, Jean-Marc G; Mitchell, Stefanie A T et al. (2017) Mice with cancer-induced bone pain show a marked decline in day/night activity. Pain Rep 2:e614
Majuta, Lisa A; Guedon, Jean-Marc G; Mitchell, Stefanie A T et al. (2016) Anti-nerve growth factor therapy increases spontaneous day/night activity in mice with orthopedic surgery induced pain. Pain :
Thompson, Michelle L; Chartier, Stephane R; Mitchell, Stefanie A et al. (2016) Preventing painful age-related bone fractures: Anti-sclerostin therapy builds cortical bone and increases the proliferation of osteogenic cells in the periosteum of the geriatric mouse femur. Mol Pain 12:
Guedon, Jean-Marc G; Longo, Geraldine; Majuta, Lisa A et al. (2016) Dissociation between the relief of skeletal pain behaviors and skin hypersensitivity in a model of bone cancer pain. Pain 157:1239-47
Thompson, Michelle L; Jimenez-Andrade, Juan Miguel; Mantyh, Patrick W (2016) Sclerostin Immunoreactivity Increases in Cortical Bone Osteocytes and Decreases in Articular Cartilage Chondrocytes in Aging Mice. J Histochem Cytochem 64:179-89
Thompson, Michelle L; Jimenez-Andrade, Juan M; Chartier, Stephane et al. (2015) Targeting cells of the myeloid lineage attenuates pain and disease progression in a prostate model of bone cancer. Pain 156:1692-702
Majuta, Lisa A; Longo, Geraldine; Fealk, Michelle N et al. (2015) Orthopedic surgery and bone fracture pain are both significantly attenuated by sustained blockade of nerve growth factor. Pain 156:157-65

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