1.中山大学附属第一医院麻醉疼痛科, 广东 广州 510080
2.中山大学中山医学院生理教研室//中山大学疼痛研究中心, 广东 广州 510080
刘安然,研究方向:慢性疼痛的机制研究,E-mail:liua.anran@outlook.com
收稿:2023-03-25,
纸质出版:2023-07-20
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刘安然,林震嘉,彭湘格等.鞘内注射2R, 6R-HNK缓解雌性小鼠的神经病理性疼痛[J].中山大学学报(医学科学版),2023,44(04):607-616.
LIU An-ran,LIN Zhen-jia,PENG Xiang-ge,et al.Analgesic Effect of Intrathecal 2R, 6R-HNK on Neuropathic Pain in Female Mice[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(04):607-616.
刘安然,林震嘉,彭湘格等.鞘内注射2R, 6R-HNK缓解雌性小鼠的神经病理性疼痛[J].中山大学学报(医学科学版),2023,44(04):607-616. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20230523.002.
LIU An-ran,LIN Zhen-jia,PENG Xiang-ge,et al.Analgesic Effect of Intrathecal 2R, 6R-HNK on Neuropathic Pain in Female Mice[J].Journal of Sun Yat-sen University(Medical Sciences),2023,44(04):607-616. DOI: 10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).20230523.002.
目的
2
初步探究鞘内注射2R, 6R-羟化去甲氯胺酮(2R, 6R-HNK)对慢性神经病理性疼痛(CNP)的镇痛作用及其机制。
方法
2
采用坐骨神经选择性损伤(SNI)诱导的CNP模型。将雌性小鼠随机分不同组:假手术或SNI术后3 周或术前30 min/1 d给予溶剂、2R, 6R-HNK、S-ketamine(10 mg/kg腹腔注射或7、21 μmol/L鞘内注射)(每组3 ~ 7只)。采用机械缩足阈值(PWT)和镇痛效率评估2R, 6R-HNK的治疗或预防效果。再用免疫荧光和RT-PCR方法检测背根神经节(DRG)和脊髓背角中蛋白转录及表达水平,并探讨其可能的作用机制。
结果
2
鞘内注射2R, 6R-HNK剂量依赖地缓解雌性小鼠SNI建模3 周的双侧机械痛敏;其中21 μmol/L 2R, 6R-HNK的镇痛效率达峰时间为2 d,峰值为(75.32±7.69)%。预先鞘内2R, 6R-HNK还能延迟SNI诱导双侧机械痛敏产生2 ~ 3 d。机制上,2R, 6R-HNK预处理不仅显著抑制SNI引起的双侧DRG和脊髓背角浅层神经元异常兴奋,还下调DRG内降钙素基因相关肽(CGRP)及脑源性神经生长因子(BDNF)的高表达。
结论
2
鞘内注射2R, 6R-HNK通过抑制上行痛觉通路神经元异常兴奋并下调DRG神经元CGRP和BDNF表达从而对CNP产生镇痛作用。
Objective
2
To investigate the analgesic action and mechanism of intrathecal 2R, 6R-hydroxynorketamine (2R, 6R-HNK) on spared nerve injury (SNI)-induced chronic neuropathic pain (CNP) in female mice.
Methods
2
SNI was used to establish acute and chronic CNP models in female mice. The mice were randomly divided into different groups with administration of vehicle, 2R, 6R-HNK or S-ketamine (10 mg/kg intraperitoneal injection/i.p. or 7, 21 μmol/L intrathecal injection/i.t.) at 3 weeks after or 30 min/1 d before operation (
n
= 3 - 7 mice/group). The curative or preventive effect of 2R, 6R-HNK was evaluated by mechanical paw withdrawal threshold (PWT) and the analgesic efficiency. Finally, immunofluorescence and RT-PCR of dorsal root ganglion (DRG) and spinal dorsal horn (SDH) were used to explore the possible mechanisms.
Results
2
Compared with vehicle, intrathecal injection of 2R, 6R-HNK largely reversed SNI-induced bilateral mechanical allodynia in a delayed-and-dose-dependent way. Among them, 21 μmol/L 2R, 6R-HNK reached its maximum analgesic efficiency (75.32±7.69) % at 2 d. Pre-intrathecal delivery of 2R, 6R-HNK also delayed the development of bilateral mechanical hypersensitivity 2 - 3 d induced by SNI. Mechanically, 2R, 6R-HNK reversed not only the abnormal excitability of neurons in bilateral DRG and superficial SDH, but also the upregulation of calcitonin gene-related peptide (CGRP) and brain-derived nerve growth factor (BDNF) in DRG.
Conclusion
2
Intrathecal administration of 2R, 6R-HNK exerts an analgesic effect against CNP, probably via suppressing abnormal neuronal excitability in ascending pain pathway as well as down-regulating CGRP and BDNF expression in DRG neurons.
Treede RD , Rief W , Barke A , et al . Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the international classification of diseases (ICD-11) [J]. Pain , 2019 , 160 ( 1 ): 19 - 27 .
Scholz J , Finnerup NB , Attal N , et al . The IASP classification of chronic pain for ICD-11: chronic neuropathic pain [J]. Pain , 2019 , 160 ( 1 ): 53 - 59 .
Pricope CV , Tamba BI , Stanciu GD , et al . The roles of imaging biomarkers in the management of chronic neuropathic pain [J]. Int J Mol Sci , 2022 , 23 ( 21 ): 13038 .
Mercer Lindsay N , Chen C , Gilam G , et al . Brain circuits for pain and its treatment [J]. Sci Transl Med , 2021 , 13 ( 619 ): eabj7360 .
Cohen SP , Vase L , Hooten WM . Chronic pain: an update on burden, best practices, and new advances [J]. Lancet , 2021 , 397 ( 10289 ): 2082 - 2097 .
Zanos P , Moaddel R , Morris PJ , et al . Ketamine and ketamine metabolite pharmacology: insights into therapeutic mechanisms [J]. Pharmacol Rev , 2018 , 70 ( 3 ): 621 - 660 .
Henter ID , Park LT , Zarate CA , Jr . Novel glutamatergic modulators for the treatment of mood disorders: current status [J]. CNS Drugs , 2021 , 35 ( 5 ): 527 - 543 .
Moaddel R , Abdrakhmanova G , Kozak J , et al . Sub-anesthetic concentrations of (R, S)-ketamine metabolites inhibit acetylcholine-evoked currents in alpha7 nicotinic acetylcholine receptors [J]. Eur J Pharmacol , 2013 , 698 ( 1-3 ): 228 - 234 .
Highland JN , Zanos P , Riggs LM , et al . Hydroxynorketamines: pharmacology and potential therapeutic applications [J]. Pharmacol Rev , 2021 , 73 ( 2 ): 763 - 791 .
Kroin JS , Das V , Moric M , et al . Efficacy of the ketamine metabolite (2R, 6R)-hydroxynorketamine in mice models of pain [J]. Reg Anesth Pain Med , 2019 , 44 ( 1 ): 111 - 117 .
Yost JG , Wulf HA , Browne CA , et al . Antinociceptive and analgesic effects of (2R, 6R)-hydroxynorketamine [J]. J Pharmacol Exp Ther , 2022 , 382 ( 3 ): 256 - 265 .
Yost JG , Browne CA , Lucki I . (2R, 6R)-hydroxynorketamine(HNK) reverses mechanical hypersensitivity in a model of localized inflammatory pain [J]. Neuropharmacology , 2022 , 221 : 109276 .
Goswami N , Aleem M , Manda K . Intranasal (2R, 6R)-hydroxynorketamine for acute pain: behavioural and neurophysiological safety analysis in mice [J]. Clin Exp Pharmacol Physiol , 2023 , 50 ( 2 ): 169 - 177 .
Carrier N , Kabbaj M . Sex differences in the antidepressant-like effects of ketamine [J]. Neuropharmacology , 2013 , 70 : 27 - 34 .
Franceschelli A , Sens J , Herchick S , et al . Sex differences in the rapid and the sustained antidepressant-like effects of ketamine in stress-naive and "depressed" mice exposed to chronic mild stress [J]. Neuroscience , 2015 , 290 : 49 - 60 .
Zanos P , Moaddel R , Morris PJ , et al . NMDAR inhibition-independent antidepressant actions of ketamine metabolites [J]. Nature , 2016 , 533 ( 7604 ): 481 - 486 .
Lumsden EW , Troppoli TA , Myers SJ , et al . Antidepressant-relevant concentrations of the ketamine metabolite (2R, 6R)-hydroxynorketamine do not block NMDA receptor function [J]. Proc Natl Acad Sci USA , 2019 , 116 ( 11 ): 5160 - 5169 .
Deuis JR , Dvorakova LS , Vetter I . Methods used to evaluate pain behaviors in rodents [J]. Front Mol Neurosci , 2017 , 10 : 284 .
Zhou LJ , Peng J , Xu YN , et al . Microglia are indispensable for synaptic plasticity in the spinal dorsal horn and chronic pain [J]. Cell Rep , 2019 , 27 ( 13 ): 3844 - 3859 . e6.
Decosterd I , Woolf CJ . Spared nerve injury: an animal model of persistent peripheral neuropathic pain [J]. Pain , 2000 , 87 ( 2 ): 149 - 158 .
Lilius TO , Viisanen H , Jokinen V , et al . Interactions of (2S, 6S;2R, 6R)-hydroxynorketamine, a secondary metabolite of (R, S)-ketamine, with morphine [J]. Basic Clin Pharmacol Toxicol , 2018 , 122 ( 5 ): 481 - 488 .
Laffleur F , Bauer B . Progress in nasal drug delivery systems [J]. Int J Pharm , 2021 , 607 : 120994 .
Zanos P , Highland JN , Liu X , et al . (R)-ketamine exerts antidepressant actions partly via conversion to (2R, 6R)-hydroxynorketamine, while causing adverse effects at sub-anaesthetic doses [J]. Br J Pharmacol , 2019 , 176 ( 14 ): 2573 - 2592 .
Walker SM , Westin BD , Deumens R , et al . Effects of intrathecal ketamine in the neonatal rat: evaluation of apoptosis and long-term functional outcome [J]. Anesthesiology , 2010 , 113 ( 1 ): 147 - 159 .
Truin M , Janssen SP , van Kleef M , et al . Successful pain relief in non-responders to spinal cord stimulation: the combined use of ketamine and spinal cord stimulation [J]. Eur J Pain , 2011 , 15 ( 10 ): 1049 e1 - 1049 . e9.
da Costa FLP , Pinto MCX , Santos DC , et al . Ketamine potentiates TRPV1 receptor signaling in the peripheral nociceptive pathways [J]. Biochem Pharmacol , 2020 , 182 : 114210 .
Pham TH , Defaix C , Xu X , et al . Common neurotransmission recruited in (R, S)-ketamine and (2R, 6R)-hydroxynorketamine-induced sustained antidepressant-like effects [J]. Biol Psychiatry , 2018 , 84 ( 1 ): e3 - e6 .
Russell FA , King R , Smillie SJ , et al . Calcitonin gene-related peptide: physiology and pathophysiology [J]. Physiol Rev , 2014 , 94 ( 4 ): 1099 - 1142 .
Rees TA , Hendrikse ER , Hay DL , et al . Beyond CGRP: the calcitonin peptide family as targets for migraine and pain [J]. Br J Pharmacol , 2022 , 179 ( 3 ): 381 - 399 .
Kang SA , Govindarajan R . Anti-calcitonin gene-related peptide monoclonal antibodies for neuropathic pain in patients with migraine headache [J]. Muscle Nerve , 2021 , 63 ( 4 ): 563 - 567 .
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