Wong C S, Hsu M M, Chou R, Chou Y Y, Tung C S
Department of Anesthesiology, National Defense Medical Center, Taipei, Taiwan.
Br J Anaesth. 2000 Nov;85(5):747-51. doi: 10.1093/bja/85.5.747.
Several lines of evidence suggest that the N-methyl-D-aspartate receptor (NMDA) and nitric oxide (NO) systems are involved in morphine tolerance. Cyclooxygenase (COX) inhibitors may also play a role in morphine tolerance by interacting with both systems. In the present study, we examined the effects of the COX inhibitors N-(2-cyclohexyloxy-4-nitrophenyl) methanesulphonamide (NS-398, selective COX2 inhibitor) and indomethacin (non-selective COX inhibitor) on the development of antinociceptive tolerance of morphine in a rat spinal model. The antinociceptive effect was determined by the tail-flick test. Tolerance was induced by injection of morphine 50 micrograms intrathecally (i.t.) twice daily for 5 days. The effects of NS-398 and indomethacin on morphine antinociceptive tolerance were examined after administering these drugs i.t. 10 min before each morphine injection. Neither NS-398 nor indomethacin alone produced an antinociception effect at doses up to 40 micrograms. NS-398 and indomethacin did not enhance the antinociceptive effect of morphine in naïve and morphine-tolerant rats. However, they shifted the morphine antinociceptive dose-response curve to the left when coadministered with morphine during tolerance induction, and reduced the increase in the ED50 of morphine (dose producing 50% of the maximum response) three- to four-fold. Collectively, these findings and previous studies suggest that COX may be involved in the development of morphine tolerance without directly enhancing its antinociceptive effect.
多条证据表明,N-甲基-D-天冬氨酸受体(NMDA)和一氧化氮(NO)系统与吗啡耐受性有关。环氧化酶(COX)抑制剂可能也通过与这两个系统相互作用而在吗啡耐受性中发挥作用。在本研究中,我们在大鼠脊髓模型中研究了COX抑制剂N-(2-环己氧基-4-硝基苯基)甲磺酰胺(NS-398,选择性COX2抑制剂)和吲哚美辛(非选择性COX抑制剂)对吗啡抗伤害感受性耐受性形成的影响。通过甩尾试验测定抗伤害感受作用。通过每天两次鞘内注射(i.t.)50微克吗啡,连续5天诱导耐受性。在每次吗啡注射前10分钟鞘内注射这些药物后,检测NS-398和吲哚美辛对吗啡抗伤害感受性耐受性的影响。单独使用NS-398和吲哚美辛,剂量高达40微克时均未产生抗伤害感受作用。NS-398和吲哚美辛在未用吗啡和已产生吗啡耐受性的大鼠中均未增强吗啡的抗伤害感受作用。然而,在诱导耐受性期间与吗啡共同给药时,它们使吗啡抗伤害感受剂量-反应曲线左移,并使吗啡的半数有效剂量(ED50,产生最大反应50%的剂量)增加幅度降低三到四倍。总体而言,这些发现和先前的研究表明COX可能参与吗啡耐受性的形成,而不直接增强其抗伤害感受作用。