Liang D, Li X, Lighthall G, Clark J D
Veterans Affairs Palo Alto Health Care System and Stanford University Department of Anesthesiology, 3801 Miranda Avenue, Palo Alto, CA 94304, USA.
Neuroscience. 2003;121(4):999-1005. doi: 10.1016/s0306-4522(03)00483-4.
The heme oxygenase (HO) enzyme system has been shown to participate in nociceptive signaling in a number of different models of pain. In these experiments we investigated the role of the HO type 2 (HO-2) isozyme in tolerance to the analgesic effects of morphine, and the hyperalgesia and allodynia which are measurable upon cessation of administration. Wild type C57Bl/6 wild type mice or HO-2 null mutants in that background strain were treated with morphine for 5 days. The morphine administration protocol consisted of either twice daily repeated s.c. boluses of 15 mg/kg or s.c. implantation of a morphine pellet. At the end of the treatment period wild type mice treated by either protocol exhibited tolerance, but the HO-2 null mutants did not. The HO-2 null mutants also exhibited less mechanical allodynia following cessation of morphine administration, though only modest differences in thermal hyperalgesia were noted. There was no correlation between the degree of tolerance obtained in the bolus and pellet protocols and the degree of hyperalgesia and allodynia observed after cessation of morphine administration in the wild type mice. Our final experiments analyzed increases in expression of mRNA for nitric oxide synthase type 1, N-methyl-D-aspartate (NMDA) receptor NMDAR1 subunit and prodynorphin in spinal cord tissue. In pellet-treated mice two- to three-fold increases were observed in the abundance of these species, but very little change was observed in the null-mutant mice. Taken together our results indicate that HO-2 participates in the acquisition of opioid tolerance, the expression of mechanical allodynia after cessation of opioid administration and in gene regulation occurring in the setting of treatment with morphine. Furthermore, these studies suggest that the mechanisms underlying analgesic tolerance and opioid-induced hypersensitivity are at least somewhat distinct.
血红素加氧酶(HO)酶系统已被证实在多种不同的疼痛模型中参与伤害性信号传导。在这些实验中,我们研究了HO-2同工酶在对吗啡镇痛作用的耐受性以及停药后可测量的痛觉过敏和异常性疼痛中的作用。用野生型C57Bl/6野生型小鼠或该背景品系的HO-2基因敲除突变体进行为期5天的吗啡处理。吗啡给药方案包括每日两次皮下注射15mg/kg的推注剂量或皮下植入吗啡缓释片。在治疗期结束时,采用任一方案处理的野生型小鼠均表现出耐受性,但HO-2基因敲除突变体未出现耐受性。HO-2基因敲除突变体在停用吗啡后也表现出较轻的机械性异常性疼痛,尽管仅观察到热痛觉过敏有适度差异。在野生型小鼠中,推注和缓释片给药方案所获得的耐受程度与停用吗啡后观察到的痛觉过敏和异常性疼痛程度之间没有相关性。我们最后的实验分析了脊髓组织中一氧化氮合酶1型、N-甲基-D-天冬氨酸(NMDA)受体NMDAR1亚基和前强啡肽mRNA表达的增加情况。在植入缓释片处理的小鼠中,这些物质的丰度增加了2至3倍,但在基因敲除突变体小鼠中几乎没有变化。综合我们的结果表明,HO-2参与阿片类药物耐受性的形成、阿片类药物停用后机械性异常性疼痛的表达以及吗啡治疗过程中的基因调控。此外,这些研究表明,镇痛耐受性和阿片类药物诱导的超敏反应的潜在机制至少在一定程度上是不同的。