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在大鼠神经损伤后的不同时间测试的抗伤害性药物的效果。

The effect of antinociceptive drugs tested at different times after nerve injury in rats.

作者信息

Hama Aldric T, Borsook David

机构信息

Descartes Therapeutics, Inc., Waltham, Massachusetts, USA.

出版信息

Anesth Analg. 2005 Jul;101(1):175-9, table of contents. doi: 10.1213/01.ANE.0000155247.93604.62.

Abstract

Given the evolving nature of anatomical and functional changes in the nervous system that are involved in the development of neuropathic pain, it is possible that the differing time course after injury underlies the inconsistent efficacy of drugs in neuropathic pain patients. In the current study, we evaluated the behavioral effects of two standard drugs used clinically for neuropathic pain, the anticonvulsant gabapentin and antidepressant imipramine, in rats at different times after peripheral nerve injury. Rats that underwent the spared nerve injury procedure responded to an innocuous mechanical stimulus (von Frey filament) 2, 4, and 8 wk after injury. Gabapentin dose-dependently suppressed mechanical sensitivity at all time points tested but the potency of gabapentin was three-fold less 4 wk postinjury (135 mg/kg) compared with 2 and 8 wk postinjury (41 and 44 mg/kg, respectively). In contrast, imipramine lacked significant efficacy at 2 and 8 wk postinjury but slightly attenuated mechanical hypersensitivity at 4 wk postinjury. The results show that drug effects may change over time in the neuropathic state, which should be an important consideration in the evaluation of drugs in preclinical animal pain models and has implications for temporal approaches to therapy in the clinic.

摘要

鉴于参与神经性疼痛发展的神经系统解剖和功能变化具有不断演变的性质,受伤后不同的时间进程可能是导致药物对神经性疼痛患者疗效不一致的原因。在本研究中,我们评估了临床上用于治疗神经性疼痛的两种标准药物,抗惊厥药加巴喷丁和抗抑郁药丙咪嗪,在大鼠外周神经损伤后不同时间的行为学效应。接受保留神经损伤手术的大鼠在损伤后2周、4周和8周对无害机械刺激(von Frey细丝)有反应。加巴喷丁在所有测试时间点均呈剂量依赖性地抑制机械敏感性,但与损伤后2周和8周(分别为41 mg/kg和44 mg/kg)相比,损伤后4周加巴喷丁的效力降低了三倍(135 mg/kg)。相比之下,丙咪嗪在损伤后2周和8周缺乏显著疗效,但在损伤后4周略微减轻了机械性超敏反应。结果表明,在神经病变状态下,药物效果可能随时间变化,这在临床前动物疼痛模型的药物评估中应是一个重要考虑因素,并且对临床上的时间性治疗方法具有启示意义。

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