Lin Jui-An, Lee Meei-Shyuan, Wu Ching-Tang, Yeh Chun-Chang, Lin Shinn-Long, Wen Zhi-Hong, Wong Chih-Shung
Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, #325, Chenggung Road, Section 2, Neihu 114, Taipei, Taiwan.
Brain Res. 2005 Aug 30;1054(2):167-73. doi: 10.1016/j.brainres.2005.06.058.
This study was designed to investigate the effect of acute and chronic intrathecal (i.t.) injection of gabapentin (GBP) on the antinociceptive effect of morphine and tolerance development using a tail-flick latency test. Levels of excitatory amino acids (EAA) in i.t. CSF dialysates were also measured by high performance liquid chromatography. Male Wistar rats were implanted with either one or two i.t. catheters for drug injection or pump infusion and with a microdialysis probe for CSF dialysate collection. The effect of acute GBP (10 microg i.t.) injection on the morphine dose response was examined in both naïve rats and rats made tolerant by continuous infusion of morphine (15 microg/h i.t.) for 5 days. At such a low dose (10 microg i.t.), GBP did not enhance morphine's antinociception in naïve rats. In morphine-tolerant rats, however, acute GBP (10 microg i.t.) injection potentiated morphine's antinociception and yielded a 14.6-fold shift in morphine's dose-response curve. When GBP (10 microg/h i.t.) was co-infused with morphine (15 microg/h i.t.) to examine its effect on the development of morphine tolerance, GBP attenuated the development of morphine tolerance. The effect of GBP and morphine on CSF glutamate and aspartate levels was examined in naïve rats, and the effect of morphine challenge on CSF glutamate and aspartate levels was examined in rats previously infused for 5 days with morphine alone or morphine plus GBP. Acute injection of GBP (10 microg i.t.), morphine (50 microg i.t.), or GBP (10 microg i.t.) followed by morphine (50 microg i.t.) 30 min later had no significant effect on CSF EAA concentration in naïve rats; however, in tolerant rats, morphine challenge (50 microg i.t.) increased aspartate and glutamate levels to 221 +/- 22% and 296 +/- 43%, respectively, of those before morphine challenge, and this phenomenon was inhibited by GBP co-infusion. Our results show that GBP, at a dose without enhanced effect on morphine's antinociception in naïve rats, not only potentiates morphine's antinociceptive effect in morphine-tolerant rats but also attenuates the development of morphine tolerance. The mechanism of the effect of GBP on morphine tolerance might be via suppression of the EAA concentration in spinal CSF dialysate.
本研究旨在通过甩尾潜伏期试验,研究急性和慢性鞘内注射加巴喷丁(GBP)对吗啡镇痛作用及耐受性形成的影响。同时,采用高效液相色谱法测定鞘内脑脊液透析液中兴奋性氨基酸(EAA)的水平。将雄性Wistar大鼠植入一根或两根鞘内导管用于药物注射或泵注,并植入一个微透析探针用于收集脑脊液透析液。在未用药的大鼠和通过连续5天鞘内输注吗啡(15μg/h)产生耐受性的大鼠中,均检测了急性注射GBP(10μg鞘内注射)对吗啡剂量反应的影响。在如此低的剂量(10μg鞘内注射)下,GBP并未增强未用药大鼠的吗啡镇痛作用。然而,在吗啡耐受的大鼠中,急性注射GBP(10μg鞘内注射)可增强吗啡的镇痛作用,并使吗啡的剂量反应曲线发生14.6倍的位移。当将GBP(10μg/h鞘内注射)与吗啡(15μg/h鞘内注射)共同输注以研究其对吗啡耐受性形成的影响时,GBP可减弱吗啡耐受性的形成。在未用药的大鼠中检测了GBP和吗啡对脑脊液谷氨酸和天冬氨酸水平的影响,在先前单独输注吗啡或吗啡加GBP 5天的大鼠中检测了吗啡激发对脑脊液谷氨酸和天冬氨酸水平的影响。急性注射GBP(10μg鞘内注射)、吗啡(50μg鞘内注射)或先注射GBP(10μg鞘内注射)30分钟后再注射吗啡(50μg鞘内注射),对未用药大鼠的脑脊液EAA浓度均无显著影响;然而,在耐受大鼠中,吗啡激发(50μg鞘内注射)可使天冬氨酸和谷氨酸水平分别升高至吗啡激发前的221±22%和296±43%,而这种现象可被GBP共同输注所抑制。我们的结果表明,在未用药大鼠中对吗啡镇痛作用无增强效应的剂量下,GBP不仅可增强吗啡耐受大鼠的吗啡镇痛作用,还可减弱吗啡耐受性的形成。GBP对吗啡耐受性影响的机制可能是通过抑制脊髓脑脊液透析液中EAA的浓度。