Chu Ya-Chun, Chan Kwok-Hon, Tsou Mei-Yung, Lin Su-Man, Hsieh Ying-Chou, Tao Yuan-Xiang
Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, School of Medicine, Taiwan, Republic of China.
Anesthesiology. 2007 Jun;106(6):1204-12. doi: 10.1097/01.anes.0000267604.40258.d1.
Neonatal pain and inflammation may lead to a long-term effect on nociceptive processing in adults. The current study examined the characteristics of postoperative incisional pain behaviors in adult rats that were subjected to neonatal peripheral inflammation.
Rat pups received a subcutaneous injection of saline or carrageenan into the plantar surface of the left hind paw at postnatal day 1. Naive pups were used as the control. Paw withdrawal thresholds to punctuate mechanical stimuli were examined at postnatal days 35, 42, and 49. After rats received a plantar incision on the left or right hind paw at postnatal day 50, paw withdrawal thresholds were measured at 4 h, 1 day, 2 days, 3 days, 5 days, and 7 days after incision. In addition, spinal cord Fos expression was detected at 2 h after incision. Finally, the effects of intrathecal N-methyl-D-aspartate receptor antagonists DL-2-amino-5-phosphonovaleric acid and dizocilpine and the nitric oxide synthase inhibitor L-N-nitro-arginine methylester on incisional pain were examined at 4 h after incision.
Although the rats subjected to neonatal peripheral carrageenan injection developed mechanical hypoalgesia in bilateral hind paws at baseline, they displayed increased spinal cord Fos expression at 2 h and exaggerated mechanical pain hypersensitivity at 4 h (but not at other time points) after plantar incision. Intrathecal DL-2-amino-5-phosphonovaleric acid, dizocilpine, and L-N-nitro-arginine methylester significantly attenuated incision-induced mechanical pain hypersensitivity at 4 h after incision in the neonatally carrageenan-treated rats, but not in the naive or neonatally saline-treated rats.
The authors' results suggest that early inflammatory insults during the neonatal period could produce excessive incision-associated mechanical pain hypersensitivity in adult rats. Spinal cord N-methyl-D-aspartate receptors and downstream nitric oxide signaling might contribute to this abnormal pain hypersensitivity, although the mechanisms underlying the long-term effect of neonatal inflammation are still unclear.
新生儿疼痛和炎症可能会对成人的伤害性感受处理产生长期影响。本研究探讨了经历过新生儿期外周炎症的成年大鼠术后切口疼痛行为的特征。
在出生后第1天,给幼鼠左侧后爪足底皮下注射生理盐水或角叉菜胶。未处理的幼鼠作为对照。在出生后第35、42和49天检测对点状机械刺激的爪退缩阈值。在出生后第50天,给大鼠左侧或右侧后爪进行足底切口后,于切口后4小时、1天、2天、3天、5天和7天测量爪退缩阈值。此外,在切口后2小时检测脊髓Fos表达。最后,在切口后4小时,研究鞘内注射N-甲基-D-天冬氨酸受体拮抗剂DL-2-氨基-5-磷酸戊酸、地佐环平以及一氧化氮合酶抑制剂L-N-硝基-精氨酸甲酯对切口疼痛的影响。
尽管在新生儿期接受外周角叉菜胶注射的大鼠在基线时双侧后爪出现机械性痛觉减退,但在足底切口后2小时,它们的脊髓Fos表达增加,并且在切口后4小时(但在其他时间点未出现)表现出夸张的机械性疼痛超敏反应。在新生儿期接受角叉菜胶处理的大鼠中,鞘内注射DL-2-氨基-5-磷酸戊酸、地佐环平以及L-N-硝基-精氨酸甲酯在切口后4小时可显著减轻切口诱导的机械性疼痛超敏反应,但在未处理的或新生儿期接受生理盐水处理的大鼠中则无此作用。
作者的结果表明,新生儿期的早期炎症损伤可能会在成年大鼠中产生与切口相关的过度机械性疼痛超敏反应。脊髓N-甲基-D-天冬氨酸受体和下游一氧化氮信号通路可能导致这种异常的疼痛超敏反应,尽管新生儿炎症长期影响的潜在机制仍不清楚。