Leith J Lianne, Wilson Alex W, Donaldson Lucy F, Lumb Bridget M
Department of Physiology, University of Bristol, Bristol BS8 1TD, United Kingdom.
J Neurosci. 2007 Oct 17;27(42):11296-305. doi: 10.1523/JNEUROSCI.2586-07.2007.
Nonsteroidal anti-inflammatory drugs (NSAIDs) exert analgesic effects by inhibiting peripheral cyclooxygenases (COXs). It is now clear that these drugs also have central actions that include the modulation of descending control of spinal nociception from the midbrain periaqueductal gray (PAG). Descending control is a powerful determinant of the pain experience and is thus a potential target for analgesic drugs, including COX inhibitors. Noxious information from the periphery is conveyed to the spinal cord in A- and C-fiber nociceptors, which convey different qualities of the pain signal and have different roles in chronic pain. This in vivo study used different rates of skin heating to preferentially activate A- or C-heat nociceptors to further investigate the actions of COX inhibitors and prostaglandins in the PAG on spinal nociceptive processing. The results significantly advance our understanding of the central mechanisms underlying the actions of NSAIDs and prostaglandins by demonstrating that (1) in the PAG, it is COX-1 and not COX-2 that is responsible for acute antinociceptive effects of NSAIDs in vivo; (2) these effects are only evoked from the opioid-sensitive ventrolateral PAG; and (3) prostaglandins in the PAG exert tonic facilitatory control that targets C- rather than A-fiber-mediated spinal nociception. This selectivity of control is of particular significance given the distinct roles of A- and C-nociceptors in acute and chronic pain. Thus, effects of centrally acting prostaglandins are pivotal, we suggest, to both the understanding of nociceptive processing and the development of new analgesic drugs.
非甾体抗炎药(NSAIDs)通过抑制外周环氧化酶(COXs)发挥镇痛作用。现在已经清楚,这些药物也具有中枢作用,包括调节中脑导水管周围灰质(PAG)对脊髓伤害性感受的下行控制。下行控制是疼痛体验的一个重要决定因素,因此是包括COX抑制剂在内的镇痛药的一个潜在靶点。来自外周的伤害性信息通过A类和C类纤维伤害感受器传递到脊髓,这些感受器传递不同性质的疼痛信号,并且在慢性疼痛中具有不同作用。这项体内研究使用不同的皮肤加热速率来优先激活A类或C类热伤害感受器,以进一步研究COX抑制剂和前列腺素在PAG中对脊髓伤害性处理的作用。这些结果显著推进了我们对NSAIDs和前列腺素作用的中枢机制的理解,表明:(1)在PAG中,负责NSAIDs体内急性抗伤害感受作用的是COX-1而非COX-2;(2)这些作用仅从对阿片类敏感的腹外侧PAG诱发;(3)PAG中的前列腺素发挥紧张性易化控制,其靶点是C类而非A类纤维介导的脊髓伤害性感受。鉴于A类和C类伤害感受器在急性和慢性疼痛中的不同作用,这种控制的选择性具有特别重要的意义。因此,我们认为,中枢作用的前列腺素的作用对于理解伤害性处理和开发新的镇痛药都至关重要。
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