Ikoma Miho, Kohno Tatsuro, Baba Hiroshi
Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences Niigata, Japan.
Anesthesiology. 2007 Nov;107(5):807-12. doi: 10.1097/01.anes.0000286985.80301.5e.
Although intrathecal administration of opioids produces antinociceptive effects in the spinal cord, it has not been established whether intrathecal opioid application more effectively terminates C fiber-mediated pain than A fiber-mediated pain. Here, the authors focus on the differences in opioid actions on Adelta- and C-afferent responses.
Using the whole cell patch clamp technique, the authors investigated the presynaptic inhibitory actions of micro-, delta-, and kappa-opioid receptor agonists on primary afferent-evoked excitatory postsynaptic currents (EPSCs) in substantia gelatinosa neurons of adult rat spinal cord slices.
The micro agonist DAMGO (0.1, 1 microM) reduced the amplitude of glutamatergic monosynaptic Adelta- or C fiber-evoked EPSCs. C fiber-evoked EPSCs were inhibited to a greater extent than Adelta fiber-evoked EPSCs. The delta agonist DPDPE (1, 10 microM) produced modest inhibition of Adelta- or C fiber-evoked EPSCs. In contrast, the kappa agonist U69593 (1 microM) did not affect the amplitude of either Adelta or C fiber-evoked EPSCs.
These results indicate that opioids suppress excitatory synaptic transmission mainly through activation of micro receptors on primary afferent C fibers. Given that the substantia gelatinosa is the main termination of Adelta and C fibers transmitting nociceptive information, the current findings may partially explain the different potency of opioid agonists.
尽管鞘内注射阿片类药物可在脊髓产生抗伤害感受作用,但鞘内应用阿片类药物是否比A纤维介导的疼痛更有效地终止C纤维介导的疼痛尚未明确。在此,作者聚焦于阿片类药物对Aδ和C传入反应作用的差异。
作者采用全细胞膜片钳技术,研究了μ、δ和κ阿片受体激动剂对成年大鼠脊髓切片胶状质神经元初级传入诱发的兴奋性突触后电流(EPSCs)的突触前抑制作用。
μ激动剂DAMGO(0.1、1微摩尔)降低了谷氨酸能单突触Aδ或C纤维诱发的EPSCs的幅度。C纤维诱发的EPSCs比Aδ纤维诱发的EPSCs受到更大程度的抑制。δ激动剂DPDPE(1、10微摩尔)对Aδ或C纤维诱发的EPSCs产生适度抑制。相比之下,κ激动剂U69593(1微摩尔)对Aδ或C纤维诱发的EPSCs的幅度均无影响。
这些结果表明,阿片类药物主要通过激活初级传入C纤维上的μ受体来抑制兴奋性突触传递。鉴于胶状质是传递伤害性信息的Aδ和C纤维的主要终末部位,目前的研究结果可能部分解释了阿片类激动剂的不同效力。