Angst M S, Clark J D, Carvalho B, Tingle M, Schmelz M, Yeomans D C
Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305-5117, USA Department of Anesthesia, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA Department of Anesthesiology, University of Heidelberg, Mannheim, Germany.
Pain. 2008 Sep 30;139(1):15-27. doi: 10.1016/j.pain.2008.02.028. Epub 2008 Apr 8.
Animal studies have documented a critical role for cytokines in cell signaling events underlying inflammation and pain associated with tissue injury. While clinical reports indicate an important role of cytokines in inflammatory pain, methodological limitations have made systematic human studies difficult. This study examined the utility of a human in vivo bioassay combining microdialysis with multiplex immunoassay techniques for measuring cytokine arrays in tissue. The first experiment measured cytokines in interstitial fluid collected from non-inflamed and experimentally inflamed skin (UVB). The effects of noxious heat on cytokine release were also assessed. The second experiment examined whether anti-hyperalgesic effects of the COX-inhibitor ibuprofen were associated with decreased tissue levels of the pro-inflammatory cytokines IL-1 beta and IL-6. In the first experiment, inflammation significantly increased IL-1 beta, IL-6, IL-8, IL-10, G-CSF, and MIP-1 beta. Noxious heat but not experimental inflammation significantly increased IL-7 and IL-13. In the second experiment, an oral dose of 400 and 800 mg ibuprofen produced similar anti-hyperalgesic effects suggesting a ceiling effect. Tissue levels of IL-1 beta and IL-6 were not affected after the 400mg dose but decreased significantly (44+/-32% and 38+/-13%) after the 800 mg dose. These results support the utility of explored method for tracking cytokines in human tissue and suggest that anti-hyperalgesic and anti-inflammatory effects of ibuprofen are at least partially dissociated. The data further suggest that high clinical doses of ibuprofen exert anti-inflammatory effects by down-regulating tissue cytokine levels. Explored human bioassay is a promising tool for studying the pathology and pharmacology of inflammatory and chronic pain conditions.
动物研究已证明细胞因子在与组织损伤相关的炎症和疼痛的细胞信号传导事件中起关键作用。虽然临床报告表明细胞因子在炎性疼痛中起重要作用,但方法学上的局限性使得系统的人体研究变得困难。本研究考察了一种将微透析与多重免疫测定技术相结合的人体体内生物测定法在测量组织中细胞因子阵列方面的实用性。第一个实验测量了从非炎症和实验性炎症皮肤(紫外线B)收集的间质液中的细胞因子。还评估了有害热对细胞因子释放的影响。第二个实验研究了环氧化酶抑制剂布洛芬的抗痛觉过敏作用是否与促炎细胞因子白细胞介素-1β和白细胞介素-6的组织水平降低有关。在第一个实验中,炎症显著增加了白细胞介素-1β、白细胞介素-6、白细胞介素-8、白细胞介素-10、粒细胞集落刺激因子和巨噬细胞炎性蛋白-1β。有害热而非实验性炎症显著增加了白细胞介素-7和白细胞介素-13。在第二个实验中,口服400毫克和800毫克布洛芬产生了相似的抗痛觉过敏作用,表明存在天花板效应。400毫克剂量后白细胞介素-1β和白细胞介素-6的组织水平未受影响,但800毫克剂量后显著降低(分别为44±32%和38±13%)。这些结果支持了所探索方法在追踪人体组织中细胞因子方面的实用性,并表明布洛芬的抗痛觉过敏和抗炎作用至少部分是分离的。数据进一步表明,高临床剂量的布洛芬通过下调组织细胞因子水平发挥抗炎作用。所探索的人体生物测定法是研究炎性和慢性疼痛病症的病理学和药理学的一个有前景的工具。