Zelinski Lisa M, Ohgami Yusuke, Chung Eunhee, Shirachi Donald Y, Quock Raymond M
Department of Pharmaceutical Sciences, College of Pharmacy, Pullman, Washington, USA.
J Pain. 2009 Feb;10(2):167-72. doi: 10.1016/j.jpain.2008.08.003. Epub 2008 Oct 31.
Hyperbaric oxygen (HBO(2)) therapy is reported to cause pain relief in several conditions of chronic pain. A single 60-minute session of HBO(2) treatment produced a prolonged antinociceptive effect in mice that persisted for 90 minutes after cessation of treatment. The HBO(2)-induced antinociception was significantly attenuated by pretreatment before HBO(2) exposure with the opioid antagonist naltrexone, the nonspecific nitric oxide synthase (NOS)-inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME), and the selective neuronal NOS-inhibitor S-methyl-L-thiocitrulline (SMTC) but not the selective endothelial NOS-inhibitor N(5)-(1-iminoethyl)-L-ornithine (L-NIO). The antinociception was also significantly reduced by central pretreatment with a rabbit antiserum against dynorphin(1-13) but not by rabbit antisera against either beta-endorphin or methionine-enkephalin. The prolonged antinociceptive effect at 90 minutes after HBO(2)-induced treatment was also significantly attenuated by naltrexone but not L-NAME administered 60 minutes after HBO(2) treatment but before nociceptive testing. These findings indicate that the antinociception that persists for 90 minutes after HBO(2) exposure is mediated by nitric oxide (NO) and opioid mechanisms but that the NO involvement is critical during the HBO(2) treatment and not at the time of nociceptive testing. These results are consistent with the concept that HBO(2) may induce an NO-dependent release of opioid peptide to cause a long-acting antinociceptive effect.
This article presents evidence of a persistent antinociceptive effect of hyperbaric oxygen treatment that is mediated by opioid and NO mechanisms. Further elucidation of the underlying mechanism could identify molecular targets to cause a longer-acting activation of endogenous pain-modulating systems.
据报道,高压氧(HBO₂)疗法可在多种慢性疼痛状况下缓解疼痛。单次60分钟的HBO₂治疗在小鼠中产生了持久的抗伤害感受作用,该作用在治疗停止后持续90分钟。HBO₂诱导的抗伤害感受作用在HBO₂暴露前用阿片类拮抗剂纳曲酮、非特异性一氧化氮合酶(NOS)抑制剂N⁺-硝基-L-精氨酸甲酯(L-NAME)以及选择性神经元NOS抑制剂S-甲基-L-硫代瓜氨酸(SMTC)进行预处理后显著减弱,但用选择性内皮NOS抑制剂N⁺-(1-亚氨基乙基)-L-鸟氨酸(L-NIO)预处理则无此效果。用抗强啡肽(1-13)兔抗血清进行中枢预处理也可显著降低抗伤害感受作用,但用抗β-内啡肽或甲硫氨酸脑啡肽兔抗血清预处理则无此效果。在HBO₂诱导治疗后90分钟时的持久抗伤害感受作用在用纳曲酮预处理后也显著减弱,但在HBO₂治疗60分钟后且在伤害性测试前给予L-NAME则无此效果。这些发现表明,HBO₂暴露后持续90分钟的抗伤害感受作用是由一氧化氮(NO)和阿片类机制介导的,但NO的参与在HBO₂治疗期间至关重要,而在伤害性测试时并非如此。这些结果与HBO₂可能诱导阿片肽的NO依赖性释放从而产生长效抗伤害感受作用的概念一致。
本文提供了高压氧治疗的持久抗伤害感受作用由阿片类和NO机制介导的证据。对潜在机制的进一步阐明可能会确定分子靶点,以实现内源性疼痛调节系统的长效激活。