Batinić-Haberle Ines, Ndengele Michael M, Cuzzocrea Salvatore, Rebouças Júlio S, Spasojević Ivan, Salvemini Daniela
Department of Radiation Oncology, Duke University Medical School, Durham, NC 27710, USA.
Free Radic Biol Med. 2009 Jan 15;46(2):212-9. doi: 10.1016/j.freeradbiomed.2008.09.037. Epub 2008 Oct 17.
Severe pain syndromes reduce the quality of life of patients with inflammatory and neoplastic diseases, partly because reduced analgesic effectiveness with chronic opiate therapy (i.e., tolerance) leads to escalating doses and distressing side effects. Peroxynitrite-mediated nitroxidative stress in the dorsal horn of the spinal cord plays a critical role in the induction and development of antinociceptive tolerance to morphine. This provides a valid pharmacological basis for developing peroxynitrite scavengers as potent adjuncts to opiates in the management of pain. The cationic Mn(III) ortho-N-alkylpyridylporphyrins MnTE-2-PyP(5+) and MnTnHex-2-PyP(5+) are among the most potent peroxynitrite scavengers, with nearly identical scavenging rate constants (approximately 10(7) M(-1) s(-1)). Yet, MnTnHex-2-PyP(5+) is significantly more lipophilic and more bioavailable and, in turn, was 30-fold more effective in blocking the development of morphine antinociceptive tolerance than MnTE-2-PyP(5+) using the hot-plate test in a well-characterized murine model. The hydrophilic MnTE-2-PyP(5+) and the lipophilic MnTnHex-2-PyP(5+) were 10- and 300-fold, respectively, more effective in inhibiting morphine tolerance than the hydrophilic Fe(III) porphyrin FeTM-4-PyP(5+). Both Mn porphyrins decreased levels of TNF-alpha, IL-1 beta, and IL-6 to normal values. Neither of them affected acute morphine antinociceptive effects nor caused motor function impairment. Also neither was able to reverse already established morphine tolerance. We have recently shown that the anionic porphyrin Mn(III) tetrakis(4-carboxylatophenyl)porphyrin is selective in removing ONOO(-) over O(2)(-), but at approximately 2 orders of magnitude lower efficacy than MnTE-2-PyP(5+) and MnTnHex-2-PyP(5+), which in turn parallels up to 100-fold lower ability to reverse morphine tolerance. These data (1) support the role of peroxynitrite rather than superoxide as a major mechanism in blocking the development of morphine tolerance and (2) show that lipophilicity is a critical parameter in enhancing the potency of such novel peroxynitrite scavengers.
严重疼痛综合征会降低炎症性和肿瘤性疾病患者的生活质量,部分原因是慢性阿片类药物治疗的镇痛效果降低(即耐受性)会导致剂量不断增加以及出现令人痛苦的副作用。脊髓背角中过氧亚硝酸盐介导的氮氧化应激在吗啡抗伤害感受耐受性的诱导和发展中起关键作用。这为开发过氧亚硝酸盐清除剂作为阿片类药物治疗疼痛的有效辅助药物提供了有效的药理学依据。阳离子型锰(III)邻 - N - 烷基吡啶基卟啉MnTE - 2 - PyP(5+)和MnTnHex - 2 - PyP(5+)是最有效的过氧亚硝酸盐清除剂之一,其清除速率常数几乎相同(约10(7) M(-1) s(-1))。然而,MnTnHex - 2 - PyP(5+)的亲脂性明显更强且生物利用度更高,进而在一个特征明确的小鼠模型中,通过热板试验,其在阻断吗啡抗伤害感受耐受性发展方面的效果比MnTE - 2 - PyP(5+)强30倍。亲水性MnTE - 2 - PyP(5+)和亲脂性MnTnHex - 2 - PyP(5+)在抑制吗啡耐受性方面分别比亲水性铁(III)卟啉FeTM - 4 - PyP(5+)有效10倍和300倍。两种锰卟啉都将肿瘤坏死因子 - α、白细胞介素 - 1β和白细胞介素 - 6水平降至正常。它们都不影响吗啡急性抗伤害感受作用也不引起运动功能损害。而且它们都无法逆转已经建立起来的吗啡耐受性。我们最近表明,阴离子型卟啉锰(III)四(4 - 羧基苯基)卟啉在清除过氧亚硝酸盐方面比超氧阴离子具有选择性,但效力比MnTE - 2 - PyP(5+)和MnTnHex - 2 - PyP(5+)低约2个数量级,这反过来与逆转吗啡耐受性的能力低达100倍相平行。这些数据(1)支持过氧亚硝酸盐而非超氧阴离子作为阻断吗啡耐受性发展主要机制的作用,以及(2)表明亲脂性是增强此类新型过氧亚硝酸盐清除剂效力的关键参数。