Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.
Spine J. 2010 Dec;10(12):1049-54. doi: 10.1016/j.spinee.2010.08.015.
There is increasing evidence for a role of the cannabinoid (CB) system in the development of neuropathic pain (NP) after spinal cord injury (SCI). The nonspecific CB₁ and CB₂ receptor agonists, WIN 55, 212-2 (WIN), have previously been shown to alleviate both mechanical and thermal hyperalgesia (TH) after peripheral nerve injury.
The present study was designed to identify the CB receptors involved in the antihyperalgesic effect of WIN by using selective antagonists for CB₁ and CB₂ receptors.
This is an in vivo and behavioral study using a moderate T9 contusion SCI. After injury, TH of the hind paws was measured on postinjury days 21 through 42.
Sprague-Dawley rats underwent a contusion SCI using the Multicenter Animal Spinal Cord Injury Study (MASCIS) weight-drop impactor, which induced a moderate T9 SCI. Only animals showing consistent plantar stepping and consistent forelimb and hind limb coordination (Basso, Beattie, and Bresnahan score=15) were tested for TH. Animals exhibiting decreased withdrawal latency time, indicating TH, on or before Day 42, were selected for pharmacological intervention. Animals not exhibiting TH did not receive pharmacological intervention and were sacrificed. Rats underwent hind paw testing before any drug administration (after injury), 45 minutes after selective CB antagonist (AM 251 or AM 630) administration (postantagonist) and again 45 minutes after WIN administration (post-WIN). There were a total of seven treatment groups: saline vehicle control; Dimethyl sulfoxide (DMSO) vehicle control; low-dose WIN (0.2 mg/kg); and high-dose WIN (2.0 mg/kg); AM 251 (3 mg/kg) and AM 630 (1 mg/kg) were given subcutaneously in a total volume of 0.5 mL. Followed by intraperitoneal injection of WIN after each antagonist, sham-operated rats repeated pharmacological intervention used with treatment Groups 5 and 6.
Thermal hyperalgesia was significantly ameliorated in a dose-dependent manner with systemically administered WIN. Cannabinoid receptor Type 1 antagonist AM 251 pretreatment did not affect the antihyperalgesic effect of WIN. By contrast, pretreatment with the CB₂ receptor antagonist AM 630 significantly attenuated the effect of WIN.
Taken together, these results suggest a role of the CB₂ receptor in modulating SCI-induced TH. Selective activation of the CB₂ receptor could potentially lead to analgesic effects on NP while avoiding psychotropic side effects in patients with SCI.
越来越多的证据表明,大麻素(CB)系统在脊髓损伤(SCI)后神经性疼痛(NP)的发展中起作用。非特异性 CB₁ 和 CB₂ 受体激动剂 WIN 55,212-2(WIN)先前已被证明可减轻周围神经损伤后的机械性和热痛觉过敏(TH)。
本研究旨在通过使用 CB₁ 和 CB₂ 受体的选择性拮抗剂来确定 WIN 的抗痛觉过敏作用所涉及的 CB 受体。
这是一项体内和行为研究,使用中度 T9 挫伤 SCI。损伤后,在损伤后第 21 天至第 42 天测量后爪的 TH。
Sprague-Dawley 大鼠使用 Multicenter Animal Spinal Cord Injury Study(MASCIS)重物跌落撞击器进行挫伤 SCI,该撞击器导致中度 T9 SCI。只有表现出一致的跖部踏足和一致的前肢和后肢协调(Basso、Beattie 和 Bresnahan 评分=15)的动物才进行 TH 测试。表现出潜伏期缩短时间(表明有 TH)的动物在第 42 天或之前接受药物干预。未表现出 TH 的动物未接受药物干预并被处死。在任何药物给药前(损伤后)、选择性 CB 拮抗剂(AM 251 或 AM 630)给药后 45 分钟(后拮抗剂)和 WIN 给药后 45 分钟(后 WIN)对后爪进行测试。共有 7 个治疗组:生理盐水载体对照;二甲基亚砜(DMSO)载体对照;低剂量 WIN(0.2mg/kg);高剂量 WIN(2.0mg/kg);AM 251(3mg/kg)和 AM 630(1mg/kg)以 0.5mL 总体积皮下给药。在每种拮抗剂后,通过腹腔注射 WIN 进行后续处理,假手术大鼠重复使用与治疗组 5 和 6 相同的药物干预。
WIN 以剂量依赖性方式显著改善热痛觉过敏。预先给予大麻素受体 1 拮抗剂 AM 251 不影响 WIN 的抗痛觉过敏作用。相比之下,预先给予 CB₂ 受体拮抗剂 AM 630 显著减弱了 WIN 的作用。
综上所述,这些结果表明 CB₂ 受体在调节 SCI 诱导的 TH 中起作用。选择性激活 CB₂ 受体可能会导致 NP 产生镇痛作用,同时避免 SCI 患者出现精神副作用。