Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Neuropsychopharmacology. 2011 Feb;36(3):664-76. doi: 10.1038/npp.2010.197. Epub 2010 Nov 10.
Tolerance and dependence are common complications of long-term treatment of pain with opioids, which substantially limit the long-term use of these drugs. The mechanisms underlying these phenomena are poorly understood. Studies have implicated the midbrain periaqueductal gray (PAG) in the pathogenesis of morphine withdrawal, and recent evidence suggests that proinflammatory cytokines in the PAG may play an important role in morphine withdrawal. Here we report that chronic morphine withdrawal-induced upregulation of glial fibrillary acidic protein (GFAP), tumor necrosis factor alpha (TNFα) and phosphorylation of ERK1/2 (pERK1/2) in the caudal ventrolateral PAG (vlPAG). Microinjection of recombinant TNFα into the vlPAG followed by intraperitoneal naloxone resulted in morphine withdrawal-like behavioral signs, and upregulation of pERK1/2, expression of Fos, and phosphorylation of cAMP response element binding (pCREB) protein. We used a herpes simplex virus (HSV)-based vector expressing p55 soluble TNF receptor (sTNFR) microinjected into the PAG to examine the role of the proinflammatory cytokine TNFα in the PAG in the naloxone-precipitated withdrawal response. Microinjection of HSV vector expressing sTNFR into the PAG before the start of morphine treatment significantly reduced the naloxone-precipitated withdrawal behavioral response and downregulated the expression of GFAP and TNFα in astrocytes of the PAG. TNFR type I colocalized with neuronal pERK1/2. Microinjection of HSV vector expressing sTNFR into the PAG also significantly reduced the phosphorylation of both ERK1/2 and CREB, and reduced Fos immunoreactivity in neurons of the PAG following naloxone-precipitated withdrawal. These results support the concept that proinflammatory cytokines expressed in astrocytes in the PAG may play an important role in the pathogenesis of morphine withdrawal response.
耐受和依赖是长期使用阿片类药物治疗疼痛的常见并发症,这极大地限制了这些药物的长期使用。这些现象的机制尚不清楚。研究表明,中脑导水管周围灰质(periaqueductal gray,PAG)在吗啡戒断的发病机制中起作用,最近的证据表明,PAG 中的促炎细胞因子可能在吗啡戒断中起重要作用。在这里,我们报告慢性吗啡戒断诱导尾侧腹外侧 PAG(vlPAG)中胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、肿瘤坏死因子-α(tumor necrosis factor alpha,TNFα)和 ERK1/2 磷酸化(pERK1/2)的上调。PAG 中的 vlPAG 内注射重组 TNFα 后,腹腔内注射纳洛酮可导致吗啡戒断样行为体征,并上调 pERK1/2、Fos 表达和 cAMP 反应元件结合蛋白(cAMP response element binding protein,CREB)磷酸化。我们使用表达 p55 可溶性 TNF 受体(soluble TNF receptor,sTNFR)的单纯疱疹病毒(herpes simplex virus,HSV)载体在 PAG 中注射,以研究 PAG 中的促炎细胞因子 TNFα 在纳洛酮诱发的戒断反应中的作用。在吗啡治疗开始前,将表达 sTNFR 的 HSV 载体微注射到 PAG 中,可显著减少纳洛酮诱发的戒断行为反应,并下调 PAG 中星形胶质细胞的 GFAP 和 TNFα 表达。TNFR 型 I 与神经元 pERK1/2 共定位。将表达 sTNFR 的 HSV 载体微注射到 PAG 中,也可显著减少 ERK1/2 和 CREB 的磷酸化,并减少纳洛酮诱发戒断后 PAG 神经元中的 Fos 免疫反应性。这些结果支持 PAG 中星形胶质细胞中表达的促炎细胞因子可能在吗啡戒断反应的发病机制中起重要作用的概念。