Rheumatology Section, Veteran's Affairs Medical Center, Minneapolis, Minnesota;
J Pain Res. 2010 Sep 6;3:161-8. doi: 10.2147/JPR.S12520.
To evaluate the analgesic effectiveness of intra-articular botulinum toxin Type B (BoNT/B) in a murine model of chronic degenerative arthritis pain.
Chronic arthritis was produced in adult C57Bl6 mice by intra-articular injection of Type IV collagenase into the left knee. Following induction of arthritis, the treatment group received intra-articular BoNT/B. Arthritic control groups were treated with intra-articular normal saline or sham injections. Pain behavior testing was performed prior to arthritis, after induction of arthritis, and following treatments. Pain behavior measures included analysis of gait impairment (spontaneous pain behavior) and joint tenderness evaluation (evoked pain response). Strength was measured as ability to grasp and cling.
Visual gait analysis showed significant impairment of gait in arthritic mice that improved 43% after intra-articular BoNT/B, demonstrating a substantial articular analgesic effect. Joint tenderness, measured with evoked pain response scores, increased with arthritis induction and decreased 49.5% after intra-articular BoNT/B treatment. No improvement in visual gait scores or decrease in evoked pain response scores were found in the control groups receiving intra-articular normal saline or sham injections. Intra-articular BoNT/B was safe, and no systemic effects or limb weakness was noted.
This study is the first report of intra-articular BoNT/B for analgesia in a murine model of arthritis pain. The results of this study validate prior work using intra-articular neurotoxins in murine models. Our findings show chronic degenerative arthritis pain can be quantitated in a murine model by measuring gait impairment using visual gait analysis scores (spontaneous pain behavior) and joint tenderness scores (evoked pain responses). Reduction of joint pain seen in this study is consistent with our hypothesis of inhibition of release of pain mediators by intra-articular BoNT/B, supporting further investigation of this novel approach to treatment of arthritis pain with intra-articular neurotoxins.
评估关节内注射 B 型肉毒毒素(BoNT/B)在慢性退行性关节炎疼痛小鼠模型中的镇痛效果。
通过向左侧膝关节内注射 IV 型胶原酶,在成年 C57Bl6 小鼠中产生慢性关节炎。关节炎诱导后,治疗组接受关节内 BoNT/B 治疗。关节炎对照组接受关节内生理盐水或假注射治疗。在关节炎前、关节炎诱导后和治疗后进行疼痛行为测试。疼痛行为测量包括步态障碍分析(自发性疼痛行为)和关节压痛评估(诱发疼痛反应)。力量测量为抓握和附着能力。
视觉步态分析显示关节炎小鼠的步态明显受损,关节内注射 BoNT/B 后改善了 43%,表明关节有明显的镇痛作用。用诱发疼痛反应评分测量的关节压痛,随着关节炎的诱导而增加,关节内注射 BoNT/B 治疗后降低了 49.5%。接受关节内生理盐水或假注射的对照组在视觉步态评分或诱发疼痛反应评分方面没有改善。关节内 BoNT/B 是安全的,没有观察到全身作用或肢体无力。
本研究是关节内 BoNT/B 在关节炎疼痛小鼠模型中镇痛的首次报道。本研究的结果验证了先前在小鼠模型中使用关节内神经毒素的工作。我们的发现表明,通过使用视觉步态分析评分(自发性疼痛行为)和关节压痛评分(诱发疼痛反应)来测量步态障碍,可以在小鼠模型中定量评估慢性退行性关节炎疼痛。本研究中观察到的关节疼痛减轻与我们的假设一致,即关节内 BoNT/B 抑制疼痛介质的释放,支持进一步研究关节内神经毒素治疗关节炎疼痛的这种新方法。