Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Anesthesiology. 2011 Mar;114(3):624-32. doi: 10.1097/ALN.0b013e31820a4edb.
Opioids are powerful analgesics, but are also common drugs of abuse. Few studies have examined how neuropathic pain alters the pharmacology of opioids in modulating limbic pathways that underlie abuse liability.
Rats with or without spinal nerve ligation (SNL) were implanted with electrodes into the left ventral tegmental area and trained to lever press for electrical stimulation. The effects of morphine, heroin, and cocaine on facilitating electrical stimulation of the ventral tegmental area and mechanical allodynia were assessed in SNL and control subjects.
Responding for electrical stimulation of the ventral tegmental area was similar in control and SNL rats. The frequency at which rats emitted 50% of maximal responding was 98.2 ± 5.1 (mean ± SEM) and 93.7 ± 2.8 Hz in control and SNL rats, respectively. Morphine reduced the frequency at which rats emitted 50% of maximal responding in control (maximal shift of 14.8 ± 3.1 Hz), but not SNL (2.3 ± 2.2 Hz) rats. Heroin was less potent in SNL rats, whereas cocaine produced similar shifts in control (42.3 ± 2.0 Hz) and SNL (37.5 ± 4.2 Hz) rats.
Nerve injury suppressed potentiation of electrical stimulation of the ventral tegmental area by opioids, suggesting that the positive reinforcing effects are diminished by chronic pain. Given concerns regarding prescription opioid abuse, developing strategies that assess both analgesia and abuse liability within the context of chronic pain may aid in determining which opioids are most suitable for treating chronic pain when abuse is a concern.
阿片类药物是强效的镇痛药,但也是常见的滥用药物。很少有研究探讨神经病理性疼痛如何改变阿片类药物在调节与滥用倾向相关的边缘通路中的药理学。
有无脊神经结扎(SNL)的大鼠被植入左侧腹侧被盖区电极,并接受训练以按压杠杆进行电刺激。在 SNL 和对照组大鼠中评估吗啡、海洛因和可卡因对促进腹侧被盖区电刺激和机械性痛觉过敏的影响。
SNL 和对照组大鼠对腹侧被盖区电刺激的反应相似。大鼠发出 50%最大反应的频率分别为 98.2±5.1(平均值±SEM)和 93.7±2.8 Hz。吗啡降低了对照组大鼠(最大移位 14.8±3.1 Hz),但未降低 SNL 大鼠(2.3±2.2 Hz)发出 50%最大反应的频率。海洛因在 SNL 大鼠中的效力较低,而可卡因在对照组(42.3±2.0 Hz)和 SNL 大鼠(37.5±4.2 Hz)中产生相似的移位。
神经损伤抑制了阿片类药物对腹侧被盖区电刺激的增强作用,表明慢性疼痛会降低正性强化作用。鉴于对处方类阿片类药物滥用的担忧,开发一种既能评估镇痛作用又能评估慢性疼痛背景下滥用倾向的策略,可能有助于确定在滥用是一个问题时,哪些阿片类药物最适合治疗慢性疼痛。