Departamento de Farmacologia, Instituto de Ciências Biológicas, ICB-UFMG, Av. Antônio Carlos, 6627, Pampulha, CEP 31.270-100, Belo Horizonte, MG, Brazil.
Anesth Analg. 2011 Nov;113(5):1254-9. doi: 10.1213/ANE.0b013e3182285dda. Epub 2011 Jul 25.
The involvement of the L-arginine/nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway in antinociception has been implicated as a molecular mechanism of antinociception produced by several antinociceptive agents, including μ-, κ-, or δ-opioid receptor agonists, nonsteroidal analgesics, cholinergic agonist, and α2C adrenoceptor agonist. In this study, we investigated whether ketamine, a dissociative anesthetic N-methyl-D-aspartate receptor antagonist, was also capable of activating the L-arginine/NO/cGMP pathway and eliciting peripheral antinociception.
The rat paw pressure test was used, with hyperalgesia induced by intraplantar injection of prostaglandin E2. All drugs were locally administered into the right hindpaw of male Wistar rats.
Ketamine (10, 20, 40, 80 μg/paw) elicited a local antinociceptive effect that was antagonized by the nonselective NOS inhibitor L-NOARG (12, 18, and 24 μg/paw) and by the selective neuronal NOS inhibitor L-NPA (12, 18, and 24 μg/paw). In another experiment, we used the inhibitors L-NIO and L-NIL (24 μg/paw) to selectively inhibit endothelial and inducible NOS, respectively. These 2 drugs were ineffective at blocking the effects of the peripheral ketamine injection. In addition, the level of nitrite in the homogenized paw indicated that exogenous ketamine is able to induce NO release. The soluble guanylyl cyclase inhibitor ODQ (25, 50, and 100 μg/paw) blocked the action of ketamine, and the cGMP-phosphodiesterase inhibitor zaprinast (50 μg/paw) enhanced the antinociceptive effects of low-dose ketamine (10 μg/paw).
Our results suggest that ketamine stimulates the L-arginine/NO/cyclic GMP pathway via neuronal NO synthase to induce peripheral antinociceptive effects.
精氨酸/一氧化氮(NO)/环鸟苷酸(cGMP)途径的参与被认为是几种镇痛剂产生镇痛作用的分子机制,包括μ、κ或δ阿片受体激动剂、非甾体类镇痛药、胆碱能激动剂和α2C 肾上腺素能受体激动剂。在这项研究中,我们研究了分离麻醉 NMDA 受体拮抗剂氯胺酮是否也能够激活精氨酸/NO/cGMP 途径并产生外周镇痛作用。
采用足底注射前列腺素 E2 诱导的大鼠足底压痛试验。所有药物均局部注射到雄性 Wistar 大鼠的右后足。
氯胺酮(10、20、40、80μg/足)产生局部镇痛作用,该作用可被非选择性一氧化氮合酶抑制剂 L-NOARG(12、18 和 24μg/足)和选择性神经元型一氧化氮合酶抑制剂 L-NPA(12、18 和 24μg/足)拮抗。在另一个实验中,我们使用抑制剂 L-NIO 和 L-NIL(24μg/足)分别选择性抑制内皮型和诱导型一氧化氮合酶。这两种药物对阻断外周氯胺酮注射的作用均无效。此外,匀浆足中的亚硝酸盐水平表明外源性氯胺酮能够诱导 NO 释放。可溶性鸟苷酸环化酶抑制剂 ODQ(25、50 和 100μg/足)阻断了氯胺酮的作用,而 cGMP-磷酸二酯酶抑制剂扎普司特(50μg/足)增强了低剂量氯胺酮(10μg/足)的镇痛作用。
我们的结果表明,氯胺酮通过神经元型一氧化氮合酶刺激精氨酸/NO/cGMP 途径诱导外周镇痛作用。