Yeh Chin-Yi, Chung Shih-Chieh, Tseng Fan-Ling, Tsai Yu-Chuan, Liu Yen-Chin
Department of Anesthesiology, Tainan Hospital, Tainan City, Taiwan, ROC.
Acta Anaesthesiol Taiwan. 2011 Dec;49(4):144-8. doi: 10.1016/j.aat.2011.11.006. Epub 2011 Dec 23.
Patients suffering from neuropathic pain are difficult to treat and many methods are used to resolve this issue. In this study, we used a model of neuropathic pain comprising rats with chronic constriction injury (CCI) on the left sciatic nerve to investigate the chronic effect of gabapentin via intrathecal administration. We also observed the expression of dorsal spinal protein kinase C gamma subunit (PKCγ) and other pain-related molecules in the spinal area which included cyclooxygenase 2 (COX2), c-Fos and cyclic AMP-dependent transcription factor (ATF3) in the neuropathic pain animals.
Male Sprague-Dawley (SD) rats (250-380 g) were randomly assigned to four groups, i.e., control, gabapentin (Gaba), MK801, and gabapentin plus MK801 (Gaba+M) groups. A PE-5 catheter was inserted into the lumbar spine area via the cervical spine area. CCI was performed the following day after the intrathecal catheter implant surgery. Gabapentin (1.05 μmol/day) was then given the following day after CCI surgery. Intrathecal gabapentin was administrated for 14 consecutive days. Pain-related behavior was assessed every 2 days thereafter by measuring the latency of foot withdrawal elicited by noxious radiant heat or Von Frey microfilament applied to the hind-paw plantar surface. MK801 (30 μg/day), an N-methyl-D-aspartate (NMDA) receptor blocker, was also added for potential effect. The tissue of dorsal horn of the lumbar spine was harvested on the 14(th) day for the expression of COX2, c-Fos, ATF3 and PKCγ with Western blotting, and positive finding protein was then checked on 7(th) day for further evaluation.
The beneficial effect of intrathecal gabapentin of statistic significance on thermal duration and mechanical microfilament appeared after 7-day and 11-day consecutive treatment, respectively. Furthermore, the NMDA receptor blocker also potentiated the effect on the behavior of thermal and mechanical stimulations. Gabapentin had no effect on the expression of COX2, c-Fos and ATF3. Interestingly, the expression of PKCγ in the spinal cord was initially inhibited by gabapentin on the 7(th) day but was potentiated on the 14(th) day.
Our results indicate that chronic intrathecal gabapentin has beneficial effects on the behaviors of both thermal and mechanical stimulations in the neuropathic pain animals and the NMDA blocker can potentiate this effect. Furthermore, gabapentin has biphasic effect on the expression of PKCγ in the spinal cord on Day 7 and Day 14 for the model rats with CCI.
患有神经性疼痛的患者难以治疗,人们采用了多种方法来解决这一问题。在本研究中,我们使用一种神经性疼痛模型,该模型由左侧坐骨神经慢性压迫损伤(CCI)的大鼠组成,以研究鞘内注射加巴喷丁的长期效果。我们还观察了神经性疼痛动物脊髓区域中背侧脊髓蛋白激酶Cγ亚基(PKCγ)以及其他与疼痛相关分子的表达,这些分子包括环氧化酶2(COX2)、c-Fos和环磷酸腺苷依赖性转录因子(ATF3)。
将雄性Sprague-Dawley(SD)大鼠(250 - 380 g)随机分为四组,即对照组、加巴喷丁(Gaba)组、MK801组和加巴喷丁加MK801(Gaba + M)组。通过颈椎区域将PE - 5导管插入腰椎区域。在鞘内导管植入手术后第二天进行CCI手术。CCI手术后第二天开始给予加巴喷丁(1.05 μmol/天)。鞘内注射加巴喷丁连续给药14天。此后每2天通过测量有害辐射热或应用于后爪足底表面的von Frey微丝引发的足退缩潜伏期来评估疼痛相关行为。还添加了N - 甲基 - D - 天冬氨酸(NMDA)受体阻滞剂MK801(30 μg/天)以观察其潜在作用。在第14天收获腰椎背角组织,通过蛋白质印迹法检测COX2、c-Fos、ATF3和PKCγ的表达,并在第7天检查阳性发现蛋白以进行进一步评估。
鞘内注射加巴喷丁在连续治疗7天和11天后,分别对热持续时间和机械微丝产生具有统计学意义的有益效果。此外,NMDA受体阻滞剂也增强了对热和机械刺激行为的影响。加巴喷丁对COX2、c-Fos和ATF3的表达没有影响。有趣的是,加巴喷丁在第7天最初抑制脊髓中PKCγ的表达,但在第14天增强其表达。
我们的结果表明,慢性鞘内注射加巴喷丁对神经性疼痛动物的热刺激和机械刺激行为具有有益作用,并且NMDA阻滞剂可以增强这种作用。此外,对于CCI模型大鼠,加巴喷丁在第7天和第14天对脊髓中PKCγ的表达具有双相作用。