Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 8 Hakdong, Donggu, Gwangju 501-757, Korea.
Anesth Analg. 2012 Mar;114(3):683-9. doi: 10.1213/ANE.0b013e31824181e7. Epub 2012 Jan 17.
Tianeptine is an atypical antidepressant that exhibits structural similarities to the tricyclic antidepressants but has distinct neurochemical properties. We evaluated the antinociceptive activity of tianeptine and its mechanism of action regarding serotonergic and adrenergic transmission at the spinal level.
The effects of intrathecally administered tianeptine and DUP-697 (a cyclooxygenase-2 inhibitor) were examined on flinching behavior evoked by intraplantar formalin injection, and their interaction was characterized using isobolographic analysis. Dihydroergocristine, prazosin, or yohimbine-which are serotonergic, α-1, and α-2 adrenergic receptor antagonists, respectively-were intrathecally administered 10 minutes before tianeptine to investigate its mechanism of action.
Intrathecally administered tianeptine and DUP-697 reduced the flinching response evoked by formalin injection during phases 1 and 2 in an additive fashion. Prazosin and yohimbine attenuated the antinociceptive effect of intrathecal tianeptine during both phases of the formalin test. Dihydroergocristine reversed the antinociception of tianeptine during phase 2, but not during phase 1.
Intrathecally administered tianeptine effectively relieved inflammatory pain in rats. The serotonergic system is related to the activity of tianeptine for facilitated pain at the spinal level. Adrenergic transmission is also involved in tianeptine-induced analgesia for both facilitated and acute pain. The combination of tianeptine and cyclooxygenase-2 inhibitor may provide additional benefits for the management of inflammatory pain.
天普西汀是一种非典型的抗抑郁药,其结构与三环类抗抑郁药相似,但具有明显不同的神经化学特性。我们评估了鞘内给予天普西汀及其对脊髓水平 5-羟色胺能和肾上腺素能传递的作用机制的镇痛活性。
通过足底皮下注射福尔马林诱发的退缩行为来检测鞘内给予天普西汀和 DUP-697(环氧化酶-2 抑制剂)的作用,并用等对数分析来描述它们的相互作用。10 分钟前鞘内给予二氢麦角隐亭、哌唑嗪或育亨宾,分别为 5-羟色胺能、α-1 和 α-2 肾上腺素能受体拮抗剂,以研究其作用机制。
鞘内给予天普西汀和 DUP-697 以累加的方式减少福尔马林注射引起的退缩反应,在 1 相和 2 相。哌唑嗪和育亨宾减弱了鞘内天普西汀对福尔马林试验 2 相的镇痛作用。二氢麦角隐亭逆转了天普西汀在第 2 相的镇痛作用,但在第 1 相没有。
鞘内给予天普西汀能有效缓解大鼠的炎性疼痛。5-羟色胺能系统与天普西汀在脊髓水平促进疼痛的活性有关。肾上腺素能传递也参与了天普西汀诱导的急、慢性疼痛的镇痛作用。天普西汀与环氧化酶-2 抑制剂的联合应用可能为炎性疼痛的治疗提供额外的益处。