Departamento de Farmacología y Nutrición, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.
Eur J Pain. 2012 Sep;16(8):1116-27. doi: 10.1002/j.1532-2149.2012.00115.x.
Pain associated with musculoskeletal disorders can be difficult to control and the incorporation of new approaches for its treatment is an interesting challenge. Activation of cannabinoid (CB) receptors decreases nociceptive transmission in acute, inflammatory and neuropathic pain states; however, although the use of cannabis derivatives has been recently accepted as a useful alternative for the treatment of spasticity and pain in patients with multiple sclerosis, the effects of CB receptor agonists in muscular pain have hardly been studied.
Here, we characterized the antinociceptive effect of non selective and selective CB agonists by systemic and local administration, in two muscular models of pain, masseter and gastrocnemius, induced by hypertonic saline (HS) injection. Drugs used were: the non-selective agonist WIN 55,212-2 and two selective agonists, ACEA (CB 1) and JWH 015 (CB 2); AM 251 (CB 1) and AM 630 (CB 2) were used as selective antagonists.
In the masseter pain model, both systemic (intraperitoneal) and local (intramuscular) administration of CB 1 and CB 2 agonists reduced the nociceptive behaviour induced by HS, whereas in the gastrocnemius model the local administration was more effective than systemic.
Our results provide evidence that both, CB 1 and CB 2 receptors can contribute to muscular antinociception and, interestingly, suggest that the local administration of CB agonists could be a new and useful pharmacological strategy in the treatment of muscular pain, avoiding adverse effects induced by systemic administration.
与肌肉骨骼疾病相关的疼痛难以控制,因此采用新方法治疗疼痛是一个具有挑战性的问题。激活大麻素(CB)受体可以降低急性、炎症性和神经性疼痛状态下的伤害性传递;然而,尽管最近已经接受大麻衍生物作为治疗多发性硬化症患者痉挛和疼痛的有用替代方法,但是 CB 受体激动剂在肌肉疼痛中的作用几乎没有被研究过。
在这里,我们通过系统和局部给药,在两种由高渗盐水(HS)注射引起的肌肉疼痛模型(咬肌和腓肠肌)中,表征了非选择性和选择性 CB 激动剂的镇痛作用。所用药物为:非选择性激动剂 WIN 55,212-2 和两种选择性激动剂,ACEA(CB 1)和 JWH 015(CB 2);AM 251(CB 1)和 AM 630(CB 2)被用作选择性拮抗剂。
在咬肌疼痛模型中,CB 1 和 CB 2 激动剂的系统(腹腔内)和局部(肌肉内)给药均减轻了 HS 引起的伤害性行为,而在腓肠肌模型中,局部给药比系统给药更有效。
我们的结果提供了证据,表明 CB 1 和 CB 2 受体都可以有助于肌肉镇痛,并且有趣的是,提示 CB 激动剂的局部给药可能是治疗肌肉疼痛的一种新的有用的药理学策略,可以避免系统给药引起的不良反应。