Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2520, USA.
Anesthesiology. 2012 May;116(5):1013-24. doi: 10.1097/ALN.0b013e31825153ea.
Gabapentin is most commonly prescribed for chronic pain, but acute perioperative effects, including preemptive analgesia and hemodynamic stabilization, have been reported. Adrenal chromaffin cells are a widely used model to investigate neurosecretion, and adrenal catecholamines play important physiologic roles and contribute to the acute stress response. However, the effects of gabapentin on adrenal catecholamine release have never been tested.
Primary cultures of bovine adrenal chromaffin cells were treated with gabapentin or vehicle for 18-24 h. The authors quantified catecholamine secretion from dishes of cells using high-performance liquid chromatography and resolved exocytosis of individual secretory vesicles from single cells using carbon fiber amperometry. Voltage-gated calcium channel currents were recorded using patch clamp electrophysiology and intracellular [Ca2+] using fluorescent imaging.
Gabapentin produced statistically significant reductions in catecholamine secretion evoked by cholinergic agonists (24 ± 3%, n = 12) or KCl (16 ± 4%, n = 8) (mean ± SEM) but did not inhibit Ca2+ entry or calcium channel currents. Amperometry (n = 51 cells) revealed that gabapentin inhibited the number of vesicles released upon stimulation, with no change in quantal size or kinetics of these unitary events.
The authors show Ca2+ entry was not inhibited by gabapentin but was less effective at triggering vesicle fusion. The work also demonstrates that chromaffin cells are a useful model for additional investigation of the cellular mechanism(s) by which gabapentin controls neurosecretion. In addition, it identifies altered adrenal catecholamine release as a potential contributor to some of the beneficial perioperative effects of gabapentin.
加巴喷丁最常用于治疗慢性疼痛,但也有报道称其具有急性围手术期效应,包括预防性镇痛和血液动力学稳定作用。肾上腺嗜铬细胞是研究神经分泌的常用模型,而肾上腺儿茶酚胺在生理上起着重要作用,并有助于急性应激反应。然而,加巴喷丁对肾上腺儿茶酚胺释放的影响从未被测试过。
用加巴喷丁或载体处理牛肾上腺嗜铬细胞原代培养物 18-24 小时。作者使用高效液相色谱法从细胞培养盘中定量测定儿茶酚胺的分泌,并使用碳纤维安培法从单个细胞中的单个分泌囊泡解析胞吐作用。使用膜片钳电生理学记录电压门控钙通道电流,并使用荧光成像测定细胞内[Ca2+]。
加巴喷丁可显著减少乙酰胆碱激动剂(24±3%,n=12)或 KCl(16±4%,n=8)引起的儿茶酚胺分泌(均数±SEM),但不抑制 Ca2+内流或钙通道电流。安培法(n=51 个细胞)显示,加巴喷丁抑制了刺激时释放的囊泡数量,而这些单位事件的量子大小或动力学没有变化。
作者表明,加巴喷丁不抑制 Ca2+内流,但触发囊泡融合的效果较差。这项工作还表明,嗜铬细胞是进一步研究加巴喷丁控制神经分泌的细胞机制的有用模型。此外,它确定了改变的肾上腺儿茶酚胺释放可能是加巴喷丁一些有益围手术期效应的潜在贡献因素。