Department of Anesthesiology, Intensive Care, Emergency Care and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium.
Reg Anesth Pain Med. 2013 Mar-Apr;38(2):124-30. doi: 10.1097/AAP.0b013e31827d611b.
In animal models of neuropathic pain (NP), promising results have been reported with the administration of minocycline, possibly through inhibition of spinal brain-derived neurotrophic factor (BDNF) expression. No data are available on the effect of amitriptyline and gabapentin on spinal BDNF expression. If the mechanism of action of the latter drugs does not involve brain-derived NP inhibition, further clinical research in BDNF is warranted.
In this placebo-controlled study, we investigated the effects of amitriptyline (5 mg/kg), gabapentin (50 mg/kg), and minocycline (25 mg/kg) twice a day on NP behavior in a sciatic chronic constriction injury (CCI) rat model. Drug treatment started 7 days after CCI and lasted 14 days. At postoperative day 21, spinal BDNF expression in laminae I and II was quantified using immunocytochemistry.
Sciatic CCI resulted in NP behavior throughout the duration of the experiment in the placebo group. When administered for 2 weeks, minocycline (P ≤ 0.001) and amitriptyline (P ≤ 0.05), but not gabapentin, reduced thermal hyperalgesia. None of these drugs reduced mechanical allodynia. As opposed to amitriptyline and gabapentin, 2 weeks of treatment with minocycline reduced brain-derived, neurotrophic factor immunoreactivity (P ≤ 0.05) in the ipsilateral dorsal horn.
Minocycline and amitriptyline both reduce NP behavior in a sciatic CCI rat model, but only minocycline reduces spinal BDNF, indicating different modes of action of these 2 drugs. The observed actions of minocycline closely fit the clinical needs for the treatment of NP.
在神经病理性疼痛(NP)的动物模型中,米诺环素的给药显示出有希望的结果,这可能是通过抑制脊髓脑源性神经营养因子(BDNF)的表达。尚无关于阿米替林和加巴喷丁对脊髓 BDNF 表达影响的数据。如果这些药物的作用机制不涉及抑制脑源性 NP,那么进一步研究 BDNF 是有必要的。
在这项安慰剂对照研究中,我们研究了阿米替林(5mg/kg)、加巴喷丁(50mg/kg)和米诺环素(25mg/kg)每天两次给药对坐骨神经慢性缩窄性损伤(CCI)大鼠模型 NP 行为的影响。CCI 后 7 天开始药物治疗,持续 14 天。术后第 21 天,使用免疫细胞化学法定量测定 I 和 II 层的脊髓 BDNF 表达。
CCI 导致安慰剂组在整个实验过程中均出现 NP 行为。当给药 2 周时,米诺环素(P≤0.001)和阿米替林(P≤0.05),但不是加巴喷丁,减轻了热痛觉过敏。这些药物均未减轻机械性痛觉过敏。与阿米替林和加巴喷丁相反,2 周的米诺环素治疗降低了同侧背角的脑源性神经营养因子免疫反应性(P≤0.05)。
米诺环素和阿米替林均可减轻坐骨神经 CCI 大鼠模型中的 NP 行为,但只有米诺环素降低脊髓 BDNF,表明这两种药物的作用方式不同。米诺环素的观察到的作用与治疗 NP 的临床需求非常吻合。