Department of Preclinical and Clinical Pharmacology, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy.
Eur J Pharmacol. 2013 Jul 5;711(1-3):87-94. doi: 10.1016/j.ejphar.2013.04.022. Epub 2013 May 3.
Chemotherapy-induced neuropathies are widespread disorders evoked by characteristic damage of the nervous system. Sensory alterations, as paresthesia and dysesthesia, and severe pain are disabling side effects that altered quality of life, leading to therapy discontinuation. These kind of neuropathies are extremely difficult to treat and actual therapies are generally palliative. A great deal of interest has evolved around the relevance of nicotinic receptors as target for chronic pain therapy. Selective receptor subtype modulators have been described as active in pain relief. On the other hand, the profile of nicotine as such, or delivered by tobacco smoke, is a matter of debate since the analgesic properties may be impaired by receptor desensitization and tolerance. Nicotine acute effect on nociceptive threshold was evaluated in the Chronic Constriction Injury model in comparison with neuropathies induced by chemotherapeutic agents. Fourteen days after nerve injury, intraperitoneally administered nicotine (0.5-1.5 mg/kg) reduced hypersensitivity to noxious and non-noxious stimuli. Painful neuropathic state was alternatively established by the intravenously injection of the antiviral agent dideoxycytidine (25 mg/kg). Nicotine significantly reduced antiviral-dependent alterations of the nociceptive threshold. Moreover, nicotine decreased neuropathic pain induced by repeated intraperitoneal administration of the anticancer agent oxaliplatin (2.4 mg/kg), lowering the hypersensitivity to mechanical and thermal stimuli. In conclusion, intraperitoneal nicotine administration controls neuropathic pain evoked by traumatic or toxic nervous system alterations. These results support the nAChR modulation as a possible therapeutic approach to the complex, undertreated chemotherapy-induced neuropathies.
化疗引起的神经病变是由神经系统特征性损伤引起的广泛疾病。感觉改变,如感觉异常和感觉不良,以及严重疼痛是使人丧失能力的副作用,会改变生活质量,导致治疗中断。这些类型的神经病变极难治疗,实际治疗通常是姑息性的。尼古丁受体作为慢性疼痛治疗靶点的相关性引起了极大的关注。选择性受体亚型调节剂已被描述为具有缓解疼痛的作用。另一方面,尼古丁本身或以烟草烟雾形式输送的尼古丁的特征是有争议的,因为受体脱敏和耐受性可能会损害其镇痛特性。在慢性缩窄性损伤模型中,与化疗药物引起的神经病变进行比较,评估了尼古丁对伤害感受阈值的急性作用。神经损伤后 14 天,腹腔内给予尼古丁(0.5-1.5mg/kg)可减轻对有害和非有害刺激的过敏反应。通过静脉注射抗病毒药物双脱氧胞苷(25mg/kg)来建立另一种疼痛性神经病变状态。尼古丁显著降低了抗病毒药物依赖性伤害感受阈值的改变。此外,尼古丁降低了抗癌药物奥沙利铂(2.4mg/kg)重复腹腔给药引起的神经病变性疼痛,降低了对机械和热刺激的过敏反应。总之,腹腔内给予尼古丁可控制由创伤或毒性神经系统改变引起的神经病变性疼痛。这些结果支持 nAChR 调节作为一种可能的治疗方法来治疗复杂、治疗不足的化疗引起的神经病变。