From the Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical College of Nanjing University, Nanjing, Jiangsu province, China.
Anesth Analg. 2014 Apr;118(4):841-53. doi: 10.1213/ANE.0000000000000146.
Hyperalgesia and neuroinflammation are associated with glia, which consists of macroglia and microglia. In this study, we used a selective cannabinoid receptor type 2 (CB2) agonist JWH015 to investigate remifentanil-induced postoperative hyperalgesia.
Mechanical allodynia and thermal hyperalgesia after postoperative hyperalgesia and intrathecal injection of JWH015 were assessed by the paw withdrawal mechanical threshold and paw withdrawal thermal latency tests. We used immunohistochemistry and immunoblotting to investigate the effect of JWH015 on CB2 receptor, NR2B subunits, activated glial cells, and proinflammatory cytokine expression in rats after remifentanil-induced postoperative hyperalgesia.
Postoperative hyperalgesia was induced by intraoperative infusion of remifentanil. Glial cells were activated, and expression levels of several genes were significantly increased, including interleukin 6, tumor necrosis factor α, CB2, and the NR2B subunit phosphorylated at Tyr-1472 (p-NR2B). Intrathecal injection of JWH015 significantly inhibited glial cell activation, suppressed expression of interleukin 6, tumor necrosis factor α, and p-NR2B, and stimulated CB2 expression, thus attenuating postoperative hyperalgesia. However, these phenomena were abolished in the group that was preadministered with AM630.
The activation of glia, the production of proinflammatory cytokines, and the expression of CB2 and p-NR2B in the spinal dorsal horn increase significantly during the process of remifentanil-induced hyperalgesia. These changes can be regulated by pretreatment with JWH015, which may be the main mechanism underlying the antihyperalgesia effects of JWH015.
痛觉过敏和神经炎症与神经胶质有关,神经胶质包括巨胶质细胞和小胶质细胞。在这项研究中,我们使用选择性大麻素受体 2 型(CB2)激动剂 JWH015 来研究瑞芬太尼引起的术后痛觉过敏。
通过足底撤回机械阈值和足底撤回热潜伏期试验评估术后痛觉过敏和鞘内注射 JWH015 后机械性痛觉过敏和热痛觉过敏。我们使用免疫组织化学和免疫印迹法研究 JWH015 对瑞芬太尼引起的术后痛觉过敏大鼠脊髓背角 CB2 受体、NR2B 亚基、活化的神经胶质细胞和促炎细胞因子表达的影响。
术中输注瑞芬太尼可诱导术后痛觉过敏。神经胶质细胞被激活,几种基因的表达水平显著增加,包括白细胞介素 6、肿瘤坏死因子 α、CB2 和磷酸化的 NR2B 亚基 Tyr-1472(p-NR2B)。鞘内注射 JWH015 可显著抑制神经胶质细胞的激活,抑制白细胞介素 6、肿瘤坏死因子 α 和 p-NR2B 的表达,并刺激 CB2 的表达,从而减轻术后痛觉过敏。然而,这些现象在预先给予 AM630 的组中被消除。
在瑞芬太尼引起的痛觉过敏过程中,脊髓背角的神经胶质细胞激活、促炎细胞因子的产生以及 CB2 和 p-NR2B 的表达显著增加。这些变化可以通过 JWH015 的预处理来调节,这可能是 JWH015 抗痛觉过敏作用的主要机制。