Rosa Fernanda, Trevisan Gabriela, Rigo Flávia Karine, Tonello Raquel, Andrade Edinéia Lemos, do Nascimento Cordeiro Marta, Calixto João Batista, Gomez Marcus Vinícius, Ferreira Juliano
From the Graduate Program in Biological Sciences: Toxicological Biochemistry, Department of Chemistry, Center of Natural and Exact Sciences, Federal University of Santa Maria (UFSM), Santa Maria (RS); Laboratory of Molecular and Cellular Biology, Graduate Program of Health Sciences, Department of Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Graduate Program in Health Sciences: Medicine and Biomedicine, Institute of Education and Research, Santa Casa de Belo Horizonte, Grupo Santa Casa de Belo Horizonte, Belo Horizonte (MG), Brazil; Department of Pharmacology, Biological Sciences Centre, Federal University of Santa Catarina, Florianópolis, Santa Catarina; and Ezequiel Dias Foundation, Belo Horizonte (MG), Brazil.
Anesth Analg. 2014 Jul;119(1):196-202. doi: 10.1213/ANE.0000000000000249.
Neuropathic pain is a severe painful pathology that is difficult to treat. One option for its management is the continuous intrathecal (i.t.) infusion of ziconotide (the Conus magnus peptide ω-conotoxin MVIIA), which, in addition to being effective, produces serious adverse effects at analgesic doses. Single i.t. administration of Phα1β, a peptide purified from the venom of the spider Phoneutria nigriventer, has antinociceptive effects with a greater therapeutic window than ziconotide in rodents. To further evaluate its analgesic potential, we investigated the antinociceptive and toxic effects of Phα1β after single or continuous i.t. infusion in a rat model of neuropathic pain.
Adult male Wistar rats (200-300 g) bred in-house were used. Chronic constriction injury (CCI) of the sciatic nerve was used as the neuropathic pain model. Nociception was assessed by detecting mechanical hyperalgesia, considering a significant reduction in 50% paw withdrawal threshold values after CCI compared with baseline values. First, we assessed the antinociceptive effect of a single i.t. injection of Phα1β (10, 30, or 100 pmol/site) in a model of neuropathic pain 8 days after nerve injury. In a different experiment, we delivered Phα1β (60 pmol/μL/h) or vehicle (phosphate-buffered saline, 1.0 μL/h) through continuous infusion using an osmotic pump by spinal catheterization for 7 days in rats submitted to nerve injury. Behavioral adverse effects were evaluated after single or continuous Phα1β i.t. administration, and histopathological analysis of spinal cord, brainstem, and encephalon was performed after continuous Phα1β i.t. injection.
We observed that CCI of the sciatic nerve but not sham surgery caused intense (reduction of approximately 2.5 times in mechanical withdrawal threshold) and persistent (up to 14 days) nociception in rats. The single i.t. injection of Phα1β (30 or 100 pmol/site) reduced neuropathic nociception from 1 to 6 hours after administration, without showing detectable side effects. Similarly, the continuous infusion of Phα1β (60 pmol/μL/h for 7 days) was also able to reverse nerve injury-induced nociception from 1 to 7 days, but did not cause either behavioral side effects or histopathological changes in the central nervous system.
Thus, we have shown for the first time that the continuous i.t. delivery of Phα1β produces analgesia disconnected from toxicity in a relevant model of neuropathic pain, indicating that it is an effective and safe drug with a great potential to treat pain.
神经性疼痛是一种难以治疗的严重疼痛性疾病。其治疗的一种选择是持续鞘内(i.t.)输注齐考诺肽(来自大毒蜥的肽ω-芋螺毒素MVIIA),该药物除了有效外,在镇痛剂量下会产生严重的不良反应。单次鞘内注射从黑腹捕鸟蛛毒液中纯化的肽Phα1β,在啮齿动物中具有抗伤害感受作用,且治疗窗比齐考诺肽更大。为进一步评估其镇痛潜力,我们在神经性疼痛大鼠模型中研究了单次或持续鞘内输注Phα1β后的抗伤害感受和毒性作用。
使用在本机构饲养的成年雄性Wistar大鼠(200 - 300 g)。坐骨神经慢性压迫损伤(CCI)用作神经性疼痛模型。通过检测机械性痛觉过敏来评估伤害感受,与基线值相比,考虑CCI后50%爪退缩阈值显著降低。首先,我们评估了在神经损伤8天后的神经性疼痛模型中单次鞘内注射Phα1β(10、30或100 pmol/部位)的抗伤害感受作用。在另一个实验中,我们通过脊髓导管插入术使用渗透泵对神经损伤大鼠持续输注Phα1β(60 pmol/μL/h)或赋形剂(磷酸盐缓冲盐水,1.0 μL/h)7天。在单次或持续鞘内注射Phα1β后评估行为学不良反应,并在持续鞘内注射Phα1β后对脊髓、脑干和脑进行组织病理学分析。
我们观察到坐骨神经CCI而非假手术导致大鼠出现强烈(机械性退缩阈值降低约2.5倍)且持续(长达14天)的伤害感受。单次鞘内注射Phα1β(30或100 pmol/部位)在给药后1至6小时减轻了神经性伤害感受,且未显示出可检测到的副作用。同样,持续输注Phα1β(6×10⁻⁵mol/L,持续7天)也能够在1至7天内逆转神经损伤诱导的伤害感受,但未引起行为学副作用或中枢神经系统的组织病理学变化。
因此,我们首次表明在相关的神经性疼痛模型中,持续鞘内递送Phα1β产生了与毒性无关的镇痛作用,表明它是一种有效且安全的药物,具有治疗疼痛的巨大潜力。