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脊髓甘氨酸抑制所产生的触觉诱发性异常性疼痛的行为学和自主神经相关性:调节性受体系统和兴奋性氨基酸拮抗剂的作用。

Behavioral and autonomic correlates of the tactile evoked allodynia produced by spinal glycine inhibition: effects of modulatory receptor systems and excitatory amino acid antagonists.

作者信息

Yaksh Tony L

机构信息

Department of Pharmacology and Laboratory of Neurosurgical Research, Mayo Clinic, Rochester, MN 55905 U.S.A.

出版信息

Pain. 1989 Apr;37(1):111-123. doi: 10.1016/0304-3959(89)90160-7.

DOI:10.1016/0304-3959(89)90160-7
PMID:2542867
Abstract

Intrathecal administration of glycine (strychnine) or GABA (bicuculline) but not opioid (naloxone), adrenergic (phentolamine) or serotonin (methysergide) receptor antagonists resulted in a dose-dependent organized agitation response to light tactile stimulation. This effect was maximally evoked by oscillating but not continuous stimulation applied to a dermatome corresponding to the levels of spinal cord acted upon by the intrathecal antagonist. Similar results were observed in chloralose-urethane anesthetized rats in which tactile stimulation evoked hypertensive responses following local tactile stimuli. The effects were only mildly depressed by even high doses of spinal morphine or DADL and not at all by ST-91 or baclofen. In contrast, intrathecal injections of glutamate receptor antagonists resulted in a dose-dependent depression of the strychnine evoked hyperesthesia with the ordering of activity being MK-801, AP-5, kynurenic acid, SKF10047 and ketamine. At doses below those which produced motor dysfunction, however, these agents had no effects on the hot-plate response latency. These data emphasize that low threshold afferent input is likely subject to an ongoing modulation, the loss of which results in a miscoding of the afferent stimulus yielding a pain relevant message. The lack of effect of agents having a powerful effect on somatic pain stimuli and the converse effects of glutamate receptor antagonists on the strychnine hyperesthesia at doses which do not affect the somatic pain response indicate discriminable processing systems, the characteristics of which resemble the clinical phenomenon observed in patients suffering from sensory dysesthesia following central and peripheral horn injury.

摘要

鞘内注射甘氨酸(士的宁)或γ-氨基丁酸(荷包牡丹碱)而非阿片类(纳洛酮)、肾上腺素能(酚妥拉明)或5-羟色胺(甲基麦角新碱)受体拮抗剂,会导致对轻触觉刺激产生剂量依赖性的有组织的激惹反应。这种效应在对与鞘内拮抗剂作用的脊髓节段相对应的皮节施加振荡而非持续刺激时最大程度地诱发。在水合氯醛-乌拉坦麻醉的大鼠中也观察到了类似结果,在这些大鼠中,局部触觉刺激后触觉刺激会诱发高血压反应。即使是高剂量的脊髓吗啡或二丙氨酰亮氨酸对这些效应也仅有轻微抑制作用,而ST-91或巴氯芬则完全没有作用。相反,鞘内注射谷氨酸受体拮抗剂会导致士的宁诱发的感觉过敏呈剂量依赖性降低,活性顺序为MK-801、AP-5、犬尿氨酸、SKF10047和氯胺酮。然而,在产生运动功能障碍剂量以下,这些药物对热板反应潜伏期没有影响。这些数据强调低阈值传入输入可能受到持续调节,这种调节的丧失会导致传入刺激的错误编码,产生与疼痛相关的信息。对躯体疼痛刺激有强大作用的药物无效,而谷氨酸受体拮抗剂在不影响躯体疼痛反应的剂量下对士的宁感觉过敏有相反作用,这表明存在可区分的处理系统,其特征类似于中枢和外周角损伤后感觉异常患者中观察到的临床现象。

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