Muchacki Rafał, Szkilnik Ryszard, Malinowska-Borowska Jolanta, Żelazko Aleksandra, Lewkowicz Łukasz, Nowak Przemysław G
Beskid Oncology Center, John Paul II City Hospital in Bielsko-Biała, Poland.
Department of Basic Medical Sciences, Public Health Faculty, Medical University of Silesia, Bytom, Poland.
Adv Clin Exp Med. 2015 May-Jun;24(3):419-27. doi: 10.17219/acem/23362.
Whereas some studies have demonstrated the essential role of 5-hydroxytryptamine (5-HT) in tramadol and acetaminophen analgesia, other research has presented conflicting results. To dispel doubts, some aspects of the involvement of 5-HT in the antinociceptive properties of these drugs remain to be clarified.
The aim of this study was to determine whether the serotoninergic system dysfunction produced by neonatal 5-HT lesion in rats may affect the antinociceptive effects of tramadol and acetaminophen administered in adulthood.
Three days after birth, the control rats were pretreated with desipramine HCl (20 mg/kg i.p.) 30 min before intraventricular saline--vehicle injection. A separate group received 5.7-DHT; 2×35 µg in each lateral ventricle. At the age of 8 weeks, 5-HT and 5-hydroxyidoleaceticacid (5-HIAA) concentrations were determined in the thalamus and spinal cord by an HPLC/ED method. The antinociceptive effects of tramadol (20 mg/kg i.p.) or acetaminophen (100 mg/kg i.p.) were evaluated by a battery of tests.
5.7-DHT lesioning was associated with a reduction in 5-HT and 5-HIAA content of the thalamus (>85% and >90%) and spinal cord (>58% and 70%). Neonatal 5.7-DHT treatment produced a significant reduction in the antinociceptive effect of tramadol in the hot plate, tail-immersion, paw withdrawal and writhing tests. In the formalin hind paw test, the results were ambiguous. 5-HT lesion was also associated with a decrease in the analgesic effect of acetaminophen in the hot plate and writhing tests. A similar relationship wasn't found in the other assessments conducted with the use of acetaminophen.
The present study provides evidence that (1) an intact serotoninergic system is required for the adequate antinociceptive action of tramadol, and (2) the serotoninergic system exerts a negligible influence on acetaminophen-induced analgesia in rats. We hypothesize that similar abnormalities in nociception may occur in patients with 5-HT dysfunction (e.g. depression), so these results should be complied in analgesic dosage adjustment.
尽管一些研究已证明5-羟色胺(5-HT)在曲马多和对乙酰氨基酚镇痛中起重要作用,但其他研究却给出了相互矛盾的结果。为消除疑虑,5-HT参与这些药物抗伤害感受特性的某些方面仍有待阐明。
本研究旨在确定新生大鼠5-HT损伤导致的血清素能系统功能障碍是否会影响成年大鼠给予曲马多和对乙酰氨基酚后的抗伤害感受作用。
出生后三天,对照组大鼠在脑室内注射生理盐水(溶剂)前30分钟腹腔注射盐酸地昔帕明(20毫克/千克)。另一组接受5,7-二氢色胺;每侧脑室注射2×35微克。8周龄时,采用高效液相色谱/电化学检测法测定丘脑和脊髓中的5-HT和5-羟吲哚乙酸(5-HIAA)浓度。通过一系列试验评估曲马多(20毫克/千克腹腔注射)或对乙酰氨基酚(100毫克/千克腹腔注射)的抗伤害感受作用。
5,7-二氢色胺损伤与丘脑(>85%和>90%)和脊髓(>58%和70%)中5-HT和5-HIAA含量降低有关。新生大鼠5,7-二氢色胺处理使曲马多在热板、尾浸、爪撤离和扭体试验中的抗伤害感受作用显著降低。在福尔马林后爪试验中,结果不明确。5-HT损伤还与对乙酰氨基酚在热板和扭体试验中的镇痛作用降低有关。在用对乙酰氨基酚进行的其他评估中未发现类似关系。
本研究提供的证据表明:(1)完整的血清素能系统是曲马多充分发挥抗伤害感受作用所必需的;(2)血清素能系统对大鼠对乙酰氨基酚诱导的镇痛作用影响可忽略不计。我们推测,5-HT功能障碍(如抑郁症)患者可能出现类似的伤害感受异常,因此在调整镇痛剂量时应考虑这些结果。