Murai Nobuhito, Sekizawa Toshihiro, Gotoh Takayasu, Watabiki Tomonari, Takahashi Masayasu, Kakimoto Shuichiro, Takahashi Yuko, Iino Masanobu, Nagakura Yukinori
Drug Discovery Research, Astellas Pharma, Inc., 21 Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan.
Drug Discovery Research, Astellas Pharma, Inc., 21 Miyukigaoka, Tsukuba, Ibaraki 305-8585, Japan.
Pharmacol Biochem Behav. 2016 Feb;141:10-7. doi: 10.1016/j.pbb.2015.11.008. Epub 2015 Nov 17.
Given that patients with neuropathic pain suffer a mixture of spontaneous and evoked pain symptoms, we assessed the effects of drugs with different mechanism of action on spontaneous and evoked pain-associated behaviors in a rat model of neuropathic pain induced by chronic constriction injury (CCI) of the sciatic nerve. Frequent aberrant limb movement on the operated side was measured to assess spontaneous pain-associated behavior, and mechanical allodynia and thermal hyperalgesia were evaluated to assess evoked pain-associated behaviors. These three types of behavior were assessed after administration of the following drugs: pregabalin (α2δ-subunit ligand), morphine (μ-opioid receptor agonist), perampanel (α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid [AMPA] receptor antagonist), clonidine, dexmedetomidine (α2-adrenoceptor agonists), and diclofenac (non-steroidal anti-inflammatory drug [NSAID]). Pregabalin at an oral dose of 10 or 30mg/kg significantly alleviated frequent aberrant limb movement and mechanical allodynia, but not thermal hyperalgesia. Morphine at a subcutaneous dose of 1 or 3mg/kg significantly improved all three types of behavior. Perampanel at an oral dose of 1mg/kg attenuated only frequent aberrant limb movement. Intraperitoneal administration of clonidine (0.01 or 0.03mg/kg) and dexmedetomidine (0.03mg/kg) significantly improved all three types of behavior, while diclofenac did not relieve any of the behaviors. Pregabalin, clonidine, and dexmedetomidine significantly decreased motor performance at doses close to analgesic doses in the rotarod test. The present study demonstrates that responses to spontaneous and evoked pain symptoms in neuropathic pain condition differ depending on a drug's mechanism of action. The selection and application of drugs according to the specific symptoms would be considered for the medication of patients with neuropathic pain.
鉴于神经性疼痛患者会同时出现自发痛和诱发性疼痛症状,我们在坐骨神经慢性缩窄损伤(CCI)诱导的神经性疼痛大鼠模型中,评估了具有不同作用机制的药物对自发痛和诱发性疼痛相关行为的影响。通过测量术侧频繁出现的异常肢体运动来评估自发痛相关行为,并通过评估机械性异常性疼痛和热痛觉过敏来评估诱发性疼痛相关行为。在给予以下药物后对这三种行为进行评估:普瑞巴林(α2δ亚基配体)、吗啡(μ阿片受体激动剂)、吡仑帕奈(α-氨基-3-羟基-5-甲基-4-异恶唑丙酸[AMPA]受体拮抗剂)、可乐定、右美托咪定(α2肾上腺素能受体激动剂)和双氯芬酸(非甾体抗炎药[NSAID])。口服剂量为10或30mg/kg的普瑞巴林可显著减轻频繁的异常肢体运动和机械性异常性疼痛,但对热痛觉过敏无效。皮下剂量为1或3mg/kg的吗啡可显著改善所有三种行为。口服剂量为1mg/kg的吡仑帕奈仅减轻频繁的异常肢体运动。腹腔注射可乐定(0.01或0.03mg/kg)和右美托咪定(0.03mg/kg)可显著改善所有三种行为,而双氯芬酸对任何一种行为均无缓解作用。在转棒试验中,普瑞巴林、可乐定和右美托咪定在接近镇痛剂量时显著降低运动能力。本研究表明,神经性疼痛状态下对自发痛和诱发性疼痛症状的反应因药物作用机制而异。对于神经性疼痛患者的药物治疗,应考虑根据具体症状选择和应用药物。