Hu Tao, Liu Nana, Lv Minhua, Ma Longxian, Peng Huizhen, Peng Sicong, Liu Tao
From the Departments of *Pediatrics and †Anesthesiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China; and ‡Center for Laboratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China.
Anesth Analg. 2016 Apr;122(4):1048-59. doi: 10.1213/ANE.0000000000001140.
Lidocaine, which blocks voltage-gated sodium channels, is widely used in surgical anesthesia and pain management. Recently, it has been proposed that the hyperpolarization-activated cyclic nucleotide (HCN) channel is one of the other novel targets of lidocaine. Substantia gelatinosa in the spinal dorsal horn, which plays key roles in modulating nociceptive information from primary afferents, comprises heterogeneous interneurons that can be electrophysiologically categorized by firing pattern. Our previous study demonstrated that a substantial proportion of substantia gelatinosa neurons reveal the presence of HCN current (Ih); however, the roles of lidocaine and HCN channel expression in different types of substantia gelatinosa neurons remain unclear.
By using the whole-cell patch-clamp technique, we investigated the effect of lidocaine on Ih in rat substantia gelatinosa neurons of acute dissociated spinal cord slices.
We found that lidocaine rapidly decreased the peak Ih amplitude with an IC50 of 80 μM. The inhibition rate on Ih was not significantly different with a second application of lidocaine in the same neuron. Tetrodotoxin, a sodium channel blocker, did not affect lidocaine's effect on Ih. In addition, lidocaine shifted the half-activation potential of Ih from -109.7 to -114.9 mV and slowed activation. Moreover, the reversal potential of Ih was shifted by -7.5 mV by lidocaine. In the current clamp, lidocaine decreased the resting membrane potential, increased membrane resistance, delayed rebound depolarization latency, and reduced the rebound spike frequency. We further found that approximately 58% of substantia gelatinosa neurons examined expressed Ih, in which most of them were tonically firing.
Our studies demonstrate that lidocaine strongly inhibits Ih in a reversible and concentration-dependent manner in substantia gelatinosa neurons, independent of tetrodotoxin-sensitive sodium channels. Thus, our study provides new insight into the mechanism underlying the central analgesic effect of the systemic administration of lidocaine.
利多卡因可阻断电压门控钠通道,广泛应用于外科麻醉和疼痛管理。最近,有人提出超极化激活环核苷酸(HCN)通道是利多卡因的另一个新靶点。脊髓背角的胶状质在调节来自初级传入纤维的伤害性信息中起关键作用,它由异质性中间神经元组成,可根据放电模式进行电生理分类。我们之前的研究表明,相当一部分胶状质神经元存在HCN电流(Ih);然而,利多卡因和HCN通道表达在不同类型胶状质神经元中的作用仍不清楚。
采用全细胞膜片钳技术,我们研究了利多卡因对急性分离脊髓切片大鼠胶状质神经元Ih的影响。
我们发现利多卡因能迅速降低Ih的峰值幅度,IC50为80μM。在同一神经元中再次应用利多卡因时,对Ih的抑制率无显著差异。钠通道阻滞剂河豚毒素不影响利多卡因对Ih的作用。此外,利多卡因使Ih的半激活电位从-109.7 mV移至-114.9 mV,并减慢激活速度。而且,利多卡因使Ih的反转电位偏移了-7.5 mV。在电流钳记录中,利多卡因降低了静息膜电位,增加了膜电阻,延迟了反弹去极化潜伏期,并降低了反弹放电频率。我们进一步发现,所检测的约58%的胶状质神经元表达Ih,其中大多数为紧张性放电。
我们的研究表明,利多卡因在胶状质神经元中以可逆且浓度依赖的方式强烈抑制Ih,独立于河豚毒素敏感的钠通道。因此,我们的研究为利多卡因全身给药的中枢镇痛作用机制提供了新的见解。