Bannister K, Lockwood S, Goncalves L, Patel R, Dickenson A H
Department of Neuroscience, Physiology and Pharmacology, University College London, UK.
Eur J Pain. 2017 Apr;21(4):750-760. doi: 10.1002/ejp.979. Epub 2016 Nov 28.
Following neuropathy α2-adrenoceptor-mediated diffuse noxious inhibitory controls (DNIC), whereby a noxious conditioning stimulus inhibits the activity of spinal wide dynamic range (WDR) neurons, are abolished, and spinal 5-HT7 receptor densities are increased. Here, we manipulate spinal 5-HT content in spinal nerve ligated (SNL) animals and investigate which 5-HT receptor mediated actions predominate.
Using in vivo electrophysiology we recorded WDR neuronal responses to von frey filaments applied to the hind paw before, and concurrent to, a noxious ear pinch (the conditioning stimulus) in isoflurane-anaesthetised rats. The expression of DNIC was quantified as a reduction in WDR neuronal firing in the presence of conditioning stimulus and was investigated in SNL rats following spinal application of (1) selective serotonin reuptake inhibitors (SSRIs) citalopram or fluoxetine, or dual application of (2) SSRI plus 5-HT7 receptor antagonist SB269970, or (3) SSRI plus α2 adrenoceptor antagonist atipamezole.
DNIC were revealed in SNL animals following spinal application of SSRI, but this effect was abolished upon joint application of SSRI plus SB269970 or atipamezole.
We propose that in SNL animals the inhibitory actions (quantified as the presence of DNIC) of excess spinal 5-HT (presumed present following application of SSRI) were mediated via 5-HT7 receptors. The anti-nociception depends upon an underlying tonic noradrenergic inhibitory tone via the α2-adrenoceptor.
Following neuropathy enhanced spinal serotonin availability switches the predominant spinal 5-HT receptor-mediated actions but also alters noradrenergic signalling. We highlight the therapeutic complexity of SSRIs and monoamine modulators for the treatment of neuropathic pain.
在神经病变后,α2 - 肾上腺素能受体介导的弥漫性伤害性抑制控制(DNIC)被消除,即伤害性条件刺激抑制脊髓广动力范围(WDR)神经元的活动,且脊髓5 - HT7受体密度增加。在此,我们操纵脊髓神经结扎(SNL)动物的脊髓5 - HT含量,并研究哪种5 - HT受体介导的作用占主导。
在异氟烷麻醉的大鼠中,我们使用体内电生理学记录WDR神经元对施加于后爪的von frey细丝的反应,以及在有害耳部夹捏(条件刺激)之前和同时的反应。DNIC的表达被量化为在条件刺激存在下WDR神经元放电的减少,并在脊髓应用(1)选择性5 - 羟色胺再摄取抑制剂(SSRI)西酞普兰或氟西汀后,或(2)SSRI加5 - HT7受体拮抗剂SB269970,或(3)SSRI加α2肾上腺素能受体拮抗剂阿替美唑后,在SNL大鼠中进行研究。
脊髓应用SSRI后,SNL动物中出现DNIC,但在联合应用SSRI加SB269970或阿替美唑后,这种作用被消除。
我们提出,在SNL动物中,过量脊髓5 - HT(推测在应用SSRI后存在)的抑制作用(量化为DNIC的存在)是通过5 - HT7受体介导的。抗伤害感受取决于通过α2 - 肾上腺素能受体的潜在紧张性去甲肾上腺素能抑制作用。
神经病变后,脊髓5 - 羟色胺可用性增加会改变主要的脊髓5 - HT受体介导的作用,但也会改变去甲肾上腺素能信号传导。我们强调了SSRI和单胺调节剂治疗神经性疼痛的治疗复杂性。