Li Jing, Fu Caihong, Liu Hongwei, Fu Rao, Zuo Wanhong, Kang Seungwoo, Chen Pei, Gregor Danielle, Paulose Rose, Bekker Alex, Ye Jiang-Hong
Department of Anesthesiology, Rutgers, New Jersey Medical School, Newark, New Jersey.
Department of Neurology, Dong-Zhi-Men Hospital, Key Laboratory for Internal Chinese Medicine of Ministry of Education, Beijing University of Chinese Medicine, Beijing, China.
Alcohol Clin Exp Res. 2017 Mar;41(3):637-643. doi: 10.1111/acer.13332. Epub 2017 Feb 6.
Hyperalgesia or increased sensitivity to pain is often found in alcoholics during alcohol withdrawal and may contribute to relapse drinking. Alternative therapies such as acupuncture and electroacupuncture (EA), through mechanisms involving opioid receptors, may reduce pain and substance dependence and withdrawal syndromes. The lateral habenula (LHb), an epithalamic structure rich in mu opioid receptors (MORs), is a critical target for both drugs of abuse and pain. We previously observed hyperalgesia in rats withdrawn from chronic ethanol (EtOH) drinking and found that EA at the acupoint Zusanli (ST36) reduced EtOH intake. This raised question of whether EA can alleviate hyperalgesia during alcohol withdrawal and, if so, whether the mechanism involves MORs in the LHb.
We trained male rats to drink EtOH using the intermittent access 20% EtOH 2-bottle free-choice drinking paradigm for 8 weeks, after which the alcohol supply was discontinued. We measured pain sensitivity using radiant heat (a light beam directed at the hind paw of rats) and compared the paw withdrawal latencies (PWLs) with and without EA at ST36.
The PWLs were significantly shorter in rats at 24, 48, and 72 hours and 7 days after the discontinuation of EtOH when compared to EtOH-naïve rats. After a single administration of 2-Hz EA for 20 minutes at ST36, the PWLs at 24 hours after the withdrawal of EtOH were significantly greater than those of the sham group (2-Hz EA at the tail). Furthermore, the effect of EA on PWLs was significantly attenuated by bilateral intrahabenula infusion of the MOR antagonist naltrexone.
These results suggest that EA can alleviate hyperalgesia during EtOH withdrawal through a mechanism involving MORs in the habenula. Based on this, EA could be of potential value as a therapy for hyperalgesia in alcohol dependence.
痛觉过敏或对疼痛的敏感性增加在酒精戒断期间的酗酒者中经常出现,并且可能导致复饮。诸如针灸和电针(EA)等替代疗法,通过涉及阿片受体的机制,可能减轻疼痛、物质依赖和戒断综合征。外侧缰核(LHb)是一个富含μ阿片受体(MORs)的丘脑上结构,是滥用药物和疼痛的关键靶点。我们之前观察到从慢性乙醇(EtOH)饮用中戒断的大鼠存在痛觉过敏,并发现足三里穴(ST36)电针可减少EtOH摄入量。这就提出了一个问题,即电针是否能缓解酒精戒断期间的痛觉过敏,如果可以,其机制是否涉及LHb中的MORs。
我们使用间歇性给予20% EtOH的两瓶自由选择饮用范式训练雄性大鼠饮用EtOH 8周,之后停止供应酒精。我们使用辐射热(一束指向大鼠后爪的光束)测量疼痛敏感性,并比较在ST36进行电针和不进行电针时的爪撤离潜伏期(PWLs)。
与未接触过EtOH的大鼠相比,在停止EtOH后的24、48和72小时以及7天时,大鼠的PWLs显著缩短。在ST36单次给予2赫兹电针20分钟后,EtOH戒断后24小时的PWLs显著长于假手术组(尾部给予2赫兹电针)。此外,双侧缰核内注射MOR拮抗剂纳曲酮可显著减弱电针对PWLs的影响。
这些结果表明,电针可通过涉及缰核中MORs的机制缓解EtOH戒断期间的痛觉过敏。基于此,电针作为酒精依赖中痛觉过敏的一种治疗方法可能具有潜在价值。