Vellani Vittorio, Giacomoni Chiara
Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
Dipartimento di Economia, Scienze e Diritto, Università degli Studi della Repubblica di San Marino, Salita alla Rocca 44, 47890 San Marino (Città), San Marino.
ScientificWorldJournal. 2017;2017:3595903. doi: 10.1155/2017/3595903. Epub 2017 Feb 16.
Gabapentin is a well-established anticonvulsant drug which is also effective for the treatment of neuropathic pain. Although the exact mechanism leading to relief of allodynia and hyperalgesia caused by neuropathy is not known, the blocking effect of gabapentin on voltage-dependent calcium channels has been proposed to be involved. In order to further evaluate its analgesic mechanisms, we tested the efficacy of gabapentin on protein kinase C epsilon (PKC) translocation in cultured peripheral neurons isolated from rat dorsal root ganglia (DRGs). We found that gabapentin significantly reduced PKC translocation induced by the pronociceptive peptides bradykinin and prokineticin 2, involved in both inflammatory and chronic pain. We recently showed that paracetamol (acetaminophen), a very commonly used analgesic drug, also produces inhibition of PKC. We tested the effect of the combined use of paracetamol and gabapentin, and we found that the inhibition of translocation adds up. Our study provides a novel mechanism of action for gabapentin in sensory neurons and suggests a mechanism of action for the combined use of paracetamol and gabapentin, which has recently been shown to be effective, with a cumulative behavior, in the control of postoperative pain in human patients.
加巴喷丁是一种成熟的抗惊厥药物,对治疗神经性疼痛也有效。尽管导致缓解由神经病变引起的异常性疼痛和痛觉过敏的确切机制尚不清楚,但有人提出加巴喷丁对电压依赖性钙通道的阻断作用与之有关。为了进一步评估其镇痛机制,我们测试了加巴喷丁对从大鼠背根神经节(DRG)分离的培养外周神经元中蛋白激酶Cε(PKC)转位的作用。我们发现加巴喷丁显著减少了由伤害感受性肽缓激肽和促动力蛋白2诱导的PKC转位,这两种肽都参与炎症性疼痛和慢性疼痛。我们最近发现,常用的镇痛药对乙酰氨基酚(扑热息痛)也能抑制PKC。我们测试了对乙酰氨基酚和加巴喷丁联合使用的效果,发现转位抑制作用具有累加性。我们的研究揭示了加巴喷丁在感觉神经元中的一种新作用机制,并提示了对乙酰氨基酚和加巴喷丁联合使用的作用机制,最近的研究表明,二者联合使用对控制人类患者术后疼痛有效,且具有累积效应。