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抗神经生长因子疗法可增加因骨科手术诱导疼痛的小鼠的自发昼夜活动。

Anti-nerve growth factor therapy increases spontaneous day/night activity in mice with orthopedic surgery-induced pain.

作者信息

Majuta Lisa A, Guedon Jean-Marc G, Mitchell Stefanie A T, Ossipov Michael H, Mantyh Patrick W

机构信息

Department of Pharmacology, University of Arizona, Tucson, AZ, USA.

Cancer Center, University of Arizona, Tucson, AZ, USA.

出版信息

Pain. 2017 Apr;158(4):605-617. doi: 10.1097/j.pain.0000000000000799.

Abstract

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently, opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA or THA pain. Recently, issues including efficacy, dependence, overdose, and death from opiates have made clinicians and researchers more critical of use of opioids for treating nonmalignant skeletal pain. In the present report, a nonopiate therapy using a monoclonal antibody raised against nerve growth factor (anti-NGF) was assessed for its ability to increase the spontaneous activity of the operated knee joint in a mouse model of orthopedic surgery pain-induced by drilling and coring the trochlear groove of the mouse femur. Horizontal activity and velocity and vertical rearing were continually assessed over a 20 hours day/night period using automated activity boxes in an effort to reduce observer bias and capture night activity when the mice are most active. At days 1 and 3, after orthopedic surgery, there was a marked reduction in spontaneous activity and vertical rearing; anti-NGF significantly attenuated this decline. The present data suggest that anti-NGF improves limb use in a rodent model of joint/orthopedic surgery and as such anti-NGF may be useful in controlling pain after orthopedic surgeries such as TKA or THA.

摘要

全膝关节置换术(TKA)和全髋关节置换术(THA)是缓解骨关节炎疼痛最常见且最成功的两种外科手术干预方式。术后疼痛控制对于患者充分参与必要的物理治疗至关重要,而物理治疗是术后膝关节有效康复的最具影响力因素。目前,阿片类药物是管理包括TKA或THA疼痛在内的术后骨科手术疼痛的主要手段。最近,包括阿片类药物的疗效、依赖性、过量使用及致死等问题,使得临床医生和研究人员对使用阿片类药物治疗非恶性骨骼疼痛更为审慎。在本报告中,在通过钻取和去除小鼠股骨滑车沟建立的骨科手术疼痛小鼠模型中,评估了一种使用抗神经生长因子单克隆抗体(抗NGF)的非阿片类疗法增加手术膝关节自发活动的能力。使用自动活动箱在20小时昼夜周期内持续评估水平活动、速度和垂直站立情况,以减少观察者偏差并捕捉小鼠最活跃时的夜间活动。在骨科手术后第1天和第3天,自发活动和垂直站立明显减少;抗NGF显著减轻了这种下降。目前的数据表明,抗NGF可改善关节/骨科手术啮齿动物模型中的肢体使用情况,因此抗NGF可能有助于控制TKA或THA等骨科手术后的疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bedb/5370196/3257bc97549b/nihms-835845-f0001.jpg

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