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持续鞘内输注大麻素受体激动剂可减轻大鼠神经结扎诱导的疼痛。

Continuous Intrathecal Infusion of Cannabinoid Receptor Agonists Attenuates Nerve Ligation-Induced Pain in Rats.

机构信息

From the *Department of Anesthesiology, MacKay Memorial Hospital, Taipei; †Department of Medicine, MacKay Medical College, New Taipei City; and ‡Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

Reg Anesth Pain Med. 2017 Jul/Aug;42(4):499-506. doi: 10.1097/AAP.0000000000000601.

Abstract

BACKGROUND AND OBJECTIVES

Cannabinoid receptors (CB1R/CB2R) are known to play important roles in pain transmission. In this study, we investigated the effects of continuous intrathecal infusion of CB1/2R agonists in the L5/6 spinal nerve ligation pain model.

METHODS

Under isoflurane anesthesia, rats received nerve ligation and intrathecal catheter connected to an infusion pump. After surgery, saline (1 μL/h), CB1/2R agonist WIN55,212-2, CB1R agonist ACEA, or CB2R agonist AM1241 (1 μmol/h) was given intrathecally for 7 days. The mechanical and thermal sensitivities of rat hindpaw were determined by von Frey hair and radiant heat tests. The expression of CB1/2R and protein levels of CB1/2R, Iba1, glial fibrillary acidic protein, and tumor necrosis factor α were examined by immunofluorescence study and Western blotting.

RESULTS

On postligation day 7, rats that received WIN55,212-2, ACEA or AM1241 had significantly higher mean withdrawal thresholds (6.8, 8.4, and 10.2 g) and latencies (6.3, 7.3, and 9.1 seconds) than did saline-treated rats (1.7 g, 2.2 seconds). Cannabinoid receptors were expressed not only in IB4 (isolectin B4) and CGRP (calcitonin gene-related peptide) dorsal root ganglion neurons, their central terminals, and peripheral axons, but also in neurons, microglia, and astrocytes in spinal cord. Cannabinoid receptor agonists enhanced nerve ligation-induced up-regulation of cannabinoid receptor in spinal cord and dorsal root ganglion. Treatment with WIN55,212-2 or AM1241, but not ACEA, markedly reduced nerve ligation-induced up-regulation of Iba1, glial fibrillary acidic protein, and tumor necrosis factor α in spinal cord.

CONCLUSIONS

Continuous intrathecal infusion of CB1/2R agonists elicits antinociception in the pain model. The mechanisms might involve their actions on neurons and glial cells. CB2R, but not CB1R, seems to play an important role in the regulation of nerve injury-induced neuroinflammation.

摘要

背景与目的

大麻素受体(CB1R/CB2R)已知在疼痛传递中发挥重要作用。在这项研究中,我们研究了连续鞘内输注 CB1/2R 激动剂在 L5/6 脊神经结扎疼痛模型中的作用。

方法

在异氟烷麻醉下,大鼠接受神经结扎和与输注泵相连的鞘内导管。手术后,给予生理盐水(1 μL/h)、CB1/2R 激动剂 WIN55,212-2、CB1R 激动剂 ACEA 或 CB2R 激动剂 AM1241(1 μmol/h)鞘内输注 7 天。通过 von Frey 毛发和辐射热试验测定大鼠后爪的机械和热敏性。通过免疫荧光研究和 Western blot 检测 CB1/2R 的表达以及 CB1/2R、Iba1、胶质纤维酸性蛋白和肿瘤坏死因子 α 的蛋白水平。

结果

在结扎后第 7 天,接受 WIN55,212-2、ACEA 或 AM1241 治疗的大鼠的平均撤回阈值(6.8、8.4 和 10.2 g)和潜伏期(6.3、7.3 和 9.1 秒)明显高于生理盐水处理的大鼠(1.7 g,2.2 秒)。大麻素受体不仅在 IB4(异硫氰酸荧光素 B4)和 CGRP(降钙素基因相关肽)背根神经节神经元及其中央末端和周围轴突中表达,而且在脊髓和背根神经节神经元、小胶质细胞和星形胶质细胞中表达。大麻素受体激动剂增强了神经结扎诱导的脊髓和背根神经节中大麻素受体的上调。WIN55,212-2 或 AM1241 治疗,但不是 ACEA 治疗,显著降低了神经结扎诱导的脊髓中 Iba1、胶质纤维酸性蛋白和肿瘤坏死因子 α 的上调。

结论

连续鞘内输注 CB1/2R 激动剂在疼痛模型中产生镇痛作用。其机制可能涉及它们对神经元和神经胶质细胞的作用。CB2R 而不是 CB1R 似乎在调节神经损伤诱导的神经炎症中发挥重要作用。

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