Department of Physiology, Shanxi Medical University, Taiyuan, China.
Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, USA.
Eur J Pain. 2018 Apr;22(4):679-690. doi: 10.1002/ejp.1132. Epub 2017 Oct 16.
Current medical treatments for chemotherapy-induced pain (CIP) are either ineffective or have adverse side effects. Acupuncture may alleviate CIP, but its effectiveness against this condition has not been studied. Paclitaxel causes neuropathic pain in cancer patients.
We evaluated the effects of electroacupuncture (EA) on paclitaxel-induced CIP in a rat model. Paclitaxel (2 mg/kg) or vehicle was injected (i.p.) on alternate days of 0-6. The resulting pain was treated with 10 Hz/2 mA/0.4 ms pulse EA for 30 min at the equivalent of human acupoint GB30 (Huantiao) once every other day between days 14 and 26. For sham control, EA needles were inserted into GB30 without stimulation. Von Frey filaments with bending forces of 2-8 g and 15 g were used to assess mechanical allodynia and hyperalgesia, respectively, on day 13 and once every other day between 14-26 days and then for 2-3 weeks after EA treatment.
Compared to sham control, EA significantly alleviated paclitaxel-induced mechanical allodynia and hyperalgesia, as shown by less frequent withdrawal responses to the filaments. The alleviation of allodynia/hyperalgesia lasted up to 3 weeks after the EA treatment. EA significantly inhibited phosphorylation of Ca /calmodulin-dependent protein kinase II (CaMKII) in the spinal cord. KN-93, a selective inhibitor of p-CaMKII, inhibited mechanical allodynia/hyperalgesia and p-CaMKII. 5-HT1A receptor antagonist blocked EA inhibition of allodynia/hyperalgesia and p-CaMKII.
Electroacupuncture activates 5-HT 1A receptors in the spinal cord and inhibits p-CaMKII to alleviate both allodynia and hyperalgesia. The data support acupuncture/EA as a complementary therapy for CIP.
Electroacupuncture (EA) activates spinal 5-HT1A receptors to inhibit p-CaMKII to alleviate paclitaxel-induced pain. Acupuncture/EA may be used as a complementary therapy for CIP.
目前针对化疗引起的疼痛(CIP)的医学治疗方法要么无效,要么有不良反应。针刺可能缓解 CIP,但尚未研究其对这种疾病的有效性。紫杉醇会引起癌症患者的神经病理性疼痛。
我们在紫杉醇诱导的 CIP 大鼠模型中评估了电针(EA)的效果。紫杉醇(2mg/kg)或载体在 0-6 天内每天交替注射(ip)。在第 14 天至第 26 天期间,每天每隔一天,用 10Hz/2mA/0.4ms 脉冲 EA 在相当于人穴位环跳(Huantiao)的位置治疗 30 分钟,以治疗由此产生的疼痛。对于假对照,将 EA 针插入环跳穴但不进行刺激。在第 13 天和第 14-26 天之间的每隔一天,使用弯曲力为 2-8g 和 15g 的 Von Frey 细丝分别评估机械性痛觉过敏和痛觉超敏,然后在 EA 治疗后持续 2-3 周。
与假对照相比,EA 显著减轻了紫杉醇引起的机械性痛觉过敏和痛觉超敏,表现为对细丝的回避反应频率降低。痛觉过敏/超敏反应的缓解持续到 EA 治疗后 3 周。EA 显著抑制脊髓中钙/钙调蛋白依赖性蛋白激酶 II(CaMKII)的磷酸化。CaMKII 的选择性抑制剂 KN-93 抑制机械性痛觉过敏/超敏反应和 p-CaMKII。5-HT1A 受体拮抗剂阻断了 EA 对痛觉过敏/超敏反应和 p-CaMKII 的抑制作用。
电针激活脊髓 5-HT1A 受体并抑制 p-CaMKII,以缓解痛觉过敏和痛觉超敏。数据支持针刺/EA 作为 CIP 的辅助治疗。
电针(EA)激活脊髓 5-HT1A 受体抑制 p-CaMKII,以缓解紫杉醇引起的疼痛。针刺/EA 可作为 CIP 的辅助治疗方法。