Seol Tai-Kyung, Lee Wonho, Park Sunah, Kim Kyu Nam, Kim Tae Yeon, Oh You Na, Jun Jong Hun
Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2017 Oct;70(5):561-566. doi: 10.4097/kjae.2017.70.5.561. Epub 2017 Jul 13.
A growing body of evidence suggests that neuroinflammation, which is characterized by infiltration of immune cells, activation of mast cells and glial cells, and production of inflammatory mediators in the peripheral and central nervous systems, plays an important role in the induction and maintenance of chronic pain. Palmitoylethanolamide (PEA), which is a type of N-acylethanolamide and a lipid, has an anti-inflammatory effect. Relative to the anti-inflammatory effect, little is known about its analgesic effect in chronic pain. This study aimed to determine whether PEA relieves chronic inflammatory and neuropathic pain.
Male Sprague-Dawley rats were injured by transection of the left L5 and L6 spinal nerves to induce neuropathic pain or were injected with monoiodoacetic acid into the synovial cavity of knee joints to induce inflammatory pain. To assess the degree of pain, two kinds of stimuli - pressing von Frey filaments and wetting with acetone - were applied to the plantar surface of the rat to measure mechanical and cold sensitivity, respectively. Pain was measured by assessing behavioral responses, including paw withdrawal response threshold and paw withdrawal frequency upon stimulation.
Neuropathic pain caused by spinal nerve transection (SNT) decreased the mechanical threshold and increased the frequency of response to acetone application. But, cold allodynia caused by SNT did not decrease the withdrawal frequency. Mechanical hyperalgesia caused by chronic inflammation was significantly reduced by both intraperitoneal and intra-articular injections of PEA.
These outcomes revealed that PEA might be effective in relieving inflammatory and neuropathic pain, especially pain induced by mechanical hyperalgesia, but not cold allodynia.
越来越多的证据表明,神经炎症在外周和中枢神经系统中以免疫细胞浸润、肥大细胞和神经胶质细胞激活以及炎症介质产生为特征,在慢性疼痛的诱导和维持中起重要作用。棕榈酰乙醇胺(PEA)是一种N-酰基乙醇胺类脂质,具有抗炎作用。相对于其抗炎作用,人们对其在慢性疼痛中的镇痛作用知之甚少。本研究旨在确定PEA是否能缓解慢性炎症性疼痛和神经性疼痛。
雄性Sprague-Dawley大鼠通过切断左侧L5和L6脊神经诱导神经性疼痛,或向膝关节滑膜腔内注射单碘乙酸诱导炎症性疼痛。为了评估疼痛程度,分别采用两种刺激——按压von Frey细丝和用丙酮浸湿——作用于大鼠足底表面,以测量机械敏感性和冷敏感性。通过评估行为反应来测量疼痛,包括爪子撤离反应阈值和刺激时的爪子撤离频率。
脊神经切断术(SNT)引起的神经性疼痛降低了机械阈值,增加了对丙酮刺激的反应频率。但是,SNT引起的冷觉异常并没有降低撤离频率。腹腔内和关节内注射PEA均显著降低了慢性炎症引起的机械性痛觉过敏。
这些结果表明,PEA可能有效缓解炎症性疼痛和神经性疼痛,尤其是由机械性痛觉过敏引起的疼痛,但对冷觉异常无效。