Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Yoshida-Shimoadachi-cho, Sakyo-ku, Kyoto 606-8501, Japan.
Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Mol Pain. 2017 Jan-Dec;13:1744806917743680. doi: 10.1177/1744806917743680.
Acute postoperative pain is induced by most incisional surgeries and usually resolves with wound repair. However, many patients experience moderate to severe pain despite receiving currently available postoperative pain relief. Accumulating evidence suggests that inflammatory cells, neutrophils, and macrophages infiltrating the wound site contribute to the acute inflammation, pain, and subsequent wound repair. Colchicine is commonly used to relieve pain in gout by inhibiting the infiltration of granulocytes and other motile cells. In this study, we examined the effects of colchicine on acute postoperative pain and wound repair by correlating the infiltration of neutrophils and macrophages in a mouse model of postoperative pain induced by plantar incision. Furthermore, these effects of colchicine were compared with clodronate liposomes, which selectively deplete circulating macrophages.
Plantar incision induced mechanical hypersensitivity in the ipsilateral hind paw that peaked one day and lasted for three days after the surgery. Treatment with colchicine significantly attenuated the early infiltration of Gr1-positive cells (neutrophils) around the incision site and mechanical hypersensitivity, which was accompanied with inhibition of the subsequent infiltration of Iba1-positive cells (macrophages) and macrophage polarization toward the proinflammatory M1 phenotype. By contrast, an intravenous injection of clodronate liposomes significantly inhibited the infiltration of macrophages around the incision site but had little effect on the infiltration of neutrophils or mechanical hypersensitivity. Importantly, colchicine treatment significantly delayed wound closure after the incisional surgery, whereas clodronate liposome administration had no effect on wound closure.
These results suggest that colchicine can alleviate acute postoperative pain and also enhance the risk of delayed wound repair, which are associated with the suppression of neutrophil and subsequent proinflammatory M1 macrophage infiltration around the incision site, while the involvement of macrophages may be limited.
大多数切口手术都会引起急性术后疼痛,通常随着伤口愈合而缓解。然而,尽管目前有术后止痛方法可用,许多患者仍经历中度至重度疼痛。越来越多的证据表明,浸润伤口部位的炎症细胞、中性粒细胞和巨噬细胞有助于急性炎症、疼痛和随后的伤口修复。秋水仙碱常用于通过抑制粒细胞和其他游走细胞的浸润来缓解痛风疼痛。在这项研究中,我们通过在足底切口诱导的术后疼痛小鼠模型中,关联中性粒细胞和巨噬细胞的浸润,来研究秋水仙碱对急性术后疼痛和伤口修复的影响。此外,我们将秋水仙碱的这些作用与选择性耗尽循环巨噬细胞的氯膦酸脂质体进行了比较。
足底切口导致对侧后爪机械性痛觉过敏,在手术后一天达到峰值,并持续三天。秋水仙碱治疗显著减轻了切口部位周围 Gr1 阳性细胞(中性粒细胞)的早期浸润和机械性痛觉过敏,伴随着随后 Iba1 阳性细胞(巨噬细胞)的浸润抑制以及向促炎 M1 表型的巨噬细胞极化。相比之下,静脉注射氯膦酸脂质体显著抑制了切口部位周围的巨噬细胞浸润,但对中性粒细胞浸润或机械性痛觉过敏几乎没有影响。重要的是,秋水仙碱治疗显著延迟了切口手术后的伤口闭合,而氯膦酸脂质体给药对伤口闭合没有影响。
这些结果表明,秋水仙碱可以缓解急性术后疼痛,并且还会增加延迟伤口修复的风险,这与抑制切口部位周围的中性粒细胞和随后的促炎 M1 巨噬细胞浸润有关,而巨噬细胞的参与可能有限。