Wang Tao, Hurwitz Olivia, Shimada Steven G, Tian Daofeng, Dai Feng, Zhou Jiangbing, Ma Chao, LaMotte Robert H
Department of Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China; Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, 06520-8051, USA.
Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, 06520-8051, USA.
Neurosci Lett. 2018 Mar 6;668:154-158. doi: 10.1016/j.neulet.2018.01.031. Epub 2018 Feb 3.
Bupivacaine is a commonly used local anesthetic in postoperative pain management. We evaluated the effects of a prolonged, local delivery of bupivacaine on pain behavior accompanying a chronic compression of the dorsal root ganglion (CCD) - an animal model of radicular pain. Poly(lactide-coglycolide) (PLGA) nanoparticles encapsulating bupivacaine were injected unilaterally into the L3 and L4 DRGs of mice just before producing CCD by implanting a stainless-steel rod in the intervertebral foramen of each ganglion. Behavioral sensitivity to punctate mechanical stimuli (Von Frey filaments) of different forces of indentation, delivered to each hind paw, was measured before and on subsequent days of testing after the CCD. Nanoparticles were spherical in morphology and 150 ± 10 nm in diameter. Bupivacaine was steadily released as measured in vitro over 35 days. A dye that was encapsulated in the nanoparticles was found in the intact DRG after 2 weeks. CCD alone or with injection of blank (control) nanoparticles produced a behavioral hypersensitivity to the punctate stimuli on the ipsilateral paw without affecting sensitivity on the contralateral, over a period of 7-14 days. The hypersensitivity was manifested as an increased incidence of paw-withdrawal to indentation forces normally below threshold (allodynia) and an increased shaking to a filament force that always elicited withdrawal prior to CCD (hyperalgesia). In contrast, nanoparticles with bupivacaine prevented any manifestation of allodynia or hyperalgesia on the ipsilateral hind paw while leaving normal nociceptive responses largely intact on both hind paws. CCD induced behavioral hypersensitivity to nociceptive stimuli is known to be associated with a hyperexcitability of sensory neurons originating in the compressed ganglion. We hypothesize that bupivacaine-loaded PLGA nanoparticles may prevent the occurrence of this neuronal hyperexcitability without reducing the nociceptive information normally conducted from the periphery to the central nervous system. The slow, sustained delivery of bupivacaine by nanoparticles may provide a means of preventing the occurrence of postoperative neuronal hyperexcitability that could develop into chronic neuropathic pain.
布比卡因是术后疼痛管理中常用的局部麻醉剂。我们评估了布比卡因长时间局部给药对伴随背根神经节慢性压迫(CCD)——一种神经根性疼痛动物模型——的疼痛行为的影响。在通过在每个神经节的椎间孔植入不锈钢棒产生CCD之前,将包裹布比卡因的聚(丙交酯-乙交酯)(PLGA)纳米颗粒单侧注射到小鼠的L3和L4背根神经节中。在CCD之前以及之后测试的后续几天,测量对施加于每个后爪的不同压痕力的点状机械刺激(von Frey细丝)的行为敏感性。纳米颗粒形态呈球形,直径为150±10nm。体外测量显示,布比卡因在35天内持续释放。2周后,在完整的背根神经节中发现了包裹在纳米颗粒中的一种染料。单独的CCD或注射空白(对照)纳米颗粒在7至14天内会使同侧爪对点状刺激产生行为超敏反应,而不影响对侧的敏感性。超敏反应表现为对通常低于阈值的压痕力的爪退缩发生率增加(痛觉过敏),以及对在CCD之前总是引起退缩的细丝力的抖动增加(痛觉超敏)。相比之下,含有布比卡因的纳米颗粒可防止同侧后爪出现任何痛觉过敏或痛觉超敏表现,同时使两个后爪的正常伤害性反应基本保持完整。已知CCD诱导的对伤害性刺激的行为超敏反应与起源于受压神经节的感觉神经元的过度兴奋有关。我们假设负载布比卡因的PLGA纳米颗粒可能会阻止这种神经元过度兴奋的发生,而不会减少通常从外周传导至中枢神经系统的伤害性信息。纳米颗粒缓慢、持续地释放布比卡因可能提供一种预防术后神经元过度兴奋发生的方法,而这种过度兴奋可能会发展为慢性神经性疼痛。