Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina; Division of Meridian and Structural Medicine, School of Korean Medicine, Pusan National University, Yangsan, Korea.
Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina; Pain Management Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
J Pain. 2018 Dec;19(12):1384.e1-1384.e14. doi: 10.1016/j.jpain.2018.05.013. Epub 2018 Jul 4.
Patients with chronic overlapping pain conditions have decreased levels of catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines. Consistent with clinical syndromes, we previously demonstrated that COMT inhibition in rodents produces persistent pain and heightened immune responses. Here, we sought to determine the efficacy of manual acupuncture in resolving persistent pain and neuroinflammation in the classic inbred C57BL/6 strain and the rapid-wound healing MRL/MpJ strain. Mice received subcutaneous osmotic minipumps to deliver the COMT inhibitor OR486 or vehicle for 13 days. On day 7 after pump implantation, acupuncture was performed at the Zusanli (ST36) point or a non-acupoint for 6 consecutive days. Behavioral responses to mechanical stimuli were measured throughout the experiment. Immunohistochemical analysis of spinal phosphorylated p38 mitogen-activated protein kinase, a marker of inflammation, and glial fibrillary acidic protein, a marker of astrogliosis, was performed on day 13. Results demonstrated that ST36, but not sham, acupuncture resolved mechanical hypersensitivity and reduced OR486-dependent increases in phosphorylated p38 and glial fibrillary acidic protein in both strains. The magnitude of the analgesic response was greater in MRL/MpJ mice. These findings indicate acupuncture as an effective treatment for persistent pain linked to abnormalities in catecholamine signaling and, furthermore, that analgesic efficacy may be influenced by genetic differences. PERSPECTIVE: Chronic overlapping pain conditions remain ineffectively managed by conventional pharmacotherapies. Here, we demonstrate that acupuncture alleviates persistent pain and neuroinflammation linked to heightened catecholaminergic tone. Mice with superior healing capacity exhibit greater analgesic efficacy. Findings indicate acupuncture as an effective treatment for chronic overlapping pain conditions and provide insight into treatment response variability.
患有慢性重叠性疼痛病症的患者其儿茶酚-O-甲基转移酶(COMT)水平降低,这种酶可以代谢儿茶酚胺。与临床综合征一致,我们之前的研究表明,啮齿动物的 COMT 抑制会产生持续性疼痛和增强的免疫反应。在这里,我们试图确定手动针刺在解决经典近交 C57BL/6 品系和快速愈合 MRL/MpJ 品系中持续性疼痛和神经炎症中的功效。小鼠接受皮下渗透微型泵输注 COMT 抑制剂 OR486 或载体 13 天。在泵植入后的第 7 天,进行了 Zusanli(ST36)点或非穴位的连续 6 天针刺。整个实验过程中测量了对机械刺激的行为反应。在第 13 天进行了脊髓磷酸化 p38 丝裂原活化蛋白激酶(炎症标志物)和神经胶质纤维酸性蛋白(星形胶质细胞标志物)的免疫组织化学分析。结果表明,ST36 针刺而非 sham 针刺可缓解机械性过敏,并降低两种品系中 OR486 依赖性磷酸化 p38 和神经胶质纤维酸性蛋白的增加。MRL/MpJ 小鼠的镇痛反应幅度更大。这些发现表明针刺是治疗与儿茶酚胺信号异常相关的持续性疼痛的有效方法,并且镇痛效果可能受到遗传差异的影响。观点:慢性重叠性疼痛病症仍然无法通过常规药物治疗有效管理。在这里,我们证明针刺可缓解与儿茶酚胺能亢进相关的持续性疼痛和神经炎症。具有优越愈合能力的小鼠表现出更大的镇痛功效。研究结果表明针刺是治疗慢性重叠性疼痛病症的有效方法,并为治疗反应的可变性提供了见解。