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阿尔茨海默病 TASTPM 小鼠模型中慢性疼痛样行为受损和阿片能系统改变。

Impaired chronic pain-like behaviour and altered opioidergic system in the TASTPM mouse model of Alzheimer's disease.

机构信息

Wolfson Centre for Age Related Diseases, King's College London, UK.

Medical School, University of Exeter, UK.

出版信息

Eur J Pain. 2019 Jan;23(1):91-106. doi: 10.1002/ejp.1288. Epub 2018 Jul 30.

Abstract

BACKGROUND

Chronic pain conditions, especially osteoarthritis (OA), are as common in individuals with Alzheimer's disease (AD) as in the general elderly population, which results in detrimental impact on patient's quality of life. However, alteration in perception of pain in AD coupled with deteriorating ability to communicate pain sensations often result in under-diagnosis and inappropriate management of pain. Therefore, a better understanding of mechanisms in chronic pain processing in AD is needed. Here, we explored the development and progression of OA pain and the effect of analgesics in a transgenic mouse model of AD.

METHODS

Unilateral OA pain was induced chemically, via an intra-articular injection of monosodium iodoacetate (MIA) in the left knee joint of AD-mice (TASTPM) and age- and gender-matched C57BL/6J (WT). Pharmacological and biochemical assessments were conducted in plasma and spinal cord tissue.

RESULTS

MIA resulted in hind paw mechanical hypersensitivity (allodynia), initiating on day 3, in TASTPM and WT controls. However, from 14 to 28 days, TASTPM displayed partial attenuation of allodynia and diminished spinal microglial response compared to WT controls. Naloxone, an opioid antagonist, re-established allodynia levels as observed in the WT group. Morphine, an opioid agonist, induced heightened analgesia in AD-mice whilst gabapentin was devoid of efficacy. TASTPM exhibited elevated plasma level of β-endorphin post-MIA which correlated with impaired allodynia.

CONCLUSIONS

These results indicate an alteration of the opioidergic system in TASTPM as possible mechanisms underlying impaired persistent pain sensitivity in AD. This work provides basis for re-evaluation of opioid analgesic use for management of pain in AD.

SIGNIFICANCE

This study shows attenuated pain-like behaviour in a transgenic mouse model of Alzheimer's disease due to alterations in the opioidergic system and central plasticity mechanisms of persistent pain.

摘要

背景

慢性疼痛疾病,尤其是骨关节炎(OA),在阿尔茨海默病(AD)患者中的发生率与普通老年人群相同,这对患者的生活质量造成了不利影响。然而,AD 患者对疼痛的感知改变以及沟通疼痛感觉的能力下降,往往导致疼痛的诊断不足和管理不当。因此,需要更好地了解 AD 中慢性疼痛处理的机制。在这里,我们研究了 AD 转基因小鼠模型中 OA 疼痛的发展和进展以及镇痛药的作用。

方法

通过向左侧膝关节内注射单碘乙酸(MIA)在 AD 转基因小鼠(TASTPM)和年龄及性别匹配的 C57BL/6J(WT)中诱导单侧 OA 疼痛。在血浆和脊髓组织中进行了药理学和生化评估。

结果

MIA 导致 TASTPM 和 WT 对照组的后爪机械性超敏反应(痛觉过敏),从第 3 天开始出现。然而,从第 14 天到第 28 天,TASTPM 显示出对痛觉过敏的部分衰减,以及与 WT 对照组相比脊髓小胶质细胞反应的减弱。阿片受体拮抗剂纳洛酮恢复了 WT 组观察到的痛觉过敏水平。阿片受体激动剂吗啡在 AD 小鼠中诱导出更高的镇痛作用,而加巴喷丁则无效。MIA 后 TASTPM 血浆中β-内啡肽水平升高,与痛觉过敏受损相关。

结论

这些结果表明 TASTPM 中的阿片能系统发生改变,这可能是 AD 中持续性疼痛敏感性受损的潜在机制。这项工作为重新评估阿片类镇痛药在 AD 疼痛管理中的应用提供了依据。

意义

本研究显示,由于阿片能系统和持续性疼痛的中枢可塑性机制的改变,在阿尔茨海默病的转基因小鼠模型中疼痛样行为减弱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a667/6492091/406a7f6f0452/EJP-23-91-g001.jpg

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