School of Behavioral and Brain Sciences and Center for Advanced Pain Studies, University of Texas at Dallas, United States.
School of Behavioral and Brain Sciences and Center for Advanced Pain Studies, University of Texas at Dallas, United States.
Pharmacol Res. 2019 Jan;139:1-16. doi: 10.1016/j.phrs.2018.10.027. Epub 2018 Nov 1.
Metformin is a widely prescribed drug used in the treatment of type II diabetes. While the drug has many mechanisms of action, most of these converge on AMP activated protein kinase (AMPK), which metformin activates. AMPK is a multifunctional kinase that is a negative regulator of mechanistic target of rapamycin (mTOR) and mitogen activated protein kinase (MAPK) signaling. Activation of AMPK decreases the excitability of dorsal root ganglion neurons and AMPK activators are effective in reducing chronic pain in inflammatory, post-surgical and neuropathic rodent models. We have previously shown that metformin leads to an enduring resolution of neuropathic pain in the spared nerve injury (SNI) model in male mice and rats. The precise mechanism underlying this long-lasting effect is not known. We conducted experiments to investigate the effects of metformin on SNI-induced microglial activation, a process implicated in the maintenance of neuropathic pain that has recently been shown to be sexually dimorphic. We find that metformin is effective at inhibiting development of neuropathic pain when treatment is given around the time of injury and that metformin is likewise effective at reversing neuropathic mechanical hypersensitivity when treatment is initiation weeks after injury. This effect is linked to decreased Iba-1 staining in the dorsal horn, a marker of microglial activation. Importantly, these positive behavioral and microglia effects of metformin were only observed in male mice. We conclude that the neuropathic pain modifying effects of metformin are sex-specific supporting a differential role for microglial activation in male and female mice.
二甲双胍是一种广泛用于治疗 2 型糖尿病的处方药物。虽然该药物有许多作用机制,但大多数机制都集中在 AMP 激活蛋白激酶(AMPK)上,二甲双胍可以激活 AMPK。AMPK 是一种多功能激酶,是雷帕霉素靶蛋白(mTOR)和丝裂原激活蛋白激酶(MAPK)信号的负调节剂。AMPK 的激活降低了背根神经节神经元的兴奋性,AMPK 激活剂在减轻炎性、手术后和神经性啮齿动物模型的慢性疼痛方面非常有效。我们之前已经表明,二甲双胍可导致雄性小鼠和大鼠的 spared nerve injury(SNI)模型中的神经性疼痛持久缓解。这种持久效应的精确机制尚不清楚。我们进行了实验以研究二甲双胍对 SNI 诱导的小胶质细胞激活的影响,该过程与神经性疼痛的维持有关,最近的研究表明其具有性别二态性。我们发现,在损伤时给予治疗,二甲双胍可有效抑制神经性疼痛的发展,而在损伤后数周开始治疗时,二甲双胍同样可有效逆转神经性机械性超敏反应。这种作用与背角中 Iba-1 染色的减少有关,Iba-1 是小胶质细胞激活的标志物。重要的是,只有雄性小鼠才观察到二甲双胍的这些积极的行为和小胶质细胞作用。我们得出的结论是,二甲双胍对神经性疼痛的调节作用具有性别特异性,支持小胶质细胞激活在雄性和雌性小鼠中具有不同的作用。
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