Kotoda Masakazu, Ino Hirofumi, Kumakura Yasutomo, Iijima Tetsuya, Ishiyama Tadahiko, Matsukawa Takashi
Department of Anesthesiology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan.
Surgical Center, University of Yamanashi Hospital, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan.
J Pain Res. 2019 Jun 6;12:1825-1832. doi: 10.2147/JPR.S196480. eCollection 2019.
Although amiodarone is classified as a Vaughan-Williams class Ⅲ antiarrhythmic drug, it has inhibitory effects on voltage-gated sodium and calcium channels and on β-adrenergic receptors. Given these pharmacological profiles, amiodarone may have analgesic properties. Most patients who are prescribed amiodarone possess multiple cardiovascular risk factors. Despite the fact that pain plays a crucial role as a clinical indicator of cardiovascular events, the effects of amiodarone on pain have not been investigated. The aim of the current study was to investigate the analgesic effects of amiodarone by using mouse models of pain in an effort to elucidate underlying mechanisms. Adult male C57B6 mice received single bolus intraperitoneal injections of amiodarone at doses of 25, 50, 100, and 200 mg/kg, while the mice in the control group received only normal saline. The analgesic effects of amiodarone were evaluated using the acetic acid-induced writhing test, formalin test, and tail withdrawal test. In addition, the potassium channel opener NS1643, voltage-gated sodium channel opener veratrine, calcium channel opener BAYK8644, and selective β-adrenergic agonist isoproterenol were used to uncover the underlying mechanism. During the acetic acid-induced writhing test, formalin test, and tail withdrawal test, amiodarone induced analgesic responses in a dose-dependent manner. The analgesic effects of amiodarone were abolished by veratrine but not by NS1643, BAYK8644, or isoproterenol. Amiodarone induced analgesic responses in a dose-dependent manner, likely by blocking voltage-gated sodium channels. These results indicate that clinical doses of amiodarone can affect nociception and may mask or attenuate pain induced by acute cardiovascular events.
虽然胺碘酮被归类为 Vaughan-Williams Ⅲ类抗心律失常药物,但它对电压门控钠通道和钙通道以及β-肾上腺素能受体具有抑制作用。鉴于这些药理学特性,胺碘酮可能具有镇痛特性。大多数服用胺碘酮的患者具有多种心血管危险因素。尽管疼痛作为心血管事件的临床指标起着至关重要的作用,但胺碘酮对疼痛的影响尚未得到研究。本研究的目的是通过使用疼痛小鼠模型来研究胺碘酮的镇痛作用,以阐明其潜在机制。成年雄性 C57B6 小鼠腹腔注射单剂量 25、50、100 和 200 mg/kg 的胺碘酮,而对照组小鼠仅接受生理盐水。使用醋酸诱导扭体试验、福尔马林试验和甩尾试验评估胺碘酮的镇痛作用。此外,使用钾通道开放剂 NS1643、电压门控钠通道开放剂藜芦碱、钙通道开放剂 BAYK8644 和选择性β-肾上腺素能激动剂异丙肾上腺素来揭示潜在机制。在醋酸诱导扭体试验、福尔马林试验和甩尾试验中,胺碘酮以剂量依赖性方式诱导镇痛反应。胺碘酮的镇痛作用被藜芦碱消除,但未被 NS1643、BAYK8644 或异丙肾上腺素消除。胺碘酮可能通过阻断电压门控钠通道以剂量依赖性方式诱导镇痛反应。这些结果表明,临床剂量的胺碘酮可影响痛觉,可能掩盖或减轻急性心血管事件引起的疼痛。