Vieira Marcio Carneiro, Monte Fernanda Bezerra de Mello, Eduardo Dematte Bruno, Montagnoli Tadeu Lima, Montes Guilherme Carneiro, da Silva Jaqueline Soares, Mendez-Otero Rosalia, Trachez Margarete Manhães, Sudo Roberto Takashi, Zapata-Sudo Gisele
Programa de Pós-graduação em Ciências Cirúrgicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil.
Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 21941-902, Brazil.
J Pain Res. 2021 Mar 30;14:857-866. doi: 10.2147/JPR.S295265. eCollection 2021.
New therapeutic alternatives for pain relief include the use of phosphodiesterase-5 (PDE5) inhibitors, which could prevent the transmission of painful stimuli by neuron hyperpolarization via nitric oxide (NO)/cyclic 3',5'-guanosine monophosphate (cGMP) pathway. The present work investigated the antinociceptive activity of a new PDE5 inhibitor, lodenafil carbonate, in inflammatory and neuropathic pain models.
Although no effect was detected on neurogenic phase of formalin test in mice, oral administration of lodenafil carbonate dose-dependently reduced reactivity in the inflammatory phase (200.6 ± 39.1 to 81.9 ± 18.8 s at 10 μmol/kg, p= 0.0172) and this effect was totally blocked by NO synthase inhibitor, L-Nω-nitroarginine methyl ester (L-NAME). Lodenafil carbonate (10 μmol/kg p.o.) significantly reduced nociceptive response as demonstrated by increased paw withdrawal latency to thermal stimulus (from 6.8 ± 0.7 to 10.6 ± 1.3 s, p= 0.0006) and paw withdrawal threshold to compressive force (from 188.0 ± 14.0 to 252.5 ± 5.3 g, p<0.0001) in carrageenan-induced paw inflammation model. In a spinal nerve ligation-induced neuropathic pain, oral lodenafil carbonate (10 μmol/kg) also reversed thermal hyperalgesia and mechanical allodynia by increasing paw withdrawal latency from 17.9 ± 1.5 to 22.8 ± 1.9 s (p= 0.0062) and paw withdrawal threshold from 26.0 ± 2.8 to 41.4 ± 2.9 g (p= 0.0196). These effects were reinforced by the reduced GFAP (3.4 ± 0.5 to 1.4 ± 0.3%, p= 0.0253) and TNF-alpha (1.1 ± 0.1 to 0.4 ± 0.1%, p= 0.0111) stained area densities as detected by immunofluorescence in ipsilateral dorsal horns.
Lodenafil carbonate demonstrates important analgesic activity by promoting presynaptic hyperpolarization and preventing neuroplastic changes, which may perpetuate chronic pain, thus representing a potential treatment for neuropathic pain.
缓解疼痛的新治疗选择包括使用磷酸二酯酶-5(PDE5)抑制剂,其可通过一氧化氮(NO)/环磷酸鸟苷(cGMP)途径使神经元超极化来阻止痛觉刺激的传递。本研究调查了一种新型PDE5抑制剂碳酸洛地那非在炎症性和神经性疼痛模型中的抗伤害感受活性。
虽然在小鼠福尔马林试验的神经源性期未检测到碳酸洛地那非有作用,但口服碳酸洛地那非可剂量依赖性地降低炎症期的反应性(在10μmol/kg时,从200.6±39.1秒降至81.9±18.8秒,p = 0.0172),且该作用被NO合酶抑制剂L-Nω-硝基精氨酸甲酯(L-NAME)完全阻断。碳酸洛地那非(10μmol/kg口服)显著降低伤害感受反应,如在角叉菜胶诱导的爪部炎症模型中,热刺激引起的爪部退缩潜伏期延长(从6.8±0.7秒增至10.6±1.3秒,p = 0.0006)以及对压力的爪部退缩阈值提高(从188.0±14.0克增至252.5±5.3克,p<0.0001)。在脊髓神经结扎诱导的神经性疼痛中,口服碳酸洛地那非(10μmol/kg)也通过延长爪部退缩潜伏期从17.9±1.5秒至22.8±1.9秒(p = 0.0062)以及提高爪部退缩阈值从26.0±2.8克至41.4±2.9克(p = 0.0196)逆转了热痛觉过敏和机械性异常性疼痛。通过免疫荧光检测同侧背角中GFAP(从3.4±0.5%降至1.4±0.3%,p = 0.0253)和肿瘤坏死因子-α(TNF-α,从1.1±0.1%降至0.4±0.1%,p = 0.0111)染色面积密度降低,这些作用得到了加强。
碳酸洛地那非通过促进突触前超极化和防止可能使慢性疼痛持续存在的神经可塑性变化,表现出重要的镇痛活性,因此代表了一种治疗神经性疼痛的潜在方法。