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乌司他丁单独或联合舒芬太尼用于术后镇痛的效果:一种新的术后镇痛治疗潜力。

The analgesic effects of ulinastatin either as a single agent or in combination with sufentanil: A novel therapeutic potential for postoperative pain.

机构信息

Department of Anesthesiology and Perioperative Medicine, 900 Hospital of the Joint Logistic Support Force / Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, 350025, Fujian, PR China; Department of Anesthesiology and Perioperative Medicine, Dongfang Hospital, Xiamen University, Fuzhou, 350025, Fujian, PR China.

Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, PR China.

出版信息

Eur J Pharmacol. 2021 Sep 15;907:174267. doi: 10.1016/j.ejphar.2021.174267. Epub 2021 Jun 17.

Abstract

Ulinastatin is a broad-spectrum protease inhibitor widely used for the treatment of various inflammation-related diseases owing to its recognized excellent anti-inflammatory and cytoprotective properties. However, whether ulinastatin can relieve postoperative pain remains unclear. In this study, we evaluated the analgesic effects of ulinastatin administered either as a single agent or in combination with sufentanil in a validated preclinical rat model of postoperative pain induced by plantar incision. We found that incisional surgery on the hind paw of these rats induced sustained ipsilateral mechanical pain hypersensitivity that lasted for at least 10 days. A single intraperitoneal (i.p.) injection of ulinastatin prevented the development and reversed the maintenance of incision-induced mechanical pain hypersensitivity in a dose-dependent manner. However, ulinastatin had no effect on the baseline nociceptive threshold. Moreover, repeated i.p. injections of ulinastatin persistently attenuated incision-induced mechanical pain hypersensitivity and promoted recovery from the surgery. The rats did not develop any analgesic tolerance over the course of repeated injections of ulinastatin. A single i.p. injection of ulinastatin was also sufficient to inhibit the initiation and maintenance of incision-induced hyperalgesic priming when the rats were subsequently challenged with an ipsilateral intraplantar prostaglandin E2 injection. Furthermore, the combined administration of ulinastatin and sufentanil significantly enhanced the analgesic effect of sufentanil on postoperative pain, which involved mechanisms other than a direct influence on opioid receptors. These findings demonstrated that ulinastatin had a significant analgesic effect on postoperative pain and might be a novel pharmacotherapeutic agent for managing postoperative pain either alone or as an adjuvant.

摘要

乌司他丁是一种广谱蛋白酶抑制剂,由于其公认的出色抗炎和细胞保护特性,广泛用于治疗各种炎症相关疾病。然而,乌司他丁是否可以缓解术后疼痛尚不清楚。在这项研究中,我们评估了乌司他丁单独或与舒芬太尼联合应用于足底切口术后疼痛的临床前大鼠模型中的镇痛效果。我们发现,这些大鼠后爪的切开手术会引起持续的同侧机械性疼痛过敏,至少持续 10 天。单次腹腔内(i.p.)注射乌司他丁可预防切口引起的机械性疼痛过敏的发展并逆转其维持,呈剂量依赖性。然而,乌司他丁对基础痛觉阈值没有影响。此外,重复 i.p.注射乌司他丁持续减弱切口引起的机械性疼痛过敏,并促进手术恢复。在重复注射乌司他丁的过程中,大鼠没有产生任何镇痛耐受。单次 i.p.注射乌司他丁也足以抑制当大鼠随后接受同侧足底前列腺素 E2 注射时引起的切口诱导性痛觉过敏启动和维持。此外,乌司他丁和舒芬太尼联合给药显著增强了舒芬太尼对术后疼痛的镇痛作用,其涉及到除了直接影响阿片受体以外的机制。这些发现表明,乌司他丁对术后疼痛具有显著的镇痛作用,无论是单独使用还是作为辅助药物,都可能成为治疗术后疼痛的新型药物治疗剂。

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