Department of Pharmacology, College of Medicine, The University of Arizona, Tucson, Arizona; Department of Anesthesiology, College of Medicine, The University of Arizona, Tucson, Arizona.
Department of Pharmacology, College of Medicine, The University of Arizona, Tucson, Arizona.
J Pain. 2021 Dec;22(12):1646-1656. doi: 10.1016/j.jpain.2021.05.006. Epub 2021 Jun 19.
Benefits of phototherapy were characterized in multiple diseases including depression, circadian rhythm disruptions, and neurodegeneration. Studies on migraine and fibromyalgia patients revealed that green light-emitting diodes (GLED) exposure provides a pragmatic and safe therapy to manage chronic pain. In rodents, GLED reversed hypersensitivity related to neuropathic pain. However, little is known about the underlying mechanisms of GLED efficacy. Here, we sought to understand how green light modulates the endogenous opioid system. We first characterized how exposure to GLED stimulates release of β-endorphin and proenkephalin in the central nervous system of male rats. Moreover, by individually editing each of the receptors, we found that µ- and δ-opioid receptors are required for green light's antinociceptive effect in naïve rats and a model of HIV-induced peripheral neuropathy. We investigated how GLED could increase pain thresholds, and explored its potential in reversing hypersensitivity in a model of HIV-related neuropathy. Through behavioral and gene editing approaches, we identified that green light provides antinociception via modulation of the endogenous opioid system in the spinal cord. This work identifies a previously unknown mechanism by which GLED can improve pain management. Clinical translation of these results will advance the development of an innovative therapy devoid of adverse effects. PERSPECTIVE: Development of new pain management therapies, especially for HIV patients, is crucial as long-term opioid prescription is not recommended due to adverse side effects. Green light addresses this necessity. Characterizing the underlying mechanisms of this potentially groundbreaking and safe antinociceptive therapy will advance its clinical translation.
光照疗法的益处已在多种疾病中得到证实,包括抑郁症、昼夜节律紊乱和神经退行性疾病。对偏头痛和纤维肌痛患者的研究表明,绿光发光二极管(GLED)照射提供了一种实用且安全的疗法来治疗慢性疼痛。在啮齿动物中,GLED 逆转了与神经病理性疼痛相关的过敏反应。然而,对于 GLED 疗效的潜在机制知之甚少。在这里,我们试图了解绿光如何调节内源性阿片系统。我们首先描述了 GLED 如何刺激雄性大鼠中枢神经系统中β-内啡肽和脑啡肽原的释放。此外,通过单独编辑每个受体,我们发现μ和δ阿片受体是 GLED 在未处理大鼠和 HIV 诱导的周围神经病变模型中产生抗伤害作用所必需的。我们研究了 GLED 如何增加疼痛阈值,并探讨了其在逆转 HIV 相关神经病变模型中过敏反应的潜力。通过行为和基因编辑方法,我们确定 GLED 通过调节脊髓内源性阿片系统提供镇痛作用。这项工作确定了 GLED 改善疼痛管理的一种以前未知的机制。这些结果的临床转化将推进一种创新疗法的发展,这种疗法没有不良反应。观点:开发新的疼痛管理疗法,特别是针对 HIV 患者的疗法,至关重要,因为长期使用阿片类药物会因不良反应而不被推荐。绿光满足了这一需求。描述这种潜在开创性和安全的镇痛疗法的潜在机制将推进其临床转化。