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血管紧张素 II 型 1 型受体阻断通过抑制脊髓中的神经胶质细胞激活来减轻创伤后应激障碍相关的慢性疼痛。

Angiotensin II type 1 receptor blockade attenuates posttraumatic stress disorder-related chronic pain by inhibiting glial activation in the spinal cord.

机构信息

Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Anesthesiology, Huanggang Central Hospital, Huanggang, China.

出版信息

Neuropharmacology. 2021 Sep 15;196:108704. doi: 10.1016/j.neuropharm.2021.108704. Epub 2021 Jul 10.

Abstract

Clinically, posttraumatic stress disorder (PTSD) and chronic pain are highly comorbid conditions, but the underlying mechanisms of and therapeutic strategies against PTSD-related pain remain unclear. Our previous studies suggested that dysregulation of neuroinflammation contributes to the development of stress-induced hyperalgesia. Recent studies reported that angiotensin II was a 'stress-related hormone', and could induce glial activation by stimulating the type 1 receptor (AT1R). In the present study, we aimed to investigate whether AT1R blockade could attenuate mechanical allodynia induced by PTSD-like stress. Adult male rats were exposed to single prolonged stress (SPS) to establish a model of PTSD-pain comorbidity. Our results showed that SPS exposure increased the levels of angiotensin II in the hippocampus, prefrontal cortex (PFC) and spinal cord; intraperitoneal injection of losartan attenuated SPS-induced mechanical allodynia, and suppressed SPS-induced glial activation (both microglia and astrocytes) and proinflammatory cytokine expression in the PFC and spinal cord, but not in the hippocampus. We further showed that intrathecal injection of losartan also exerted anti-hyperalgesic effect and suppressed SPS-induced glial activation and proinflammatory cytokine expression in the spinal cord. These results indicated that AT1R blockade by losartan attenuated mechanical allodynia induced by PTSD-like stress, and this may be attributed to the suppression of glial activation and proinflammatory cytokine expression in the spinal cord. Although further research is warranted to verify our findings in female rodents and to assess pharmacological effects of AT1R blockade in PFC and hippocampus, our study suggested the therapeutic potential of targeting AT1R in the treatment of PTSD-related chronic pain.

摘要

临床上,创伤后应激障碍(PTSD)和慢性疼痛是高度共病的情况,但 PTSD 相关疼痛的潜在机制和治疗策略仍不清楚。我们之前的研究表明,神经炎症失调导致应激诱导的痛觉过敏的发展。最近的研究报告称,血管紧张素 II 是一种“应激相关激素”,通过刺激 1 型受体(AT1R)可以诱导神经胶质细胞激活。在本研究中,我们旨在研究 AT1R 阻断是否可以减轻 PTSD 样应激引起的机械性痛觉过敏。成年雄性大鼠接受单次延长应激(SPS)以建立 PTSD-疼痛共病模型。我们的结果表明,SPS 暴露增加了海马体、前额叶皮层(PFC)和脊髓中的血管紧张素 II 水平;腹腔内注射氯沙坦减轻了 SPS 引起的机械性痛觉过敏,并抑制了 SPS 诱导的 PFC 和脊髓中的神经胶质细胞激活(小胶质细胞和星形胶质细胞)和促炎细胞因子表达,但对海马体没有影响。我们进一步表明,鞘内注射氯沙坦也发挥了抗痛觉过敏作用,并抑制了 SPS 诱导的脊髓中的神经胶质细胞激活和促炎细胞因子表达。这些结果表明,氯沙坦通过 AT1R 阻断减轻了 PTSD 样应激引起的机械性痛觉过敏,这可能归因于抑制了脊髓中的神经胶质细胞激活和促炎细胞因子表达。尽管需要进一步的研究来验证我们在雌性啮齿动物中的发现,并评估 AT1R 阻断在 PFC 和海马体中的药理学作用,但我们的研究表明靶向 AT1R 在治疗 PTSD 相关慢性疼痛方面具有治疗潜力。

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