Park J H, Lee C-H, Ham H D, Choi E-S, Lee C, Lee S
Brain Research Institute of Wonkwang University, Department of Pharmacology, Department of Anesthesiology, Wonkwang University School of Medicine, Iksan, Jeonbuk, Korea.
Eur Rev Med Pharmacol Sci. 2021 Nov;25(22):7051-7057. doi: 10.26355/eurrev_202111_27256.
Complex regional pain syndrome (CRPS) is caused by injuries from fracture after trauma and orthopaedic surgical procedures in the hind limbs. The symptoms of CRPS include warmth, pain, allodynia, and hyperalgesia. It is known that 5-hydroxytryptamine 3 (5-HT3) receptors contribute to hyperalgesia, but their role has not yet been fully elucidated. This study investigated the mechanism of pain relief when a 5-HT3 receptor antagonist was administered in a CRPS animal model.
To establish a CRPS animal model, 10-week-old Sprague-Dawley rats were used in the experiment. On the fourth week post tibial fracture surgery, we performed the von Frey test to measure mechanical allodynia. After performing behavioural tests, we collected blood and tissue samples after sacrificing the animals. Enzyme-linked immunosorbent assay and western blot were also performed.
The experimental tibia fracture model-induced CRPS animals elicited increased 5-HT3 receptor expression, and the 5-HT transporter was decreased in the brain stem after 4 weeks of surgical intervention. Additionally, in CRPS-induced animals, both the concentration of substance P and the level of interleukin 6 were increased peripherally and centrally. Treatment with the 5-HT3 receptor antagonist, ramosetron, exerted an analgesic effect in the paw withdrawal test and was dependent on the attenuation of the 5-HT3 receptor population with inflammatory pain mediators.
These data suggest that treatment with the 5-HT3 receptor antagonist, ramosetron, in experimental CRPS animal models alleviated pain-related behaviours and may be a new therapeutic option or potential therapeutic agent for patients with CRPS.
复杂性区域疼痛综合征(CRPS)由后肢创伤后骨折及骨科手术损伤引起。CRPS的症状包括发热、疼痛、痛觉过敏和痛觉超敏。已知5-羟色胺3(5-HT3)受体促成痛觉超敏,但其作用尚未完全阐明。本研究调查了在CRPS动物模型中给予5-HT3受体拮抗剂时的疼痛缓解机制。
为建立CRPS动物模型,实验采用10周龄的Sprague-Dawley大鼠。在胫骨骨折手术后第四周,我们进行了von Frey试验以测量机械性痛觉过敏。进行行为测试后,处死动物并采集血液和组织样本。还进行了酶联免疫吸附测定和蛋白质印迹分析。
实验性胫骨骨折模型诱导的CRPS动物在手术干预4周后,脑干中5-HT3受体表达增加,5-羟色胺转运体减少。此外,在CRPS诱导的动物中,P物质浓度和白细胞介素6水平在周围和中枢均升高。用5-HT3受体拮抗剂雷莫司琼治疗在爪撤离试验中发挥了镇痛作用,且依赖于炎症性疼痛介质对5-HT3受体数量的减弱。
这些数据表明,在实验性CRPS动物模型中用5-HT3受体拮抗剂雷莫司琼治疗可减轻疼痛相关行为,可能是CRPS患者的一种新的治疗选择或潜在治疗药物。