Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China.
Department for Translational Anaesthesiology and Intensive Care Medicine, Medical Faculty University of Augsburg, 86156, Augsburg, Germany.
Neurochem Res. 2023 Dec;48(12):3597-3609. doi: 10.1007/s11064-023-03998-6. Epub 2023 Aug 10.
Morphine is amongst the most effective analgesics available for the management of severe pain. However, prolonged morphine treatment leads to analgesic tolerance which limits its clinical usage. Previous studies have demonstrated that melatonin ameliorates morphine tolerance by reducing neuroinflammation. However, little is known about the relationship between Toll like receptor 2 (TLR2) and neuroinflammation in morphine tolerance. The aim of this study was to explore the role of TLR2 in morphine tolerance and its connections with melatonin and Nod-like receptor protein 3 (NLRP3) inflammasome.
Sprague-Dawley rats were treated with morphine for 7 days and tail-flick latency test was performed to identify the induction of analgesic tolerance. The roles of TLR2 in microglia activation and morphine tolerance were assessed pharmacologically, and the possible interactions between melatonin, TLR2 and NLRP3 inflammasome were investigated.
Morphine tolerance was accompanied by increased TLR2 expression and NLRP3 inflammasome activation in spinal cord. whereas melatonin level was down-regulated. Chronic melatonin administration resulted in a reduced TLR2 expression and NLRP3 inflammasome activation. Moreover, the analgesic effect of morphine was partially restored. Inhibition of TLR2 suppressed the microglia and NLRP3 inflammasome activation, as well as restored the spinal melatonin level while attenuated the development of morphine tolerance. Furthermore, the inhibition of microglia activation ameliorated morphine tolerance via inhibiting TLR2-NLRP3 inflammasome signaling in spinal cord.
In this study, we directly demonstrate a TLR2-melatonin negative feedback loop regulating microglia and NLRP3 inflammasome activation during the development of morphine tolerance.
吗啡是治疗重度疼痛最有效的镇痛药之一。然而,长期使用吗啡会导致镇痛耐受,限制了其临床应用。先前的研究表明,褪黑素通过减轻神经炎症来改善吗啡耐受。然而,关于吗啡耐受过程中 Toll 样受体 2(TLR2)与神经炎症之间的关系知之甚少。本研究旨在探讨 TLR2 在吗啡耐受中的作用及其与褪黑素和 Nod 样受体蛋白 3(NLRP3)炎性小体的关系。
用吗啡处理 Sprague-Dawley 大鼠 7 天,通过尾巴敲击潜伏期试验鉴定镇痛耐受的诱导。通过药理学方法评估 TLR2 在小胶质细胞激活和吗啡耐受中的作用,并研究褪黑素、TLR2 和 NLRP3 炎性小体之间的可能相互作用。
吗啡耐受伴随着脊髓中 TLR2 表达和 NLRP3 炎性小体激活增加,而褪黑素水平下调。慢性褪黑素给药导致 TLR2 表达和 NLRP3 炎性小体激活减少。此外,吗啡的镇痛作用部分恢复。TLR2 抑制抑制小胶质细胞和 NLRP3 炎性小体激活,恢复脊髓褪黑素水平,减轻吗啡耐受的发展。此外,抑制小胶质细胞激活通过抑制脊髓 TLR2-NLRP3 炎性小体信号通路改善吗啡耐受。
在这项研究中,我们直接证明了 TLR2-褪黑素负反馈环调节吗啡耐受发展过程中小胶质细胞和 NLRP3 炎性小体的激活。