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地佐辛通过激活κ-和μ-阿片受体以及抑制去甲肾上腺素和血清素再摄取对慢性疼痛发挥镇痛作用。

Dezocine Exerts Analgesic Effects in Chronic Pain by Activation of κ- and μ-Opioid Receptors and Inhibition of Norepinephrine and Serotonin Reuptake.

作者信息

Liu Zihan, Liu Anan, Chen Jing, Chai Jing-Rui, Liu Panwen, Ye Ru-Feng, Liu Jing-Gen, Wang Yu-Jun

机构信息

School of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China.

Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China.

出版信息

Pain Res Manag. 2025 Apr 4;2025:5656675. doi: 10.1155/prm/5656675. eCollection 2025.

Abstract

Dezocine is a leading analgesic in China used for relieving moderate to severe pain. Previous studies have characterized its pharmacological properties, demonstrating its role as a partial agonist at both the κ-opioid receptor (KOR) and the μ-opioid receptor (MOR), thereby producing potent antinociceptive effects in acute pain models. However, its efficacy and mechanisms in chronic pain management remained unclear. Chronic pain models, including chronic neuropathic pain and cancer pain, were employed using chronic constriction injury (CCI) of the sciatic nerve and bone cancer pain (BCP) methodologies, respectively. The assessment of the mechanical allodynia was conducted using a von Frey filament. Dezocine, administered via the intraperitoneal route, alleviated both neuropathic pain and cancer pain in a dose-dependent manner, with ED of 1.3 mg/kg and 1.6 mg/kg, respectively. In the CCI model, the analgesic effect of dezocine was significantly inhibited by pretreating with KOR antagonist nor-BNI, MOR antagonist β-FNA, α2-adrenoceptor antagonist yohimbine, and 5-HT2A receptor antagonist altanserin. In the BCP model, dezocine-induced analgesia was markedly suppressed by nor-BNI, β-FNA, and yohimbine but not altanserin. These results suggest that, in neuropathic pain, the analgesic effects of dezocine are mediated through KOR and MOR activation, together with norepinephrine reuptake inhibition (NRI) and serotonin reuptake inhibition. In contrast, in cancer pain, KOR and MOR activation and NRI are involved in mediating the analgesic effect of dezocine. This study, along with previous data, enhances our understanding of the potential clinical utility of dezocine and elucidates its mechanisms of action in chronic pain management.

摘要

地佐辛是中国一种用于缓解中重度疼痛的主要镇痛药。先前的研究已对其药理特性进行了表征,证明其作为κ-阿片受体(KOR)和μ-阿片受体(MOR)的部分激动剂发挥作用,从而在急性疼痛模型中产生强效的镇痛作用。然而,其在慢性疼痛管理中的疗效和机制仍不清楚。分别采用坐骨神经慢性压迫损伤(CCI)和骨癌痛(BCP)方法建立了包括慢性神经病理性疼痛和癌痛在内的慢性疼痛模型。使用von Frey细丝对机械性异常性疼痛进行评估。通过腹腔注射途径给药的地佐辛以剂量依赖性方式减轻了神经病理性疼痛和癌痛,其半数有效剂量(ED)分别为1.3mg/kg和1.6mg/kg。在CCI模型中,预先用KOR拮抗剂nor-BNI、MOR拮抗剂β-FNA、α2-肾上腺素能受体拮抗剂育亨宾和5-HT2A受体拮抗剂阿坦色林处理可显著抑制地佐辛的镇痛作用。在BCP模型中,nor-BNI、β-FNA和育亨宾可显著抑制地佐辛诱导的镇痛作用,但阿坦色林则无此作用。这些结果表明,在神经病理性疼痛中,地佐辛的镇痛作用是通过激活KOR和MOR,以及抑制去甲肾上腺素再摄取(NRI)和血清素再摄取来介导的。相比之下,在癌痛中,KOR和MOR的激活以及NRI参与介导地佐辛的镇痛作用。这项研究与先前的数据一起,加深了我们对 地佐辛潜在临床应用的理解,并阐明了其在慢性疼痛管理中的作用机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6037/11991863/64decaf8755d/PRM2025-5656675.001.jpg

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