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Tan YZ, Shi RJ, Ke BW, Tang YL, Liang XH. Paresthesia in dentistry: The ignored neurotoxicity of local anesthetics. Heliyon 2023; 9:e18031. [PMID: 37539316 PMCID: PMC10395355 DOI: 10.1016/j.heliyon.2023.e18031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 06/20/2023] [Accepted: 07/05/2023] [Indexed: 08/05/2023] Open
Abstract
Local anesthetics are frequently used by dentists to relieve localized discomfort of the patient and improve treatment conditions. The risk of paresthesia after local anesthesia is frequently encountered in dental clinics. The neurotoxicity of local anesthetics is a disregarded factor in paresthesia. The review summarizes the types of common local anesthetics, incidence and influencing factors of paresthesia after local anesthesia, and systematically describes the neurotoxicity mechanisms of dental local anesthetic. Innovative strategies may be developed to lessen the neurotoxicity and prevent paresthesia following local anesthesia with the support of a substantial understanding of paresthesia and neurotoxicity.
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Affiliation(s)
- Yong-zhen Tan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rong-jia Shi
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Bo-wen Ke
- Laboratory of Anesthesiology & Critical Care Medicine, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Ya-ling Tang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin-hua Liang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Lan X, Xu Y. Protective role of lidocaine against cerebral ischemia-reperfusion injury: An in vitro study. Exp Ther Med 2021; 23:42. [PMID: 34849157 PMCID: PMC8613535 DOI: 10.3892/etm.2021.10964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 05/20/2020] [Indexed: 12/17/2022] Open
Abstract
Lidocaine, a local anesthetic, is a valuable agent for the treatment of neuronal ischemia/reperfusion (I/R) injury. The aim of the present study was to investigate the role of lidocaine in oxygen-glucose deprivation/reperfusion (OGD/R)-induced cortical neurons and explore the related molecular mechanisms. Cerebral cortical neurons were isolated from Sprague-Dawley rat embryos and stimulated with OGD/R to establish an in vitro I/R injury model. Subsequently, neuronal cell viability, cytotoxicity and apoptosis were evaluated by performing the MTT assay, lactate dehydrogenase (LDH) assay and flow cytometry, respectively. The results suggested that OGD/R exposure significantly decreased cerebral cortical neuron cell viability, accelerated LDH release and induced cell apoptosis compared with control neurons, indicating that cerebral I/R injury was stimulated by OGD/R treatment. Further investigation indicated that 10 µM lidocaine significantly enhanced neuronal cell viability, and reduced LDH release and neuronal cell apoptosis in OGD/R-exposed cells compared with the OGD/R + saline group, which indicated that lidocaine displayed neuroprotective effects against I/R damage. In addition, the findings of the present study suggested that OGD/R exposure significantly decreased Bcl-2 and Bcl-xl protein expression levels, but increased Bax protein expression levels, the Bax/Bcl-2 ratio and caspase-3 activity compared with control neurons. However, lidocaine reversed OGD/R-mediated alterations to apoptosis-related protein expression. Furthermore, the results of the present study indicated that lidocaine increased Wnt3a, β-catenin and cyclin D1 expression levels in OGD/R-exposed cells compared with the OGD/R + saline group, thus activating the Wnt/β-catenin signaling pathway. The findings of the present study suggested that lidocaine served a protective role in OGD/R-triggered neuronal damage by activating the Wnt/β-catenin signaling pathway; therefore, lidocaine may serve as a potential candidate for the treatment of cerebral I/R injury.
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Affiliation(s)
- Xiaoyang Lan
- Department of Neurology, First Medical Center, People's Liberation Army General Hospital, Beijing 100853, P.R. China
| | - Yumin Xu
- Department of Anesthesiology, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China
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3
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Targeting T-type channels in cancer: What is on and what is off? Drug Discov Today 2021; 27:743-758. [PMID: 34838727 DOI: 10.1016/j.drudis.2021.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/10/2021] [Accepted: 11/18/2021] [Indexed: 12/27/2022]
Abstract
Over the past 20 years, various studies have demonstrated a pivotal role of T-type calcium channels (TTCCs) in tumor progression. Cytotoxic effects of TTCC pharmacological blockers have been reported in vitro and in preclinical models. However, their roles in cancer physiology are only beginning to be understood. In this review, we discuss evidence for the signaling pathways and cellular processes stemming from TTCC activity, mainly inferred by inverse reasoning from pharmacological blocks and, only in a few studies, by gene silencing or channel activation. A thorough analysis indicates that drug-induced cytotoxicity is partially an off-target effect. Dissection of on/off-target activity is paramount to elucidate the physiological roles of TTCCs, and to deliver efficacious therapies suited to different cancer types and stages.
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Wen X, Li Y, Liu X, Sun C, Lin J, Zhang W, Wu Y, Wang X. Roles of CaMKIIβ in the neurotoxicity induced by ropivacaine hydrochloride in dorsal root ganglion. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:2948-2956. [PMID: 31317779 DOI: 10.1080/21691401.2019.1642208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Xianjie Wen
- Department of Pain Management, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
- Department of Anesthesology, Affiliated Foshan Hospital of the Southern Medical University and The Second People's Hospital of Foshan City, Foshan, Guangdong Province, China
| | - Yiqun Li
- Department of Orthopaedics, Affiliated Foshan Hospital of the Southern Medical University and The Second Peoplès Hospital of Foshan City, Foshan, Guangdong Province, China
| | - Xingqing Liu
- Department of Anesthesology, Affiliated Foshan Hospital of the Southern Medical University and The Second People's Hospital of Foshan City, Foshan, Guangdong Province, China
| | - Can Sun
- Department of Anesthesology, Affiliated Foshan Hospital of the Southern Medical University and The Second People's Hospital of Foshan City, Foshan, Guangdong Province, China
| | - Jinbing Lin
- Department of Anesthesology, Affiliated Foshan Hospital of the Southern Medical University and The Second People's Hospital of Foshan City, Foshan, Guangdong Province, China
| | - Wenli Zhang
- Department of Anesthesology, Affiliated Foshan Hospital of the Southern Medical University and The Second People's Hospital of Foshan City, Foshan, Guangdong Province, China
| | - Yabin Wu
- Department of Anesthesology, Affiliated Foshan Hospital of the Southern Medical University and The Second People's Hospital of Foshan City, Foshan, Guangdong Province, China
| | - Xiaoping Wang
- Department of Pain Management, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
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Snutch TP, Zamponi GW. Recent advances in the development of T-type calcium channel blockers for pain intervention. Br J Pharmacol 2018; 175:2375-2383. [PMID: 28608534 PMCID: PMC5980537 DOI: 10.1111/bph.13906] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/19/2017] [Accepted: 06/05/2017] [Indexed: 01/15/2023] Open
Abstract
Cav 3.2 T-type calcium channels are important regulators of pain signals in the afferent pain pathway, and their activities are dysregulated during various chronic pain states. Therefore, it is reasonable to predict that inhibiting T-type calcium channels in dorsal root ganglion neurons and in the spinal dorsal horn can be targeted for pain relief. This is supported by early pharmacological studies with T-type channel blockers, such as ethosuximide, and by analgesic effects of siRNA depletion of Cav 3.2 channels. In the past 5 years, considerable effort has been applied towards identifying novel classes of T-type calcium channel blockers. Here, we review recent developments in the discovery of novel classes of T-type calcium channel blockers, and their analgesic effects in animal models of pain and in clinical trials. LINKED ARTICLES This article is part of a themed section on Recent Advances in Targeting Ion Channels to Treat Chronic Pain. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.12/issuetoc.
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Affiliation(s)
- Terrance P Snutch
- Michael Smith Laboratories and Djavad Mowafaghian Centre for Brain HealthUniversity of British ColumbiaVancouverBCCanada
| | - Gerald W Zamponi
- Department of Physiology and Pharmacology, Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
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Gong Q, Wen X, Li H, He J, Wang Y, Wu H, Wang H, Wang X. Up-regulation of Cav3.1 expression in SH-SY5Y cells induced by lidocaine hydrochloride. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2018; 46:372-379. [PMID: 29327607 DOI: 10.1080/21691401.2018.1425697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Qin Gong
- Department of Pain Management, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
- Department of Anesthesiology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong Province, China
| | - Xianjie Wen
- Department of Anesthesiology, The First People’s Hospital of Foshan & Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Heng Li
- Department of Anesthesiology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qinyuan, Guangdong Province, China
| | - Jian He
- Department of Anesthesiology, The First People’s Hospital of Foshan & Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Yunhua Wang
- Department of Anesthesiology, The First People’s Hospital of Foshan & Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Huiping Wu
- Department of Anesthesiology, The First People’s Hospital of Foshan & Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Hanbing Wang
- Department of Anesthesiology, The First People’s Hospital of Foshan & Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Xiaoping Wang
- Department of Pain Management, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
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Valdor M, Wagner A, Röhrs V, Berg J, Fechner H, Schröder W, Tzschentke TM, Bahrenberg G, Christoph T, Kurreck J. RNA interference-based functional knockdown of the voltage-gated potassium channel Kv7.2 in dorsal root ganglion neurons after in vitro and in vivo gene transfer by adeno-associated virus vectors. Mol Pain 2017; 14:1744806917749669. [PMID: 29212407 PMCID: PMC5805000 DOI: 10.1177/1744806917749669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Activation of the neuronal potassium channel Kv7.2 encoded by the KCNQ2 gene has recently been shown to be an attractive mechanism to inhibit nociceptive transmission. However, potent, selective, and clinically proven activators of Kv7.2/Kv7.3 currents with analgesic properties are still lacking. An important prerequisite for the development of new drugs is a model to test the selectivity of novel agonists by abrogating Kv7.2/Kv7.3 function. Since constitutive knockout mice are not viable, we developed a model based on RNA interference-mediated silencing of KCNQ2. By delivery of a KCNQ2-specific short hairpin RNA with adeno-associated virus vectors, we completely abolished the activity of the specific Kv7.2/Kv7.3-opener ICA-27243 in rat sensory neurons. Results obtained in the silencing experiments were consistent between freshly prepared and cryopreserved dorsal root ganglion neurons, as well as in dorsal root ganglion neurons dissociated and cultured after in vivo administration of the silencing vector by intrathecal injections into rats. Interestingly, the tested associated virus serotypes substantially differed with respect to their transduction capability in cultured neuronal cell lines and primary dorsal root ganglion neurons and the in vivo transfer of transgenes by intrathecal injection of associated virus vectors. However, our study provides the proof-of-concept that RNA interference-mediated silencing of KCNQ2 is a suitable approach to create an ex vivo model for testing the specificity of novel Kv7.2/Kv7.3 agonists.
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Affiliation(s)
- Markus Valdor
- 1 14938 Grünenthal GmbH , Pharmacology and Biomarker Development, Aachen, Germany
| | - Anke Wagner
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| | - Viola Röhrs
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| | - Johanna Berg
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| | - Henry Fechner
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
| | - Wolfgang Schröder
- 1 14938 Grünenthal GmbH , Pharmacology and Biomarker Development, Aachen, Germany
| | - Thomas M Tzschentke
- 1 14938 Grünenthal GmbH , Pharmacology and Biomarker Development, Aachen, Germany
| | | | - Thomas Christoph
- 1 14938 Grünenthal GmbH , Pharmacology and Biomarker Development, Aachen, Germany
| | - Jens Kurreck
- 2 Department of Applied Biochemistry, Institute of Biotechnology, Berlin University of Technology, Berlin, Germany
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Wen X, Liang H, Li H, Ou W, Wang HB, Liu H, Li S. In vitroneurotoxicity by ropivacaine is reduced by silencing Cav3.3 T-type calcium subunits in neonatal rat sensory neurons. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2017; 46:1617-1624. [PMID: 28974111 DOI: 10.1080/21691401.2017.1384386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Xianjie Wen
- Department of Anaesthesiology, The First People’s Hospital of Foshan and Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Hua Liang
- Department of Anaesthesiology, The First People’s Hospital of Foshan and Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Heng Li
- Department of Anaesthesiology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qinyuan, Guangdong Province, China
| | - Weiming Ou
- Department of Anaesthesiology, The First People’s Hospital of Foshan and Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Han-Bing Wang
- Department of Anaesthesiology, The First People’s Hospital of Foshan and Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Hongzhen Liu
- Department of Anaesthesiology, The First People’s Hospital of Foshan and Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
| | - Shijie Li
- Department of Anaesthesiology, The First People’s Hospital of Foshan and Foshan Hospital of Sun Yat-sen University, Foshan, Guangdong Province, China
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CaMK II γ down regulation protects dorsal root ganglion neurons from ropivacaine hydrochloride neurotoxicity. Sci Rep 2017; 7:5262. [PMID: 28701796 PMCID: PMC5507888 DOI: 10.1038/s41598-017-05678-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/01/2017] [Indexed: 12/29/2022] Open
Abstract
T-type calcium channels are intimately involved in the local anesthetics neurotoxicity. Does CaMKIIγ regulate T-type calcium currents in local anesthetics neurotoxicity? This study generated pAd-CaMKIIγ and pAd-shRNA adenovirus vectors to up- and down-regulate CaMKIIγ mRNA expression in dorsal root ganglion neurons (DRG). Normal DRG (Normal group), empty vector DRG (Empty vector group), pAd-CaMKIIγ DRG (pAd-CaMKIIγ group) and pAd-shRNA DRG (pAd-shRNA group) were treated or untreated with 3 mM ropivacaine hydrochloride for 4 h. Cell viability, apoptosis rate, CaMKIIγ, pCaMKIIγ, Cav3.2, and Cav3.3 expression were detected. Ultrastructural changes in DRG were observed under a transmission electron microscope. The results demonstrated that the cell viability of DRG treated with ropivacaine hydrochloride decreased markedly, the apoptosis rate, CaMKIIγ, pCaMKIIγ, Cav3.2, Cav3.3 expression increased significantly. CaMKIIγ up-regulation aggravated ropivacaine hydrochloride-induced cell damage and increased Cav3.2 and Cav3.3 expression. In conclusion, CaMKIIγ regulated Cav3.2 and Cav3.3 expression in DRG, which was involved with ropivacaine hydrochloride-induced cell injury.
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Li X, Peng C, Wang X, Wen X. One-cell model for inhibiting Cav3.3 mRNA expression by RNA interference. BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1282838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Xiaohong Li
- Department of Pain Clinic, The First Affiliated Hospital of Jinan University, Guangzhou, PR China
- Department of Anesthesiology, The First People's Hospital of Foshan & Foshan Hospital of Sun Yat-sen University, Foshan, PR China
| | - Changzheng Peng
- Department of Anesthesiology, Dongcheng People's Hospital of Dongwan City, Dongwan, PR China
| | - Xiaoping Wang
- Department of Pain Clinic, The First Affiliated Hospital of Jinan University, Guangzhou, PR China
| | - Xianjie Wen
- Department of Anesthesiology, The First People's Hospital of Foshan & Foshan Hospital of Sun Yat-sen University, Foshan, PR China
- Department of Anesthesiology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qinyuan, PR China
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The effects of ropivacaine hydrochloride on the expression of CaMK II mRNA in the dorsal root ganglion neurons. Biomed Pharmacother 2016; 84:2014-2019. [PMID: 27863837 DOI: 10.1016/j.biopha.2016.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 01/27/2023] Open
Abstract
In this study, we identified the subtype of Calcium/calmodulin-dependent protein kinase II (CaMK II) mRNA in dorsal root ganglion neurons and observed the effects of ropivacaine hydrochloride in different concentration and different exposure time on the mRNA expression. Dorsal root ganglion neurons were isolated from the SD rats and cultured in vitro. The mRNA of the CaMK II subtype in dorsal root ganglion neurons were detected by real-time PCR. As well as, the dorsal root ganglion neurons were treated with ropivacaine hydrochloride in different concentration (1mM,2mM, 3mM and 4mM) for the same exposure time of 4h, or different exposure time (0h,2h,3h,4h and 6h) at the same concentration(3mM). The changes of the mRNA expression of the CaMK II subtype were observed with real-time PCR. All subtype mRNA of the CaMK II, CaMK IIα, CaMK IIβ, CaMK II δ, CaMK IIγ, can be detected in dorsal root ganglion neurons. With the increased of the concentration and exposure time of the ropivacaine hydrochloride, all the subtype mRNA expression increased. Ropivacaine hydrochloride up-regulate the CaMK IIβ, CaMK IIδ, CaMK IIg mRNA expression with the concentration and exposure time increasing. The nerve blocking or the neurotoxicity of the ropivacaine hydrochloride maybe involved with CaMK II.
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Wen X, Li X, Liang H, Yang C, Zhong J, Wang H, Liu H. One cell model establishment to inhibit CaMKII γ mRNA expression in the dorsal root ganglion neuron by RNA interfere. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2016; 45:1-7. [PMID: 27685016 DOI: 10.1080/21691401.2016.1216860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CaMKIIγ in dorsal root ganglion neurons is closely related to the neuropathic pain, neuron injury induced by local anesthetics. To get great insight into the function of CaMKIIγ in dorsal root ganglion neurons, we need one cell model to specially inhibit the CaMKIIγ mRNA expression. The present study was aimed to establish one cell model to specially inhibit the CaMKIIγ mRNA expression. We designed the CaMKIIγ shRNA sequence and connected with pYr-1.1 plasmid. The ligation product of the CaMKIIγshRNA and pYr-1.1 plasmid was recombined with pAd/PL-DEST vector into pAD-CaMKIIγ-shRNA. adenovirus vector. pAD-CaMKIIγ-shRNA. adenovirus vector infected the dorsal root ganglion neuron to inhibit the CaMKIIγ mRNA expression in vitro. The pAD-CaMKIIγ-shRNA adenovirus vector was verified to be correct by the digestion, sequence. And pAD-CaMKIIγ-shRNA. adenovirus vector can infect the DRG cells to inhibit the CaMKIIγ mRNA or protein expression by the real-time polymerase chain reaction (PCR) or western blotting. Those results showed that we successfully constructed one adenovirus vector that can infect the dorsal root ganglion neuron to inhibit the CaMKIIγ mRNA and protein expression. That will supply with one cell model for the CaMKIIγ function study.
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Affiliation(s)
- Xianjie Wen
- a Department of Anesthesiology , The First People's Hospital of Foshan and Foshan Hospital of Sun Yat-Sen University , Foshan , China
| | - Xiaohong Li
- a Department of Anesthesiology , The First People's Hospital of Foshan and Foshan Hospital of Sun Yat-Sen University , Foshan , China.,b Department of Pain Clinic , the First Affiliated Hospital of Jinan University , Guangzhou , China
| | - Hua Liang
- a Department of Anesthesiology , The First People's Hospital of Foshan and Foshan Hospital of Sun Yat-Sen University , Foshan , China
| | - Chenxiang Yang
- a Department of Anesthesiology , The First People's Hospital of Foshan and Foshan Hospital of Sun Yat-Sen University , Foshan , China
| | - Jiying Zhong
- a Department of Anesthesiology , The First People's Hospital of Foshan and Foshan Hospital of Sun Yat-Sen University , Foshan , China
| | - Hanbing Wang
- a Department of Anesthesiology , The First People's Hospital of Foshan and Foshan Hospital of Sun Yat-Sen University , Foshan , China
| | - Hongzhen Liu
- a Department of Anesthesiology , The First People's Hospital of Foshan and Foshan Hospital of Sun Yat-Sen University , Foshan , China
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