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Wong SSC, Sun L, Qiu Q, Gu P, Li Q, Wang XM, Cheung CW. Propofol attenuates postoperative hyperalgesia via regulating spinal GluN2B-p38MAPK/EPAC1 pathway in an animal model of postoperative pain. Eur J Pain 2019; 23:812-822. [PMID: 30570802 DOI: 10.1002/ejp.1349] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/16/2018] [Accepted: 12/11/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Total intravenous anesthesia with propofol has been shown to reduce postoperative pain in some clinical studies, but knowledge of its underlying analgesic mechanism remains limited. In this study, we compared the analgesic effects of propofol versus isoflurane in an animal model of postoperative pain and evaluated its underlying molecular mechanisms. METHODS Plantar incision was made in the hind paws of rats under general anesthesia with 2.5% of inhalational isoflurane (isoflurane group) or intravenous infusion of propofol (1.5 mg kg-1 min-1 , propofol group). Mechanical allodynia was assessed by paw withdrawal threshold before and after incision. Spinal dorsal horns (L3-L5) were harvested 1 hr after incision to assess the level of phosphorylated GluN2B, p38MAPK, ERK, JNK, and EPAC using Western blot and immunofluorescence. RESULTS Mechanical allodynia induced by plantar incision peaked at 1 hr and lasted for 3 days after incision. It was significantly less in the propofol group compared with the isoflurane group in the first 2 hr following incision. The incision-induced increases in phosphorylated GluN2B, p38MAPK, and EPAC1 were significantly reduced in the propofol group. The number of spinal dorsal neurons co-expressed with EPAC1 and c-Fos after the incision was significantly lower in the propofol group. CONCLUSION Propofol reduced pain responses in an animal model of postoperative pain and suppressed the spinal GluN2B-p38MAPK/EPAC1 signaling pathway. Since the p38MAPK/EPAC pathway plays a critical role in the development of postoperative hyperalgesia, our results provide evidence-based behavioral, molecular, and cellular mechanisms for the analgesic effects of propofol when used for general anesthesia. SIGNIFICANCE These findings may provide a new mechanism for the postsurgical analgesic effect of propofol, which is particularly interesting during the subacute period after surgery as it is the critical period for the development of persistent postsurgical pain.
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Affiliation(s)
- Stanley S-C Wong
- Laboratory and Clinical Research Institute for Pain, Hong Kong SAR, China.,Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Liting Sun
- The First Rehabilitation Hospital of Shanghai, Tongji University School of Medicine, Advanced Institute of Translational Medicine, Tongji University, Shanghai, China
| | - Qiu Qiu
- Laboratory and Clinical Research Institute for Pain, Hong Kong SAR, China
| | - Pan Gu
- Laboratory and Clinical Research Institute for Pain, Hong Kong SAR, China.,Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Qing Li
- Department of Anesthesiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei Province, China
| | - Xiao-Min Wang
- Laboratory and Clinical Research Institute for Pain, Hong Kong SAR, China.,Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chi Wai Cheung
- Laboratory and Clinical Research Institute for Pain, Hong Kong SAR, China.,Department of Anaesthesiology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Hu ML, Zhu HM, Zhang QL, Liu JJ, Ding Y, Zhong JM, Vodyanoy V, Ding MX. Exploring the Mechanisms of Electroacupuncture-Induced Analgesia through RNA Sequencing of the Periaqueductal Gray. Int J Mol Sci 2017; 19:ijms19010002. [PMID: 29295561 PMCID: PMC5795954 DOI: 10.3390/ijms19010002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 12/15/2017] [Accepted: 12/17/2017] [Indexed: 12/19/2022] Open
Abstract
Electroacupuncture (EA) can relieve various pains. However, its mechanism in terms of the transcriptome is still not well-known. To explore the full profile of EA-induced molecular modification in the central nerve system, three twins of goats were selected for a match-paired experiment: EA stimulation (60 Hz, 30 min) and none-EA (control). Goats in the EA group showed an increased (p < 0.05) nociceptive threshold compared with the control goats. Experimental goats were sacrificed at 4 h of the experiment, and the periaqueductal grays were harvested for RNA sequencing. As a result, 2651 differentially expressed genes (1803 up-regulated and 848 down-regulated genes) were found and enriched in 30 Kyoto Encyclopedia of Genes and Genomes pathways and 149 gene ontology terms. EA-regulated five neuropeptide genes (proenkephalin, proopiomelanocortin, preprodynorphin, diazepam-binding inhibitor and proprotein convertase 1 inhibitor) were validated with quantitative PCR. Furthermore, up-regulated glutamate receptors, glutamate transporters, γ-aminobutyric acid (GABA) receptors, GABA transporters, synaptotagmins or mitogen-activated protein kinase (MAPK) genes might contribute to EA-induced analgesia through regulating the glutamatergic synapse, GABAergic synapse, MAPKs, ribosome or ubiquitin-proteasome pathways. Our findings reveal a full profile of molecular modification in response to EA and provide a solid experimental framework for exploring the mechanisms underlying EA-induced analgesia.
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Affiliation(s)
- Man-Li Hu
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China.
| | - Hong-Mei Zhu
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China.
| | - Qiu-Lin Zhang
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China.
| | - Jing-Jing Liu
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China.
| | - Yi Ding
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China.
| | - Ju-Ming Zhong
- College of Physiology and Pharmacology, Auburn University, Auburn, AL 36849, USA.
| | - Vitaly Vodyanoy
- College of Physiology and Pharmacology, Auburn University, Auburn, AL 36849, USA.
| | - Ming-Xing Ding
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China.
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Zeng YJ, Lin YH, Wang YC, Chang JH, Wu JH, Hsu SF, Tsai SY, Lin CH, Wen YR. Laser acupuncture-induced analgesic effect and molecular alterations in an incision pain model: a comparison with electroacupuncture-induced effects. Lasers Med Sci 2017; 33:295-304. [PMID: 29103083 PMCID: PMC5803293 DOI: 10.1007/s10103-017-2367-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 10/17/2017] [Indexed: 11/28/2022]
Abstract
Low-level laser acupuncture (LLLA) produces photobiomodulation through acupuncture point and is an alternative to low-level laser therapy. Although the analgesic effect of LLLA on chronic pain has been proven, its effect on acute postincisional pain has yet to be investigated. A plantar incision (PI) model was used to mimic human postsurgical pain. Male adult rats received GaAlAs laser irradiation at the right ST36 acupoint immediately after operation and on the following 4 days. Three laser treatment groups (two red laser groups with a 30- or 15-min treatment duration and one 30-min near-infrared laser group) were compared with sham LLLA and naive groups and an electroacupuncture (EA) group (separate study). Behavioral withdrawal thresholds of both hind paws were measured before and after incision. Expression of mitogen-activated protein kinases (p-ERK and p-p38), inducible nitric oxide synthase (iNOS), and tumor necrosis factor (TNF) in the spinal cord was analyzed. All three LLLA treatments attenuated post-PI tactile allodynia in the ipsilateral paw, but only the 30-min red laser treatment affected the contralateral paw and had similar efficacy to that of EA. All laser treatments barely reduced heat hyperalgesia in both hind paws. At 3 days after PI, the 30-min red laser group showed reversed increases of PI-induced p-ERK, p-p38, and iNOS but not TNF expression in the spinal cord. Repetitive LLLA treatments ameliorated PI-induced mechanical pain. The inhibition of multiple sensitization signals highlights the unique clinical role of LLLA. Thus, LLLA is an alternative to EA as an adjuvant for postoperative pain control.
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Affiliation(s)
- Yen-Jing Zeng
- Graduate Institute of Clinical Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Hsiang Lin
- Microelectronic and Optoelectronic Engineering Department of Electronic Engineering, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - You-Cheng Wang
- Department of Electronic Engineering, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Ju-Hsin Chang
- Graduate Institute of Clinical Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Anesthesiology, China Medical University Hospital, No. 2, Yuh-Der Rd, North District, 40447, Taichung, Taiwan
| | - Jih-Huah Wu
- Department of Biomedical Engineering, Ming Chuan University, Taipei City, Taiwan
| | - Sheng-Feng Hsu
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Acupuncture, China Medical University Hospital Taipei Branch, Taipei, Taiwan.,Acupuncture Research Center, China Medical University, Taichung, Taiwan
| | - Shih-Ying Tsai
- Department of Anesthesiology, China Medical University Hospital, No. 2, Yuh-Der Rd, North District, 40447, Taichung, Taiwan
| | - Ching-Huang Lin
- Microelectronic and Optoelectronic Engineering Department of Electronic Engineering, National Yunlin University of Science and Technology, Yunlin, Taiwan.,Department of Electronic Engineering, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Yeong-Ray Wen
- Department of Anesthesiology, China Medical University Hospital, No. 2, Yuh-Der Rd, North District, 40447, Taichung, Taiwan. .,Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan. .,Acupuncture Research Center, China Medical University, Taichung, Taiwan. .,Department of Anesthesiology, School of Medicine, China Medical University, Taichung, Taiwan. .,Center for Pain Research and Management, Department of Anesthesiology, School of Medicine, China Medical University, Taichung, Taiwan.
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Sun L, Tai L, Qiu Q, Mitchell R, Fleetwood-Walker S, Joosten EA, Cheung CW. Endocannabinoid activation of CB 1 receptors contributes to long-lasting reversal of neuropathic pain by repetitive spinal cord stimulation. Eur J Pain 2017; 21:804-814. [PMID: 28107590 DOI: 10.1002/ejp.983] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Spinal cord stimulation (SCS) has been shown to be effective in the management of certain neuropathic pain conditions, however, the underlying mechanisms are incompletely understood. In this study, we investigated repetitive SCS in a rodent neuropathic pain model, revealing long-lasting and incremental attenuation of hyperalgesia and a mechanism of action involving endocannabinoids. METHOD Animals were implanted with monopolar electrodes at the time of partial sciatic nerve injury. Dorsal columns at spinal segments T12/13 were stimulated 3 days later (early SCS), and again at day 7 (late SCS) using low-frequency parameters. Hypersensitivity to cutaneous mechanical stimuli was assessed using von Frey filaments. Pharmacological agents, selected to identify endocannabinoid and opioid involvement, were administered intraperitoneally, 10 min before SCS. RESULTS Early SCS caused partial reversal of mechanical hypersensitivity with corresponding changes in the biomarker of central sensitization, [phospho-Tyr1472 ]-GluN2B. The partial reversal of hyperalgesia by early SCS was amplified by co-administration of LY 2183240, an inhibitor of endocannabinoid reuptake/breakdown. This amplification was inhibited by a CB1 R antagonist, AM251, but not by a CB2 R antagonist, AM630. Early SCS-induced reversal of hyperalgesia was attenuated by naloxone, indicating a role for opioids. Late SCS resulted in an incremental level of reversal of hyperalgesia, which was inhibited by AM251, but not by CB2 or opioid receptor antagonists. CONCLUSION The endocannabinoid system, and in particular the CB1 R, plays a pivotal role in the long-lasting and incremental reversal of hyperalgesia induced by repetitive SCS in a neuropathic pain model. SIGNIFICANCE Alternative parameters for repetitive spinal cord stimulation (SCS) at 25/10 Hz elicit particularly long-lasting and incremental reversal of hyperalgesia in a neuropathic pain model through a mechanism involving endocannabinoids.
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Affiliation(s)
- L Sun
- Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, HKSAR, China
| | - L Tai
- Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, HKSAR, China
| | - Q Qiu
- Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, HKSAR, China
| | - R Mitchell
- Centre for Integrative Physiology, Edinburgh Medical School: Biomedical Sciences, The University of Edinburgh, UK
| | - S Fleetwood-Walker
- Centre for Integrative Physiology, Edinburgh Medical School: Biomedical Sciences, The University of Edinburgh, UK
| | - E A Joosten
- Department of Anesthesiology/Pain Management, The University Pain Center Maastricht, Maastricht University Medical Center, The Netherlands
| | - C W Cheung
- Laboratory and Clinical Research Institute for Pain, Department of Anaesthesiology, The University of Hong Kong, HKSAR, China
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