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Friesner ID, Martinez E, Zhou H, Gould JD, Li A, Chen ZS, Zhang Q, Wang J. Ketamine normalizes high-gamma power in the anterior cingulate cortex in a rat chronic pain model. Mol Brain 2020; 13:129. [PMID: 32967695 PMCID: PMC7513294 DOI: 10.1186/s13041-020-00670-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/14/2020] [Indexed: 11/18/2022] Open
Abstract
Chronic pain alters cortical and subcortical plasticity, causing enhanced sensory and affective responses to peripheral nociceptive inputs. Previous studies have shown that ketamine had the potential to inhibit abnormally amplified affective responses of single neurons by suppressing hyperactivity in the anterior cingulate cortex (ACC). However, the mechanism of this enduring effect has yet to be understood at the network level. In this study, we recorded local field potentials from the ACC of freely moving rats. Animals were injected with complete Freund’s adjuvant (CFA) to induce persistent inflammatory pain. Mechanical stimulations were administered to the hind paw before and after CFA administration. We found a significant increase in the high-gamma band (60–100 Hz) power in response to evoked pain after CFA treatment. Ketamine, however, reduced the high-gamma band power in response to evoked pain in CFA-treated rats. In addition, ketamine had a sustained effect on the high-gamma band power lasting up to five days after a single dose administration. These results demonstrate that ketamine has the potential to alter maladaptive neural responses in the ACC induced by chronic pain.
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Affiliation(s)
- Isabel D Friesner
- Department of Anesthesiology, Perioperative Care and Pain, New York University School of Medicine, New York, NY, 10016, USA
| | - Erik Martinez
- Department of Anesthesiology, Perioperative Care and Pain, New York University School of Medicine, New York, NY, 10016, USA
| | - Haocheng Zhou
- Department of Anesthesiology, Perioperative Care and Pain, New York University School of Medicine, New York, NY, 10016, USA
| | | | - Anna Li
- Department of Anesthesiology, Perioperative Care and Pain, New York University School of Medicine, New York, NY, 10016, USA
| | - Zhe Sage Chen
- Department of Psychiatry, New York University School of Medicine, New York, NY, 10016, USA.,Department of Neuroscience & Physiology, New York University School of Medicine, New York, NY, 10016, USA.,Neuroscience Institute, New York University School of Medicine, New York, NY, 10016, USA
| | - Qiaosheng Zhang
- Department of Anesthesiology, Perioperative Care and Pain, New York University School of Medicine, New York, NY, 10016, USA.
| | - Jing Wang
- Department of Anesthesiology, Perioperative Care and Pain, New York University School of Medicine, New York, NY, 10016, USA. .,Department of Neuroscience & Physiology, New York University School of Medicine, New York, NY, 10016, USA. .,Neuroscience Institute, New York University School of Medicine, New York, NY, 10016, USA.
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Abstract
OBJECTIVE In the context of the current opioid epidemic, there has been a renewed interest in the use of ketamine as an analgesic agent. METHODS We reviewed ketamine analgesia. RESULTS Ketamine is well-known as an antagonist for N-methyl-D-aspartate receptors. In addition, it can regulate the function of opioid receptors and sodium channels. Ketamine also increases signaling through α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors. These myriad of molecular and cellular mechanisms are responsible for a number of pharmacological functions including pain relief and mood regulation. Clinically, a number of studies have investigated the role of ketamine in the setting of acute and chronic pain, and there is evidence that ketamine can provide analgesia in a variety of pain syndromes. DISCUSSION In this review, we examined basic mechanisms of ketamine and its current clinical use and potential novel use in pain management.
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Chen YW, Chiu CC, Wang JN, Hung CH, Wang JJ. Ifenprodil for prolonged spinal blockades of motor function and nociception in rats. Pharmacol Rep 2016; 68:357-62. [PMID: 26922539 DOI: 10.1016/j.pharep.2015.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/03/2015] [Accepted: 09/29/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of the study was to compare the proposed spinal anesthetic effect of ifenprodil, an a1 adrenergic receptor antagonist, with that of the long-acting local anesthetic bupivacaine. METHODS After intrathecally injecting the rats with five different doses of each drug, the dose-response curves of ifenprodil and bupivacaine were constructed to obtain the 50% effective dose (ED50). The spinal blockades of motor function and nociception of ifenprodil were compared with that of bupivacaine. RESULTS We showed that either ifenprodil or bupivacaine produced spinal blockades of motor function and nociception dose-dependently. On the ED50 basis, the potency of ifenprodil (0.42(0.38-0.46) μmol; 0.40(0.36-0.44) μmol) was equal (p>0.05) to that of bupivacaine (0.38(0.36-0.40) μmol; 0.35(0.32-0.38) μmol) in motor function and nociception, respectively. At the equianesthetic doses (ED25, ED50, and ED75), duration produced by ifenprodil was greater than that produced by bupivacaine in motor function and nociception (p<0.05 for the differences). Furthermore, both ifenprodil and bupivacaine showed longer duration of sensory blockade than that of motor blockade (p<0.05 for the differences). CONCLUSIONS The resulting data demonstrated that ifenprodil produces a dose-dependent local anesthetic effect in spinal anesthesia. Ifenprodil shows a more sensory-selective duration of action over motor block, whereas the duration of anesthesia is significantly longer with ifenprodil than with bupivacaine.
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Affiliation(s)
- Yu-Wen Chen
- Department of Physical Therapy, College of Health Care, China Medical University, Taichung, Taiwan; Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, Chi Mei Medical Center, Tainan and Liouying, Taiwan; Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Jieh-Neng Wang
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Hsia Hung
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
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Flores FJ, Ching S, Hartnack K, Fath AB, Purdon PL, Wilson MA, Brown EN. A PK-PD model of ketamine-induced high-frequency oscillations. J Neural Eng 2015; 12:056006. [PMID: 26268223 DOI: 10.1088/1741-2560/12/5/056006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Ketamine is a widely used drug with clinical and research applications, and also known to be used as a recreational drug. Ketamine produces conspicuous changes in the electrocorticographic (ECoG) signals observed both in humans and rodents. In rodents, the intracranial ECoG displays a high-frequency oscillation (HFO) which power is modulated nonlinearly by ketamine dose. Despite the widespread use of ketamine there is no model description of the relationship between the pharmacokinetic-pharmacodynamics (PK-PDs) of ketamine and the observed HFO power. APPROACH In the present study, we developed a PK-PD model based on estimated ketamine concentration, its known pharmacological actions, and observed ECoG effects. The main pharmacological action of ketamine is antagonism of the NMDA receptor (NMDAR), which in rodents is accompanied by an HFO observed in the ECoG. At high doses, however, ketamine also acts at non-NMDAR sites, produces loss of consciousness, and the transient disappearance of the HFO. We propose a two-compartment PK model that represents the concentration of ketamine, and a PD model based in opposing effects of the NMDAR and non-NMDAR actions on the HFO power. MAIN RESULTS We recorded ECoG from the cortex of rats after two doses of ketamine, and extracted the HFO power from the ECoG spectrograms. We fit the PK-PD model to the time course of the HFO power, and showed that the model reproduces the dose-dependent profile of the HFO power. The model provides good fits even in the presence of high variability in HFO power across animals. As expected, the model does not provide good fits to the HFO power after dosing the pure NMDAR antagonist MK-801. SIGNIFICANCE Our study provides a simple model to relate the observed electrophysiological effects of ketamine to its actions at the molecular level at different concentrations. This will improve the study of ketamine and rodent models of schizophrenia to better understand the wide and divergent range of effects that ketamine has.
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Affiliation(s)
- Francisco J Flores
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
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Bravo D, Maturana CJ, Pelissier T, Hernández A, Constandil L. Interactions of pannexin 1 with NMDA and P2X7 receptors in central nervous system pathologies: Possible role on chronic pain. Pharmacol Res 2015. [PMID: 26211949 DOI: 10.1016/j.phrs.2015.07.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Pannexin 1 (Panx1) is a glycoprotein that acts as a membrane channel in a wide variety of tissues in mammals. In the central nervous system (CNS) Panx1 is expressed in neurons, astrocytes and microglia, participating in the pathophysiology of some CNS diseases, such as epilepsy, anoxic depolarization after stroke and neuroinflammation. In these conditions Panx1 acts as an important modulator of the neuroinflammatory response, by secreting ATP, by interacting with the P2X7 receptor (P2X7R), and as an amplifier of NMDA receptor (NMDAR) currents, particularly in conditions of pathological neuronal hyperexcitability. Here, we briefly reviewed the current evidences that support the interaction of Panx1 with NMDAR and P2X7R in pathological contexts of the CNS, with special focus in recent data supporting that Panx1 is involved in chronic pain signaling by interacting with NMDAR in neurons and with P2X7R in glia. The participation of Panx1 in chronic pain constitutes a novel topic for research in the field of clinical neurosciences and a potential target for pharmacological interventions in chronic pain.
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Affiliation(s)
- D Bravo
- Laboratory of Neurobiology, Department of Biology, Faculty of Chemistry and Biology, University of Santiago of Chile, Chile; School of Kinesiology, Faculty of Sport, Health and Recreation, University Bernardo O'Higgins, Chile.
| | - C J Maturana
- Departamento de Fisiología, Pontificia Universidad Católica De Chile, Chile
| | - T Pelissier
- Program of Molecular and Clinical Pharmacology, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Chile
| | - A Hernández
- Laboratory of Neurobiology, Department of Biology, Faculty of Chemistry and Biology, University of Santiago of Chile, Chile
| | - L Constandil
- Laboratory of Neurobiology, Department of Biology, Faculty of Chemistry and Biology, University of Santiago of Chile, Chile
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Ultraviolet B-induced inflammation in the rat: A model of secondary hyperalgesia? Pain 2011; 152:2844-2851. [DOI: 10.1016/j.pain.2011.09.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 08/08/2011] [Accepted: 09/16/2011] [Indexed: 01/31/2023]
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Bishop T, Marchand F, Young AR, Lewin GR, McMahon SB. Ultraviolet-B-induced mechanical hyperalgesia: A role for peripheral sensitisation. Pain 2010; 150:141-152. [DOI: 10.1016/j.pain.2010.04.018] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Revised: 03/29/2010] [Accepted: 04/12/2010] [Indexed: 10/19/2022]
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Spinally applied ketamine or morphine attenuate peripheral inflammation and hyperalgesia in acute and chronic phases of experimental arthritis. Brain Behav Immun 2010; 24:474-85. [PMID: 20006700 DOI: 10.1016/j.bbi.2009.12.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 11/25/2009] [Accepted: 12/09/2009] [Indexed: 12/26/2022] Open
Abstract
Inflammation causes sensitization of peripheral and central nociceptive neurons. Pharmacological modulation of the latter has successfully been used for clinical pain relief. In particular, inhibitors of the NMDA glutamate receptor such as ketamine and agonists at the mu-opioid receptor such as morphine are broadly used. Besides driving the propagation of pain signals, spinal mechanisms are also discussed to modulate inflammation in the periphery. Here, we tested the hypothesis that intrathecally applied ketamine or morphine not only reduce pain-related behavior, but also attenuate induction and maintenance of the inflammatory response in a model of chronic antigen-induced arthritis (AIA). Ketamine, morphine or vehicle was applied to the spinal cords of anesthesized animals with AIA. Swelling and histopathological changes were assessed after 6h (acute phase). Intrathecal catheters were implanted in another set of animals with AIA and substances were applied continuously. During the observation period of 21 days, inflammation and pain-related behavior were assessed. Ketamine and morphine significantly reduced arthritis severity as indicated by reduced joint swelling, but even more intriguingly by reduced infiltration with inflammatory cells and joint destruction in the acute and the chronic phase of arthritis. Morphine showed strong antinociceptive effects in the acute phase only, while the newly established effective dose for ketamine in a continuous application design reduced hyperalgesia in the acute and the chronic stage. In conclusion, both compounds exhibit anti-inflammatory effects during induction and maintenance of arthritis when applied intrathecally. These data thus propose a role of spinal NMDA- and opioid-receptors in the neuronal control of immune-mediated inflammation.
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Arriagada O, Constandil L, Hernández A, Barra R, Soto-Moyano R, Laurido C. EFFECTS OF INTERLEUKIN-1β ON SPINAL CORD NOCICEPTIVE TRANSMISSION IN INTACT AND PROPENTOFYLLINE-TREATED RATS. Int J Neurosci 2009; 117:617-25. [PMID: 17464780 DOI: 10.1080/00207450600773806] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To investigate the contribution of glial cells in the spinal cord nociceptive transmission, the effect of intrathecally administered interleukin-1beta (IL-1beta) was studied in rats treated with the glial cell inactivator propentofylline and submitted to a C-fiber-mediated reflex paradigm evoked by single and repetitive (wind-up) electric stimulation. Intrathecal IL-1beta did not modify the C reflex integrated activity in either group of animals, while producing increased wind-up in intact and decreased wind-up in propentofylline pre-treated rats. Results suggest that the excitatory effect of IL-1beta on spinal wind-up activity in healthy rats is produced by a glial mediator, whereas the inhibitory effect resulted from a direct effect of the cytokine on dorsal horn neurons.
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Affiliation(s)
- Osvaldo Arriagada
- Laboratory of Neurobiology, Department of Biology Faculty of Chemistry and Biology, University of Santiago of Chile, Santiago, Chile
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10
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Zhang W, Shi CX, Gu XP, Ma ZL, Zhu W. Ifenprodil induced antinociception and decreased the expression of NR2B subunits in the dorsal horn after chronic dorsal root ganglia compression in rats. Anesth Analg 2009; 108:1015-20. [PMID: 19224818 DOI: 10.1213/ane.0b013e318193ffd2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Spinal N-methyl D-aspartate receptors play an important role in the pathogenesis of neuropathic pain, and administration of N-methyl D-aspartate receptor antagonists can attenuate this hyperpathia. Ifenprodil is an antagonist selective for N-methyl D-aspartate receptor 2B (NR2B) subunits. Several researches have reported effective analgesia of ifenprodil in animal models of neuropathic pain. We extended this work to include chronic compression of the dorsal root ganglia (CCD). METHODS The paw withdrawal mechanical threshold and paw withdrawal thermal latency tests were used to assess mechanical allodynia and thermal hyperalgesia after a CCD operation and intrathecal injection of ifenprodil. We used immunohistochemistry and immunoblotting to investigate the effect of ifenprodil on NR2B subunits expression in CCD rats. RESULTS The data revealed increased expression of NR2B subunits in the superficial dorsal horn in CCD rats. We found that, in addition to a marked suppression of thermal hyperalgesia and mechanical allodynia, intrathecal injection ifenprodil treatment causes a decreased expression of NR2B in the spinal cord. CONCLUSIONS These data suggest that ifenprodil induced antinociception in CCD rats and provided further evidence for the important role of NR2B subunits in the development of neuropathic pain.
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Affiliation(s)
- Wei Zhang
- Department of Anesthesiology, Drum Tower Hospital, Medical Department of Nanjing University, Nanjing 210008, Jiangsu Province, China
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Kiefer RT, Rohr P, Ploppa A, Dieterich HJ, Grothusen J, Koffler S, Altemeyer KH, Unertl K, Schwartzman RJ. Efficacy of Ketamine in Anesthetic Dosage for the Treatment of Refractory Complex Regional Pain Syndrome: An Open-Label Phase II Study. PAIN MEDICINE 2008; 9:1173-201. [DOI: 10.1111/j.1526-4637.2007.00402.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Infante C, Díaz M, Hernández A, Constandil L, Pelissier T. Expression of nitric oxide synthase isoforms in the dorsal horn of monoarthritic rats: effects of competitive and uncompetitive N-methyl-D-aspartate antagonists. Arthritis Res Ther 2008; 9:R53. [PMID: 17521446 PMCID: PMC2206346 DOI: 10.1186/ar2208] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 04/10/2007] [Accepted: 05/23/2007] [Indexed: 11/29/2022] Open
Abstract
Chronic pain is associated with N-methyl-D-aspartate (NMDA) receptor activation and downstream production of nitric oxide, which has a pivotal role in multisynaptic local circuit nociceptive processing in the spinal cord. The formation of nitric oxide is catalyzed by three major nitric oxide synthase (NOS) isoforms (neuronal, nNOS; inducible, iNOS; endothelial, eNOS), which are increased in the spinal cord of rodents subjected to some tonic and chronic forms of experimental pain. Despite the important role of NOS in spinal cord nociceptive transmission, there have been no studies exploring the effect of NMDA receptor blockade on NOS expression in the dorsal horn during chronic pain. Furthermore, NOS isoforms have not been fully characterized in the dorsal horn of animals subjected to arthritic pain. The aim of this work was therefore to study the expression of nNOS, iNOS and eNOS in the dorsal horns of monoarthritic rats, and the modifications in NOS expression induced by pharmacological blockade of spinal cord NMDA receptors. Monoarthritis was produced by intra-articular injection of complete Freund's adjuvant into the right tibio-tarsal joint. At week 4, monoarthritic rats were given either the competitive NMDA antagonist (±)-3-(2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP) or the uncompetitive NMDA antagonist ketamine. After 6 and 24 hours, animals were killed and posterior quadrants of the lumbar spinal cord were dissected. Sample tissues were homogenized and subjected to immunoblotting with anti-nNOS, anti-iNOS or anti-eNOS monoclonal antibodies. The nNOS isoform, but not the iNOS and eNOS isoforms, were detected in the dorsal horns of control rats. Monoarthritis increased the expression of nNOS, iNOS and eNOS in the dorsal horns ipsilateral and contralateral to the inflamed hindpaw. Intrathecal administration of CPP and ketamine reduced nNOS expression in monoarthritic rats but increased the expression of iNOS and eNOS. Results suggest that blockade of spinal cord NMDA receptors produces complex regulatory changes in the expression of NOS isoforms in monoarthritic rats that may be relevant for nitridergic neuronal/glial mechanisms involved in the pathophysiology of monoarthritis and in the pharmacological response to drugs interacting with NMDA receptors.
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Affiliation(s)
- Claudio Infante
- Program of Physiopathology, Institute of Biomedical Sciences (ICBM), Faculty of Medicine, University of Chile, Ave. Salvador 486, P.O. Box 16038 Santiago 9, Santiago, Chile
| | - Marcelo Díaz
- Program of Physiopathology, Institute of Biomedical Sciences (ICBM), Faculty of Medicine, University of Chile, Ave. Salvador 486, P.O. Box 16038 Santiago 9, Santiago, Chile
| | - Alejandro Hernández
- Laboratory of Neurobiology, Department of Biology, Faculty of Chemistry and Biology, University of Santiago of Chile (USACH), Ave. B. Libertador B. O'Higgins 3363, P.O. Box 40 Correo 33, Santiago, Chile
| | - Luis Constandil
- Laboratory of Neurobiology, Department of Biology, Faculty of Chemistry and Biology, University of Santiago of Chile (USACH), Ave. B. Libertador B. O'Higgins 3363, P.O. Box 40 Correo 33, Santiago, Chile
| | - Teresa Pelissier
- Program of Molecular and Clinical Pharmacology, Institute of Biomedical Sciences (ICBM), Faculty of Medicine, University of Chile, Independencia 1027, P.O. Box 70000 Santiago 7, Santiago, Chile
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Pelissier T, Infante C, Constandil L, Espinosa J, Lapeyra CD, Hernández A. Antinociceptive effect and interaction of uncompetitive and competitive NMDA receptor antagonists upon capsaicin and paw pressure testing in normal and monoarthritic rats. Pain 2007; 134:113-27. [PMID: 17517475 DOI: 10.1016/j.pain.2007.04.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Revised: 01/24/2007] [Accepted: 04/09/2007] [Indexed: 10/23/2022]
Abstract
We assessed whether intrathecal administration of the uncompetitive and competitive NMDA receptor antagonists ketamine and (+/-)CPP, respectively, could produce differential modulation on chemical and mechanical nociception in normal and monoarthritic rats. In addition, the antinociceptive interaction of ketamine and (+/-)CPP on monoarthritic pain was also studied using isobolographic analysis. Monoarthritis was produced by intra-articular injection of complete Freund's adjuvant into the tibio-tarsal joint. Four weeks later, the antinociceptive effect of intrathecal administration of the drugs alone or combined was evaluated by using the intraplantar capsaicin and the paw pressure tests. Ketamine (0.1, 1, 10, 30, 100, 300 and 1000 microg i.t.) and (+/-)CPP (0.125, 2.5, 7.5, 12.5, 25 and 50 microg i.t.) produced significantly greater dose-dependent antinociception in the capsaicin than in the paw pressure test. Irrespective of the nociceptive test employed, both antagonists showed greater antinociceptive activity in monoarthritic than in healthy rats. Combinations produced synergy of a supra-additive nature in the capsaicin test, but only additive antinociception in paw pressure testing. The efficacy of the drugs, alone or combined, is likely to depend on the differential sensitivity of tonic versus phasic pain and/or chemical versus mechanical pain to NMDA antagonists.
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MESH Headings
- Analgesics/pharmacology
- Analgesics/therapeutic use
- Animals
- Arthritis, Experimental/drug therapy
- Arthritis, Experimental/metabolism
- Arthritis, Experimental/physiopathology
- Binding, Competitive
- Capsaicin/toxicity
- Drug Interactions/physiology
- Drug Therapy, Combination
- Excitatory Amino Acid Antagonists/pharmacology
- Excitatory Amino Acid Antagonists/therapeutic use
- Injections, Spinal
- Pain/chemically induced
- Pain/drug therapy
- Pain/metabolism
- Pain Measurement/drug effects
- Pain Measurement/methods
- Physical Stimulation/methods
- Pressure
- Rats
- Rats, Sprague-Dawley
- Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors
- Receptors, N-Methyl-D-Aspartate/metabolism
- Vocalization, Animal/drug effects
- Vocalization, Animal/physiology
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Affiliation(s)
- Teresa Pelissier
- Program of Molecular and Clinical Pharmacology, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, P.O. Box 70,000, Santiago 7, Chile.
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14
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Lankveld DPK, Driessen B, Soma LR, Moate PJ, Rudy J, Uboh CE, van Dijk P, Hellebrekers LJ. Pharmacodynamic effects and pharmacokinetic profile of a long-term continuous rate infusion of racemic ketamine in healthy conscious horses. J Vet Pharmacol Ther 2006; 29:477-88. [PMID: 17083451 DOI: 10.1111/j.1365-2885.2006.00794.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ketamine (KET) possesses analgesic and anti-inflammatory activity at sub-anesthetic doses, suggesting a benefit of long-term KET treatment in horses suffering from pain, inflammatory tissue injury and/or endotoxemia. However, data describing the pharmacodynamic effects and safety of constant rate infusion (CRI) of KET and its pharmacokinetic profile in nonpremedicated horses are missing. Therefore, we administered to six healthy horses a CRI of 1.5 mg/kg/h KET over 320 min following initial drug loading. Cardiopulmonary parameters, arterial blood gases, glucose, lactate, cortisol, insulin, nonesterified fatty acids, and muscle enzyme levels were measured, as were plasma concentrations of KET and its metabolites using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Levels of sedation and muscle tension were scored. Respiration and heart rate significantly increased during the early infusion phase. Glucose and cortisol significantly varied both during and after infusion. During CRI all horses scored 0 on sedation. All but one horse scored 0 on muscle tension, with one mare scoring 1. All other parameters remained within or close to physiological limits without significant changes from pre-CRI values. The mean plasma concentration of KET during the 1.5 mg/kg/h KET CRI was 235 ng/mL. The decline of its plasma concentration-time curve of both KET and norketamine (NKET) following the CRI was described by a two-compartmental model. The metabolic cascade of KET was NKET, hydroxynorketamine (HNK), and 5,6-dehydronorketamine (DHNK). The KET median elimination half-lives (t1/2alpha and t1/2beta) were 2.3 and 67.4 min, respectively. The area under the KET plasma concentration-time curve (AUC), elimination was 76.0 microg.min/mL. Volumes of C1 and C2 were 0.24 and 0.79 L/kg, respectively. It was concluded that a KET CRI of 1.5 mg/kg/h can safely be administered to healthy conscious horses for at least 6 h, although a slight modification of the initial infusion rate regimen may be indicated. Furthermore, in the horse KET undergoes very rapid biotransformation to NKET and HNK and DHNK were the major terminal metabolites.
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Affiliation(s)
- D P K Lankveld
- Equine Sciences Department, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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15
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Wilson JA, Garry EM, Anderson HA, Rosie R, Colvin LA, Mitchell R, Fleetwood-Walker SM. NMDA receptor antagonist treatment at the time of nerve injury prevents injury-induced changes in spinal NR1 and NR2B subunit expression and increases the sensitivity of residual pain behaviours to subsequently administered NMDA receptor antagonists. Pain 2006; 117:421-432. [PMID: 16150544 DOI: 10.1016/j.pain.2005.07.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Revised: 05/02/2005] [Accepted: 07/12/2005] [Indexed: 11/30/2022]
Abstract
Spinal NMDA receptors (NMDA R) are important in neuropathic sensitisation and acute administration of antagonists can provide temporary attenuation of sensitisation. If establishment of the chronic pain state could be prevented by brief administration of such agents at or around the time of nerve injury (pre-emptive analgesia) it might be possible to avoid many of the unacceptable side effects associated with repeated administration of these or other antagonists. Several reports describe aspects of effective pre-emptive analgesia from NMDA R antagonists in animal models of neuropathic pain. The first aim of the present study was to make a direct comparison of changes in mechanical allodynia, cold allodynia and thermal hyperalgesia following nerve injury, demonstrating their increasing degree of susceptibility to pre-emptive NMDA R antagonist treatment. Secondly, we used immunoblotting and immunohistochemistry to investigate the effects of nerve injury on NMDA receptor subunit expression, revealing increased expression of NR2B, but not NR2A and reduced NR1 in the superficial dorsal horn. These changes were attenuated following NMDA receptor antagonist pre-treatment. Thirdly, we investigated the pharmacological properties of residual mechanical allodynia and cold allodynia that remained after pre-emptive treatment and revealed a greater sensitivity to NMDA R antagonists. These findings indicate that in addition to a marked suppression of thermal hyperalgesia and cold allodynia, pre-emptive treatment with NMDA R antagonist causes a lasting change in spinal NMDA R complexes such that remaining mechanical allodynia should be more effectively targeted by NMDA R antagonists.
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Affiliation(s)
- John A Wilson
- Centre for Neuroscience Research, Division of Veterinary Biomedical Sciences, The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Summerhall, Edinburgh EH9 1QH, UK Department of Anaesthesia, Critical Care & Pain Medicine, Western General Hospital, Crewe Rd, Edinburgh EH4 2XU, UK Centre for Integrative Physiology (Membrane Biology Group), School of Biomedical and Clinical Laboratory Sciences, University of Edinburgh EH8 9XD, UK
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16
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Strigo IA, Duncan GH, Bushnell CM, Boivin M, Wainer I, Rodriguez Rosas EM, Persson J. The effects of racemic ketamine on painful stimulation of skin and viscera in human subjects. Pain 2005; 113:255-264. [PMID: 15661431 DOI: 10.1016/j.pain.2004.10.023] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2004] [Revised: 10/06/2004] [Accepted: 10/18/2004] [Indexed: 01/24/2023]
Abstract
Evidence suggests that NMDA receptors may have a differential role in the modulation of visceral and somatic pain. Specifically, animal data indicate an analgesic role of NMDA-R antagonists in acute visceral but not acute somatic pain. In humans analgesic effects are documented in acute somatic pain, while the role of NMDA-R antagonists in acute visceral pain is still questionable. We, therefore, conducted a study in humans comparing the analgesic effects of ketamine in an experimental model of visceral and cutaneous pain. In a double-blind, randomized, cross-over study, 11 healthy volunteers (3M, 8F) participated in two experimental sessions in which they evaluated perceptions induced by balloon distention of the distal esophagus and contact heat on the upper chest during continuous computer-controlled i.v. infusion of either ketamine (60 and 120 ng/mL) or saline. Two stimulus intensities producing non-painful and painful sensation were used for each stimulus modality. Subjects reported maximum pain intensity and unpleasantness on visual analog scales (VAS). For noxious visceral stimulation, low dose ketamine produced significant attenuation of both pain intensity and unpleasantness. In contrast, for noxious cutaneous stimulation, ketamine reduced pain unpleasantness, but not perceived intensity. In addition, ketamine did not alter the perception of innocuous stimuli in either modality. Our results confirm the analgesic effects of low-dose ketamine, with minimal side effects, on acute visceral pain and indicate a similar but smaller effect on acute cutaneous pain. A decrease in the unpleasantness but not in the intensity of cutaneous pain may reflect the differential effect of NMDA-R antagonists for the two pain states observed in animal models.
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Affiliation(s)
- Irina A Strigo
- Department of Anesthesia, Centre for Research on Pain, McGill University, 3640 University Street, Rm. M/19, Montreal, Que. H3A 2B2, Canada Département de stomatologie, Faculté de médecine dentaire, Centre de recherche en sciences neurologiques, Université de Montréal, Montreal, Que. H3C 3J7, Canada Département de gastroentérologie, Université de Montréal, Montreal, Que. H3C 3J7, Canada Gerontology Center, National Institute of Aging, NIH, Baltimore, MD 21224, USA Departments of Anesthesiology and Intensive Care and Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden
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17
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Jinks SL, Antognini JF, Dutton RC, Carstens E, Eger EI. Isoflurane depresses windup of C fiber-evoked limb withdrawal with variable effects on nociceptive lumbar spinal neurons in rats. Anesth Analg 2004; 99:1413-1419. [PMID: 15502040 DOI: 10.1213/01.ane.0000135635.32227.da] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Windup is a progressive increase in responses of nociceptive spinal cord neurons to repeated electrical C fiber stimulation. We hypothesized that isoflurane would depress windup at approximately the minimum alveolar anesthetic concentration (MAC) required to suppress purposeful movement in response to noxious stimulation. We recorded windup responses in single lumbar spinal neurons (n = 17) to a series of 15 repetitive electrical stimuli delivered at 1 Hz to the hindpaw at C fiber strength; hindpaw withdrawal force was simultaneously recorded. The total number of action potentials per 15 stimuli (mean +/- sem as a percentage of each neuron's maximal response) was 83% +/- 5%, 84% +/- 5%, 67% +/- 7%, and 57% +/- 8% at 0.7, 0.9, 1.1, and 1.4 MAC, respectively. The 0.9 and 1.1 MAC values differed significantly from each other, whereas the 0.7 and 0.9 MAC values differed from the 1.4 MAC value (P < 0.05). The reduced firing was attributed to a depression of the initial C fiber-evoked responses in most units, and a reduction in windup slope over the initial 5 stimuli in 6 units. Muscle force was 67%, 11%, and 4% of the 0.7 MAC value at 0.9, 1.1, and 1.4 MAC, respectively. Isoflurane depressed excitability and variably affected windup of lumbar spinal cord neurons, while uniformly depressing windup of limb withdrawals in a concentration-dependent manner.
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Affiliation(s)
- Steven L Jinks
- *Department of Anesthesiology and Pain Medicine, and †Section of Neurobiology, Physiology, and Behavior, University of California, Davis; and ‡Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California
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18
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Bilbeny N, Paeile C, Contreras S, Font M, García H. Effect of the synthetic polyamine N,N'-bis-(3-aminopropyl) cyclohexane-1,4-diamine (DCD) on rat spinal cord nociceptive transmission. Brain Res 2004; 1022:257-60. [PMID: 15353239 DOI: 10.1016/j.brainres.2004.07.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2004] [Indexed: 11/20/2022]
Abstract
In rats submitted to a C-fiber reflex response paradigm, intravenous (i.v.) administration of 2.5, 5 and 10 mg/kg of the synthetic polyamine N,N'-bis-(3-aminopropyl) cyclohexane-1,4-diamine (DCD) dose-dependently reduced both the integrated C reflex responses and wind-up activity. Inhibitory effects of the polyamine on spinal cord nociceptive transmission are likely to be consequence of blockade by extracellular DCD of NMDA receptor channels localized in dorsal horn neurons, although modulatory actions at supraspinal level and at other ion channels could also be possible.
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Affiliation(s)
- Norberto Bilbeny
- Garbil Pharma Investigación Chile, Room 402, Ave. Los Leones 382, Santiago, Chile.
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19
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Marchand F, Pelissier T, Eschalier A, Ardid D, Alloui A, Soto-Moyano R, Mondaca M, Laurido C, Constandil L, Hernández A. Blockade of supraspinal 5-HT1A receptors potentiates the inhibitory effect of venlafaxine on wind-up activity in mononeuropathic rats. Brain Res 2004; 1008:288-92. [PMID: 15145768 DOI: 10.1016/j.brainres.2004.02.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2004] [Indexed: 10/26/2022]
Abstract
In mononeuropathic rats submitted to a C-fiber reflex responses paradigm, repeated administration (five successive injections every half-life) of 10 mg/kg, s.c. of venlafaxine, but not of 2.5 mg/kg, s.c., a mixed monoamine reuptake inhibitor with preferential inhibitory activity in 5-HT reuptake, induced a progressive reduction of spinal wind-up. Repeated co-administration of the selective 5-HT1A receptor antagonist WAY 100,635 i.c.v. (50 microg/injection) significantly increased the effect of venlafaxine s.c., indicating that venlafaxine-induced inhibition of spinal wind-up in mononeuropathic rats is potentiated by blockade of central 5-HT1A receptors.
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Affiliation(s)
- Fabien Marchand
- E 9904 INSERM/UdA, Laboratory of Medical Pharmacology, Faculty of Medicine, University of Auvergne-1, Clermont-Ferrand, France
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20
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Hernández A, Constandil L, Laurido C, Pelissier T, Marchand F, Ardid D, Alloui A, Eschalier A, Soto-Moyano R. Venlafaxine-induced depression of wind-up activity in mononeuropathic rats is potentiated by inhibition of brain 5-HT1A receptor expression in vivo. Int J Neurosci 2004; 114:229-42. [PMID: 14702210 DOI: 10.1080/00207450490269453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Antinociceptive effects of inhibiting 5-HT1A receptor expression by intracerebroventricular administration of an antisense oligodeoxynucleotide were studied in mononeuropathic rats. A 7-day period of treatment with the antisense produced: (i) reduction of mechanical hyperalgesia in the neuropathic hindlimb starting from day 5 of treatment, (ii) decrease of the hypothermic effect of 8-OH-DPAT challenge on day 6 of treatment, and (iii) potentiation of the inhibitory effect of velafaxine on spinal wind-up activity on day 7 of treatment. Results suggest a counteracting role of somatodendritic 5-HT1A receptors of raphe nuclei neurons in the antinociceptive efficacy of antidepressants with serotonergic spectrum in neuropathic pain.
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Affiliation(s)
- Alejandro Hernández
- Faculty of Chemistry and Biology, University of Santiago of Chile, Santiago, Chile.
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21
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Mondaca M, Hernández A, Valladares L, Sierralta W, Noseda R, Soto-Moyano R. Involvement of melatonin metabolites in the long-term inhibitory effect of the hormone on rat spinal nociceptive transmission. Pharmacol Biochem Behav 2004; 77:275-9. [PMID: 14751455 DOI: 10.1016/j.pbb.2003.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
There is evidence that melatonin and its metabolites could bind to nuclear sites in neurones, suggesting that this hormone is able to exert long-term functional effects in the central nervous system via genomic mechanisms. This study was designed to investigate (i) whether systemically administered melatonin can exert long-term effects on spinal cord windup activity, and (ii) whether blockade of melatonin degradation with eserine could prevent this effect. Rats receiving melatonin (10 mg/kg ip), the same dose of melatonin plus eserine (0.5 mg/kg ip), or saline were studied. Seven days after administration of the drugs or saline, spinal windup of rats was assessed in a C-fiber reflex response paradigm. Results show that rats receiving melatonin exhibited a reduction in spinal windup activity. This was not observed in the animals receiving melatonin plus eserine or saline, suggesting a role for melatonin metabolites in long-term changes of nociceptive transmission in the rat spinal cord.
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Affiliation(s)
- Mauricio Mondaca
- Institute of Nutrition and Food Technology (INTA), University of Chile, P.O. Box 138-11, Santiago, Chile
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22
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Laurido C, Hernández A, Constandil L, Pelissier T. Nitric oxide synthase and soluble guanylate cyclase are involved in spinal cord wind-up activity of monoarthritic, but not of normal rats. Neurosci Lett 2003; 352:64-6. [PMID: 14615051 DOI: 10.1016/j.neulet.2003.08.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
While increasing evidence points to a role for the nitric oxide (NO)/cyclic guanosine 3,5-monophosphate (GMPc) cascade in hyperalgesia and allodynia, participation of the NO/GMPc pathway in synaptic processing in the spinal cord, i.e. wind-up activity, is less clear. We studied the effects of intrathecal administration of Nomega-nitro-L-arginine methyl ester (L-NAME) and methylene blue, inhibitors of NO synthase and guanylate cyclase respectively, on wind-up activity developed in a C-fiber reflex response paradigm. 5, 10 and 20 microg i.t. of L-NAME or methylene blue did not modify spinal wind-up in normal rats, while a dose-dependent inhibition of wind-up was observed in monoarthritic rats. Results suggest that the NO/GMPc pathway plays a non-significant role in wind-up activity evoked in normal animals, while it may be essential in chronic pain processing.
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Affiliation(s)
- Claudio Laurido
- Laboratory of Neurobiology, Department of Biology, Faculty of Chemistry and Biology, University of Santiago of Chile, P.O. Box 40 Correo 33, Santiago, Chile
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Constandil L, Pelissier T, Soto-Moyano R, Mondaca M, Sáez H, Laurido C, Muñoz C, López N, Hernández A. Interleukin-1beta increases spinal cord wind-up activity in normal but not in monoarthritic rats. Neurosci Lett 2003; 342:139-42. [PMID: 12757884 DOI: 10.1016/s0304-3940(03)00278-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cytokines produced by spinal cord glia after peripheral inflammation, infection or trauma have a relevant role in the maintenance of pain states. The effect of intrathecally administered interleukin-1beta (IL-1beta) on spinal cord nociceptive transmission was studied in normal and monoarthritic rats by assessing wind-up activity in a C-fiber-mediated reflex paradigm evoked by repetitive (1 Hz) electric stimulation. Low i.t. doses of IL-1beta (0.03, 0.12, 0.5 and 2.0 ng) dose-dependently enhanced wind-up activity in normal rats, while higher doses (8.0 ng) only produced a marginal unsignificant effect. IL-1beta administration to monoarthritic rats did not significantly change wind-up scores at any dose. Adaptive changes developed in the spinal cord during chronic pain may underlie the ineffectiveness of exogenous IL-1beta to up-regulate nociceptive transmission.
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Affiliation(s)
- Luis Constandil
- Laboratory of Neurobiology, Department of Biological Sciences, Faculty of Chemistry and Biology, University of Santiago of Chile, Casilla 40 Correo 33, Santiago, Chile
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24
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Laurido C, Pelissie T, Soto-Moyano R, Valladares L, Flores F, Hernández A. Effect of melatonin on rat spinal cord nociceptive transmission. Neuroreport 2002; 13:89-91. [PMID: 11924900 DOI: 10.1097/00001756-200201210-00021] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Melatonin has been shown to exert potent antinociception but the sites and mechanisms of action underlying this effect have not yet been clarified. The effect of melatonin on spinal cord nociceptive transmission was studied in rats by assessing wid-up activity in a C-fiber reflex responses paradigm evoked by repetitive (0.6 Hz) electric stimulation. Intraperitoneal administration of 1.25, 2.5, 5.0 and 10.0 mg/kg melatonin induced a dose-dependent inhibition of spinal wind-up activity, the higher dose of the drug used being able to depress completely the C reflex gain. Results indicate that melatonin markedly depresses spinal wind-up in rats, probably through hyperpolarization of dorsal horn neurons consecutive to melatonin binding to membrane receptors, and/or via intracellular interference with a NMDA receptor-dependent nitric oxide generating pathway.
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Affiliation(s)
- Claudio Laurido
- Department of Biological Sciences, Faculty of Chemistry and Biology, University of Santiago of Chile
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