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Bhattacharya T, Gupta A, Gupta S, Saha S, Ghosh S, Shireen Z, Dey S, Sinha S. Benzofuran Iboga-Analogs Modulate Nociception and Inflammation in an Acute Mouse Pain Model. Chembiochem 2024; 25:e202400162. [PMID: 38874536 DOI: 10.1002/cbic.202400162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/20/2024] [Accepted: 06/12/2024] [Indexed: 06/15/2024]
Abstract
Pain management following acute injury or post-operative procedures is highly necessary for proper recovery and quality of life. Opioids and non-steroidal anti-inflammatory drugs (NSAIDS) have been used for this purpose, but opioids cause addiction and withdrawal symptoms whereas NSAIDS have several systemic toxicities. Derivatives of the naturally occurring iboga alkaloids have previously shown promising behavior in anti-addiction of morphine by virtue of their interaction with opioid receptors. On this frontier, four benzofuran analogs of the iboga family have been synthesized and their analgesic effects have been studied in formalin induced acute pain model in male Swiss albino mice at 30 mg/kg of body weight dose administered intraperitoneally. The antioxidant, anti-inflammatory and neuro-modulatory effects of the analogs were analyzed. Reversal of tail flick latency, restricted locomotion and anxiogenic behavior were observed in iboga alcohol, primary amide and secondary amide. Local neuroinflammatory mediators' substance P, calcitonin gene related peptide, cyclooxygenase-2 and p65 were significantly decreased whereas the depletion of brain derived neurotrophic factor and glia derived neurotrophic factor was overturned on iboga analog treatment. Behavioral patterns after oral administration of the best analog were also analyzed. Taken together, these results show that the iboga family of alkaloid has huge potential in pain management.
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Affiliation(s)
- Tuhin Bhattacharya
- Department of Physiology, University of Calcutta, 92 APC Road, West Bengal, Kolkata, 70009, India
| | - Abhishek Gupta
- School of Applied and Interdisciplinary Sciences, Indian Association for the Cultivation of Science, 2A Raja S.C. Mullick Road, West Bengal, Kolkata, 700032, India
| | - Shalini Gupta
- School of Applied and Interdisciplinary Sciences, Indian Association for the Cultivation of Science, 2A Raja S.C. Mullick Road, West Bengal, Kolkata, 700032, India
| | - Samrat Saha
- Department of Physiology, University of Calcutta, 92 APC Road, West Bengal, Kolkata, 70009, India
| | - Shatabdi Ghosh
- Department of Physiology, University of Calcutta, 92 APC Road, West Bengal, Kolkata, 70009, India
| | - Zofa Shireen
- Department of Physiology, University of Calcutta, 92 APC Road, West Bengal, Kolkata, 70009, India
| | - Sanjit Dey
- Department of Physiology, University of Calcutta, 92 APC Road, West Bengal, Kolkata, 70009, India
| | - Surajit Sinha
- School of Applied and Interdisciplinary Sciences, Indian Association for the Cultivation of Science, 2A Raja S.C. Mullick Road, West Bengal, Kolkata, 700032, India
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Li Y, Kim WM, Lee YJ, Kang DH, Lee HG, Choi JI, Yoon MH. Antinociceptive effects of nefopam activating descending serotonergic modulation via 5-HT2 receptors in the nucleus raphe magnus. Eur J Pain 2024; 28:252-262. [PMID: 37615256 DOI: 10.1002/ejp.2173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/19/2023] [Accepted: 08/09/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Nefopam is a centrally acting antinociceptive drug; however, the underlying mechanisms are not fully understood. This study investigated the supraspinal mechanisms of nefopam. METHODS The effects of intraperitoneally administered nefopam were assessed in rats using the formalin test, and the mechanisms were investigated by intrathecal or intra-nucleus raphe magnus (NRM) pre-treatment with the serotonin (5-HT) receptor antagonist or 5-HT2 receptor antagonist. The change in extracellular 5-HT levels was measured by spinal cord microdialysis. RESULTS Intraperitoneally administered nefopam showed antinociceptive effects in the rat formalin test, which were reversed by intrathecal pre-treatment with 5-HT receptor antagonist dihydroergocristine. Microdialysis study revealed that systemic nefopam significantly increased 5-HT level in the spinal dorsal horn. Pretreatment of cinanserin, a 5-HT2 receptor antagonist, into the NRM blocked the antinociceptive effects of intraperitoneally delivered nefopam. Direct injection of nefopam into the NRM mimicked the effects of systemic nefopam, and this effect was reversed by intra-NRM cinanserin pre-treatment. The increase in spinal level of 5-HT by systemic nefopam was attenuated by intra-NRM cinanserin pre-treatment. CONCLUSION The antinociceptive effects of systemically administered nefopam are mediated by 5-HT2 receptors in the NRM, which recruit the descending serotonergic fibres to increase the release of 5-HT into the spinal dorsal horn. SIGNIFICANCE This study revealed supraspinal mechanisms of nefopam-produced analgesia mediated by 5-HT2 receptors in the NRM recruiting the descending serotonergic fibres to increase the release of 5-HT into the spinal dorsal horn. These observations support a potential role for nefopam in multimodal analgesia based on its distinct mechanisms of action that are not shared by the other analgesics.
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Affiliation(s)
- Yaqun Li
- Department of Pain, Northern Jiangsu People's Hospital, Yangzhou, China
| | - Woong Mo Kim
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
- Chonnam National University Hwasun Hospital, Hwasun, Chonnam, Republic of Korea
| | - Yu Jun Lee
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Dong Ho Kang
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
| | - Hyung Gon Lee
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
- Center for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jeong Il Choi
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
- Center for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Myung Ha Yoon
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea
- Center for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Republic of Korea
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Dalix E, Maalouf M, Linossier MT, Vanden-Bossche A, Peyroche S, Marotte H. Improvement of Pain Management by Nefopam in a Rat Adjuvant-Induced Arthritis Model. Front Vet Sci 2022; 9:809980. [PMID: 35558888 PMCID: PMC9087999 DOI: 10.3389/fvets.2022.809980] [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: 11/05/2021] [Accepted: 03/11/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction The adjuvant-induced arthritis (AIA) model is widely used in research to investigate arthritis pathogenesis. Hind paw inflammation is the main outcome in this model with high loss of mobility function partly related to pain. However, analgesics such as non-steroidal anti-inflammatory drugs or opioid drugs interfere with the inflammation process related to arthritis, thus reducing their beneficial use in this model. Therefore, we investigated the effect of nefopam on arthritis development in order to improve pain management in the AIA model. Methods Female Lewis rats were randomly divided into two groups, and each group received an injection of Mycobacterium butyricum on defining day (D) 0. At D6, rats (n = 10) received nefopam (intraperitoneally or orally) or NaCl 0.9% IP or 1% sucrose in water (n = 5 for each). Rats were monitored with the arthritic index (AI) and ankle circumference. Pain was assessed by scoring based on behavioral indicators. Histology, RT-qPCR, and microcomputed tomography were performed. Results The clinical parameter AI and ankle circumference were not different in both groups at various time points. However, pain score was significantly lower in the nefopam group at the early stage of the disease. At a later stage of the disease, inflammation was mildly lower whereas bone erosion and bone loss parameters increased in the nefopam group. Conclusion Nefopam provided a slight reduction in the level of pain at the arthritis onset without reducing arthritis severity and bone loss in the rat AIA model. However, it should be administrated orally for a shorter period to avoid inflammation reduction in the long run.
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Affiliation(s)
- Elisa Dalix
- INSERM, U1059-SAINBIOSE, Université de Lyon, Saint-Etienne, France
| | - Mathieu Maalouf
- INSERM, U1059-SAINBIOSE, Université de Lyon, Saint-Etienne, France
| | | | | | - Sylvie Peyroche
- INSERM, U1059-SAINBIOSE, Université de Lyon, Saint-Etienne, France
| | - Hubert Marotte
- INSERM, U1059-SAINBIOSE, Université de Lyon, Saint-Etienne, France
- Department of Rheumatology, Hôpital Nord, University Hospital Saint-Etienne, Saint-Etienne, France
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Lee JY, Sim WS, Cho NR, Kim BW, Moon JY, Park HJ. The Antiallodynic Effect of Nefopam on Vincristine-Induced Neuropathy in Mice. J Pain Res 2020; 13:323-329. [PMID: 32104054 PMCID: PMC7012248 DOI: 10.2147/jpr.s224478] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/28/2020] [Indexed: 12/12/2022] Open
Abstract
Background Chemotherapy-induced neuropathic pain is a disabling condition following cancer treatment. Vincristine has more neurotoxicity than other vinca alkaloid agents. This study evaluated the correlation of different doses of nefopam with antiallodynic effects in a mouse vincristine neuropathy model. Methods A peripheral neuropathic mouse model was made by intraperitoneal injection of vincristine (0.1 mg/kg/day; 5-day-on, 2-day-off schedule over 12 days). After the development of allodynia, mice were injected intraperitoneally with 0.9% normal saline (NS group) or various doses (10, 30, 60 mg/kg) of nefopam (Nefopam group). We examined allodynia using von Frey hairs pre-administration and at 30, 60, 90, 120, 180, 240 mins, and 24 hrs after drug administration. We also measured the neurokinin-1 receptor concentrations in the spinal cord to confirm the antiallodynic effect of nefopam after drug administration. Results The peripheral neuropathic mouse model showed prominent mechanical allodynia. Intraperitoneal nefopam produced a clear dose-dependent increase in paw withdrawal threshold compared with pre-administration values and versus the NS group. The concentration of neurokinin-1 receptor was significantly decreased in the Nefopam group (P<0.05). Conclusion Intraperitoneally administered nefopam yielded a dose-dependent attenuation of mechanical allodynia and decreased neurokinin-1 receptor concentration, suggesting that the neurokinin-1 receptor is involved in the antiallodynic effects of nefopam in vincristine neuropathy.
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Affiliation(s)
- Jin Young Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Woo Seog Sim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Noo Ree Cho
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Bae Wook Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jeong Yeon Moon
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Hue Jung Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea
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Cheon YW, Kim SH, Paek JH, Kim JA, Lee YK, Min JH, Cho HR. Effects of nefopam on catheter-related bladder discomfort in patients undergoing ureteroscopic litholapaxy. Korean J Anesthesiol 2018; 71:201-206. [PMID: 29684987 PMCID: PMC5995012 DOI: 10.4097/kja.d.18.27113] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 08/02/2017] [Accepted: 08/11/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Patients who undergo urinary catheterization may experience postoperative catheter-related bladder discomfort (CRBD). Previous studies have indicated that drugs with antimuscarinic effects could reduce the incidence and severity of CRBD. Accordingly, this study was carried out to investigate whether nefopam, a centrally acting analgesic with concomitant antimuscarinic effect, reduces the incidence and severity of CRBD. METHODS Sixty patients with American Society of Anesthesiologists physical status I and II and aged 18-70 years who were scheduled to undergo elective ureteroscopic litholapaxy participated in this double-blinded study. Patients were divided into control and nefopam groups, comprising 30 patients each. In the nefopam group, 40 mg nefopam in 100 ml of 0.9% saline was administered intravenously. In the control group, only 100 ml of 0.9% saline was administered. All patients had a urethral catheter and ureter stent inserted during surgery. The incidence and severity of CRBD, numerical rating scale (NRS) score of postoperative pain, rescue pethidine dose, and side effects were recorded in the post-anesthesia care unit after surgery. RESULTS The incidence (P = 0.020) and severity (P < 0.001) of CRBD were significantly different between the control group and the nefopam group. The NRS score of postoperative pain (P = 0.006) and rescue dose of pethidine (P < 0.001) were significantly higher in the control group than in the nefopam group. CONCLUSIONS Intravenous administration of nefopam in patients scheduled to undergo ureteroscopic litholapaxy reduced the incidence and severity of CRBD, NRS score of postoperative pain and analgesic requirements.
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Affiliation(s)
- Yong Woo Cheon
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, Korea
| | - Seon Hwan Kim
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, Korea
| | - Jin Hyub Paek
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, Korea
| | - Jin A Kim
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, Korea
| | - Yong Kyung Lee
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, Korea
| | - Jin Hye Min
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, Korea
| | - Hyung Rae Cho
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, Korea
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Kim WM, Chae JW, Heo BH, Park KS, Kim HS, Lee HG, Choi JI, Yoon MH. The role of inversely operating glutamate transporter in the paradoxical analgesia produced by glutamate transporter inhibitors. Eur J Pharmacol 2016; 793:112-118. [PMID: 27838398 DOI: 10.1016/j.ejphar.2016.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
Abstract
Controlling extracellular glutamate level in a physiological range is important to maintain normal sensory transmission. Here, we investigated the paradoxical action of glutamate transporters in the rat formalin test to elucidate a possible role of inversely operating transporters in its analgesic mechanism. The effects of glutamate transporter inhibitor on formalin-induced pain behavior were examined. Then we performed a microdialysis study to clarify the differential change in extracellular glutamate concentration by intrathecal administration of transportable and non-transportable blockers. And we further investigated the mechanism pharmacologically via pretreatment with antagonists of various receptors and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) staining. Intrathecally-injected glutamate transporter inhibitors, non-transportable DL-threo-β-benzyloxyaspartat (TBOA) and transportable trans-pyrrolidine-2,4-dicarboxylic acid (t-PDC), produced paradoxical antinociception in the formalin test. In normal rats, inhibition of the glutamate transporter increased extracellular glutamate. In the formalin model rats, TBOA suppressed while t-PDC enhanced glutamate release. When tPDC was pretreated 30min prior to formalin injection, glutamate release was blocked. Blocking α-2 adrenergic receptors reversed the tPDC analgesia. Increased apoptosis was not apparent in the spinal dorsal horn of tPDC-treated rats compared to the control group. These data suggest that glutamate transporters in a formalin-induced pain state work in a reverse mode and can be blocked from releasing glutamate by TBOA and preloaded tPDC. The analgesic mechanism of TBOA may be related to the blockade of inversely operating transporter, and that of tPDC may be associated with the activation of noradrenergic neurotransmission but not with dorsal horn neurotoxicity.
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Affiliation(s)
- Woong Mo Kim
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea; Center for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Republic of Korea; Chonnam National University Hospital Biomedical Research Institute, Gwangju, Republic of Korea.
| | - Joo Wung Chae
- Center for Creative Biomedical Scientists, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Bong Ha Heo
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Keun Suk Park
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyung Seok Kim
- Department of Forensic Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyung Gon Lee
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jeong Il Choi
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Myung Ha Yoon
- Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
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