Animal models of nociception

The study of pain in awake animals raises ethical, philosophical, and technical problems. We review the ethical standards for studying pain in animals and emphasize that there are scientific as well as moral reasons for keeping to them. Philosophically, there is the problem that pain cannot be monitored directly in animals but can only be estimated by examining their responses to nociceptive stimuli; however, such responses do not necessarily mean that there is a concomitant sensation. The types of nociceptive stimuli (electrical, thermal, mechanical, or chemical) that have been used in different pain models are reviewed with the conclusion that none is ideal, although chemical stimuli probably most closely mimic acute clinical pain. The monitored reactions are almost always motor responses ranging from spinal reflexes to complex behaviors. Most have the weakness that they may be associated with, or modulated by, other physiological functions. The main tests are critically reviewed in terms of their sensitivity, specificity, and predictiveness. Weaknesses are highlighted, including 1) that in most tests responses are monitored around a nociceptive threshold, whereas clinical pain is almost always more severe; 2) differences in the fashion whereby responses are evoked from healthy and inflamed tissues; and 3) problems in assessing threshold responses to stimuli, which continue to increase in intensity. It is concluded that although the neural basis of the most used tests is poorly understood, their use will be more profitable if pain is considered within, rather than apart from, the body's homeostatic mechanisms.

[Critical analysis of animal models of acute pain. II]

OBJECTIVE

To analyse models of acute pain in experimental animals.

DATA SOURCES

References were obtained from computerised bibliographic data banks (Medline and others) and the authors' personal documents.

DATA SYNTHESIS

The majority of tests permit only a measurement of threshold, whereas clinical pain is almost always prolonged. The relationships between tests of acute pain and motor activity are reviewed from a number of standpoints; in particular we consider the influence, which postural adjustments of the animal may exert on motor responses in the limbs and the significance of flexor and extensor reflexes. In analysing the problem of the sensitivity of tests, we raise the following questions: 1) what type(s) of fibres underlie the observed responses and might these be different depending on whether one is stimulating a healthy or an inflamed tissue; 2) what significance do measurements of "latency" have when a stimulus is increasing; 3) how valid are the methods of analysing the results? The influence of species and the genetic line used in tests and the specificity and predictivity of tests are considered. Finally, we review those factors, which may distort behavioural measurements in animals, notably--pharmacokinetics, interactions between heterotopic stimuli, environmental factors and related psychophysiological/psychological considerations (subjective "undesirable" phenomena, learning phenomena). We pay particular attention to related physiological functions (thermoregulation, vasomotricity, blood pressure). These considerations lead us to re-position nociception within a much larger homeostatic framework which in addition to pain, includes phenomena such as anxiety and vegetative functions. They also suggest that we should define an "effective stimulus" as one, which activates nociceptive nerve terminals after a physical stimulus, has passed through a "peripheral lens" which regulates its intensity for reasons, which are physical, albeit of biological origin. Finally they remind us that the "system of pain" forms part of a whole set of subsystems--sensory, motor, vegetative, emotional, motivational--which scientific method, being reductionist by nature, cannot study in its entirety. However one must consider results of nociceptive tests within this general context.

CONCLUSION

It is only by taking the approach described in this review, that fundamental and clinical research can interact usefully.

[Acute pain measurement in animals. Part 1]

OBJECTIVE

To describe tests of nociception which appear in the "pre-clinical" literature.

DATA SOURCES

References obtained by computerized bibliographic research (Medline) and the authors' personal data.

DATA SYNTHESIS

Ethical problems arising from the study of the pain in awake animals, problems arising from the choice of stimulus and stimulus parameters and the quantification of responses are presented. Pain in animals can be estimated only by examining their reactions, but at the same time, the existence of a reaction does not necessarily mean that there is a concomitant sensation. A description of the signs of pain in mammals is proposed. A noxious stimulus can be defined by its physical nature, its site of application and what has previously happened to the tissues at this site. Electrical stimulation short-circuits the process of transduction at free nerve endings and is not specific; however it has the advantage that it can be applied suddenly and briefly and thus results in synchronised signals in the relevant primary afferent fibres which can be differentiated into A delta and C fibres. Heat selectively stimulates thermoreceptors and nociceptors, but the low calorific power of conventional stimulators restricts their usefulness. Radiant sources have the disadvantage of emitting waves in the visible and the adjacent infrared spectra, for which the skin is a poor absorber and good reflector. Thermodes have the disadvantage of activating mechanoreceptors and thermoreceptors simultaneously; furthermore, their capacity for transferring heat depends on the quality of contact with skin and thus on the pressure with which they are applied. These problems can be overcome by using CO2 lasers but even today, the cost of these is a major disadvantage. Chemical stimuli differ from those mentioned above by the progressive onset of their effectiveness, their duration of action and the fact that they are of an inescapable nature. Experimental models employing chemical stimuli are undoubtedly the most similar to acute clinical pain. A wide spectrum of reactions are observed in nociceptive tests, but in almost every case they involve motor responses. After defining the ideal characteristics of a nociceptive test, tests based on the use of short duration and longer duration stimuli are presented. In tests of phasic pain, reactions are evoked by thermal (tail-flick test, hot-plate test), mechanical or electrical (flinch-jump test, vocalisation test) stimuli. Tests of tonic pain employ injections of algogenic agents intradermally (formalin test) or intraperitoneally (writhing test) or even the dilation of hollow organs. All these tests will be critically appraised in a subsequent paper [1].

CONCLUSION

The tail-flick and hot-plate tests are the most used, but there is an increasing recourse to the formalin test and tests involving foot withdrawal after mechanical stimulation.

Effects of ICI 118.551, a selective beta-2 adrenergic blocking agent on the guinea pig cardiac excitability and ventricular fibrillation threshold

In isolated guinea pig perfused hearts ICI 118.551, a selective beta 2 adrenoceptor antagonist, induced transient ventricular extrasystoles. Following the termination of the perfusion, a very significant increase of both the ventricular fibrillation threshold and the refractory periods were measured. In guanethidine pretreated hearts, ICI 118.551 failed to induce premature beats. At the same time the fibrillation threshold and refractory periods exhibited a very significant decrease. The perfusion of equimolecular concentration of metoprolol, a beta-1-adrenoceptor antagonist, and (+) propranolol, a quinidine-like compound, induced, in most experimental settings, similar results as ICI 118.551. Thus, besides its beta-2-adrenoceptor antagonist properties, ICI 118.551 presented other pharmacological actions.

Temporal summation and a C-fibre reflex in the rat: effects of morphine on facilitatory and inhibitory mechanisms

In intact rats, an inhibitory mechanism counteracts the increase in excitability of a flexor reflex, which is seen in spinal animals following temporal summation of C-fibre inputs; the Rostral Ventromedial Medulla is involved in this inhibitory mechanism. Electromyographic responses elicited by electrical stimulation of the sural nerve were recorded from the biceps femoris in four types of preparations, namely intact, sham-operated, Rostral Ventromedial Medulla-lesioned and decerebrate-spinal rats. The excitability of the C-fibre reflex was tested during and following high intensity homotopic electrical conditioning stimuli. Morphine (2 mg/kg) did not significantly change the basal test response but increased the excitability of the spinal cord during conditioning. This effect was triggered by the strength of inputs, involved the Rostral Ventromedial Medulla and was probably related to some forms of motor stimulation through dopaminergic transmission. While wind-up was not reduced, the inhibition related to Diffuse Noxious Inhibitory Controls, which occurred following the conditioning period, did. In spinal animals where inhibitory mechanisms disappear, the depressive effects of morphine were unmasked for both wind-up and post-conditioning facilitations. All effects of morphine were completely reversed by naloxone.

The influence of temporal summation on a C-fibre reflex in the rat: effects of lesions in the rostral ventromedial medulla (RVM)

In intact rats, an inhibitory mechanism counteracts the increase in excitability of a flexor reflex seen in spinal animals following high-intensity, repetitive stimulation of C-fibres. We tested the hypothesis that the rostral ventromedial medulla (RVM) is involved in these processes. Electromyographic responses elicited by electrical stimulation of the sural nerve, were recorded from the ipsilateral biceps femoris in halothane-anaesthetised, sham-operated or RVM-lesioned rats. There were no significant differences between the C-fibre reflexes in the two groups in terms of their thresholds, latencies, durations or mean recruitment curves. The excitability of the C-fibre reflex was tested following 20 s of high-intensity homotopic electrical conditioning stimuli at 1 Hz. During the conditioning period, the EMG responses first increased in both groups (the wind-up phenomenon), but then decreased in the sham-operated rats and plateaued in the RVM-lesioned rats. These effects were followed by inhibitions that were very much smaller in the RVM-lesioned rats, both in terms of their magnitudes and their durations. It is concluded that the RVM is involved in inhibitory feedback mechanisms elicited by temporal summation of C-fibre afferents that both counteract the wind-up phenomenon and trigger long periods of inhibition.

An electrophysiological investigation into the monosynaptic H-reflex in the rat

In order to set up a non-invasive, reliable and reproducible model for investigating alpha-motoneuronal activity, we studied the electrophysiological features of a monosynaptic H-reflex in anaesthetised intact rats, anaesthetised and non-anaesthetised rats transected at the level of the obex. Electrical stimulation of the tibial nerve at the ankle elicited an H-reflex, an F-wave and a direct motor (M) response in the plantaris muscles of all preparations. The H-reflex and F-wave exhibited very similar latencies. The H-reflex had a low threshold and a constant latency. Its amplitude increased as a function of stimulus intensity to reach a maximum value but then decreased when the stimulus intensity was further increased. It could follow high rates of stimulation without any change in shape or latency. The F-wave had a lower amplitude which together with its latency varied from one stimulus to the next. It appeared with intensities of stimulation that elicited an almost maximal M-response and did not decrease when the stimulation was increased. It did not appear systematically from one stimulus to the next. The H-reflex, but neither the F-wave nor the direct motor M-response, was depressed both by vibratory stimuli applied on the Achilles' tendon and following nociceptive stimulation of the flexor reflex afferents. This model could be used for assessing any potential direct effect on motoneurones of a physiological or pharmacological conditioning procedure.

Temporal summation of C-fiber afferent inputs: competition between facilitatory and inhibitory effects on C-fiber reflex in the rat

Long-lasting facilitations of spinal nociceptive reflexes resulting from temporal summation of nociceptive inputs have been described on many occasions in spinal, nonanesthetized rats. Because noxious inputs also trigger powerful descending inhibitory controls, we investigated this phenomenon in intact, halothane-anesthetized rats and compared our results with those obtained in other preparations. The effects of temporal summation of nociceptive inputs were found to be very much dependent on the type of preparation. Electromyographic responses elicited by single square-wave electrical shocks (2 ms, 0.16 Hz) applied within the territory of the sural nerve were recorded in the rat from the ipsilateral biceps femoris. The excitability of the C-fiber reflex recorded at 1.5 times the threshold (T) was tested after 20 s of electrical conditioning stimuli (2 ms, 1 Hz) within the sural nerve territory. During the conditioning procedure, the C-fiber reflex was facilitated (wind-up) in a stimulus-dependent fashion in intact, anesthetized animals during the application of the first seven conditioning stimuli; thereafter, the magnitude of the responses reached a plateau and then decreased. Such a wind-up phenomenon was seen only when the frequency of stimulation was 0.5 Hz or higher. In spinal, unanesthetized rats, the wind-up phenomenon occurred as a monotonic accelerating function that was obvious during the whole conditioning period. An intermediate picture was observed in the nonanesthetized rat whose brain was transected at the level of the obex, but the effects of conditioning were profoundly attenuated when such a preparation was anesthetized. In intact, anesthetized animals the reflex was inhibited in a stimulus-dependent manner during the postconditioning period. These effects were not dependent on the frequency of the conditioning stimulus. Such inhibitions were blocked completely by transection at the level of the obex, and in nonanesthetized rats were then replaced by a facilitation. A similar long-lasting facilitation was seen in nonanesthetized, spinal rats. It is concluded that, in intact rats, an inhibitory mechanism counteracts the long-lasting increase of excitability of the flexor reflex seen in spinal animals after high-intensity, repetitive stimulation of C-fibers. It is suggested that supraspinally mediated inhibitions also participate in long term changes in spinal cord excitability after noxious stimulation.

Effects of clonidine on a C-fibre reflex in the rat

A C-fibre reflex elicited by electrical stimulation within the territory of the sural nerve, was recorded from the ipsilateral biceps femoris muscle in anaesthetized rats. The temporal evolution of the response was studied using a constant stimulus intensity (3 x threshold) and recruitment curves were built by varying stimulus intensity from 0 to 7 x threshold. The intravenous administration of 0.02-0.2 mg/kg clonidine resulted in a dose-dependent depression of the C-fibre reflex. The alpha 2-adrenoceptor antagonist idazoxan completely prevented this depressive effect of clonidine. The effects of clonidine on the C-fibre reflex elicited by a wide range of stimulus intensities were investigated using recruitment curves: following 0.16 mg/kg clonidine, a dramatic shift of the recruitment curve to the right was seen with both an increase in the threshold and a decrease in the slope. Clonidine also produced a dose-dependent increase in blood pressure, but this was not correlated with the depression of the nociceptive reflex.

The effect of some enkephalins on calcitonin secretion

Synthetic enkephalins: 5 metenkephalin, D2 proenkephalin and 5 leuenkephalin and morphine were injected into cerebral ventricles of rats. After 30 minutes the rats were sacrificed and the calcitonin content of the thyroid was assayed. As compared to the controls, morphine reduced significantly the secretion of calcitonin. Of the enkephalins, only 5 leuenkephalin had a borderline effect on calcitonin secretion, stimulating to a significant degree the rise of the hormone. The data obtained demonstrate the selective effect of opiates on calcitonin secretion.