推拿对慢性应激大鼠抑郁行为的影响及其机制

目的: 探讨推拿对慢性应激大鼠抑郁行为的影响及其作用机制。方法: 制备慢性轻度不可预见性的应激大鼠模型^[1-2],造模21 d后,进行推拿治疗14 d。分组:空白对照组、模型组、推拿组、氟西汀组,每组10只。每日推拿膀胱经重要穴位10 min(间隔2 min,共2次)。通过体质量检测、旷场、糖水消耗实验和水迷宫实验评价抑郁模型大鼠行为学改变情况;蛋白质免疫印迹法(Western blot)法检测大鼠海马及前额叶皮质组织中ERK/P-ERK、BDNF蛋白表达情况。结果: 模型组与空白组比较,大鼠的体质量、旷场、糖水消耗实验和水迷宫数据均显著下降(P＜0.01),P-ERK、BDNF蛋白含量均显著降低(P＜0.01);推拿组和氟西汀组与模型组比较,大鼠的体质量、旷场实验、糖水消耗实验和水迷宫实验数据均显著上升(P＜0.01),推拿组和氟西汀组大鼠海马及前额叶皮质组织中P-ERK、BDNF蛋白含量均显著升高(P＜0.05,P＜0.01),氟西汀组升高更为显著(P＜0.01)。结论: 推拿可上调大鼠海马及前额叶皮质组织中ERK蛋白的磷酸化水平,激活ERK信号通路,促进效应蛋白BDNF的表达,改善慢性应激大鼠的抑郁行为。     

党参总皂苷对TNBS诱导的大鼠溃疡性结肠炎的保护作用及其机制

目的: 探讨党参总皂苷(TSC)对大鼠实验性溃疡性结肠炎(UC)的治疗作用及其作用机制。方法: 50只雄性Wistar大鼠随机分为5组:对照组、模型组、柳氮磺胺嘧啶(SASP)阳性对照组(0.3 g/kg)、TSC高剂量组(1.2 g/kg)、TSC低剂量组(0.4 g/kg),用三硝基苯磺酸(TNBS)/乙醇联合灌肠制作大鼠UC模型,给药21 d后,通过观察大鼠症状和体征、疾病活动指数(DAI)、结肠粘膜损伤指数(CMDI)、结肠组织形态;测定结肠组织中超氧化物歧化酶(SOD)、丙二醛(MDA)、炎症因子白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子α(TNF-α)的含量;检测结肠组织中细胞核内核转录因子-κB(NF-κB)蛋白表达;最终评价TSC的治疗效果。结果: 与对照组比较,模型组大鼠DAI、CMDI评分显著升高,结肠粘膜损伤严重,说明造模成功。与模型组比较,TSC高低剂量组均能显著降低UC大鼠DAI评分、CMDI评分(P＜0.05);改善结肠黏膜形态;升高结肠组织中SOD活力,降低MDA含量(P＜0.05),抑制结肠组织中IL-6、TNF-α mRNA水平,促进IL-10 mRNA表达(P＜0.01);同时降低结肠中NF-κB蛋白表达(P＜ 0.01),且TSC高剂量组优于低剂量组(P＜0.05)。结论: TSC对UC大鼠结肠黏膜损伤具有显著保护作用,以高剂量组为佳;其机制可能与抗脂质过氧化,抑制NF-κB信号通路从而调控炎性因子的释放有关。     

中风胶囊对脑缺血/再灌注损伤模型鼠脑组织自噬相关蛋白表达的影响*

目的: 观察中风胶囊对脑缺血/再灌注损伤(CIRI)模型鼠脑组织自噬相关蛋白表达的影响,初步揭示其对神经元损伤保护的分子机制。方法: 采用改良线栓法构建大鼠脑缺血/再灌注损伤模型,随机将60只雄性SD大鼠分为假手术组、模型组、丁苯酞组(0.054 g/kg)、中风胶囊高剂量组(1.08 g/kg)、中风胶囊中剂量组(0.54 g/kg)、中风胶囊低剂量组(0.27 g/kg),每组10只。造模结束后灌胃给药10 d,每天1次,实验结束后处死各组大鼠,摘取脑组织。各组大鼠末次给药24 h后进行神经功能评分;HE染色法观察各组大鼠脑组织病理形态;ELISA法检测各组大鼠血清雌二醇(E2)和卵泡刺激素(FSH);RT-PCR法与Western blot法分别测定各组大鼠脑组织PI3K/Akt/Beclin1信号通路关键基因及蛋白的表达。结果: 与假手术组比较,模型组大鼠体重及脑组织中p-PI3K、p-Akt等蛋白表达均显著降低,脑指数、神经功能缺损评分及脑组织Beclin1、LC3基因和蛋白表达均显著升高(P＜0.05或P＜0.01),脑组织结构排列疏松,间质水肿,神经细胞呈三角形,核固缩深染。与模型组相比,中风胶囊高剂量组大鼠体重显著升高,神经功能缺损评分显著下降(P＜0.05),脑组织病理损伤较模型组明显改善;中风胶囊各剂量组的脑指数及脑组织Beclin1、LC3的基因和蛋白表达均显著降低,脑组织中p-PI3K、p-Akt等蛋白表达均显著升高(P＜0.05或P＜0.01)。结论: 中风胶囊通过调控PI3K/Akt/Beclin1信号通路中Beclin1和LC3的表达来抑制CIRI模型鼠的自噬反应,从而发挥保护其脑神经元损伤的作用。     

艾灸对缺氧缺血性脑损伤新生小鼠的治疗作用*

目的: 探讨艾灸对缺氧缺血性脑损伤新生小鼠行为学表现、脑组织形态结构的影响及作用机制。方法: 将106只出生7 d小鼠随机分为三组:假手术组(23只)、模型组(46只)和艾灸组(37只)。采用左侧颈总动脉结扎后再置于37℃密闭舱内进行低氧处理(氧气浓度为8%,100 min),制备新生儿缺氧缺血性脑病动物模型。艾灸组同模型组,并于造模后2 h开始艾灸“大椎”进行治疗,以后每日1次,每次35 min,连续治疗4 d。采用行为学测试评价小鼠的行为学表现;HE染色观察小鼠脑组织形态结构;Western blot技术检测小鼠脑组织超氧化物歧化酶2(SOD2)蛋白表达;比色法测定小鼠脑组织丙二醛(MDA)含量。结果: 假手术组小鼠行为表现正常,脑组织细胞排列致密整齐,脑组织SOD2蛋白表达量和MDA含量正常。与假手术组相比,模型组小鼠翻正反射、趋地反射、悬崖躲避试验时间延长(P＜0.05),抓力试验时间缩短(P＜0.05);脑组织细胞大量坏死脱落;脑组织SOD2蛋白表达量明显减少(P＜0.05)、MDA含量增加。与模型组相比,艾灸组小鼠翻正反射、趋地反射、悬崖躲避试验时间缩短(P＜0.05),抓力试验时间增长(P＜0.05);脑组织细胞排列较致密、整齐;脑组织SOD2蛋白表达量增多(P＜0.05)、MDA含量降低(P＜0.05)。结论: 艾灸能减轻缺氧缺血性脑病新生小鼠脑损伤、改善行为学表现,这可能与其增加脑组织SOD2蛋白的表达、降低MDA含量,从而提高抗氧化应激能力有关。     

黄连素对PCOS模型大鼠LPS /NF-κB、MAPK信号通路的影响*

目的: 探讨黄连素对多囊卵巢综合征(PCOS)模型大鼠糖脂代谢、性激素结合蛋白和脂联素(LPS)以及NF-κB、MAPK信号通路的影响。方法: 将SD雌性大鼠随机分成空白组、PCOS模型组、黄连素组(0.216 g/kg)、二甲双胍组(0.135 g/kg)和达英-35(0.18 mg/kg)组,每组10只。PCOS模型组用来曲唑(1 mg/(kg·d))连续灌胃3周,随后药物干预28 d,检测大鼠体重、卵巢和子宫指数,HE染色观察大鼠卵巢卵泡数量变化,用ELISA法检测血清性激素水平、空腹葡萄糖和胰岛素、甘油三酯和胆固醇、性激素结合蛋白和脂联素水平以及用蛋白印迹法检测卵巢组织p38-MAPK、c-Jun和NF-κB蛋白表达。结果: 与空白组比较,模型组大鼠体重显著增加(P＜0.05),子宫指数显著降低(P＜0.05),囊状卵泡数量显著增加(P＜0.05),血清黄体生成素(LH)、睾酮(T)水平和LH/FSH比值显著升高(P＜0.05),卵泡刺激素(FSH)水平显著下降(P＜0.05),总胆固醇(TC)、甘油三酯(TG)、空腹胰岛素和胰岛素指数(HOMA)显著增加(P＜0.05),性激素结合蛋白(SHBG)含量显著减少以及脂联素(LPS)含量显著增加(P＜0.05),卵巢组织p38-MAPK、c-Jun和NF-κB蛋白表达上调(P＜0.05)。与模型组比较,黄连素能显著增加子宫指数(P＜0.05)、次级卵泡数量(P＜0.05),显著降低血清促黄体生成素(LH)水平、睾酮(T)水平和LH/FSH比值(P＜ 0.05),显著下调卵巢组织p38-MAPK和NF-κB蛋白表达(P＜0.05),作用类似达英-35;黄连素能明显降低血清甘油三酯(TG)、胰岛素水平和胰岛素指数(P＜0.05),升高血清SHBG水平,降低LPS水平(P＜0.05),作用类似二甲双胍。结论: 黄连素通过下调卵巢组织p38-MAPK和NF-κB蛋白表达,降低血清LPS含量,起到调控PCOS大鼠性激素紊乱和胰岛素抵抗(IR)的作用。     

蒙药绍沙-7味丸防治大鼠心肌缺血/再灌注损伤的作用

目的: 探讨蒙药绍沙-7味丸对心肌缺血/再灌注损伤大鼠的防治作用及机制。方法: 60只大鼠随机分成6组:假手术组、模型组、蒙药绍沙-7味丸低、中、高剂量组以及阳性药对照组,每组10只;蒙药绍沙-7味丸低、中、高剂量组分别灌胃0.4 g/kg、0.8 g/kg、1.6 g/kg蒙药绍沙-7味丸,阳性药对照组灌胃0.3 g/kg复方丹参片,假手术组和模型组灌胃2 ml/100 g蒸馏水,均连续灌胃15 d,1次/日;15 d后,模型组及治疗组大鼠开胸结扎冠状动脉30 min后,解开结扎线行再灌注120 min后关闭胸腔处理;6组大鼠术后行心电图检查后处死大鼠取心脏行HE染色、TTC染色,观察梗死面积及病理变化。ELISA法检测血清中cTnI、CK-MB、 LDH、MDA、SOD、GSH-PX及TNF-α、IL-18、IL-6、IL-1β的水平,免疫组化法检测心肌组织NF-кB水平。结果: 与假手术组相比,心肌缺血/再灌注损伤大鼠心肌梗死面积增大,同时血清中cTnI、CK-MB、 LDH、MDA、GSH-PX及TNF-α、IL-18、IL-6、IL-1β的含量明显增加(P＜0.01),SOD的含量则明显降低(P＜0.01),心脏组织中的NF-кB水平增加;与心肌缺血/再灌注损伤大鼠相较,蒙药绍沙-7味丸改善大鼠心律失常现象及病理变化,减少梗死面积;血清中cTnI、CK-MB、 LDH、MDA、GSH-PX及TNF-α、IL-18、IL-6、IL-1β的含量明显降低(P＜0.01),SOD的含量明显增加(P＜0.01),心脏组织中的NF-кB水平降低。结论: 蒙药绍沙-7味丸可有效缓解大鼠心肌缺血/再灌注损伤,其作用与氧化应激和凋亡相关。     

帕瑞昔布对骨关节炎大鼠软骨细胞的影响*

目的:探究帕瑞昔布对骨关节炎大鼠软骨细胞形态、数量及TNF-α/NF-κB信号通路在其中的作用。方法:将所选取的大鼠随机分组,第一组,模型组(MO组):该组大鼠制作骨关节炎大鼠模型;第二组,假手术组(SS组):该组大鼠在骨关节做切口后不做任何处理;第三组,治疗组(TR组):该组大鼠制作骨关节炎模型后给予帕瑞昔布进行治疗,每组5只。通过cck-8法、Western blot法、qRT-PCR法、HE染色法、OARSI评分分别检测三组大鼠软骨细胞增殖情况、TNF-α/NF-κB的蛋白表达、TNF-α/NF-κB mRNA的表达水平、软骨组织病变程度。结果:与SS组大鼠比较,MO组和TR组关节软组织细胞增殖虽然均显著减少(P＜0.05),但TR组的增殖显著高于MO组。同样TR组的软骨组织结构好于MO组,OARSI评分显著低于MO组(P＜0.05);与SS组大鼠比较, MO组和TR组大鼠TNF-α和NF-κB的蛋白与基因表达水平虽然均显著高于SS组,但TR组的相应蛋白与基因表达水平显著低于MO组(P＜0.05)。结论:帕瑞昔布可能通过抑制TNF-α/NF-κB信号通路的表达对骨关节炎大鼠起到治疗作用。     

达格列净对2型糖尿病大鼠肾脏葡萄糖转运蛋白2及葡萄糖转运蛋白4基因表达的影响*

目的:探讨达格列净对2型糖尿病大鼠肾脏葡萄糖转运蛋白2(GLUT2)和葡萄糖转运蛋白4(GLUT4)基因表达的影响。方法:使用高脂饲料和一次性注射40 mg/kg链脲佐菌素(STZ)建立2型糖尿病大鼠模型,造模大鼠以空腹血糖(FBG)含量≥16.7 mmol/L时视为造模成功。造模成功后随机分为模型组(B组,生理盐水)、达格列净低剂量组(C组,0.75 mg/kg)、达格列净中剂量组(D组,1.5 mg/kg)、达格列净高剂量组(E组,3.0 mg/kg),每组6只;另选取6只健康的SD大鼠作为正常对照组(A组,生理盐水)。各组均为灌胃给药,每天1次,连续7周。灌胃给药7周后测定大鼠的体重以及血清FBG、糖化血红蛋白(HbA1c)、血尿素氮(BUN)、血肌酐(Scr)的变化;采用酶联免疫吸附测定血清及肾组织丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px);采用HE观察肾脏病理学变化;采用Western blot检测肾脏组织中GLUT2、GLUT4蛋白表达;RT-qPCR检测肾脏组织中GLUT2、GLUT4 mRNA相对表达量。结果: 与A组比较,各组大鼠的体重及SOD、GSH-PX水平明显降低(P＜ 0.05),FBG、HbA1c、BUN、Scr、MDA水平明显升高(P＜0.05),肾脏病理损伤严重,肾组织GLUT2、GLUT4 mRNA相对表达量和蛋白表达均明显降低(P均＜0.05)。与B组比较,C组、D组和E组大鼠的体重、SOD、GSH-PX水平和肾组织GLUT2、GLUT4 mRNA相对表达量明显升高(P＜0.05),FBG、HbA1c、BUN、Scr、MDA水平明显降低(P＜ 0.05);D组和E组肾脏病理损伤明显减轻,肾组织GLUT2、GLUT4蛋白表达均明显升高(P均＜0.05)。结论:达格列净可缓解2型糖尿病模型大鼠的病情,并上调肾脏GLUT2及GLUT4基因的表达。     

甘麦大枣汤对抑郁模型大鼠海马神经元突触结构及结构蛋白表达的影响*

目的: 观察甘麦大枣汤对抑郁模型大鼠行为学及单胺递质的影响,并从突触结构及结构蛋白MAP-2与GAP-43表达改变探讨其潜在作用机制。方法: 60只SD大鼠随机分为5组:正常对照组、模型组、氟西汀组(10.8 mg/kg)、甘麦大枣汤高、低剂量组(9.72、4.86 g/kg),每组12只。除对照组外,其余各组大鼠均采用慢性不可预见性温和应激(CUMS)建立抑郁模型,并于造模同时给药组灌胃给药,连续21 d。采用糖水消耗实验和旷场测试评价大鼠抑郁样行为,ELISA法检测海马单胺递质5-HT、NE含量,Golgi染色观察神经元突触损伤情况,免疫组化法和Western blot法检测海马突触结构蛋白MAP-2和GAP-43的表达。结果: 与对照组比较,抑郁模型大鼠糖水偏好度及自主活动评分均显著下降(P＜0.01),海马5-HT、NE含量显著下降(P＜0.01),树突棘缺失明显,同时MAP-2和GAP-43表达均显著下调(P＜0.01);甘麦大枣汤干预后,模型大鼠抑郁样行为明显缓解(P＜0.01),5-HT、NE含量显著升高(P＜0.05),树突棘密度、长度及分枝增加,MAP-2和GAP-43表达显著回升(P＜0.01)。结论: 甘麦大枣汤能改善抑郁模型大鼠的抑郁样行为,升高海马单胺递质含量,其作用可能与上调突触结构蛋白、缓解神经元突触损伤有关。     

小檗碱对大鼠脑缺血/再灌注损伤的保护作用及免疫机制*

目的:探讨小檗碱对大鼠脑缺血/再灌注损伤的保护作用及免疫机制。方法:50只SD大鼠随机分为假手术组(Sham group)、模型组(Model group)、小檗碱低剂量组(BBR-L,25 mg/kg)、小檗碱中剂量组(BBR-M,50 mg/kg)、小檗碱高剂量组(BBR-H,100 mg/kg),每组各10只。采用Longa线栓法建立脑缺血/再灌注大鼠模型,缺血2 h后再灌注24 h处理。于造模成功2 h后灌胃给药,假手术组和模型组组按上述方法同体积给予生理盐水。给药24 h后,测定各组大鼠神经功能缺损程度评分及脑梗死率;采用ELISA法检测抗氧化酶SOD和GSH-Px的活性、细胞因子TNF-α、IFN-β、IL-6和NO的含量;采用流式细胞术检测CD4⁺、CD8⁺及CD4⁺/CD8⁺血清含量;进一步采用RT-qPCR与Western blot技术检测大鼠脑组织内NF-κB-NLRP3信号轴关键基因及蛋白的表达情况。结果:与假手术组比较,模型组大鼠神经功能缺损程度、脑梗死率均升高(P＜0.05),且血清NO、TNF-α、IFN-β、IL-6含量和脑组织的NF-κB p65、NLRP3、ASC及caspase-1基因与蛋白表达水平均升高(P＜0.05),而血清中SOD、GSH-Px活性和CD4⁺、CD8⁺及CD4⁺/CD8⁺水平下降(P＜0.05);与模型组比较,BBR-H、BBR-M、BBR-L组大鼠神经功能缺损程度、脑梗死率均下降(P＜0.05),且血清NO、TNF-α、IFN-β、IL-6含量和脑组织的NF-κB p65、NLRP3、ASC及caspase-1基因与蛋白表达水平均降低(P＜0.05),而血清中SOD、GSH-Px活性和CD4⁺、CD8⁺及CD4⁺/CD8⁺水平升高(P＜0.05)。结论:小檗碱可通过减轻氧化应激,抑制炎症反应,增强免疫功能,减轻大鼠脑缺血/再灌注损伤,其机制可能与抑制NF-κB-NLRP3信号有关。     

经输卵管注药介入治疗慢性盆腔炎性疼痛及阻塞性不孕的路径探讨和疗效观察

目的为探索治疗慢性盆腔痛及不孕的理想方法,本文尝试通过输卵管注药介入治疗盆腔炎性后遗症等疼痛疾病及输卵管阻塞性不孕,观察其疗效并对输卵管这条自身路径进一步拓宽利用进行实践论证。方法应用NCI—I型数字化输卵管通液诊断治疗仪对56例盆腔炎性等疼痛、伴有不孕或计划妊娠的患者结合超声监测通液诊断,根据输卵管通畅程度分别给予盆腔注药或输卵管疏通后介入治疗。结果56例盆腔疼痛患者仅有19例输卵管通畅,37例输卵管阻塞（不全阻塞25例,11例不通）,占66．1％。治疗后通畅组盆腔疼痛消失16例,治愈率为84．2％;不全阻塞组疼痛减轻20例,好转率为76．9％,其中14例患者输卵管得以疏通;不通组45．5％（5／11）病情好转,输卵管疏通率为63。6％（7／11）;通畅组疼痛治愈率明显高于不全阻塞和不通组（P〈0．05）。盆腔炎性疼痛治愈率和输卵管疏通率分别为45．5％和82．4％,内异症等疼痛组为13．0％和65.0％,后者虽不及前者理想（P〈0．05）,但确有60．9％患者疼痛好转。本文输卵管阻塞疏通率为72．9％,慢性盆腔疼痛治疗有效率达87．5％。结论输卵管是一条与生俱来的自身生理通道,可拓宽利用诊治盆腔疾病。NCI—I型数字化输卵管通液诊断治疗仪盆腔注药介入治疗是一种准确易行、安全无创、科学有效的诊治盆腔炎性等疾病的方法。实践证明,疏通这条路径不仅在阻塞性输卵管不孕方面起到了至关重要的临床作用,对治疗盆腔炎性后遗症等慢性盆腔疼痛疾病也有较高的研究价值,值得进一步探索和应用,并有广阔的前景和发展空间。     

P2X4 purinoceptor signaling in chronic pain

ATP, acting via P2 purinergic receptors, is a known mediator of inflammatory and neuropathic pain. There is increasing evidence that the ATP-gated P2X4 receptor (P2X4R) subtype is a locus through which activity of spinal microglia and peripheral macrophages instigate pain hypersensitivity caused by inflammation or by injury to a peripheral nerve. The present article highlights the recent advances in our understanding of microglia-neuron interactions in neuropathic pain by focusing on the signaling and regulation of the P2X4R. We will also develop a framework for understanding converging lines of evidence for involvement of P2X4Rs expressed on macrophages in peripheral inflammatory pain.     

The modification of cortical reorganization and chronic pain by sensory feedback

Recent neuroscientific evidence has revealed that the adult brain is capable of substantial plastic change in areas such as the primary somatosensory cortex that were formerly thought to be modifiable only during early experience. We discuss research on phantom limb pain as well as chronic back pain that revealed functional reorganization in both the somatosensory and the motor system in these chronic pain states. In phantom limb pain patients, cortical reorganization is correlated with the amount of phantom limb pain; in low back pain patients the amount of reorganizational change increases with chronicity. We present a model of the development of chronic pain that assumes an important role of somatosensory pain memories. In phantom limb pain, we propose that those patients who experienced intense pain prior to the amputation will later likely develop enhanced cortical reorganization and phantom limb pain. We show that cortical plasticity related to chronic pain can be reduced by behavioral interventions that provide feedback to the brain areas that were altered by somatosensory pain memories.     

包皮环切术联合α受体阻滞剂治疗慢性前列腺炎的临床研究

目的:探讨α-受体阻滞剂联合包皮环切术治疗慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)的临床疗效。方法:目标选择2016年7月至2017年10月上海市第一人民医院收治的100例年龄18～50岁的包皮过长同时合并CP/CPPS患者为研究对象,将其随机分为包皮环切术组58例和对照组52例。包皮环切术组的患者接受α-受体阻滞剂治疗的同时进行包皮环切术,对照组仅给予α-受体阻滞剂治疗。采用国际慢性前列腺炎症状指数NIH-CPSI的变化评估和比较两组的治疗效果。结果:以NIH-CPSI总分3个月从基线减少4分为治疗有效,包皮环切术组和对照组治疗有效率分别为82.6%、62.5%,包皮环切术组显著高于对照组(P0.001)。治疗12周后,包皮环切术组NIH-CPSI总分的中位数从24.0±4.0降至12.0±8.0(P0.001),对照组从24.0±3.0降至15.0±7.0(P0.001),两组比较差异具有统计学意义(P0.001)。包皮环切组NIH-CPSI总分、疼痛评分、尿路评分和生活质量评分均明显低于对照组(P0.001)。结论:与单独应用α受体阻滞剂相比,联合包皮环切术联合α-受体阻滞剂药物治疗更有效提高CP/CPPS患者的临床疗效,改善患者的慢性前列腺炎症状评分。     

Dynamic changes to the endocannabinoid system in models of chronic pain

The analgesic effects of cannabinoid ligands, mediated by CB1 receptors are well established. However, the side-effect profile of CB1 receptor ligands has necessitated the search for alternative cannabinoid-based approaches to analgesia. Herein, we review the current literature describing the impact of chronic pain states on the key components of the endocannabinoid receptor system, in terms of regionally restricted changes in receptor expression and levels of key metabolic enzymes that influence the local levels of the endocannabinoids. The evidence that spinal CB2 receptors have a novel role in the modulation of nociceptive processing in models of neuropathic pain, as well as in models of cancer pain and arthritis is discussed. Recent advances in our understanding of the spinal location of the key enzymes that regulate the levels of the endocannabinoid 2-AG are discussed alongside the outcomes of recent studies of the effects of inhibiting the catabolism of 2-AG in models of pain. The complexities of the enzymes capable of metabolizing both anandamide (AEA) and 2-AG have become increasingly apparent. More recently, it has come to light that some of the metabolites of AEA and 2-AG generated by cyclooxygenase-2, lipoxygenases and cytochrome P450 are biologically active and can either exacerbate or inhibit nociceptive signalling.     

Markedly attenuated acute and chronic pain responses in mice lacking adenylyl cyclase-5

Chronic inflammatory and neuropathic pain is often difficult to manage using conventional remedies. The underlying mechanisms and therapeutic strategies required for the management of chronic pain need to be urgently established. The cyclic AMP (cAMP) second messenger system has been implicated in the mechanism of nociception, and the inhibition of the cAMP pathway by blocking the activities of adenylyl cyclase (AC) and protein kinase A has been found to prevent chronic pain in animal models. However, little is known regarding which of the 10 known isoforms of AC are involved in nociceptive pathways. Therefore, we investigated the potential pronociceptive function of AC5 in nociception using recently developed AC5 knockout mice (AC5-/-). We found that AC5-/- mice show markedly attenuated pain-like responses in acute thermal and mechanical pain tests as compared with the wildtype control. Also, AC5-/- mice display hypoalgesic responses to inflammatory pain induced by subcutaneous formalin injection into hindpaws, and to non-inflammatory and inflammatory visceral pain induced by injecting magnesium sulfate or acetic acid into the abdomen. Moreover, AC5-/- mice show strongly suppressed mechanical and thermal allodynia in two nerve injury-induced neuropathic pain models. These results suggest that AC5 is essential for acute and chronic pain, and that AC5 knockout mice provide a useful model for the evaluation of the pathophysiological mechanisms of pain.     

P2 receptors and chronic pain

There is abundant evidence that extracellular ATP and other nucleotides have an important role in pain signaling at both the periphery and in the CNS. The focus of attention now is on the possibility that endogenous ATP and its receptor system might be activated in chronic pathological pain states, particularly in neuropathic and inflammatory pain. Neuropathic pain is often a consequence of nerve injury through surgery, bone compression, diabetes or infection. This type of pain can be so severe that even light touching can be intensely painful; unfortunately, this state is generally resistant to currently available treatments. In this review, we summarize the role of ATP receptors, particularly the P2X₄, P2X₃ and P2X₇ receptors, in neuropathic and inflammatory pain. The expression of P2X₄ receptors in the spinal cord is enhanced in spinal microglia after peripheral nerve injury, and blocking pharmacologically and suppressing molecularly P2X₄ receptors produce a reduction of the neuropathic pain behaviour. Understanding the key roles of these ATP receptors may lead to new strategies for the management of intractable chronic pain.     

Neuromuscular adaptations predict functional disability independently of clinical pain and psychological factors in patients with chronic non-specific low back pain

Patients with chronic low back pain exhibit characteristics such as clinical pain, psychological symptoms and neuromuscular adaptations. The purpose of this study was to determine the independent contribution of clinical pain, psychological factors and neuromuscular adaptations to disability in patients with chronic low back pain. Clinical pain intensity, pain catastrophizing, fear-avoidance beliefs, anxiety, neuromuscular adaptations to chronic pain and neuromuscular responses to experimental pain were assessed in 52 patients with chronic low back pain. Lumbar muscle electromyographic activity was assessed during a flexion–extension task (flexion relaxation phenomenon) to assess both chronic neuromuscular adaptations and neuromuscular responses to experimental pain during the task. Multiple regressions showed that independent predictors of disability included neuromuscular adaptations to chronic pain (β = 0.25, p = 0.006, sr² = 0.06), neuromuscular responses to experimental pain (β = −0.24, p = 0.011, sr² = 0.05), clinical pain intensity (β = 0.28, p = 0.002, sr² = 0.08) and psychological factors (β = 0.58, p < 0.001, sr² = 0.32). Together, these predictors accounted for 65% of variance in disability (R² = 0.65 p < 0.001). The current investigation revealed that neuromuscular adaptations are independent from clinical pain intensity and psychological factors, and contribute to inter-individual differences in patients’ disability. This suggests that disability, in chronic low back pain patients, is determined by a combination of factors, including clinical pain, psychological factors and neuromuscular adaptations.     

Antinociceptive and neurochemical effects of a single dose of IB-MECA in chronic pain rat models

This study aimed to evaluate the effect of a single administration of IB-MECA, an A3 adenosine receptor agonist, upon the nociceptive response and central biomarkers of rats submitted to chronic pain models. A total of 136 adult male Wistar rats were divided into two protocols: (1) chronic inflammatory pain (CIP) using complete Freund’s adjuvant and (2) neuropathic pain (NP) by chronic constriction injury of the sciatic nerve. Thermal and mechanical hyperalgesia was measured using von Frey (VF), Randal-Selitto (RS), and hot plate (HP) tests. Rats were treated with a single dose of IB-MECA (0.5 μmol/kg i.p.), a vehicle (dimethyl sulfoxide—DMSO), or positive control (morphine, 5 mg/kg i.p.). Interleukin 1β (IL-1β), brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) levels were measured in the brainstem and spinal cord using enzyme-linked immunosorbent assay (ELISA). The establishment of the chronic pain (CIP or NP) model was observed 14 days after induction by a decreased nociceptive threshold in all three tests (GEE, P < 0.05). The antinociceptive effect of a single dose of IB-MECA was observed in both chronic pain models, but this was more effective in NP model. There was an increase in IL-1β levels promoted by CIP. NP model promoted increase in the brainstem BDNF levels, which was reversed by IB-MECA     

Effect of experimental low back pain on neuromuscular control of the trunk in healthy volunteers and patients with chronic low back pain

Studies of electromyographic (EMG) activity and lumbopelvic rhythm have led to a better understanding of neuromuscular alterations in chronic low back pain (cLBP) patients. Whether these changes reflect adaptations to chronic pain or are induced by acute pain is still unclear. This work aimed to assess the effects of experimental LBP on lumbar erector spinae (LES) EMG activity and lumbopelvic kinematics during a trunk flexion–extension task in healthy volunteers and LBP patients. The contribution of disability to these effects was also examined. Twelve healthy participants and 14 cLBP patients performed flexion–extension tasks in three conditions; control, innocuous heat and noxious heat, applied on the skin over L5 or T7. The results indicated that noxious heat at L5 evoked specific increases in LES activity during static full trunk flexion and extension, irrespective of participants’ group. Kinematic data suggested that LBP patients adopted a different movement strategy than controls when noxious heat was applied at the L5 level. Besides, high disability was associated with less kinematic changes when approaching and leaving full flexion. These results indicate that experimental pain can induce neuromechanical alterations in cLBP patients and healthy volunteers, and that higher disability in patients is associated with decreased movement pattern changes.