中脑导水管周围灰质在针刺镇痛中的作用

中脑导水管周围灰质(PAG)是脑内一个重要的镇痛结构。近年来国内外对其在针刺镇痛中的作用和镇痛机理进行了广泛的研究。PAG被电针激活后,不仅可抑制躯体痛而且可抑制内脏痛。PAG有内啡肽能和5-羟色胺能两类神经元参与针刺镇痛过程,内源性鸦片样物质(OLS)和5-羟色胺(5-HT)是实现针刺镇痛作用的重要神经递质。电针穴位可激活PAG,通过其整合作用以及通过上行途径,特别是下行抑制通路抑制与痛感受有关的神经元,从而达到镇痛的效应。     

中脑导水管周围灰质在针刺镇痛中的作用

中脑导水管周围灰质(PAG)是脑内一个重要的镇痛结构。近年来国内外对其在针刺镇痛中的作用和镇痛机理进行了广泛的研究。PAG被电针激活后,不仅可抑制躯体痛而且可抑制内脏痛。PAG有内啡肽能和5-羟色胺能两类神经元参与针刺镇痛过程,内源性鸦片样物质(OLS)和5-羟色胺(5-HT)是实现针刺镇痛作用的重要神经递质。电针穴位可激活PAG,通过其整合作用以及通过上行途径,特别是下行抑制通路抑制与痛感受有关的神经元,从而达到镇痛的效应。     

家兔杏仁核内的5-羟色胺和内源性吗啡样物质在电针镇痛和吗啡镇痛中起重要作用

本工作的目的是要确定杏仁核内的吗啡样物质(内啡素)和5-羟色胺(5-HT)是否参与电针镇痛和吗啡镇痛。经慢性埋植套管向家兔杏仁核内微量注射阿片受体阻断剂纳洛酮,或5-HT受体阻断剂肉桂硫胺,可使电针的镇痛效果显著减弱,尤以注入中央杏仁核作用最为显著,双侧注射效果大于单侧,注入核外则无效。杏仁核内注入5-HT 的前体5-HTP,或脑啡肽降解酶抑制剂 D-苯丙氨酸可使电针镇痛显著加强。上述措施凡是加强或对抗电针镇痛的,也能加强或对抗吗啡镇痛。以上结果表明,电针刺激或注射吗啡可能在杏仁核内引起5-HT 和内啡素(很可能是脑啡肽)的释放,而发挥镇痛效应。     

电针可促进前脑啡肽原mRNA在大鼠脊髓和延髓的表达：原位杂交研究

本实验室以往的研究表明电针可促进脊髓脑啡肽释放,本研究进一步利用原位杂交方法观察电针后前脑啡肽原mRNA在脊髓和延髓的表达。结果表明电针刺激(2Hz,1-2-3mA,30)后24h同侧脊髓背角前脑啡肽原(PPE)-mRNA阳性细胞数高于对侧。电针后对侧延髓腹内侧网状结构[包括延髓网状巨细胞核(Gi)及其α部(GiA)和Gi的外侧旁核(LPGi)]PPE-mRNA阳性细胞数高于同侧。我们推测电针诱发前脑啡肽原mRNA表达增加可弥补因脑啡肽释放增多而导致脑啡肽前体物质的损失,从而参与针刺镇痛的长期效应。     

大鼠中枢甲硫脑啡肽和亮脑啡肽含量与电针镇痛的关系

应用放射免疫法测定电针镇痛大鼠各脑区和脊髓中甲硫脑啡肽(MEK)与亮脑啡肽(LEK)样免疫活性物质含量。结果表明,电针组大鼠尾核和下丘脑内的 MEK 与 LEK 含量显著升高,丘脑、低位脑干和脊髓的含量基本不变。将每只鼠电针镇痛效果与脑内脑啡肽含量作直线相关处理,可见尾核与下丘脑的 MEK 含量与大鼠针效呈正相关(P 均<0.05),而这两个脑区的 LEK 含量与针效优劣无相关关系。本工作提示,尾核和下丘脑的 MEK 可能在电针镇痛中具有重要作用。     

家兔伏核注射吗啡引起的镇痛可被中脑导水管周围灰质注射纳洛酮或甲啡肽抗体所阻断

本实验室以往的资料表明,在家兔中脑导水管周围灰质(PAG)到伏核之间存在一条与镇痛有夫的神经通路,该通路以5-羟色胺(5-HT)和甲啡肽(ME)为其递质。本工作进一步探讨从伏核到PAG的下行镇痛通路。 以辐射热照射家兔嘴侧部皮肤,测量其躲避反应的潜伏期(ERL)作为痛反应阈,简称痛阈。通过预先埋植的慢性套管向伏核内微量注射吗啡,20min后向PAG内双侧注射纳洛酮(NX)或脑啡肽抗血清,观察ERL的变化。(1)伏核内注射吗啡20μg/1μl,引起ERL升高80％以上,作用持续50min以上。(2)PAG内注射NX(每侧0.5、1.0或2.0μg)可不同程度地阻断伏核内注射吗啡的镇痛效应,且呈明显的剂效关系。(3)PAG内注入甲啡肽抗血清(每侧1μl)可部分阻断伏核内注射吗啡的镇痛效应,而注入亮啡肽抗血清或正常兔血清则无效。 实验结果提示,从伏核到PAG存在一条下行镇痛通路,在PAG内可能以ME为其递质。该通路与PAG到伏核的上行镇痛通路构成一个环形的“中脑边缘镇痛回路”,并在针刺镇痛和吗啡镇痛中发挥重要作用。     

电刺激猫中脑导水管周围灰质和中缝大核对脊髓背角神经元伤害性感受反应的抑制

1.在氯醛糖麻醉的猫上,观察了电刺激中脑导水管周围灰质(PAG)和中缝大核(NRM)对脊髓腰段背角神经元传入活动的影响。2.按照对刺激的反应型式,在背角记录到非伤害性低阈值传入、广动力范围、伤害性热敏以及高阈值传入诱发的自发放电抑制等四类神经元。3.刺激 PAG和 NRM对记录到的多数背角神经元皮肤传入反应有明显抑制效应,而对自发放电抑制性神经元产生去抑制。4.比较刺激两脑区的抑制效应:NRM 作用较PAG 强;PAG 活动对背角伤害性反应抑制的选择性较 NRM强;阿片肽拮抗剂-纳洛酮拮抗NRM刺激的抑制。5.这些结果提示PAG和NRM对脊髓的下行抑制,可能有一部分是通过不同神经机制实现的。     

针刺镇痛过程中中缝大核内5-羟色胺和去甲肾上腺素荧光强度的变化

本实验用荧光组织化学和显微荧光定量法测定了针刺镇痛过程中大自鼠中缝大核内5-羟色胺(5-HT)胞体和去甲肾上腺素(NA)末梢荧光强度的变化。电针组在电针后,痛阈均有不同程度的提高。33只接受电针刺激的动物中,有22只为强针效,6只弱针效,7只无针效。实验表明,针效强的动物,中缝大核内5-HT胞体荧光增强,NA末梢荧光强度减弱;针效弱的动物,5-HT胞体的荧光强度也有所增强,NA末梢的荧光强度略有减弱,但无统计意义。无针效动物,两者均无明显变化。本结果表明,针刺镇痛过程中,中缝大核内5-HT和NA含量都发生变化,其变化程度与针刺镇痛效应的强弱密切相关。本文对中缝大核5-HT和NA在针刺镇痛过程中的相互关系进行了讨论。     

家兔缰核和导水管周围灰质内微量注射氯化钙拮抗电针和吗啡的镇痛作用

通过埋植套管向家兔双侧缰核或中脑导水管周围灰质(PAG)注射 CaCl_2每侧15—20nmol,对痛阈并无显著影响,但可使电针镇痛和吗啡(2rag/kg)镇痛效果明显降低。注入上述核团附近脑区则无效。双侧缰核注射的作用大于单侧。PAG 内注射 CaCl_2对抗电针镇痛的作用大于其对抗吗啡镇痛的作用。ca~(2 )对抗吗啡和电针镇痛的结果提示,吗啡或电针(释放内啡素)使神经元内 Ca~(2 )水平降低可能是吗啡或电针镇痛的共同机理。     

针刺镇痛时兔视前区β-内啡肽样免疫活性物质和去甲肾上腺素释放的变化

本实验采用放射免疫分析法和高效液相色谱法分別测定电针前和电针10min 后兔视前区灌流液中β-内啡肽样免疫活性物质(β-EPIS)和去甲肾上腺素(NA)及其代谢物3-甲氧基-4-羟基苯乙二醇(MHPG)的含量。结果,针刺镇痛时灌流液中β-EPIS 含量增加;而 NA 和MHPG 则减少;β-EPIS 和 MHPG 含量的变化呈负相关(r=-0.831;P<0.05)。提示在针刺镇痛时;视前区β-内啡肽与 NA 的释放抑制有关。     

Mass Fragmentographic Analysis of Monoamine Metabolites in the Spinal Cord of Rat After the Administration of Morphine

Abstract: A mass fragmentographic method was used in which homovanillic acid (HVA), methoxyhydroxyphenylglycol (MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) were measured from a single sample. The results describe the effect of morphine on the metabolism of the major monoamines, dopamine (DA), noradrenaline (NA), and 5-hydroxytryptamine (5-HT) in the spinal cord. Morphine has very little effect on the metabolism of DA and NA in the spinal cord. However, morphine causes a significant increase in the metabolism of spinal 5-HT. The increase in 5-HIAA induced by morphine is not restricted to the dorsal horn. The three main functional regions of the cord—dorsal horn (sensory), zona intermedia (autonomic), and ventral horn (somatic motor)—are affected to the same degree. The results indicate that morphine causes a generalized activation of serotonin neurons in the spinal cord. There appears to be little or no selectivity for those serotonergic neurons that innervate the dorsal horn. The results are discussed with reference to current data which indicate a fairly strong link between descending serotonergic nerves and the mechanism of action of morphine-induced analgesia.     

刺激PAG对C纤维传入诱发皮层电反应的影响

电刺激中脑导水管周围灰质(Periaqueductal Gray,PAG)对 C 类纤维传入引起的体感皮层诱发电位(C-CEP)和脊髓背表面电位(C-SSP)均有明显的抑制作用,对前者的作用更大。在脊髓背表面滴加赛庚啶后,刺激 PAG 对 C-SSP 的抑制变得不明显,表明 PAG下行抑制通路被阻断;但刺激 PAG 对 C-CEP 抑制仍明显,仅稍减小。提示 PAG 除了通过下行通路以外,可能还通过上行通路抑制 C-CEP。在脊髓背表面滴加赛庚啶后,静脉注射纳洛酮和赛庚啶可明显减弱电刺激 PAG 对 C-CEP 的抑制作用,提示内源性阿片样物质和5-羟色胺可能是上行抑制通路中主要的神经递质。     

Biochemical studies on monoamine contents in spinal cord of patients with multiple system atrophy

Monoamine contents were measured in the cervical spinal cord of patients with multiple system atrophy (MSA) by high-performance liquid chromatography with electrochemical detection. The concentrations of noradrenaline (NA) and its metabolite 4-methyl-4-hydroxyphenylglycol (MHPG) were highest in ventral horn compared with other regions of the spinal cord in controls. Both NA and MHPG contents were reduced in all regions in 4 MSA patients. But in one case (case 5), which did not show an autonomic dysfunction, NA as well as MHPG level was similar to controls. Similarly, the concentrations of 5-hydroxytryptamine (5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) were highest in ventral horn and reduced in all regions in 4 MSA patients who showed mild motor weakness. In one case (case 5), which revealed clinical motor weakness associated with fasciculation and areflexia and pathological degeneration of ventral horn, 5-HT content showed higher values than controls whereas the 5-HIAA level was lower than controls. These results probably indicate that the cell loss of supraspinal monoaminergic nuclei may be one of the causes responsible for neurological dysfunction such as autonomic failures and motor weakness in MSA.     

福尔马林致痛后大鼠中脑导水管周围灰质甲啡肽及脊髓背角P物质含量的变化

本文用免疫组化方法结合计算机图像处理技术观察大鼠后脚掌皮下注射福尔马林后脊髓背角Ｐ物质免疫阳性反应（ＳＰＬＩ）变化的节段性分布及中脑导水管周围灰质（ＰＡＧ）内甲啡肽样免疫阳性反应（ＭＥＬＩ）的变化。结果显示,注射福尔马林后,脊髓腰段（Ｌ１－２,Ｌ４－５）背角ＳＰＬＩ显著增强（Ｐ＜．０５）,３０ｍｉｎ组与６０ｍｉｎ组相比较无显著变化（Ｐ＞０．０５）;胸脊髓（Ｔ８）无显著变化（Ｐ＞０．０５）;颈脊髓背角ＳＰＬＩ有增强趋势（０．０５＜Ｐ＜０．１）;ＰＡＧ中ＭＥＬＩ减弱,腹外侧部３０ｍｉｎ组比６０ｍｉｎ组变化更大（Ｐ＜０．０５）。ＰＡＧ中ＭＥＬＩ与脊髓背角ＳＰＬＩ变化的时相关系提示福尔马林致痛引起的脊髓背角Ｐ物质的增多可能与ＰＡＧ中甲啡肽及阿片受体活动有关。     

Immunocytochemical identification of axons containing coexistent serotonin and substance P in the cat lumbar spinal cord

Axons containing both serotonin-like (5-HT)-LI and substance P-like (SP)-LI immunoreactivity were identified in all laminae of the cat spinal cord at the level of the lumbar enlargement. Using an immunologically-specific, double immunofluorescence method, coexistent 5-HT-LI and SP-LI immunoreactivity could be visualized in the same tissue section with appropriate FITC and rhodamine fluorescent filter sets. The fewest number of coexistent axons were observed in the superficial laminae of the dorsal horn, while their number increased in the more ventral dorsal horn laminae. Numerous coexistent axons were observed in the area adjacent to the central canal. The greatest number of coexistent axons was found in the ventral horn, especially in the motoneuronal cell groups. This study demonstrates that axons containing coexistent 5-HT-LI and SP-LI immunoreactivity are found in all laminae of the cat lumbar spinal cord and are thus involved in both sensory and motor functions. Their more frequent occurrence in the ventral horn suggests a greater role for coexistent 5-HT and SP in motor function. Since axons containing coexistent 5-HT and SP, and those containing only 5-HT, likely originate from different populations of neurons, our observations provide evidence for a diverse origin of descending 5-HT afferents to the different spinal laminae.     

Galanin-Mediated Behavioural Hyperalgesia from the Dorsomedial Nucleus of the Hypothalamus Involves Two Independent Descending Pronociceptive Pathways

Activation of the dorsomedial nucleus of the hypothalamus (DMH) by galanin (GAL) induces behavioural hyperalgesia. Since DMH neurones do not project directly to the spinal cord, we hypothesized that the medullary dorsal reticular nucleus (DRt), a pronociceptive region projecting to the spinal dorsal horn (SDH) and/or the serotoninergic raphe-spinal pathway acting on the spinal 5-HT₃ receptor (5HT₃R) could relay descending nociceptive facilitation induced by GAL in the DMH. Heat-evoked paw-withdrawal latency (PWL) and activity of SDH neurones were assessed in monoarthritic (ARTH) and control (SHAM) animals after pharmacological manipulations of the DMH, DRt and spinal cord. The results showed that GAL in the DMH and glutamate in the DRt lead to behavioural hyperalgesia in both SHAM and ARTH animals, which is accompanied particularly by an increase in heat-evoked responses of wide-dynamic range neurons, a group of nociceptive SDH neurones. Facilitation of pain behaviour induced by GAL in the DMH was reversed by lidocaine in the DRt and by ondansetron, a 5HT₃R antagonist, in the spinal cord. However, the hyperalgesia induced by glutamate in the DRt was not blocked by spinal ondansetron. In addition, in ARTH but not SHAM animals PWL was increased after lidocaine in the DRt and ondansetron in the spinal cord. Our data demonstrate that GAL in the DMH activates two independent descending facilitatory pathways: (i) one relays in the DRt and (ii) the other one involves 5-HT neurones acting on spinal 5HT₃Rs. In experimental ARTH, the tonic pain-facilitatory action is increased in both of these descending pathways.     

Analgesia following electrostimulation of midbrain nuclei of rats with a pain syndrome of spinal origin]

The effect of electrostimulation of the mesencephalic grey matter and of the dorsal nucleus raphe on physiological pain produced by nociceptive stimulation (compression of the tail or the skin on the limb by a clamp) and on pathological pain (the pain syndrome of spinal origin) were studied in experiments on albino rats. Pathological pain was induced by creating a generator of pathologically enhanced excitation in the dorsal horn of the spinal cord by local disturbance of the inhibitory mechanisms with the aid of tetanus toxin. It was shown that electrostimulation of the indicated areas abolished both physiological and pathological pain. A conclusion was drawn that analgesia produced by electrostimulation of certain structure of the brain was connected not only with augmentation of the descending inhibition in the spinal cord as in the case of physiological pain caused by peripheral nociceptive stimulation (as shown by several authors), but also with the block of excitation at the supraspinal level. This mechanism should play a decisive role in analgesia realization in the pain syndrome of central origin, both under experimental and natural conditions.     

不同频率电针刺激对神经痛模型大鼠脊髓背角P物质的影响

目的:观察P物质(Substance P,SP)在慢性坐骨神经压迫损伤(chronic constriction injury,CCI)模型脊髓中表达的变化,探讨电针镇痛的机制是否与脊髓背角中SP表达的变化有关。方法:选择32只雄性、体重180-200 g的SD大鼠,并将其随机均分为4组(n=8)。空白组(Con组)为正常痛阈值大鼠;假电针组(CCI+A组)在损伤的坐骨神经旁置入电针,但无电流刺激;2 Hz组和100Hz组分别给予相应频率电流刺激30 min。在实验开始前和术后1、4、7、14、20、22天记录大鼠的热缩足反射潜伏期(Paw Withdrawal Latency,PWL)和机械刺激缩足反射阈值(Paw Withdrawal Threshold,PWT)。免疫组化方法检测脊髓背角SP的表达。结果:术后20天,电针治疗后,100 Hz组和2 Hz组PWT分别为(7.33±1.42)g和(7.80±1.42)g,均显著高于假电针组(2.60±1.46)g,差异有统计学意义(P0.05)。100 Hz组在术后20天后和2 Hz组在术后14天后PWL值均显著高于假电针组,差异有统计学意义(P0.05)。免疫组化显示:2 Hz组和100 Hz组大鼠脊髓背角中P物质阳性细胞显著低于假电针组(P0.05)。结论:坐骨神经旁电针刺激能够显著减轻CCI模型大鼠热痛觉及机械痛觉过敏,其机制可能与抑制脊髓背角SP的表达有关。     

5-HT7 receptors are involved in mediating 5-HT-induced activation of rat primary afferent neurons

The purpose of this study was to determine whether the 5-hydroxytryptamine7 (5-HT7) receptor is expressed by nociceptor-like neurons in the rat PNS and whether 5-HT activates these nociceptors via the 5-HT7 receptor subtype. Using a polyclonal antibody and the method of immunofluorescence staining, we demonstrated that the 5-HT7 receptor appears predominately on "nociceptor-like" neurons of the rat lumbar dorsal root ganglia. Using immunocytochemical methods, we showed that the immunoreactivity of the 5-HT7 receptor antibody complex is localized in the superficial layers of the spinal cord dorsal horn, which corresponds with laminae I, IIouter and IIinner. Furthermore, we demonstrated that noxious stimulation produced by knee injection of 5-HT or a 5-HT7 agonist dose-dependently increases c-Fos production of the rat spinal cord dorsal horn. This effect was significantly inhibited by the preinjection of a 5-HT7 antagonist. We conclude that the 5-HT7 receptor is expressed by rat primary afferent nociceptors which terminate in the superficial layers of the spinal cord dorsal horn and that the 5-HT7 receptor subtype is involved in nociceptor activation by 5-HT.