Activation of spinal alpha-7 nicotinic acetylcholine receptor shortens the duration of remifentanil-induced postoperative hyperalgesia by upregulating KCC2 in the spinal dorsal horn in rats

Gu, Wei; Zhang, Wei; Lei, Yishan; Cui, Yin; Chu, Shuaishuai; Gu, Xiaoping; Ma, Zhengliang

doi:10.1177/1744806917704769

Cited by 14 publications

(4 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previously innocuous stimulation then evokes discharge patterns characteristic for nociceptive stimulation (Pitcher and Henry 2004 ; Sharif et al 2005 ). A synopsis of this data suggests that KCC2 may represent an important novel target for the development of analgesics (Gu et al 2017a , b ).…”

Section: Dorsal Horn and Nociceptionmentioning

confidence: 99%

Substance P and pain chronicity

2018

View full text Add to dashboard Cite

Substance P (SP) is a highly conserved member of the tachykinin peptide family that is widely expressed throughout the animal kingdom. The numerous members of the tachykinin peptide family are involved in a multitude of neuronal signaling pathways, mediating sensations and emotional responses (Steinhoff et al. in Physiol Rev 94:265–301, 2014). In contrast to receptors for classical transmitters, such as glutamate (Parsons et al. in Handb Exp Pharmacol 249–303, 2005), only a minority of neurons in certain brain areas express neurokinin receptors (NKRs) (Mantyh in J Clin Psychiatry 63:6–10, 2002). SP is also expressed by a variety of non-neuronal cell types such as microglia, as well as immune cells (Mashaghi et al. in Cell Mol Life Sci 73:4249–4264, 2016). SP is an 11-amino acid neuropeptide that preferentially activates the neurokinin-1 receptor (NK1R). It transmits nociceptive signals via primary afferent fibers to spinal and brainstem second-order neurons (Cao et al. in Nature 392:390–394, 1998). Compounds that inhibit SP’s action are being investigated as potential drugs to relieve pain. More recently, SP and NKR have gained attention for their role in complex psychiatric processes. It is a key goal in the field of pain research to understand mechanisms involved in the transition between acute pain and chronic pain. The influence of emotional and cognitive inputs and feedbacks from different brain areas makes pain not only a perception but an experience (Zieglgänsberger et al. in CNS Spectr 10:298–308, 2005; Trenkwaldner et al. Sleep Med 31:78–85, 2017). This review focuses on functional neuronal plasticity in spinal dorsal horn neurons as a major relay for nociceptive information.

show abstract

Section: Dorsal Horn and Nociceptionmentioning

confidence: 99%

Substance P and pain chronicity

2018

View full text Add to dashboard Cite

show abstract

“…Most of the trials (16 trials) conducted measurements for 2 days. Cui et al [ 33 ] conducted the shortest trial, which lasted 5 h, while Gu et al [ 37 ] conducted the longest trial, lasting 21 days. The most common remifentanil administration regimens were 0.04 mg/kg subcutaneous infusion for 30 min (9 trials) or 1.0 μg/kg/min intravenous infusion for 60 min (6 trials).…”

Section: Resultsmentioning

confidence: 99%

Pharmacological Interventions for Opioid-Induced Hyperalgesia: A Scoping Review of Preclinical Trials

Koponen

Forget

2022

JCM

View full text Add to dashboard Cite

Background: Opioid analgesics are the most effective pharmacological agents for moderate and severe pain. However, opioid use has several limitations such as opioid-induced hyperalgesia (OIH), which refers to the increased pain sensitivity that occurs once analgesia wears off after opioid administration. Several pharmacological interventions have been suggested for OIH, but the current literature does not provide guidelines on which interventions are the most effective and whether they differ depending on the opioid that induces hyperalgesia. This scoping review aimed to identify and describe all the preclinical trials investigating pharmacological interventions for OIH caused by remifentanil, fentanyl, or morphine as the first step towards evaluating whether the most effective OIH interventions are different for different opioids. Methods: Electronic database searches were carried out in Embase, PubMed, and Web of Science. Detailed data extraction was conducted on the eligible trials. Results: 72 trials were eligible for the review. Of these, 27 trials investigated remifentanil, 14 trials investigated fentanyl, and 31 trials investigated morphine. A total of 82 interventions were identified. The most studied interventions were ketamine (eight trials) and gabapentin (four trials). The majority of the interventions were studied in only one trial. The most common mechanism suggested for the interventions was inhibition of N-methyl-D-aspartate (NMDA) receptors. Conclusion: This scoping review identified plenty of preclinical trials investigating pharmacological interventions for OIH. Using the current literature, it is not possible to directly compare the effectiveness of the interventions. Hence, to identify the most effective interventions for each opioid, the interventions must be indirectly compared in a meta-analysis.

show abstract

“…Antinociceptive actions mediated through GABA receptors on neurons were posed to be impaired and therefore to contribute further to LTP in hyperalgic signaling, enhancing perpetuation of OIH [ 93 , 94 ]. The impairment of GABA receptors in these conditions, while experimentally achieved through induction of inhibitory neuronal KCC2 channels [ 2 , 95 ], was not shown to be clinically applicable in acute OIH using acetazolamide, a pharmacological inhibitor of carbonic anhydrase in clinical use [ 67 , 96 ]. In an RCT involving patients under surgical analgesia using remifentanil, concomitantly revealing hyperalgic manifestations compatible with OIH, acetazolamide was unsuccessful in reverting these disturbances through the additional use of this substance [ 67 ], unlike other substances applied in similar conditions as mentioned in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

Knowing the Enemy Is Halfway towards Victory: A Scoping Review on Opioid-Induced Hyperalgesia

Sampaio-Cunha

Martins

2022

JCM

View full text Add to dashboard Cite

Opioid-induced hyperalgesia (OIH) is a paradoxical effect of opioids that is not consensually recognized in clinical settings. We conducted a revision of clinical and preclinical studies and discuss them side by side to provide an updated and renewed view on OIH. We critically analyze data on the human manifestations of OIH in the context of chronic and post-operative pain. We also discuss how, in the context of cancer pain, though there are no direct evidence of OIH, several inherent conditions to the tumor and chemotherapy provide a substrate for the development of OIH. The review of the clinical data, namely in what concerns the strategies to counter OIH, emphasizes how much OIH rely mechanistically on the existence of µ-opioid receptor (MOR) signaling through opposite, inhibitory/antinociceptive and excitatory/pronociceptive, pathways. The rationale for the maladaptive excitatory signaling of opioids is provided by the emerging growing information on the functional role of alternative splicing and heteromerization of MOR. The crossroads between opioids and neuroinflammation also play a major role in OIH. The latest pre-clinical data in this field brings new insights to new and promising therapeutic targets to address OIH. In conclusion, although OIH remains insufficiently recognized in clinical practice, the appropriate diagnosis can turn it into a treatable pain disorder. Therefore, in times of scarce alternatives to opioids to treat pain, mainly unmanageable chronic pain, increased knowledge and recognition of OIH, likely represent the first steps towards safer and efficient use of opioids as analgesics.

show abstract

Activation of spinal alpha-7 nicotinic acetylcholine receptor shortens the duration of remifentanil-induced postoperative hyperalgesia by upregulating KCC2 in the spinal dorsal horn in rats

Cited by 14 publications

References 60 publications

Substance P and pain chronicity

Substance P and pain chronicity

Pharmacological Interventions for Opioid-Induced Hyperalgesia: A Scoping Review of Preclinical Trials

Knowing the Enemy Is Halfway towards Victory: A Scoping Review on Opioid-Induced Hyperalgesia

Contact Info

Product

Resources

About