Obata Hideaki, Li Xinhui, Eisenach James C
Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Anesthesiology. 2005 Mar;102(3):657-62. doi: 10.1097/00000542-200503000-00027.
Spinally administered clonidine produces analgesia via alpha2-adrenergic receptors. The analgesic potency of clonidine and its dependency on muscarinic acetylcholine receptors increase in rats after nerve injury. The authors hypothesized that these changes reflect greater acetylcholine release from the spinal cord by clonidine, either through direct or indirect effects.
Male Sprague-Dawley rats were divided into two groups: no surgery or left L5 and L6 spinal nerve ligation (SNL). All experiments were performed 3 weeks after SNL. Crude synaptosomes were prepared from the spinal enlargement and loaded with [H]choline. Samples were incubated with clonidine in the absence or presence of KCl depolarization. The authors also examined the effect of clonidine on KCl evoked acetylcholine release using perfusion of spinal cord slices, in which some spinal circuitry is maintained.
In synaptosomes, clonidine alone induced minimal acetylcholine release, which was actually greater in tissue from normal rats than in tissue from SNL rats. In the presence of KCl depolarization, however, clonidine enhanced acetylcholine release in tissue from SNL rats but inhibited release in tissue from normal rats. Similarly, in spinal cord slices, clonidine enhanced KCl evoked acetylcholine release in tissue from SNL animals but inhibited such release in tissue from normal animals. The alpha2-adrenoceptor antagonist idazoxan inhibited the effects of clonidine in slices from SNL rats.
These results suggest that clonidine enhances depolarization-induced acetylcholine release in neuropathic but not in normal spinal cord tissue. Interestingly, this enhanced acetylcholine release by clonidine occurs in a synaptosomal preparation, consistent with a direct effect on alpha2 adrenoceptors on cholinergic terminals. Enhanced release of acetylcholine by clonidine could contribute to increased analgesia of clonidine in neuropathic pain.
脊髓给予可乐定通过α2 -肾上腺素能受体产生镇痛作用。在大鼠神经损伤后,可乐定的镇痛效力及其对毒蕈碱型乙酰胆碱受体的依赖性增加。作者推测这些变化反映了可乐定通过直接或间接作用使脊髓释放更多乙酰胆碱。
将雄性Sprague - Dawley大鼠分为两组:未手术组或左侧L5和L6脊髓神经结扎(SNL)组。所有实验在SNL术后3周进行。从脊髓膨大处制备粗制突触体并加载[H]胆碱。样品在无或有氯化钾去极化的情况下与可乐定一起孵育。作者还使用保留部分脊髓回路的脊髓切片灌注法研究了可乐定对氯化钾诱发的乙酰胆碱释放的影响。
在突触体中,单独使用可乐定诱导的乙酰胆碱释放极少,实际上正常大鼠组织中的释放量大于SNL大鼠组织中的释放量。然而,在有氯化钾去极化的情况下,可乐定增强了SNL大鼠组织中的乙酰胆碱释放,但抑制了正常大鼠组织中的释放。同样,在脊髓切片中,可乐定增强了SNL动物组织中氯化钾诱发的乙酰胆碱释放,但抑制了正常动物组织中的这种释放。α2 -肾上腺素能受体拮抗剂咪唑克生抑制了可乐定对SNL大鼠切片的作用。
这些结果表明,可乐定增强了神经病变脊髓组织而非正常脊髓组织中去极化诱导的乙酰胆碱释放。有趣的是,可乐定增强的乙酰胆碱释放在突触体制备中出现,这与对胆碱能终末上的α2肾上腺素能受体的直接作用一致。可乐定增强的乙酰胆碱释放可能有助于增加其在神经性疼痛中的镇痛作用。