Lilius Tuomas O, Rauhala Pekka V, Kambur Oleg, Kalso Eija A
Department of Pharmacology, Institute of Biomedicine, University of Helsinki, Helsinki, Finland.
Anesthesiology. 2009 Dec;111(6):1356-64. doi: 10.1097/ALN.0b013e3181bdfa11.
Opioid analgesics are effective in relieving chronic pain, but they have serious adverse effects, including development of tolerance and dependence. Ibudilast, an inhibitor of glial activation and cyclic nucleotide phosphodiesterases, has shown potential in the treatment of neuropathic pain and opioid withdrawal. Because glial cell activation could also be involved in the development of opioid tolerance in rats, the authors studied the antinociceptive effects of ibudilast and morphine in different models of coadministration.
Antinociception was assessed using male Sprague- Dawley rats in hot plate and tail-flick tests. The effects of ibudilast on acute morphine-induced antinociception, induction of morphine tolerance, and established morphine tolerance were studied.
Systemic ibudilast produced modest dose-related antinociception and decreased locomotor activity at the studied doses of 2.5-22.5 mg/kg. The highest tested dose of 22.5 mg/kg produced 52% of the maximum possible effect in the tail-flick test. It had an additive antinociceptive effect when combined with systemic morphine. Coadministration of ibudilast with morphine did not attenuate the development of morphine tolerance. However, in morphine-tolerant rats, ibudilast partly restored morphine-induced antinociception.
Ibudilast produces modest antinociception, and it is effective in restoring but not in preventing morphine tolerance. The mechanisms of the effects of ibudilast should be better understood before it is considered for clinical use.
阿片类镇痛药在缓解慢性疼痛方面有效,但具有严重的不良反应,包括耐受性和依赖性的产生。异丁司特是一种神经胶质细胞激活和环核苷酸磷酸二酯酶抑制剂,已显示出在治疗神经性疼痛和阿片类药物戒断方面的潜力。由于神经胶质细胞激活也可能参与大鼠阿片类药物耐受性的形成,作者研究了异丁司特和吗啡在不同联合给药模型中的镇痛作用。
使用雄性Sprague-Dawley大鼠通过热板法和甩尾试验评估镇痛效果。研究了异丁司特对急性吗啡诱导的镇痛作用、吗啡耐受性的诱导以及已建立的吗啡耐受性的影响。
在2.5-22.5mg/kg的研究剂量下,全身给予异丁司特产生适度的剂量相关镇痛作用,并降低运动活性。最高测试剂量22.5mg/kg在甩尾试验中产生了最大可能效应的52%。与全身给予吗啡联合使用时,它具有相加的镇痛作用。异丁司特与吗啡联合给药并未减弱吗啡耐受性的形成。然而,在吗啡耐受的大鼠中,异丁司特部分恢复了吗啡诱导的镇痛作用。
异丁司特产生适度的镇痛作用,它在恢复吗啡耐受性方面有效,但在预防方面无效。在考虑将异丁司特用于临床之前,应更好地了解其作用机制。