Opioid and endocannabinoid system in orofacial pain.

Orofacial pain disorders are frequent in the general population and their pharmacological treatment is difficult and controversial. Therefore, the search for novel, safe and efficient analgesics is an important but still elusive goal for contemporary medicine. In the recent years, the antinociceptive potential of endocannabinoids and opioids has been emphasized. However, concerns for the safety of their use limit their clinical applications. the possibility of modulating the activity of endocannabinoids by regulation of their synthesis and/or degradation offers an innovative approach to the treatment of pain. A rat model of trigeminal pain, utilizing tongue jerks evoked by electrical tooth pulp stimulation during perfusion of the cerebral ventricles with various neurotransmitter solutions can be used in the pharmacological studies of nociception in the orofacial area. The aim of this review is to present the effects of pharmacological activity of opioids and endocannabinoids affecting the transmission of the sensory information from the orofacial area on the example of trigemino-hypoglossal reflex in rats.

Interactions of galanin with endomorphin-2, vasopressin and oxytocin in nociceptive modulation of the trigemino-hypoglossal reflex in rats.

Galanin (GAL) is suggested to be a neuropeptide involved in pain transmission. In this study we tried to determine, whether the increase of GAL concentration in brain cells affects impulse transmission between the motor centers localized in the vicinity of the third and fourth cerebral ventricles. The experiments were carried out on rats under chloralose anesthesia. The study objectives were realized using the method allowing to record the amplitude of evoked tongue jerks (ETJ) in response to noxious tooth pulp stimulation during the perfusion of the cerebral ventricles with solutions containing tested compounds. Perfusion of the cerebral ventricles with GAL concentration-dependently inhibited the ETJ amplitude. The antinociceptive effect of GAL was blocked by a galanin receptor antagonist, galantide (GLT) and by opioid antagonists: non-selective naloxone (Nal) and micro-selective beta-funaltrexamine (beta-FNA). In contrast, a delta-opioid receptor antagonist, naltrindole (NTI) or the kappa-opioid receptor antagonist, nor-binaltrophimine (nor-BNI) did not inhibit the effect of GAL. The antinociceptive effect of GAL was more pronounced when GAL was perfused in combination with other neuropeptides/neurohormones, such as endomorphin-2 (EM-2), vasopressin (AVP) and oxytocin (OT). The present results demonstrate that in the orofacial area analgesic activity is modulated by GAL, OT and AVP and that EM-2-induced antinociception involves GAL.

Effect of galanin on substance P- and vasoactive intestinal polypeptide-induced nociceptive trigemino-hypoglossal reflex in rats.

Substance P (SP), vasoactive intestinal polypeptide (VIP) and galanin (GAL), present in primary sensory neurons, are involved in transmission of nociceptive signaling from the peripheral to central nervous system. In this study we investigated the effect of GAL on SP-induced or VIP-induced evoked tongue jerks (ETJ) in response to noxious tooth pulp stimulation during perfusion of the cerebral ventricles with SP or VIP solutions. The experiments were carried out on rats under chloralose anesthesia. It was shown that both, SP and VIP, perfused through the cerebral ventricles enhanced the ETJ amplitude as compared with control, but the effect produced by SP was stronger. The intracerebroventricular perfusion of GAL 5 minutes before SP caused a dose-dependent inhibition of SP-induced ETJ, whereas GAL perfused through the cerebral ventricles 5 minutes before VIP did not reduce the excitatory effect of VIP on ETJ. These results indicate that the antinociceptive effect of GAL perfused through the cerebral ventricles, tested on the trigemino-hypoglossal reflex in rats, is specifically mediated by the SP-ergic system.

Effect of cerebral ventricles perfusion with naloxone on trigemino-hypoglossal reflex in rats.

The goal of this study was to determine whether opioid receptor antagonist naloxone abolishes the influence of periaqueductal central gray (PAG) on nociceptive evoked tongue jerks (ETJ) -- a trigemino-hypoglossal reflex induced by tooth pulp stimulation. In rats under chloralose anesthesia three series of experiments were performed. In the first two groups perfusions of lateral ventricles-cerebellomedullary cistern with McIlwain-Rodnight's solution and naloxone were carried out. In group 3 naloxone was infused through a catheter through the jugular vein. The amplitudes of tongue jerks induced by tooth pulp stimulation were recorded during subsequent 10 min perfusions. Mean amplitude of tongue movements induced by tooth pulp stimulation was regarded as the indicator of the magnitude of trigemino-hypoglossal reflex. We observed that perfusion of the cerebral ventricles with naloxone (100 nmol/ml) increased the trigemino-hypoglossal reflex up to 143%. The amplitude of ETJ was significantly reduced during PAG stimulation with a train of electrical impulses. After obtaining a significant -- 93% -- inhibition of ETJ (7% of the control), naloxone (100 nmol/ml) was added to the perfusion fluid. This led to a significant increase of the reflex up to 68%. Infusion of naloxone through the jugular vein did not affect the reflex. The above results suggest that the inhibition of ETJ due to PAG stimulation is partially reversed by naloxone and mediated via interactions with endogenous opioid systems involved in modulation of nociception.

Inhibition of tongue reflex in rats by tooth pulp stimulation during cerebral ventricle perfusion with (6-11) substance P analogs.

The effect of 12 C-terminal hexapeptide analogs of substance P perfused into the cerebral ventricles on the trigemino-hypoglossal reflex caused by incisor pulp stimulation in rats was investigated. A substitution of the L-isomer by D at position 6, 7, or 8 of the substance P analogs used in this study caused the most pronounced inhibition of the trigemino-hypoglossal reflex. A correlation between the degree of inhibition of the reflex and concentration of the peptide used was observed.

The effect of naloxone on trigemino-hypoglossal reflex inhibited by periaqueductal central gray stimulation in rats.

The aim of the study was to determine whether opioid receptor antagonist naloxone abolishes the influence of periaqueductal central gray (PAG) on nociceptive evoked tongue jerks (ETJ) - a trigemino-hypoglossal reflex induced by tooth pulp stimulation. In rats under chloralose anesthesia three subsequent series of perfusions of lateral ventricles - cerebellomedullary cistern with Mc Ilwain-Rodnight's solution, Met-enkaphalin (Enk-Met) and naloxone were carried out. The amplitudes of tongue jerks induced by tooth pulp stimulation were recorded during subsequent 10 min perfusions. Mean amplitude of tongue movements induced by tooth pulp stimulation was regarded as the indicator of the magnitude of trigemino-hypoglossal reflex. We observed that perfusion of the cerebral ventricles with Enk-Met (100 nmol/mL) inhibited the trigemino-hypoglossal reflex by 46%, whereas naloxone (100 nmol/mL), added to the solution perfusing the cerebral ventricles system, increased the reflex by 42%. The amplitude of ETJ was significantly reduced during PAG stimulation with a train of electrical impulses. After obtaining a significant 93% - inhibition of ETJ, naloxone (100 nmol/mL) was added to the perfusion fluid. This led to a significant increase of the reflex by 68%. The above results suggest that the inhibition of ETJ due to PAG stimulation is partially reversed by naloxone and mediated via interactions with endogenous opioid systems involved in modulation of nociception.

Effect of tooth pulp stimulation on oxytocin and vasopressin release into the cerebrospinal fluid and fluid perfusing the cerebral ventricles in rats.

OBJECTIVE: Stress- and pain-related stimuli cause a release of vasopressin (AVP) and oxytocin (OT) into the cerebrospinal fluid (CSF) and extracellular fluid of the brain in various animal species. The aim of the study was to investigate the effect of stimulation of the nociceptive afferent terminals in the tooth pulp on the release of AVP and OT into CSF in rats under chloralose anesthesia. METHODS: Cerebrospinal fluid was collected from the cerebellomedullary cistern and then 30-minute perfusions of the lateral cerebral ventricles with artificial cerebrospinal fluid (aCSF) were carried out. The perfusate was collected from the cerebellomedullary cistern at rest (control), during electric stimulation of the tooth pulp which induced nociceptive trigemino-hypoglossal reflex, and after stimulation. In the collected CSF and aCSF perfusates, AVP-like immunoreactivity (AVPLI) and OT-like immunoreactivity (OT-LI) were determined by radioimmunoassay (RIA). RESULTS: The concentrations of AVP-LI and OT-LI in CSF were found to reach 21 pg/ml and 67 pg/ml, respectively. Electric tooth pulp stimulation exerted no effect on AVP and OT release into the fluid perfusing the cerebral ventricles during stimulation. CONCLUSION: It was found that noxious stimulus from the tooth pulp is not a factor affecting significantly AVP and OT release into CSF.

Comparison of antagonistic properties of substance P analogs, spantide I, II and III, on evoked tongue jerks in rats.

OBJECTIVE: To study and evaluate the effects of perfusion through cerebral ventricles with substance P (SP) and its analogs: spantide I, II and III on evoked tongue jerks (ETJ) in male rats. METHODS: During the perfusion, stimulation of the tooth pulp caused retractive movements of the stretched tongue, the amplitudes of which were recorded. The mean amplitudes of evoked tongue jerks (ETJ) recorded during each 10 min. period of perfusion with McIlwain-Rodnight's solution and solutions containing peptides were compared. RESULTS: Perfusion of cerebral ventricles with SP caused a significant increase in the mean amplitude of evoked tongue jerks. Spantide I caused a complete respiratory arrest in all of the examined animals, so its effect on the trigemino-hypoglossal reflex could not have been tested. Spantide II, in the first two minutes, induced a transient significant decrease in ETJ amplitude, followed by an increase in ETJ in the next 8 min. SP perfused after spantide II caused a further significant increase in ETJ, as compared with control. Perfusion of cerebral ventricles with spantide III caused a significant, dose-dependent decrease in ETJ. SP perfused after spantide III caused a smaller increase in ETJ than it was observed without spantide III. CONCLUSION: Spantide III was found to be a strong antagonist of SP in trigemino-hypoglossal reflex.