ABSTRACT
Peripheral inflammatory hyperalgesia depends on the sensitization of primary nociceptive neurons. Inflammation drives molecular alterations not only locally but also in the dorsal root ganglion (DRG) where interleukin-1 beta (IL-1ß) and purinoceptors are upregulated. Activation of the P2X7 purinoceptors by ATP is essential for IL-1ß maturation and release. At the DRG, P2X7R are expressed by satellite glial cells (SGCs) surrounding sensory neurons soma. Although SGCs have no projections outside the sensory ganglia these cells affect pain signaling through intercellular communication. Therefore, here we investigated whether activation of P2X7R by ATP and the subsequent release of IL-1ß in DRG participate in peripheral inflammatory hyperalgesia. Immunofluorescent images confirmed the expression of P2X7R and IL-1ß in SGCs of the DRG. The function of P2X7R was then verified using a selective antagonist, A-740003, or antisense for P2X7R administered in the L5-DRG. Inflammation was induced by CFA, carrageenan, IL-1ß, or PGE2 administered in rat's hind paw. Blockage of P2X7R at the DRG reduced the mechanical hyperalgesia induced by CFA, and prevented the mechanical hyperalgesia induced by carrageenan or IL-1ß, but not PGE2. It was also found an increase in P2X7 mRNA expression at the DRG after peripheral inflammation. IL-1ß production was also increased by inflammatory stimuli in vivo and in vitro, using SGC-enriched cultures stimulated with LPS. In LPS-stimulated cultures, activation of P2X7R by BzATP induced the release of IL-1ß, which was blocked by A-740003. In summary, our data suggest that peripheral inflammation leads to the activation of P2X7R expressed by SGCs at the DRG. Then, ATP-induced activation of P2X7R mediates the release of IL-1ß from SGC. This evidence places the SGC as an active player in the establishment of peripheral inflammatory hyperalgesia and highlights the importance of the events in DRG for the treatment of inflammatory diseases.
ABSTRACT
Peripheral diabetic neuropathy (PDN) manifests in 50-60% of type I and II diabetic patients and is the major cause of limb amputation. Adequate therapy for PDN is a current challenge. There are evidences that the activation of the P2X4 receptor (P2X4R) expressed on microglial cells of the central nervous system takes part in the development of neuropathic pain. However, there is an open question: Is P2X4R activation on dorsal root ganglia (DRG) involved in the development of neuropathic pain? To answer this question, this study verified the involvement of P2X4R expressed in DRG cells on diabetes-induced neuropathic mechanical hyperalgesia in rats. We found that intrathecal or ganglionar (L5-DRG) administration of a novel P2X4R antagonist (PSB-15417) or intrathecal administration of oligodeoxynucleotides (ODN)-antisense against the P2X4R reversed diabetes-induced neuropathic mechanical hyperalgesia. The DRG of the diabetic neuropathic rats showed an increase in P2X4R expression, and the DRG immunofluorescence suggested that P2X4R is expressed mainly in satellite glial cells (SGC). Finally, our study showed a functional expression of P2X4R in SGCs of the rat's DRG, because the P2X4R agonist BzATP elicits an increase in intracellular calcium concentration in SGCs, which was reduced by PSB-15417. These findings indicate that P2X4R activation in DRG is essential to diabetes-induced neuropathic mechanical hyperalgesia. Therefore, this purinergic receptor in DRG could be an interesting therapeutic target for quaternary P2X4R antagonists that do not cross the hematoencephalic barrier, for the control of neuropathic pain, preserving central nervous system functions.
Subject(s)
Diabetes Mellitus, Experimental/metabolism , Diabetic Neuropathies/metabolism , Ganglia, Spinal/metabolism , Hyperalgesia/metabolism , Neuralgia/metabolism , Receptors, Purinergic P2X4/metabolism , Animals , Calcium/metabolism , Cells, Cultured , Diabetes Mellitus, Experimental/drug therapy , Diabetes Mellitus, Experimental/pathology , Diabetic Neuropathies/drug therapy , Diabetic Neuropathies/pathology , Ganglia, Spinal/drug effects , Ganglia, Spinal/pathology , Hyperalgesia/drug therapy , Hyperalgesia/pathology , Male , Neuralgia/drug therapy , Neuralgia/pathology , Neuroglia/drug effects , Neuroglia/metabolism , Neuroglia/pathology , Neurons/drug effects , Neurons/metabolism , Neurons/pathology , Purinergic P2X Receptor Antagonists , Random Allocation , Rats, Wistar , TouchABSTRACT
O propofol em nanoemulsão é uma nova formulação constituída por sistemas nanoemulsionados, caracterizado pela ausência do veículo lipídico. A modificação do veículo pode acarretar alterações farmacocinéticas, resultando em diferentes taxas de distribuição e excreção do propofol. O objetivo deste estudo foi avaliar a farmacocinética de uma nova formulação de propofol em nanoemulsão do tipo óleo em água, comparando com a formulação tradicional em emulsão lipídica. Foram utilizadas seis cadelas sem raça definida, castradas (10,7±1,5kg), em estudo aleatório e de autocontrole, que receberam as duas formulações de propofol com intervalo de 30 dias entre os tratamentos, sendo administrada uma dose bolus de 8mg kg-1, seguida de infusão contínua por 60 minutos na taxa de 0,4mg kg-1 min-1. Amostras de sangue arterial foram colhidas momentos antes da indução (0), 2, 5, 10, 15, 30 e 60 minutos após a dose bolus e após o término da infusão nos tempos 5, 10, 15, 30, 60 e 90 minutos e 2, 3, 4, 6, 10 e 24 horas. Não foram encontradas diferenças significativas entre os parâmetros farmacocinéticos de volume de distribuição, clearance, constante de eliminação, meia-vida e constantes de distribuição, demonstrando que o propofol em nanoemulsão não apresenta alteração farmacocinética em relação à formulação tradicional.
Propofol nanoemulsion is a new formulation consisting of nanoemulsified systems, characterized by the absence of lipid vehicle. Changes in drug vehicle may alter the pharmacokinetics and result in different distribution and elimination rates of propofol. The aim of this study was to evaluate the pharmacokinetics of a new oil in water propofol nanoemulsion formulation, compared to the traditional lipid emulsion. Six neutered female mixed-breed dogs were used (10.7±1.5kg) in a randomized and self control trial with 30 days interval. They received both propofol formulations administered as a bolus dose of 8mg kg-1 followed by 60 minutes continuous infusion at 0.4mg kg-1 min-1 rate. Arterial blood samples were collected just before induction (0), 2, 5, 10, 15, 30, and 60 minutes after the bolus dose, and after the end of the infusion at five, 10, 15, 30, 60, and 90 minutes and 2, 3, 4, 6, 10, and 24 hours. There were no significant differences in the evaluated pharmacokinetics parameters that included volume of distribution, clearance, elimination rate constant, half-life, and distribution constants, demonstrating that propofol nanoemulsion has no pharmacokinetics differences when compared to the traditional formulation.
ABSTRACT
O presente estudo objetiva avaliar os efeitos cardiorrespiratórios e metabólicos do propofol em emulsão lipídica e microemulsão em gatas. Foram utilizadas 12 gatas, hígidas, adultas, alocadas em dois grupos: microemulsão (MICRO, n=6) e emulsão lipídica (EMU, n=6), os quais receberam propofol, na respectiva formulação, em dose suficiente para intubação. Em seguida, foram intubados, fornecendo-se oxigênio 100%, em sistema sem reinalação de gases. Ato contínuo, iniciou-se a infusão de propofol na dose de 0,3mg kg-1 min-1 durante 90 minutos. A dose necessária para indução foi de 9,5±1,3mg kg-1 e 10±1mg kg-1 para MICRO e EMU, respectivamente. Os valores de pressão arterial sistólica (PAS), pressão arterial média (PAM), pressão arterial diastólica (PAD) e pH foram menores, em todos os momentos, no EMU em relação ao MICRO; a f do EMU foi menor de T30 até T75 em relação ao MICRO. A PaCO2 do EMU foi maior de T15 até T90. Os tempos de extubação, decúbito esternal, deambulação e recuperação total foram de 40,6±30,7; 91±37,5; 134,5±54,5 e 169,1±55,4 minutos no MICRO e de 68,8±37,3; 133,3±85,3; 171,3±77,1 e 233,1±60,6 minutos no EMU, respectivamente. Houve aumento da enzima Alanina Aminotransferase de 12 às 72h no EMU e de 48 às 72h no MICRO. O propofol em microemulsão apresentou características clínicas de indução e manutenção, bem como efeitos metabólicos semelhantes à formulação em emulsão lipídica. A formulação em microemulsão proporcionou maior estabilidade cardiovascular e respiratória para indução e infusão contínua em gatas hígidas.
The aim of the present study was to evaluate the cardiorespiratory and metabolic effects from lipid emulsion and microemulsion of propofol in cats. Twelve healthy adult cats were included, and divided into two groups: microemulsion group (MICRO, n=6) and lipid emulsion (EMU, n=6), where they received propofol in the respective formulation, in a dose sufficient for intubation. The animals were then intubated and provided with 100% oxygen through a non-rebreathing circuit. Immediately after, the infusion of propofol was initiated (0.3mg kg-1 min-1) and maintained for 90 minutes. The dose required for induction was 9.5±1.3mg kg-1 and 10±1mg kg-1 in MICRO and EMU, respectively. The SAP, MAP, DAP and pH values were lower in all moments in EMU when compared to MICRO; the RR in EMU was lower from T30 to T75 in comparison to MICRO. The paCO2 was greater in the EMU from T15 to T90. The times to extubation, sternal recumbency, ambulation and total recovery were 40.6±30.7, 91±37.5, 134.5±54.5 and 169.1±55.4 minutes in MICRO and 68.8±37.3, 133.3±85.3, 171.3±77.1 and 233.1±60.6 minutes in EMU, respectively. There was an increase of the enzyme alanine aminotransferase from 12 to 72 hours in EMU and in MICRO from 48 to 72 hours. The propofol in microemulsion presents clinical characteristics of induction and maintenance, and metabolic effects similar to the formulation in lipid emulsion. The microemulsion formulation provides a better cardiovascular and respiratory stability for induction and continuous infusion in healthy cats.
ABSTRACT
This research aimed to evaluate the clinical and cardiorespiratory effects of a propofol formulation with nanometer droplet diameter in dogs. Six adult healthy female dogs weighing 14.8±1.2kg were used in this study. Each dog received two treatments with a 15-day washout period. A microemulsion (MICRO) or lipid emulsion (EMU) of propofol was administered intravenously (IV) for induction and maintenance of anesthesia. Anesthesia was maintained with a constant rate infusion of propofol (0.4mg kg-1 minute-1). Cardiorespiratory variables were recorded before induction (baseline), immediately after and at 15-minute intervals for 90 minutes after treatment. Arterial blood samples were also taken for blood gas analysis, except at 45 and 75 minutes after induction. The mean arterial pressure decreased significantly during both treatments, while the cardiac index decreased significantly only in MICRO treatment. The time to extubation, sternal recumbency, ambulation and total recovery was similar in both treatments. Opisthotonos was observed in 33% of the animals in each treatment. The propofol microemulsion presented clinical and respiratory parameters similar to those obtained with the lipid emulsion commercially available, but had some significantly different hemodynamic characteristics when used for inducing and maintaining anesthesia. Based only in these results, no advantages are seen in the use of this new microemulsion.
Este estudo tem o objetivo de avaliar os efeitos clínicos e cardiorrespiratórios de uma formulação de propofol formada por nanopartículas, em cães. Para esse propósito, seis cães hígidos, adultos, fêmeas, com peso médio de 14,8±1,2kg foram utilizados. Cada cão recebeu dois tratamentos, sendo que entre estes foi permitido aos animais um período de washout de 15 dias. Os animais receberam propofol em microemulsão (MICRO) ou em emulsão lipídica (EMU) por via intravenosa (IV) para a indução e manutenção da anestesia. A anestesia foi mantida com velocidade de infusão constante (0,4mg kg-1 min-1). As variáveis cardiorrespiratórias foram mensuradas antes da indução (basal), imediatamente após a indução, e então a cada 15 minutos, durante 90 minutos. Amostras de sangue arterial também foram colhidas para análise de gases sanguíneos, exceto aos 45 e 75 minutos após a indução. A pressão arterial média diminuiu significativamente com a utilização de ambos os tratamentos, enquanto o índice cardíaco reduziu significativamente somente com o tratamento MICRO. O tempo necessário para extubação, decúbito esternal, deambulação e recuperação total foi semelhante em ambos os grupos. Opistótono foi observado em 33% dos animais em cada tratamento. A microemulsão de propofol apresentou parâmetros clínicos e respiratórios semelhantes àqueles obtidos com a emulsão lipídica comercialmente disponível, porém mostrou algumas características hemodinâmicas diferentes, quando utilizada para a indução e manutenção da anestesia. Com base somente nesses resultados, não são observadas vantagens na utilização da microemulsão.
ABSTRACT
Os felinos são deficientes na biotransformação do propofol e os dados em relação à farmacocinética nessa espécie são escassos. O objetivo deste estudo foi determinar o perfil farmacocinético da infusão contínua de propofol em nanoemulsão juntamente com a emulsão lipídica em felinos. Utilizaram-se seis gatos sem raça definida (SRD), adultos, machos, castrados, com peso médio de 4,2±0,8kg, em estudo aleatório e de autocontrole. Os animais receberam 10mg kg-1 min-1 de propofol a 1% em emulsão lipídica (EMU) ou em nanoemulsão (NANO) durante 30 segundos e, imediatamente após, iniciou-se a infusão de 0,3 mg kg-1 min-1 da mesma formulação durante 60 minutos. Após 15 dias, receberam o mesmo tratamento com a formulação oposta. Amostras de 3mL de sangue venoso foram coletadas nos tempos 0 (basal), 2, 5, 10, 15, 30 e 60 minutos de infusão e aos 5, 10, 15, 30, 60, 90, 120, 180, 240, 360, 600 e 1440 minutos após o final da infusão. Os parâmetros farmacocinéticos foram determinados a partir da curva de decaimento da concentração plasmática versus tempo ao final da infusão. A análise estatística foi realizada através de ANOVA-RM com posterior teste t pareado entre os grupos. Não houve diferença entre as formulações em relação a todos os parâmetros. Os volumes de distribuição foram altos com Vdss de 23,23±12,30 litros kg-1 para a nanoemulsão e de 18,12±8,54 litros kg-1 para a emulsão lipídica. Os Cls foram baixos com um Cl central de 22,20±10,83mL kg-1 min-1 para a nanoemulsão e de 23,42±13,50mL kg-1 min-1 para emulsão lipídica. Conclui-se que a farmacocinética do propofol em gatos após infusão contínua caracteriza-se por uma ampla distribuição tecidual e uma lenta eliminação, com possível efeito cumulativo. A formulação em nanoemulsão apresenta características farmacocinéticas semelhantes às da emulsão lipídica.
Cats are deficient in the metabolism of propofol and the data on the pharmacokinetics in this species are scarce. The aim of this study was to determine the pharmacokinetic profile of continuous infusion of propofol in lipid emulsion and compare with the nanoemulsion formulation, in cats. Domestic cats, short hair, adults, male, castrated, weighting 4.2±0.8kg in a randomized and self control trial were used. The animals received 10mg kg-1 of 1% propofol in lipid emulsion or nanoemulsion for 30 seconds and immediately after that, a continuous rate infusion of 0.3mg kg-1 min-1 of the same formulation was administered for 60 minutes. After 15 days the cats received the same treatment with the opposite formulation. Samples of 3mL of venous blood were collected by a central venous catheter inserted in the jugular vein at 0 (baseline), 2, 5, 10, 15, 30, and 60 minutes of infusion and at 5, 10, 15, 30, 60, 90, 120, 180, 240, 360, 600 and 1440 minutes after the end of the infusion. The pharmacokinetic parameters were determined from the decay curve of plasma concentration versus time at the end of the infusion. Statistical analysis was performed using RM-ANOVA with subsequent paired t-test between groups. There was no difference between the formulations with respect to all parameters. The volumes of distribution were high with Vdss of 23.23±12.30 liters kg-1 for the nanoemulsion and 18.12±8.54 liters kg-1 for lipid emulsion. The Cls were low with a Cl central to 22.20±10.83mL kg-1 min-1 for the nanoemulsion and 23.42±13.50mL kg-1 min-1 for lipid emulsion. The conclusion is that the pharmacokinetics of propofol in cats after infusion is characterized by a broad tissue distribution and a slow elimination, with possible cumulative effect. The formulation nanoemulsion has pharmacokinetic properties similar to the lipid emulsion.