A dor neuropática (DN) é causada por uma lesão primária ou por uma disfunção no sistema nervoso periférico (SNP) ou central (SNC), sendo que os principais sintomas são a alodinia mecânica e a ...hiperalgesia a estímulos térmicos e mecânicos. A DN apresenta resposta analgésica insuficiente com terapeuticas farmacológicas clássicas, sendo um desafio para o tratamento clínico. Técnicas de neuromodulação central, como a estimulação transcraniana por corrente contínua (ETCC), representam um recurso promissor no manejo da dor, uma vez que promovem neuroplasticidade em vias envolvidas com o processo doloroso, sendo um método não-invasivo que pode ser combinado com outras terapias. Sendo assim, o objetivo deste estudo foi investigar os efeitos do tratamento repetido com ETCC na resposta hiperalgésica térmica e mecânica em modelo experimental de DN. Adicionalmente, foram avaliados os níveis de IL-1β, IL-10, TNF-α e NGF em estruturas do SNC destes animais. Todos os procedimentos foram aprovado pela Comissão de Ética no Uso de Animais (CEUA/HCPA:120512). Oitenta e quatro ratos machos Wistar foram divididos em 7 grupos: controle, dor neuropática, dor neuropática+ETCC, dor neuropática+sham ETCC, sham dor neuropática, sham dor neuropática+ETCC e sham dor neuropática+sham ETCC. O modelo de DN foi induzido por meio de ligura parcial do nervo isquiático na pata esquerda. O sham do modelo de DN seguiu o mesmo protocolo, com simulação da ligadura parcial do nervo isquiático e o grupo controle não sofreu nenhuma manipulação. O tratamento com ETCC consistiu em 20minutos/dia/8 dias, com intensidade de 0,5mA. Para o sham do tratamento, os eletrodos foram apenas fixados à cabeça do animal durante 20 minutos/dia/8 dias, sem nenhuma estimulação. A hiperalgesia térmica e mecânica foi avaliada por meio dos testes da Placa Quente e de Von Frey, respectivamente, no tempo basal, 7 e 14 dias após a cirurgia e imediatamente, 24 horas e 7 dias após o final do tratamento. Os níveis de IL-1β, IL-10, TNF-α e NGF no cortex cerebral, medula espinhal e tronco cerebral foram determinados por ELISA 48 horas e 7 dias após o final do tratamento. A análise estatística para os testes nociceptivos foi realizada através da Generalized Estimation Equation (GEE)/Bonferroni e para as análises bioquímicas por ANOVA de uma via (IL-1β, IL-10, TNF-α ) e ANOVA de três vias (NGF). Os dados estão expressos como media+erro padrão da média, sendo considerado significativo p<0.05. Nossos resultados demonstraram que a DN altera os níveis de IL-1β, IL-10, TNF-α e NGF no SNC em curto e longo prazo. Além disso, a ETCC reduz a resposta nociceptiva a curto e longo prazo e na modulação dos níveis de citocinas no sistema nervoso central neste modelo. Evidencia-se a importância do papel do sistema imune central nos processos de continuidade da dor neuropática, que pode estar envolvido com as alterações neuroplásticas maladaptativas características dessa patologia.
Neuropathic pain (NP) is caused by a primary insult or dysfunction in the central or peripheral nervous system and its prevalence depends on the type of trauma and related dysfunction. The main symptoms are mechanical allodynia and hyperalgesia to both mechanical and thermal stimuli. NP often shows insufficient response to classic analgesics and remains a challenge to medical treatment and scientific research; and the search for new therapies for this pathology is of fundamental important. Central neuromodulation techniques, such as transcranial direct current stimulation (tDCS), represent a promising resource to pain management since they promote neuroplasticity in the central system of pain. Moreover, tDCS has the advantages of being a noninvasive technique and can be combined with other interventions. The aim of this study was investigated the effects of tDCS in the thermal and mechanical hyperalgesia induced by chronic constriction injury (CCI) of sciatic nerve and measured its effect on the neurochemical markers (IL-1β, IL-10, TNF-α, and NGF levels) on central nervous system structures. All experiments and procedures were approved by the Institutional Animal Care and Use Committee (GPPG-HCPA No.120512) and performed in accordance with the Guide for the Care and Use of Laboratory Animals 8th ed. The CCI of sciatic nerve was used for the induction of NP. For sham surgery, the sciatic nerve was exposed similarly, but it was not ligated. The control group did not undergo surgical procedure. After the establishment of NP, the rats of treated groups were subjected to a 20 minutes session of anodal tDCS, every afternoon for eight days, under a direct constant current of 0.5 mA intensity. The thermal and mechanical hyperalgesia was assessed by Hot plate and Von Frey test, respectively, and evaluated on baseline, 7 and 14 days after surgery; immediately, 24 hours and 7 days after treatment. The IL-1β, IL-10, TNF-α and NGF levels on cortex, spinal cord and brainstem were determined by sandwich-ELISA at 48 hours and 7 days after the end of treatment. Data were expressed as the mean±standard error of the mean (S.E.M). Generalized Estimating Equation (GEE) followed by Bonferroni was performed to compare all groups in different times of nociceptive tests and to biochemical data the one-way ANOVA was used to compare the IL-1β, IL-10, TNF-α and three-way ANOVA was used to compare the NGF levels. P-values less than 0.05 were considered significant. SPSS 19.0 for Windows was used for statistical analysis. In summary, we showed that anodal tDCS is effective to relieve NP and modulate cytokine in CCI rat model, and its effect is observed at long-term. In addition, the CCI model induced increased NGF levels in cerebral cortex and spinal cord at long-lasting time, evidencing the important feature of this neurotrophin in neuropathic pain condition. Additionally, we observed an important role of the central immune system in the neuropathic process, which can be involved with the maladaptative neuroplastic changes.
We studied the interaction between the synthetic prostacyclin analog iloprost and the aggregating agent alpha-thrombin by measuring the internal calcium ion concentration (Ca(2+)i) of human ...fura-2-loaded platelets. Iloprost (0.003-100 micrograms/l) did not modify the resting calcium level; when added 2 minutes before exposure of the platelets to a submaximally active concentration of alpha-thrombin (10 U/l), iloprost dose-dependently antagonized the increase in Ca(2+)i. To evaluate if iloprost retained this antagonistic effect even after a prolonged contact, which is well known to cause a "desensitization" phenomenon, platelets were preincubated with iloprost (35 micrograms/l) for 3 hours. After washout, the effect of newly added iloprost (0.01-100 micrograms/l) on the alpha-thrombin-induced increase in Ca(2+)i was tested. Iloprost was still able to antagonize the increase in Ca(2+)i induced by alpha-thrombin in "desensitized" platelets; however, the dose-inhibitory response curve was significantly shifted to the right when compared with that obtained in control platelets (i.e., platelets preincubated for 3 hours with iloprost's solvent), and the resulting IC50 was significantly higher: 1.78 versus 0.2 micrograms/l (p < 0.001). Since the maximal inhibitory effect of iloprost could also be reached under these experimental conditions, we conclude that iloprost retains its ability to antagonize the increase in Ca(2+)i induced by alpha-thrombin in desensitized platelets.
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The antiarrhythmic potency of mexiletine was evaluated on three groups of guinea‐pig isolated hearts. Arrhythmias were induced (a) with digitalis intoxication, (b) with hypoxia followed by ...reoxygenation and (c) with ischaemia followed by reperfusion.
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Mexiletine 10 μM was found to be very effective against all three types of arrhythmias in all three groups.
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The electrophysiological effects of mexiletine were then studied on sheep cardiac Purkinje fibres manifesting oscillatory afterpotentials and triggered automaticity induced by barium or strophanthidin.
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Mexiletine 10 μM consistently decreased the amplitude of oscillatory afterpotentials and blocked subsequent triggered activity in sheep Purkinje fibres.
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In contrast, mexiletine 10 μM had no significant effect on in normal, barium‐ and strophanthidin‐treated preparations.
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The results are discussed in relation to the mechanisms of antiarrhythmic action of mexiletine.
Further modifications of the leads ((R)-(+)-hyoscyamine and (p-chlorophenyl)propionic acid alpha-tropanyl ester), which show analgesic and nootropic activities as a consequence of increased central ...presynaptic ACh release, are reported. 2-Phenoxy- and 2-(phenylthio)alkanoic acid esters showed the best results. Several members of these classes possess analgesic properties which are comparable to that of morphine and at the same time are able to reverse dicyclomine-induced amnesia. Confirmation was found that the mechanism of action is due to an increase in ACh release at central muscarinic synapses and that both auto- and heteroreceptors controlling ACh release are very likely involved. According to the results obtained with (R)-(+)-hyoscyamine, analgesic activity is stereochemistry dependent, since the R-(+)-enantiomers are always more efficacious than the corresponding S-(-)-ones. On the basis of their potency and acute toxicity, compounds (+/-)-28 (SM21) and (+/-)-42 (SM32) were selected for further study.
Lacidipine is a new 1,4-dihydropyridine derivative with potent and long-lasting antihypertensive activity. We used intracellular microelectrodes to characterize the electrophysiologic properties of ...lacidipine on different cardiac preparations. Lacidipine (10(-8) -10(-6) M) dose-dependently decreased contractility of driven sheep Purkinje fibers. For concentrations less than or equal to 10(-7) M, this effect was associated with a selective decrease of the plateau height. Higher concentrations (3 X 10(-7) and 10(-6) M), however, affected action potential amplitude, overshoot, and maximum rate of depolarization. In the same range of concentrations, lacidipine did not affect normal automaticity of guinea-pig sinus node and sheep Purkinje fibers. Lacidipine (10(-6) M) consistently blocked barium-induced abnormal automaticity in Purkinje fibers and reduced the amplitude and Vmax of the slow action potentials induced by histamine (10(-5) M) in guinea pig papillary muscle depolarized by potassium (22 mM). The effect of lacidipine on the slow inward current (Isi) was studied in shortened Purkinje fibers under voltage-clamp conditions. Lacidipine (10(-7)-10(-6) M) reduced the Isi without affecting the I-V relationship. None of the effects of lacidipine was reversed by 2-h washout. The results indicate that lacidipine has calcium-antagonistic properties in cardiac tissues. Its cardiac effects occur at concentrations 100 times higher than those active in the vascular smooth muscle. The lack of recovery of the lacidipine effects suggests that its interaction with the calcium channel may occur at an inner site of the cell membrane.
Taurine reduces the excitability of striated muscle fibers by increasing the membrane conductance to chloride ions (GCl). This action was tested on rats made myotonic by drugs that block GCl by ...different mechanisms. Experiments were made "in vivo" using electromyographic (EMG) recordings and "in vitro" with intracellular microelectrode recordings from extensor digitorum longus muscle fibers. Taurine did not antagonize the myotonic discharges produced in vivo by anthracene-9-carboxylic acid, nor did it restore GCl lowered in vitro by this agent. However, when myotonia was chronically induced by 20,25 diazacholesterol, taurine given chronically in vivo or acutely in vitro antagonized the EMG myotonia as well as the reduced GCl and increased excitability of single fibers. We conclude that taurine acts directly on chloride channels to modify their kinetics. Our findings suggest that further clinical studies on the use of taurine in muscle disease involving abnormal excitability or chloride channel function will be useful.
A period of drive in the presence of norepinephrine (NE) may be followed by the induction or acceleration of spontaneous activity. Experiments were carried out in sheep cardiac Purkinje fibers to ...determine whether the effects of NE on automaticity were modified during superfusion with hypoxic glucose-free Tyrode's solution and to assess the possible contribution of alpha-adrenergic influences on automaticity under these conditions. The following results were obtained: Low concentrations of NE (10(-7) and 3 X 10(-7)M) were able to induce automaticity after a period of drive in normal oxygenated (97% O2, 3% CO2) Tyrode's solution. Superfusion with hypoxic (97% N2, 3% CO2) glucose-free Tyrode's solution enhanced NE-induced automaticity. Practolol, in concentrations able to block the effects of NE in normal oxygenated solution, did not counteract the effects of NE in hypoxic glucose-free solution. Yohimbine, but not prazosin, antagonized the effects of NE in hypoxic glucose-free solution. At the same concentration, yohimbine did not affect transmembrane potentials or automaticity induced by isoproterenol. It is concluded that alpha-adrenergic responsiveness appears to be enhanced during superfusion in vitro with hypoxic glucose-free solution, and that alpha-adrenoceptors belonging to the alpha 2-subtype in sheep cardiac Purkinje fibers might influence abnormal automaticity, possibly through an effect on oscillatory potentials.
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