• The Korean Journal of Pain
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• v.29 no.3
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• pp.153-157
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• 2016

Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.

• The Korean Journal of Pain
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• v.25 no.4
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• pp.238-244
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• 2012

Background: Vitamin E is widely known to be one of the reactive oxygen species (ROS) scavengers and a drug that can easily be obtained, and it has been shown to attenuate the pain responses induced by various causes in animal pain models. Thus, this experiment was conducted to assess the antinociceptive effects of vitamin E by comparing intraperitoneal and intrathecal injections in rats subjected to the formalin test. Methods: After the intraperitoneal and intrathecal injections of vitamin E were carried out, respectively (IP: 500 mg/kg, 1 g/kg, and 2 g/kg, IT: 3 mg/kg, 10 mg/kg, and 30 mg/kg), the formalin test was perfumed. As soon as 5% formalin was injected into left hind paw, the number of flinches induced by pain was measured at 5-minute intervals for 1 hour. Results: Formalin injected into the left hind paw induced biphasic nociceptive behavior in all animals. Intraperitoneal injection of vitamin E diminished the nociceptive behavior in a dose-dependent manner during the early and late phase. Intrathecal vitamin E diminished nociceptive behavior dose dependently during the late phase but showed no significant difference in the early phase. Conclusions: Vitamin E attenuated acute nociception when it was injected systemically, while both systemic and intrathecal injection produced analgesia in a rat model of formalin-induced hyperalgesia.

• The Korean Journal of Pain
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• v.25 no.4
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• pp.213-220
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• 2012

Background: It has been demonstrated that the expression of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) and apoptotic cell death in the dorsal root ganglion (DRG) following spinal nerve constriction injury play a role in the initiation and continuation of hyperalgesia and allodynia. The present study was designed to investigate the effects of ethyl pyruvate (EP) on mechanical and cold allodynia, TNF-${\alpha}$ expression, and apoptosis in DRG after spinal nerve ligation injury. Methods: Rats were divided into 3 groups: control, pre-EP, and post-EP. EP (50 mg/kg) was intraperitoneally injected 30 minutes before (pre-EP) or after (post-EP) surgery. Behavioral tests to determine mechanical and cold allodynia were conducted before surgery and 4 and 7 days after surgery. Seven days after surgery, TNF-${\alpha}$ protein levels in DRG were evaluated by enzyme-linked immunosorbent assay, and DRG apoptosis was determined by immunohistochemical detection of activated caspase-3. Results: Treatment with EP significantly reduced mechanical and cold allodynia following spinal nerve ligation injury. TNF-${\alpha}$ protein levels in the pre-EP ($4.7{\pm}1.2$ pg/200 ${\mu}g$; P < 0.001) and post-EP ($6.4{\pm}1.8$ pg/200 ${\mu}g$; P < 0.001) groups were 2-3 times lower than the control group ($14.4{\pm}1.2$ pg/200 ${\mu}g$). The percentages of neurons and satellite cells that co-localized with caspase-3 were also significantly lower in the pre-EP and post-EP groups than the control group. Conclusions: These results demonstrate that EP has a strong anti-allodynic effect that acts through the inhibition of TNF-${\alpha}$ expression and apoptosis in DRG after spinal nerve ligation injury.

• The Korean Journal of Physiology and Pharmacology
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• v.9 no.3
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• pp.179-186
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• 2005

Whole bee venom (WBV) and its major component, melittin, have been reported to induce long-lasting spontaneous flinchings and hyperalgesia. The current study was designed to elucidate the peripheral and spinal mechanisms of N-methyl-D-aspartate (NMDA) and non-NMDA receptors by which intraplantar (i.pl.) injection of WBV and melittin induced nociceptive responses. Changes in mechanical threshold and flinching behaviors were measured after the injection of WBV (0.04 mg or 0.1 mg/paw) and melittin (0.02 mg or 0.05 mg/paw) into the mid-plantar area of a rat hindpaw. MK-801 and CNQX (6-cyano-7-nitroquinoxaline-2,3-dione disodium) were administered intrathecally (i.t. $10{\mu}g$) or i.pl.($15{\mu}g$) 15 min before or i.t. 60 min after i.pl. WBV and melittin injection. Intrathecal pre- and postadministration of MK-801 and CNQX significantly attenuated the ability of high dose WBV and melittin to reduce paw withdrawal threshold (PWT). In the rat injected with low dose, but not high dose, of WBV and melittin, i.pl. injection of MK-801 effectively suppressed the decrease of PWTs only at the later time-points, but the inhibitory effect of CNQX (i.pl.) was significant at all time-point after the injection of low dose melittin. High dose WBV- and melittin-induced spontaneous flinchings were significantly suppressed by i.t. administration of MK-801 and CNQX, and low dose WBV- and melittin-induced flinchings were significantly reduced only by intraplantarly administered CNQX, but not by MK-801. These experimental flinchings suggest that spinal, and partial peripheral mechanisms of NMDA and non-NMDA receptors are involved in the development and maintenance of WBV- and melittin-induced nociceptive responses.

• The Korean Journal of Physiology and Pharmacology
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• v.21 no.1
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• pp.65-74
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• 2017

Here we investigated the central processing mechanisms of mechanical allodynia and found a direct excitatory link with low-threshold input to nociceptive neurons. Experiments were performed on male Sprague-Dawley rats weighing 230-280 g. Subcutaneous injection of interleukin 1 beta ($IL-1{\beta}$) ($1ng/10{\mu}L$) was used to produce mechanical allodynia and thermal hyperalgesia. Intracisternal administration of bicuculline, a gamma aminobutyric acid A ($GABA_A$) receptor antagonist, produced mechanical allodynia in the orofacial area under normal conditions. However, intracisternal administration of bicuculline (50 ng) produced a paradoxical anti-allodynic effect under inflammatory pain conditions. Pretreatment with resiniferatoxin (RTX), which depletes capsaicin receptor protein in primary afferent fibers, did not alter the paradoxical anti-allodynic effects produced by the intracisternal injection of bicuculline. Intracisternal injection of bumetanide, an Na-K-Cl cotransporter (NKCC 1) inhibitor, reversed the $IL-1{\beta}$-induced mechanical allodynia. In the control group, application of GABA ($100{\mu}M$) or muscimol ($3{\mu}M$) led to membrane hyperpolarization in gramicidin perforated current clamp mode. However, in some neurons, application of GABA or muscimol led to membrane depolarization in the $IL-1{\beta}$-treated rats. These results suggest that some large myelinated $A{\beta}$ fibers gain access to the nociceptive system and elicit pain sensation via $GABA_A$ receptors under inflammatory pain conditions.

• The Korean Journal of Physiology and Pharmacology
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• v.9 no.1
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• pp.23-27
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• 2005

The present study was performed to investigate the effects of intra-articular injection of interleukin-1${\beta}$ (IL-1${\beta}$) on the formalin-induced temporomandibular joint (TMJ) pain. Under anesthesia, a 30-gauge needle was introduced into the right TMJ region for injection of formalin. Microinjection of 50 ${\mu}l$ of 5% formalin significantly produced noxious scratching behavioral response, and the scratching behavior lasted for 40 min. Although the responses produced by formalin injection were divided into two phases, the response of 1st phase did not significantly differ from the scratching behavior response in the saline-treated group. We examined the effects of intra-articular injection of IL-1${\beta}$ on the number of noxious behavioral responses produced by 50${\mu}l$ of 5% formalin injection. Intra-articular injection of 100 pg and 1 ng of IL-1${\beta}$ significantly increased the number of behavioral responses of the 2nd phase, while 10 pg of IL-1${\beta}$ did not change the formalin-induced behavioral responses. To investigate whether IL-1 receptor was involved in the intra-articular administration of IL-1${\beta}$-induced hyperalgesic response, IL-1 receptor antagonist (IL- ra, 50 ng) was administrated together with IL-1${\beta}$ injection. IL-1${\beta}$ receptor antagonist blocked IL-1${\beta}$- induced hyperalgesic response in the TMJ formalin test. These results suggest that intra-articular injection of IL-1${\beta}$ facilitated the transmission of nociceptive information in the TMJ area.

• Journal of Acupuncture Research
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• v.20 no.2
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• pp.112-122
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• 2003

연구 배경 및 목적 : 봉독은 항염증 등의 효과를 가지고 있다고 알려져 있지만 세포 증식과 관련된 봉독의 효과에 대한 고찰을 위해 본 연구(硏究)에서는, 봉독(蜂毒) 약침(藥鍼) 자극(刺戟)이 아세트산 유발(誘發) 통각(痛覺) 과민증(過敏症)을 가진 쥐의 치상회(齒狀回)에서의 세포(細胞) 증식(增植)과 COX2 발현(發現)에 미치는 영향(影響)에 대해 알아보고자 하였다. 실험방법 : 대조군, 아세트산 처치군, 아세트산 0.1mg/kg 봉독 처치군, 아세트산 1mg/kg 봉독처치군(n=5 in each group)의 네 군으로 나누고 해당 군에 일벌 봉독(蜂毒)(Sigma Chemical Co., St. Louis, MO, USA)을 양측 족삼리 경혈(ST36)에 주입시키고 30분 후 아세트산(100% acetic acid 1% 용액의 0.5ml)을 복강내로 주입하여 복부 긴장 회수를 세었으며, BrdU 양성, COX 2 양성 세포수를 면역 화학 조직법을 수행하여 세어 보았다. 결과 : 아세트산 처치군에서는 대조군에 비해 5 bromo 2' deoxyuridine 양성 세포의 수는 감소(減少)되며, 치상회(齒狀回)에서의 COX 2의 발현(發現)은 증강(增强)되는 것으로 보여졌다. 봉독(蜂毒) 주입(注入)은 아세트산 유발(誘發) 복부(腹部) 긴장(緊張) 횟수와 치상회(齒狀回)에서의 COX2 발현(發現)을 억제(抑制)하여, 치상회(齒狀回)에서의 세포(細胞) 증식(增植)을 증가(增加)시켰다. 결론 : 이번 결과(結果)에서 보면, 치상회(齒狀回)에서의 COX 2의 발현(發現)은 세포(細胞) 증식(增植) 억제(抑制)와 관련(關聯)되며 봉독(蜂毒)은 COX 2 발현(發現) 억제(抑制)를 통해 치상회(齒狀回)에서의 새로운 세포(細胞) 형성(形成)을 증가(增加)시킨다는 것을 알 수 있다.

• Journal of Physiology & Pathology in Korean Medicine
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• v.32 no.1
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• pp.35-42
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• 2018

TRPA1 and TRPV1 are members of the TRP superfamily of structurally related, nonselective cation channels. TRPA1 and TRPV1 are often co-expressed in sensory neurons and play an important role in mechanical hyperalgesia and allodynia during neuropathic pain. Scutellariae Radix was reported to possess anti-inflammation properties and similar patterns of therapeutic action against different diseases. also Baicalin(a known principal constituent of Scutellaria Radix) was shown to down-regulate the mRNA expression levels of TRPV1. In this study, we observed the effects of Scutellariae Radix extract(SRE) in neuropathic pain induced SD rats via modulation of TRPV1 and TRPA1. Oral administration of a Scutellaria Radix extract(in doses of 300mg/kg, SRE(300)) showed a meaningful increase in the withdrawal threshold of mechanical allodynia and showed a meaningful decrease in the expression of c-fos compared to the control group. SRE(100) and SRE(300) showed a meaningful decrease in the expression of TRPV1 level compared to the control group. These results suggest that Scutellariae Radix extract could decrease mechanical allodynia by down-regulate the TRPV1 on the model of neuropathic pain.

• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.12-20
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• 2000

The memory of pain can be more damaging than its initial experience. Several factors arc related the directions of pain memory: current pain intensity, emotion, expectation of pain, and peak intensity of previous pain. The possible mechanisms behind the memory of pain are neuroplastic changes of nervous system via peripheral and central sensitization. Peripheral sensitization is induced by neurohumoral alterations at the site of injury and nearby. Biochemicals such as K+, prostaglandins, bradykinin, substance P, histamine and serotonin, increase transduction and produce continuous nociceptive input. Central sensitization takes place within the dorsal horn of spinal cord and amplifies the nociceptive input from the periphery. The mechanisms of central sensitization involve a variety of transmitters and postsynaptic mechanisms resulting from the activations of NMDA receptors by glutamate. and activation of NK-1 tachykinnin receptors by substance-P and neurokinnin. The clinical result of peripheral and central sensitization is hyperalgesia, allodynia, spontaneous pain, referred pain, or sympathetically maintained pain. These persistent sensory responses to noxious stimuli arc a form of memory. The hypothesis of preemptive analgesia is that analgesia administered before the painful stimulus will prevent or reduce subsequent pain and analgesic requirements in comparison to the identical analgesic intervention administered after the painful stimulus, by preventing or reducing the memory of pain in the nervous system. Conventionally, pain management was initiated following noxious stimuli such as surgery. More recently, however many have endorsed preemptive analgesia initiated before surgery. Treatments to control postsurgical pain are often best started before injury activates peripheral nociceptors and triggers central sensitization. Such preemption is not achieved solely by regional anesthesia and drug therapy but also requires behavioral interventions to decrease anxiety or stress. Although the benefit of preemptive analgesia may not be obvious in every circumstance, and in many cases may not sufficient to abolish central sensitization, it is an appropriate and human goal of clinical practice.

• Journal of Acupuncture Research
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• v.20 no.3
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• pp.117-130
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• 2003

To study the analgesic and effect and its mechanism of eletroacupunture(EA) on the chronic inflammatory pain 50 rats were induced with arthralgesia by injecting complete freund's adjuvant(CFA). Two weeks after the injection of CFA, EA stimulation(2Hz, 0.07mA, 0.3ms) was delivered to Jogsamni($ST_{36}$) for 20 minutes. Analgesic effect was evaluated by using the tail flick latency(TFL) and the analgesic mechanism was observed by applying TFL with the pretreatment with naloxone and yohimbine. The results were as follows ; 1. TFL level for the model of adjuvant-induced arthritis decreased as time went by and it induced the hyperalgesia. 2. EA stimulation delivered to Jogsamni($ST_{36}$) for 20 minutes in the rat model of adjuvant-induced arthritis brought analgesic effect and its effect had lasted for 40 minutes after the stimulation. 3. The analgesic effect of Jogsamni($ST_{36}$) EA in the rat model of adjuvant-induced arthritis was blocked by pretreatment with naloxone(2mg/kg,i.p). This result suggests that the EA effect on the chronic inflammatory pain can be related to the endogenous opioid mechanism. 4. The analgesic effect of Jogsamni($ST_{36}$) EA in the rat model of adjuvant-induced arthritis was blocked by pretreatment with naloxone(2mg/kg,i.p). This result suggests that the EA effect on the chronic inflammatory pain can be related to the ${\alpha}_2$-adrenergic mechanism.