• The Korean Journal of Pain
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• v.35 no.1
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• pp.43-58
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• 2022

Background: Current therapies are quite unsuccessful in the management of neuropathic pain. Therefore, considering the inhibitory characteristics of GABA mediators, the present systematic review and meta-analysis aimed to determine the efficacy of GABAergic neural precursor cells on neuropathic pain management. Methods: Search was conducted on Medline, Embase, Scopus, and Web of Science databases. A search strategy was designed based on the keywords related to GABAergic cells combined with neuropathic pain. The outcomes were allodynia and hyperalgesia. The results were reported as a pooled standardized mean difference (SMD) with a 95% confidence interval (95% CI). Results: Data of 13 studies were analyzed in the present meta-analysis. The results showed that administration of GABAergic cells improved allodynia (SMD = 1.79; 95% CI: 0.87, 271; P < 0.001) and hyperalgesia (SMD = 1.29; 95% CI: 0.26, 2.32; P = 0.019). Moreover, the analyses demonstrated that the efficacy of GABAergic cells in the management of allodynia and hyperalgesia is only observed in rats. Also, only genetically modified cells are effective in improving both of allodynia, and hyperalgesia. Conclusions: A moderate level of pre-clinical evidence showed that transplantation of genetically-modified GABAergic cells is effective in the management of neuropathic pain. However, it seems that the transplantation efficacy of these cells is only statistically significant in improving pain symptoms in rats. Hence, caution should be exercised regarding the generalizability and the translation of the findings from rats and mice studies to large animal studies and clinical trials.

• Journal of Society of Preventive Korean Medicine
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• v.20 no.3
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• pp.55-65
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• 2016

Objectives : Mibyeong is a korea medicine have original concept of the disease. However, no previous report has effect of mibyeong herbal medicine in fatigue types of mibyeong. This study investigated the question of whether Dang Gui Bo Hyul-tang(DGBHT) of effect on fatigue types of Mibyeong. Methods : C57BL/6 mice were randomaly divided into three group (n=10). The mice were then group (1) Nocontrol, (2) Restraunt stress(veh), (3) Dang Gui Bo Hyul-tang 200mg/kg. The administered Dang Gui Bo Hyul-tang 200mg/kg or distilled water (orally) 1 hr prior to daily exposure to repeated restraint stress (2 h) for 15 days. The performed behavior test (Mechanical hyperalgesia test,, Open-field test, Forced swimming test, Sucrose preference test and immunostaining and biochemical measured in serum. Results : Stress fatigue induced mices significantly increased lethargic, hyperalgesia through behavior test (Mechanical hyperalgesia test (decrease 43%), Open-field test ($4,809{\pm} 226.13cm$ vs. $3121{\pm}226.64cm$), Forced swimming test ($11.45{\pm}3.96$ vs. $79.10{\pm}8.12sec$), Sucrose preference test (decrease 58%)). In addition, chronic fatigue model evidently increased corticosterone level ($122.54{\pm}18.88$ vs. $186.94{\pm}18.26ng/ml$), AST level ($46.22{\pm}3.23$ vs. $31.40{\pm}3.86U/L$), ALT level ($38.78{\pm}5.72$ vs. $17.60{\pm}1.30$), liver necrosis, lateral ventricle size. These alterations were significantly ameliorated by DGBHT. DGBHT significantly attend the elevated serum concentrations of corticosterone ($155.90{\pm}6.29ng/ml$), AST ($31.40{\pm}3.86U/L$), ALT ($17.60{\pm}1.30U/L$). Moreover, DGBHT improved lethargic, hyperalgesia when compared the stress fatigue (Mechanical hyperalgesia test (improve 28%), Open-field test ($4,038{\pm}615.81cm$), Forced swimming test ($7.56{\pm}1.88sec$), Sucrose preference test (increase 21%) Conclusions : Theses result suggest that DGBHT have improved lethargic, hyperalgesia and fatigue-associated hormone and liver protective on stress fatigue model. It will be necessary to research to present evidences on benefits and effects of Korean medical treatment for Mibyeong through clinical researches based on benefits and effects of those animal models.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.1-7
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• 1999

Background: To study the role of spinal alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptors in pain behaviors caused by mild burn, we examined the effect of intrathecal administered ACEA 2085, which has been recently characterized as a high potency competitive AMPA receptor antagonist, on the thermal hyperalgesia state induced by mild burn. Methods: A thermal injury was induced by applying the left hind paw to a thermal surface ($52.5^{\circ}C$) for 45 sec. Thermal escape latency of the hind paw was determined using an underglass thermal stimulus. Thirty min after thermal injury, the paw withdrawal latency (PWL) in injured paw of all groups fell from 10~12 sec to 5~7 sec. At that time, ACEA 2085 (0.01~0.1 mcg) and 6-cyano-7-nitroquinoxalinedione (CNQX, 1~30 mcg) were injected through intrathecal heters in rats with mild burn injury on the right hindpaw. And then, PWL were measured in the both hindpaw every 30 minutes for about three hours. Results: The intrathecal injection of ACEA 2085 produced a dose dependent reversal of the hyperalgesia in the right hindpaw and more potent than CNQX, but had no effect upon the response latency of the normal left hind paw even at the largest doses. All effects were observed at doses that had no significant effect upon motor function. Conclusions: Intrathecal ACEA 2085, highly selective AMPA receptor antagonist produce a dose- dependent reversal of the thermal hyperalgesia evoked mild burn injury. These results suggested that spinal AMPA receptor play an important role in the hyperalgesia induced by mild burn injury.

• International Journal of Oral Biology
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• v.40 no.3
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• pp.117-125
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• 2015

The present study investigated the role of central $GABA_A$ and $GABA_B$ receptors in orofacial pain in rats. Experiments were conducted on Sprague-Dawley rats weighing between 230 and 280 g. Intracisternal catheterization was performed for intracisternal injection, under ketamine anesthesia. Complete Freund's Adjuvant (CFA)-induced thermal hyperalgesia and inferior alveolar nerve injury-induced mechanical allodynia were employed as orofacial pain models. Intracisternal administration of bicuculline, a $GABA_A$ receptor antagonist, produced mechanical allodynia in naive rats, but not thermal hyperalgesia. However, CGP35348, a $GABA_B$ receptor antagonist, did not show any pain behavior in naive rats. Intracisternal administration of muscimol, a $GABA_A$ receptor agonist, attenuated the thermal hyperalgesia and mechanical allodynia in rats with CFA treatment and inferior alveolar nerve injury, respectively. On the contrary, intracisternal administration of bicuculline also attenuated the mechanical allodynia in rats with inferior alveolar nerve injury. Intracisternal administration of baclofen, a $GABA_B$ receptor agonist, attenuated the thermal hyperalgesia and mechanical allodynia in rats with CFA treatment and inferior alveolar nerve injury, respectively. In contrast to $GABA_A$ receptor antagonist, intracisternal administration of CGP35348 did not affect either the thermal hyperalgesia or mechanical allodynia. Our current findings suggest that the $GABA_A$ receptor, but not the $GABA_B$ receptor, participates in pain processing under normal conditions. Intracisternal administration of $GABA_A$ receptor antagonist, but not $GABA_B$ receptor antagonist, produces paradoxical antinociception under pain conditions. These results suggest that central GABA has differential roles in the processing of orofacial pain, and the blockade of $GABA_A$ receptor provides new therapeutic targets for the treatment of chronic pain.

• Biomolecules & Therapeutics
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• v.18 no.2
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• pp.159-165
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• 2010

Alpinia katsumadai has been widely used in traditional Chinese and Korean medicine to treat a variety of conditions including emesis and gastric disorders such as gastric pain and distended abdomen. To investigate the antinociceptive potential and mechanism of A. katsumadai, ethanolic extracts of A. katsumadai were assayed on cyclooxygenase-2 and evaluated for analgesic activity based on phenylbenzoquinone (PBQ)-induced writhing and carrageenan-induced hyperalgesia tests. A. katsumadai extracts inhibited the cyclooxygenase-2 enzyme activity in a dose-dependent fashion at an $IC_{50}$ value of 0.044 ${\mu}g$/ml. A. katsumadai extract (30-300 mg/kg, orally (p.o.) administered) significantly inhibited PBQ-induced writhing. This inhibition was judged not to be a false positive because a Rota-rod test revealed no difference in muscular coordination when compared to the controls. With regard to the carrageenan-induced hyperalgesia, A. katsumadai extract (30-300 mg/kg, p.o.) produced a significant, dose-dependent increase in the withdrawal response latencies. Naloxone did not reverse the analgesic effect of A. katsumadai extract in the carrageenan-induced hyperalgesia. Taken together, these results suggest that the antinociceptive activity of A. katsumadai is not related to the opioid receptor. A. katsumadai extract has remarkable, non-opioidreceptor-mediated analgesic effects on PBQ-induced writhing and carrageenan-induced hyperalgesia that occur via cyclooxygenase-2 inhibition.

• Journal of Korean Neurosurgical Society
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• v.49 no.2
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• pp.83-91
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• 2011

Objective : Minocycline, a second-generation tetracycline-class antibiotic, has been well established to exert a neuroprotective effect in animal models and neurodegenerative disease through the inhibition of microglia. Here, we investigated the effects of minocycline on motor recovery and neuropathic pain in a rat model of spinal cord injury. Methods : To simulate spinal cord injury, the rats' spinal cords were hemisected at the 10th thoracic level (T10). Minocycline was injected intraperitoneally, and was administered 30 minutes prior surgery and every second postoperative day until sacrifice 28 days after surgery. Motor recovery was assessed via the Basso-Beattie-Bresnahan test Mechanical hyperalgesia was measured throughout the 28-day post -operative course via the von Frey test Microglial and astrocyte activation was assessed by immunohistochemical staining for ionized calcium binding adaptor molecule 1 (lba1) and glial fibrillary acidic protein (GFAP) at two sites: at the level of hemisection and at the 5th lumbar level (L5). Results : In rats, spinal cord hemisection reduced locomotor function and induced a mechanical hyperalgesia of the ipsilateral hind limb. The expression of lba1 and GFAP was also increased in the dorsal and ventral horns of the spinal cord at the site of hemisection and at the L5 level. Intraperitoneal injection of minocycline facilitated overall motor recovery and attenuated mechanical hyperalgesia. The expression of lba1 and GFAP in the spinal cord was also reduced in rats treated with minocycline. Conclusion : By inhibiting microglia and astrocyte activation, minocycline may facilitate motor recovery and attenuate mechanical hyperalgesia in individuals with spinal cord injuries.

• The Journal of Korean Physical Therapy
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• v.19 no.1
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• pp.67-78
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• 2007

Purpose: The purpose of this study were to examine the anti-hyperalgesic effects of combination of electroacupuncture and microcurrent on anti-hyperalgesia in local hyperalgesia zone. Methods: It used 24 rats for experiment, divided them into control group, electroacupuncture group (EA group), microcurrent group (MC group), combination of electroacupuncture with microcurrent (EA+MC group), caused hyperalgesia by injecting ${\lambda}-carrageenan$ into hindpaw. Thickness of hindpaw, mechanical pain threshold (MPT), thermal pain threshold (TPT), noxious flexion withdrawal reflex (NFR) and somatosensory evoked potential (SEP) were measured immediately after induction, at 24 hours, 48 hours and 72 hours after induction. The electrical stimulation was given once a day for three days, 20min per session. Results: Change of thickness, MPT, and TPT showed significant difference in all groups compared to control group. In particular, there were remarkable difference in EA+ME group. In particular there were remarkable differences in EA group and EA+MC group. Change of NFR(% threshold, % reaction time, % RMS) and SEP showed mainly significant differences in EA group and EA+ME group compared to control group. In particular, there were remarkable difference in EA+ME group. Conclusion: The above results suggest that appropriate combination of microcurrent with electroacupuncture for pain control will be very desirable.

• The Korean Journal of Pain
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• v.24 no.1
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• pp.7-12
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• 2011

Background: Adenosine has been shown to have a wide spectrum of unique pain-relieving effects in various clinical situations. The aim of this study was to investigate the effects of intraoperative adenosine infusion on acute opioid tolerance and opioid induced hyperalgesia induced by remifentanil in adult patients undergoing tonsillectomy. Methods: For this study, ninety patients were randomly allocated into groups that receive either adenosine (adenosine group) or saline (remifentnail group) intravenously under remifentanil based anesthesia and saline (sevoflurane group) under sevoflurane anesthesia. The patients in adenosine group received adenosine at dose of $80\;{\mu}g$/kg/min, and those in remifentnail group and sevoflurane group received an equal volume of saline 10 minutes after the induction of anesthesia until the end of surgery. Intraoperative evaluation included time weighted mean remifentanil dose, and postoperative evaluations included degree of pain severity at 1, 6, 12, and 24 hours, time to first postoperative requirement, and analgesic dose required during 24 hours after operation. Results: Time weighted mean remifentanil dose during intraoperative period in adenosine group was significantly lower than that of remifentnail group (P = 0.00). The first postoperative analgesic were required earlier in remifentanil group than sevoflurane group or adenosine group (P = 0.00). Pethidine requirement during 24 hours in sevoflurane group and adenosine group was significantly lower than that of remifentnail group (P = 0.00). The visual analog scale scores for pain in sevoflurane group and adenosine group were significantly lower than those of remifentnail group for 12 hours after operation (P = 0.00). Incidence of hypotension (P = 0.024) and number of ephedrine administered (P = 0.011) in adenosine group were significantly higher than those of sevoflurane group. Conclusions: The above results suggest that intraoperative adenosine infusion prevent acute opioid tolerance and opioid induced hyperalgesia induced by remifentanil.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.176-184
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• 2021

Background: Diabetes-related neuropathic pain frequently occurs, and the underpinning mechanism remains elusive. The periaqueductal gray (PAG) exhibits descending inhibitory effects on central pain transmission. The current work aimed to examine whether inflammatory cytokines regulate mechanical allodynia and thermal hyperalgesia induced by diabetes through the phosphoinositide 3-kinase (PI3K)-mammalian target of rapamycin (mTOR) pathway in the PAG. Methods: Streptozotocin (STZ) was administered intraperitoneally to mimic allodynia and hyperalgesia evoked by diabetes in rats. Behavioral assays were carried out for determining mechanical pain and thermal hypersensitivity. Immunoblot and ELISA were performed to examine PAG protein amounts of interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α), as well as their corresponding receptors in STZ rats, and the expression of PI3K/protein kinase B (Akt)/mTOR signaling effectors. Results: Increased PAG p-PI3K/p-Akt/p-mTOR protein amounts were observed in STZ-induced animals, a PI3K-mTOR pathway inhibition in the PAG attenuated neuropathic pain responses. Moreover, the PAG concentrations of IL-1β, IL-6, and TNF-α and their receptors (namely, IL-1R, IL-6R, and tumor necrosis factor receptor [TNFR] subtype TNFR1, respectively) were increased in the STZ rats. Additionally, inhibiting IL-1R, IL-6R, and TNFR1 ameliorated mechanical allodynia and thermal hyperalgesia in STZ rats, alongside the downregulation of PI3K-mTOR signaling. Conclusions: Overall, the current study suggests that upregulated proinflammatory cytokines and their receptors in the PAG activate PI3K-mTOR signaling, thereby producing a de-inhibition effect on descending pathways in modulating pain transmission, and eventually contributing to neuropathic pain.

• The Korean Journal of Pain
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• v.35 no.4
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• pp.433-439
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• 2022

Background: Repeated administration of opioid analgesics for pain treatment can produce paradoxical hyperalgesia via peripheral and/or central mechanisms. Thus, this study investigated whether spinally (centrally) administered orexin A attenuates opioid-induced hyperalgesia (OIH). Methods: [D-Ala², N-Me-Phe⁴, Gly⁵-ol]-enkephalin (DAMGO), a selective µ-opioid receptor agonist, was used to induce mechanical hypersensitivity and was administered intradermally (4 times, 1-hour intervals) on the rat hind paw dorsum. To determine whether post- or pretreatments with spinal orexin A, dynorphin A, and anti-dynorphin A were effective in OIH, the drugs were injected through an intrathecal catheter whose tip was positioned dorsally at the L3 segment of the spinal cord (5 ㎍ for all). Mechanical hypersensitivity was assessed using von Frey monofilaments. Results: Repeated intradermal injections of DAMGO resulted in mechanical hypersensitivity in rats, lasting more than 8 days. Although the first intrathecal treatment of orexin A on the 6th day after DAMGO exposure did not show any significant effect on the mechanical threshold, the second (on the 8th day) significantly attenuated the DAMGO-induced mechanical hypersensitivity, which disappeared when the type 1 orexin receptor (OX1R) was blocked. However, intrathecal administration of dynorphin or an anti-dynorphin antibody (dynorphin antagonists) had no effect on DAMGO-induced hypersensitivity. Lastly, pretreatment with orexin A, dynorphin, or anti-dynorphin did not prevent DAMGO-induced mechanical hypersensitivity. Conclusions: Spinal orexin A attenuates mechanical hyperalgesia induced by repetitive intradermal injections of DAMGO through OX1R. These data suggest that OIH can be potentially treated by activating the orexin A-OX1R pathway in the spinal dorsal horn.