title: Peripheral antinociceptive effects of low doses of naloxone in an in vivo and in vitro model of trigeminal nociception.
abstract: Naloxone has been used to antagonize opioid effects for many years, even though at low doses it can exert antinociceptive effects. This 'paradoxical' analgesia has been detected after systemic administration of naloxone given alone or in combination with opioid drugs. In the present study, we investigated possible peripheral antinociceptive effects of low doses of naloxone using both an in vivo and in vitro model of trigeminal nociception. Low doses of naloxone injected locally into the rat wiskerpad elicited antinociceptive activity in the rat orofacial formalin test. The block of primary afferents with local administration of capsaicin suggested that naloxone acts both directly on sensory neurons and indirectly, by modulating the inflammatory component of the second phase of formalin test. Naloxone analgesia is maintained in rats made tolerant to the mu-receptor agonist DAMGO, suggesting the involvement of delta- and kappa-opioid receptors. Subsequently, the effects of very low doses of naloxone were tested in primary cultures of rat trigeminal neurons activated with bradykinin, in order to elucidate the mechanisms of action underlying naloxone antinociceptive effects. Naloxone inhibited bradykinin-evoked CGRP release in two different experimental paradigms, i.e. primed and unprimed cultures, acting at the level of delta- and kappa-opioids receptors. These results suggest that low doses of naloxone can directly modulate the activation of the trigeminal neurons by modulating the activity of specific opioid receptors, and this effect may be clinically relevant in combined therapies where an increased analgesic effect is sought through the potentiation of peripheral mechanisms.
authors.affiliation: Institute of Pharmacology, Catholic University School of Medicine, Largo F. Vito 1, 00168 Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capuano
authors.forename: Alice
authors.initials: A
authors.lastname: De Corato
authors.forename: Mariangela
authors.initials: M
authors.lastname: Treglia
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tringali
authors.forename: Diego
authors.initials: D
authors.lastname: Currò
authors.forename: Cinzia
authors.initials: C
authors.lastname: Dello Russo
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Navarra
mesh_terms: D000818:Animals; D002478:Cells, Cultured; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D008297:Male; D009270:Naloxone / Q000008:administration & dosage*; D010146:Pain / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement / Q000187:drug effects* / Q000379:methods; D051381:Rats; D017208:Rats, Wistar; D011957:Receptors, Opioid / Q000378:metabolism; D012668:Trigeminal Ganglion / Q000187:drug effects / Q000502:physiology; D014277:Trigeminal Neuralgia / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D011957:Receptors, Opioid; D009270:Naloxone