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Volume 17, Number 2,
Issue of January 15, 1997
pp. 735-744
Copyright ©1997 Society for Neuroscience
Multiple Receptors Involved in Peripheral 2, µ,
and A1 Antinociception, Tolerance, and Withdrawal
K. O. Aley and
Jon D. Levine
Departments of Anatomy, Medicine, and Oral and Maxillofacial
Surgery, Division of Neuroscience and Biomedical Sciences Program,
University of California at San Francisco, San Francisco, California
94143-0452
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
FOOTNOTES
REFERENCES
ABSTRACT
We examined the interactions among three classes of
peripherally-acting antinociceptive agents (µ-opioid,
2-adrenergic, and A1-adenosine) in the
development of tolerance and dependence to their antinociceptive
effects. Antinociception was determined by assessing the degree of
inhibition of prostaglandin E2 (PGE2)-induced mechanical hyperalgesia, using the Randall-Selitto paw-withdrawal test.
Tolerance developed within 4 hr to the antinociceptive effect of the
2-adrenergic agonist clonidine; dependence also occurred at that time, demonstrated as a withdrawal hyperalgesia that was precipitated by the 2-receptor antagonist yohimbine.
These findings are similar to those reported previously for tolerance
and dependence to µ and A1 peripheral antinociception
(Aley et al., 1995 ).
Furthermore, cross-tolerance and cross-withdrawal between µ,
A1, and 2 agonists occurred. The
observations of cross-tolerance and cross-withdrawal suggest that all
three receptors are located on the same primary afferent nociceptors.
In addition, the observations suggest that the mechanisms of tolerance
and dependence to the antinociceptive effects of µ, A1,
and 2 are mediated by a common mechanism.
Although any of the agonists administered alone produce
antinociception, we found that µ, A1, and
2 receptors may not act independently to produce
antinociception, but rather may require the physical presence of the
other receptors to produce antinociception by any one agonist. This was
suggested by the finding that clonidine ( 2-agonist)
antinociception was blocked not only by yohimbine ( 2-antagonist) but also by PACPX
(A1-antagonist) and by naloxone (µ-antagonist), and that
DAMGO (µ-agonist) antinociception and CPA (A1-agonist)
antinociception were blocked not only by naloxone (µ-antagonist) and
PACPX (A1-antagonist), respectively, but also by yohimbine
( 2-antagonist). This cross-antagonism of antinociception occurred at the ID80 dose for each antagonist at its
homologous receptor. To test the hypothesis that the physical presence
of µ-opioid receptor is required not only for µ antinociception but also for 2 antinociception, antisense
oligodeoxynucleotides (ODNs) for the µ-opioid and
2C-adrenergic receptors were administered intrathecally
to reduce the expression of these receptors on primary afferent
neurons. These studies demonstrated that µ-opioid ODN administration
decreased not only µ-opioid but also 2-adrenergic antinociception; A1 antinociception was unaffected. In
contrast, 2C-adrenergic ODN decreased antinociception
induced by all three classes of antinociceptive agents.
In conclusion, these data suggest that peripheral antinociception
induced by µ, 2, and A1 agonists requires
the physical presence of multiple receptors. We propose that there is a
µ, A1, 2 receptor complex mediating
antinociception in the periphery. In addition, there is cross-tolerance
and cross-dependence between µ, A1, and 2
antinociception, suggesting that their underlying mechanisms are
related.
Key words:
pain;
analgesia;
dorsal root ganglion;
opioid;
antisense
oligodeoxynucleotide;
receptor cross-talk
INTRODUCTION
Both µ-opioid and A1-adenosine
agonists have been shown to produce a potent antinociception when
administered in the periphery (Taiwo and Levine, 1990 ; Aley et al.,
1995 ). This antinociception is detected in the presence of hyperalgesia
produced by numerous inflammatory mediators including PGE2
(Taiwo and Levine, 1990 ). Many of the effects produced by µ and
A1 agonists are mediated through a common second messenger,
specifically, activation of an inhibitory guanine nucleotide binding
(Gi) protein (Sharma et al., 1975 ; Law et al., 1981 ;
Childers and LaRiviere, 1984 ; Mankman et al., 1988 ).
We have found that tolerance and dependence develop to both µ and
A1 peripheral antinociception. In addition, a symmetric cross-tolerance and cross-dependence exists between the µ and A1 antinociceptive mechanisms (Aley et al., 1995 ).
2-adrenergic agonists have also been shown to produce
antinociception when administered peripherally (Khasar et al., 1995 ). Because many of the effects of 2 agonists, like those
produced by µ and A1 agonists, involve Gi
protein signaling (Sharma et al., 1975 ; Law et al., 1981 ; Childers and
LaRiviere, 1984 ; Mankman et al., 1988 ), we hypothesized that they all
produce antinociception in the periphery through common cellular
mechanisms. In addition, we hypothesized that there would be symmetric
cross-tolerance and cross-dependence between the peripheral
antinociceptive actions of these three agonists. Because
2-adrenergic, µ-opioid, and A1-adenosine
agonists are widely used clinically, interactions between their
peripheral antinociceptive effects is of significant interest.
MATERIALS AND METHODS
Animals
Experiments were performed on male Sprague Dawley rats (250-300
gm, Bantin and Kingman, Fremont, CA). Animals were housed in groups of
two under a 12 hr light/dark cycle (light on 6.0 hr). Food and water
were available ad libitum. All testing was done between 10.0 and 16.0 hr. Experiments were carried out under approval of the
Institutional Animal Care Committee of the University of California,
San Francisco.
Behavioral testing
The nociceptive flexion reflex was quantified with a Basile
Analgesymeter (Stoelting, Chicago, IL), which applies a linearly increasing mechanical force to the dorsum of the hindpaw of the rat.
Before the experiments, rats were exposed to the procedure for 3 d
(1 hr daily at 5 min intervals, i.e., 12 exposures), a procedure that
produces a stable baseline threshold measurement and enhances the
ability to detect the action of hyperalgesic agents (Taiwo et al.,
1989 ; Aley et al., 1995 ). On the day of the experiment, rats were
exposed to the same procedure, and the mean of the last 6 of the 12 readings was considered to be the baseline mechanical nociceptive
threshold. The mean baseline threshold in these experiments was
110.9 ± 0.4 gm (n = 466; mean ± SEM). Mechanical threshold was again determined at different time points (15, 20, and 25 min) after various treatments. The mean of these three
readings was defined as the paw-withdrawal threshold post-treatment for
that paw, and this value was used to calculate the percentage change
from the baseline threshold [% change in threshold = (pretreatment threshold - post-treatment threshold)/(pretreatment
threshold)] × 100.
Drug administration
The drugs used in this study were PGE2 [100 ng;
direct-acting hyperalgesic inflammatory mediator (Pitchford and Levine,
1991 , Gold et al., 1994 )], DAMGO (µ-opioid receptor agonist),
clonidine ( 2-adrenergic receptor agonist), CPA
(A1-adenosine receptor agonist), naloxone methyl iodide
(opioid receptor antagonist), yohimbine HCl
( 2-adrenergic receptor antagonist), and PACPX
(A1-adenosine receptor antagonist), all from Research
Biochemicals International (Natick, MA). The selection of the drug
doses used in this study was based on the dose-response curves
determined during this study or from previous work done in this
laboratory (Aley et al., 1995 ). The stock solution of PGE2
(1 µg/2.5 µl) was prepared in 10% ethanol and further dilutions
were made in saline; the final concentration of ethanol was 1%.
DAMGO, clonidine, CPA, naloxone, yohimbine, and PACPX were dissolved in
saline. When drug combinations were used, they were administered from
the same syringe so that the drug mentioned first reached the
intradermal site first; the two drugs were separated in the syringe by
a small air bubble to avoid the problem of diffusion. When an
antagonist was included to antagonize the effect of an agonist, it was
always injected first. The ID80 dose of each antagonist
(i.e., naloxone 200 ng, yohimbine 100 ng, and PACPX 100 ng), calculated
from its dose-response curve for reversal of the effect of its
homologous agonist, was used throughout the study. All the drugs except
the oligodeoxynucleotides were administered intradermally in a volume
of 2.5 µl/paw.
Intrathecal cannulation
To administer drugs intrathecally, a catheter (PE-10
polyethylene tubing) was inserted caudally 8.5 cm into the subdural
space through a midline incision made in the atlanto-occipital membrane of rats anesthetized with pentobarbital (50 mg/kg, i.p.); the external
end of the catheter was secured to the skull with screws and dental
acrylic (Yaksh and Rudy, 1976 ). The skin incision was sutured closed,
and the animals were allowed to recover. Two days after surgery, rats
that showed no motor deficits were used for experimental studies
involving intrathecal administration of ODNs.
Antisense oligodeoxynucleotides
µ-Opioid receptor oligodeoxynucleotides. The
µ-opioid receptor antisense and sense ODNs used in this study were
synthesized using a Nucleic Acid Synthesizer model 391 (PCR Mate;
Applied Biosystems, Foster City, CA). The µ-opioid receptor antisense ODN, 5 -CGCCCCAGCCTCTTCCTCT-3 , is directed against the
5 -untranslated region of µ-opioid receptor-1 (MOR-1) clone, located
between bases 87 and 69 upstream from the initiating ATG. The sense
ODN, 5 -AGAGGAAGAGGCTGGGGCG-3 (Rossi et al., 1994 ), is
complementary to the antisense sequence. Concentrations of ODN stocks
were determined by spectrophotometry. Before their use, ODNs were
lyophilized and resuspended in 0.9% NaCl to a concentration of 1 µg/10 µl.
Rats were divided into three groups: one group was untreated (without
cannulae), a second group was treated with sense ODN (1 µg), and the
third group was treated with antisense ODN (1 µg/rat). Using a
microsyringe (Hamilton, Nevada City, UT), a dose of 1 µg ODN was
administered to each rat intrathecally, in a volume of 10 µl,
followed by 10 µl of saline (the dead space of the intrathecal catheter), on alternate days (days 1, 3, and 5). Behavioral tests were
done 24 hr after the last dose of ODN. We have found that antisense ODN
against MOR-1 attenuates µ-opioid receptor-like immunoreactivity in
the dorsal horn of the spinal cord and peripheral nerve, DAMGO-induced
inhibition of calcium current in cultured dorsal root ganglion neurons
and DAMGO-induced inhibition of PGE2-induced hyperalgesia
(Khasar et al., 1996 ).
2C-opioid receptor oligodeoxynucleotides. We
have demonstrated previously that the 2-adrenergic
receptor mediating peripheral antinociception has the pharmacological
characteristics of the 2C subtype (Khasar et al., 1995 ).
Therefore, we also synthesized the antisense and sense ODNs for the
2C receptor subtype, using Nucleic Acid Synthesizer
model 391 PCR Mate. The 2C receptor antisense
ODN, 5 -ACCTGCGGAGTACTG-3 , was developed by Lingen and Ordway
(1995) . The sense ODN sequence 5 -CAGTACTCCGCAGGT-3 is complementary
to the antisense sequence.
Rats were divided into three groups: one group was untreated (without
cannulae), a second group was treated with sense ODN (1 µg/rat), and
the third group was treated with antisense ODN (1 µg). Treatment and
behavioral testing were as described for µ-opioid receptor ODN
experiments.
Abbreviations for the drugs used in this study and their actions are
shown in Table 1; experimental protocols are shown in Table 2.
Table 2.
Experimental
protocols
| Group |
N |
Treatment |
Dose(s) |
|
| I-A |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
16 |
Clonidine + PGE2 |
100 ng + 100 ng |
| 3 |
6 |
Clonidine hourly × 3 |
100 ng × 3 |
| 4 |
12 |
Clonidine hourly × 3, fourth hour clonidine + PGE2 |
100 ng × 3, 100 ng + 100 ng |
| I-B |
| 1 |
12 |
DAMGO hourly × 3, fourth
hour clonidine + PGE2 |
1 µg × 3, 100 ng + 100 ng |
| 2 |
12 |
CPA hourly × 3, fourth hour clonidine + PGE2 |
1 µg × 3, 100 ng + 100 ng |
| 3 |
16 |
Clonidine + PGE2 |
100 ng + 100 ng |
| 4 |
12 |
Clonidine hourly × 3, fourth
hour DAMGO + PGE2 |
100 ng × 3, 1 µg + 100 ng |
| 5 |
6 |
DAMGO + PGE2 |
1 µg + 100 ng |
| 6 |
6 |
DAMGO hourly × 3 |
1 µg × 3 |
| 7 |
6 |
CPA hourly × 3 |
1 µg × 3 |
| 8 |
12 |
Clonidine hourly × 3, fourth hour CPA + PGE2 |
100 ng × 3, 1 µg + 100 ng |
| 9 |
6 |
CPA + PGE2 |
1 µg + 100 ng |
| II-A |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
16 |
Clonidine + PGE2 |
100 ng + 100 ng |
| 3 |
6 |
Clonidine × 3 |
100 ng × 3 |
| 4 |
8 |
Clonidine hourly × 3, fourth hour
yohimbine |
100 ng × 3, 100 ng |
| II-B |
| 1 |
10 |
Clonidine hourly × 3, fourth hour naloxone |
100 ng × 3, 200 ng |
| 2 |
10 |
Clonidine hourly × 3, fourth hour
PACPX |
100 ng × 3, 100 ng |
| 3 |
6 |
Clonidine × 3 |
100 ng × 3 |
| 4 |
10 |
DAMGO hourly × 3, fourth
hour yohimbine |
1 µg × 3, 100 ng |
| 5 |
6 |
DAMGO × 3 |
1 µg × 3 |
| 6 |
10 |
CPA hourly × 3, fourth hour
yohimbine |
1 µg × 3, 100 ng |
| 7 |
6 |
CPA hourly × 3 |
1 µg × 3 |
| III-A |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
6 |
DAMGO + PGE2 |
1 µg + 100 ng |
| 3 |
6 |
Naloxone + DAMGO + PGE2 |
1 ng + 1 µg + 100 ng |
| 4 |
6 |
Naloxone + DAMGO + PGE2 |
10 ng + 1 µg + 100 ng |
| 5 |
6 |
Naloxone + DAMGO + PGE2 |
100
ng + 1 µg + 100 ng |
| 6 |
6 |
Naloxone + DAMGO + PGE2 |
1 µg + 1 µg + 100 ng |
| III-B |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
16 |
Clonidine + PGE2 |
100 ng + 100 ng |
| 3 |
6 |
Yohimbine + clonidine + PGE2 |
1 ng + 100 ng + 100 ng |
| 4 |
6 |
Yohimbine + clonidine + PGE2 |
10 ng + 100 ng + 100 ng |
| 5 |
6 |
Yohimbine + clonidine + PGE2 |
100 ng + 100 ng + 100 ng |
| 6 |
6 |
Yohimbine + clonidine + PGE2 |
1 µg + 100 ng + 100 ng |
| III-C |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
6 |
CPA + PGE2 |
1 µg + 100 ng |
| 3 |
6 |
PACPX + CPA + PGE2 |
1 ng + 1 µg + 100 ng |
| 4 |
6 |
PACPX + CPA + PGE2 |
10 ng + 1 µg + 100 ng |
| 5 |
6 |
PACPX + CPA + PGE2 |
100 ng + 1 µg + 100 ng |
| 6 |
6 |
PACPX + CPA + PGE2 |
1 µg + 1 µg + 100 ng |
| IV-A |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
16 |
Clonidine + PGE2 |
100 ng + 100 ng |
| 3 |
6 |
Yohimbine + clonidine + PGE2 |
100 ng + 100 ng + 100 ng |
| 4 |
10 |
Naloxone + clonidine + PGE2 |
200 ng + 100 ng + 100 ng |
| 5 |
10 |
PACPX + clonidine + PGE2 |
100
ng + 100 ng + 100 ng |
| IV-B |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
6 |
DAMGO + PGE2 |
1 µg + 100 ng |
| 3 |
6 |
Naloxone + DAMGO + PGE2 |
200 ng + 1 µg + 100 ng |
| 4 |
8 |
Yohimbine + DAMGO + PGE2 |
100
ng + 1 µg + 100 ng |
| 5 |
6 |
PACPX + DAMGO + PGE2 |
100 ng + 1 µg + 100 ng |
| IV-C |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
6 |
CPA + PGE2 |
1 µg + 100 ng |
| Group |
N |
Treatment |
Dose(s) |
| IV-C |
| 3 |
6 |
PACPX + CPA + PGE2 |
100 ng + 1 µg + 100 ng |
| 4 |
8 |
Naloxone + CPA + PGE2 |
200 ng + 1 µg + 100 ng |
| 5 |
6 |
Yohimbine + CPA + PGE2 |
100 ng + 1 µg + 100 ng |
| V-A |
| 1 |
8 |
Clonidine hourly × 3, fourth hour yohimbine |
100 ng × 3, 100 ng |
| 2 |
6 |
Clonidine hourly × 3, fourth hour
clonidine + yohimbine |
100 ng × 3, 100 ng + 100 ng |
| 3 |
8 |
Clonidine hourly × 3, fourth hour
DAMGO + yohimbine |
100 ng × 3, 1 µg + 100 ng |
| 4 |
8 |
Clonidine hourly × 3, fourth hour CPA + yohimbine |
100 ng × 3, 1 µg + 100 ng |
| V-B |
| 1 |
6 |
DAMGO hourly × 3, fourth
hour naloxone |
1 µg × 3, 200 ng |
| 2 |
6 |
DAMGO hourly × 3, fourth hour DAMGO + naloxone |
1 µg + 1 µg + 200 ng |
| 3 |
8 |
DAMGO
hourly × 3, fourth hour clonidine + naloxone |
1 µg + 100 ng + 200 ng |
| 4 |
8 |
DAMGO hourly × 3, fourth hour CPA + naloxone |
1 µg + 1 µg + 200 ng |
| V-C |
| 1 |
8 |
CPA hourly × 3, fourth hour
PACPX |
1 µg × 3, 100 ng |
| 2 |
6 |
CPA hourly × 3, fourth hour CPA + PACPX |
1 µg + 1 µg + 100 ng |
| 3 |
8 |
CPA hourly × 3, fourth hour clonidine + PACPX |
1 µg + 100 ng + 100 ng |
| 4 |
8 |
CPA hourly × 3, fourth hour DAMGO + PACPX |
1 µg + 1 µg + 100 ng |
| VI-A |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
6 |
DAMGO + PGE2 |
1 µg + 100 ng |
| 3 |
6 |
µ-antisense intrathecally alternate days × 3, 24 hr after DAMGO + PGE2 |
1 µg × 3, 1 µg + 100 ng |
| 4 |
6 |
µ-sense intrathecally alternate days × 3, 24 hr after DAMGO + PGE2 |
1 µg × 3, 1 µg + 100 ng |
| VI-B |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
16 |
Clonidine + PGE2 |
100 ng + 100 ng |
| 3 |
6 |
µ-antisense intrathecally alternate
days × 3, 24 hr after clonidine + PGE2 |
1 µg × 3, 100 ng + 100 ng |
| 4 |
6 |
µ-sense intrathecally alternate
days × 3, 24 hr after clonidine + PGE2 |
1 µg × 3, 100 ng + 100 ng |
| VI-C |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
6 |
CPA + PGE2 |
1 µg + 100 ng |
| 3 |
6 |
µ-antisense intrathecally alternate days × 3, 24 hr after CPA + PGE2 |
1 µg × 3, 1 µg + 100 ng |
| 4 |
6 |
µ-sense intrathecally alternate days × 3, 24 hr after CPA + PGE2 |
1 µg × 3, 1 µg + 100 ng |
| VII-A |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
6 |
DAMGO + PGE2 |
1 µg + 100 ng |
| 3 |
6 |
2-antisense intrathecally
alternate days × 3, 24 hr after DAMGO + PGE2 |
1 µg × 3, 1 µg + 100 ng |
| 4 |
6 |
2-sense intrathecally
alternate days × 3, 24 hr after DAMGO + PGE2 |
1 µg × 3, 1 µg + 100 ng |
| VII-B |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
16 |
Clonidine + PGE2 |
100 ng + 100 ng |
| 3 |
6 |
2-antisense intrathecally
alternate days × 3, 24 hr after clonidine + PGE2 |
1 µg × 3, 100 ng + 100 ng |
| 4 |
6 |
2-sense intrathecally
alternate days × 3, 24 hr after clonidine + PGE2 |
1 µg × 3, 100 ng + 100 ng |
| VII-C |
| 1 |
24 |
PGE2 |
100
ng |
| 2 |
6 |
CPA + PGE2 |
1 µg + 100 ng |
| 3 |
6 |
2-antisense
intrathecally days × 3, 24 hr after CPA + PGE2 |
1 µg × 3, 1 µg + 100 ng |
| 4 |
6 |
2-sense
intrathecally alternate days × 3, 24 hr after CPA + PGE2 |
1 µg × 3, 1 µg + 100 ng |
|
Abbreviations: PGE2, Prostaglandin E2 (EP
receptor agonist); DAMGO, [D-Ala2,
N-Me-Phe4, gly5-ol] (µ-opioid receptor
agonist); Cl, clonidine ( 2 agonist); Yo, yohimbine
( 2 antagonist); CPA, N6-cyclopentyl
adenosine (A1-adenosine agonist); PACPX,
1,3-dipropyl-8-(2-amino-4-chlorophenyl)-xanthine (A1-adenosine antagonist). There are repetitions for the
sake of comparison.
|
|
Statistical analysis
Data are presented as mean ± SEM of six or more
observations in each of the experimental groups. Statistical
significance was determined by ANOVA, followed by Scheffe's post
hoc test; p < 0.05 was considered statistically
significant. Some data are repeated for comparison (see figure
legends).
RESULTS
Tolerance to clonidine antinociception
In the present study, we found that after repeated administration,
clonidine (100 ng) produces tolerance for its inhibition of
PGE2 (100 ng)-induced hyperalgesia (Fig.
1A), similar to that seen for µ and
A1 agonists (Aley et al., 1995 ).
Fig. 1.
A, Repeated administration of
clonidine produces tolerance to antinociception. Effect of
PGE2 (E2), clonidine plus PGE2
(Cl+E2), clonidine once hourly for 3 hr
(Clx3), clonidine once hourly for 3 hr, and at the
fourth hour clonidine plus PGE2 (Clx3,
Cl+E2) on mechanical paw withdrawal threshold in the rat.
B, Bidirectional cross-tolerance develops among
A1, 2, and µ antinociception. Effect of
clonidine plus PGE2 (Cl+E2), DAMGO once
hourly for 3 hr (Dx3), DAMGO once hourly for 3 hr and at
the fourth hour clonidine plus PGE2
(Dx3,Cl+E2), CPA once hourly for 3 hr and at the fourth hour clonidine plus PGE2 (CPAx3, Cl+E2), CPA
once hourly for 3 hr (CPAx3), clonidine once hourly for
3 hr and at the fourth hour DAMGO plus PGE2 (Clx3,
D+E2), and clonidine once hourly for 3 hr and at the fourth
hour CPA plus PGE2 (Clx3, CPA+E2) on
mechanical paw withdrawal threshold in the rat.
[View Larger Version of this Image (13K GIF file)]
Bidirectional cross-tolerance for µ, A1, and
2 peripheral antinociception
In paws made tolerant to DAMGO or CPA, clonidine failed to produce
a significant antinociceptive effect when injected at the fourth hour
(Fig. 1B). Also, in paws made tolerant to clonidine, DAMGO and CPA were
no longer antinociceptive (Fig. 1B). These observations suggest that there is bidirectional cross-tolerance between 2, µ, and A1 to their peripheral
antinociceptive effects.
Yohimbine precipitated withdrawal hyperalgesia in
clonidine-tolerant paws
In the present study, we found that after induction of tolerance
with three hourly injections of clonidine (100 ng), administration of
its receptor antagonist yohimbine (100 ng) precipitated a withdrawal hyperalgesia, revealing the development of dependence (Fig.
2A).
Fig. 2.
A, Yohimbine precipitates
withdrawal hyperalgesia in clonidine tolerant paws. Effect of
PGE2 (E2), clonidine plus PGE2
(Cl+E2), clonidine once hourly for 3 hr
(Clx3), clonidine once hourly for 3 hr
(Clx3), clonidine once hourly for 3 hr, and at the
fourth hour yohimbine (Clx3, Yo) on mechanical
paw-withdrawal threshold in the rat. B, Bidirectional
cross-withdrawal develops among A1, 2, and µ antinociception. Effect of clonidine once hourly for 3 hr and at
the fourth hour naloxone (Clx3, N), clonidine
once hourly for 3 hr and at the fourth hour PACPX (Clx3,
PACPX), clonidine once hourly for 3 hr
(Clx3), DAMGO once hourly for 3 hr and at the fourth
hour yohimbine (Dx3, Yo), DAMGO once hourly for 3 hr (Dx3), CPA once hourly for 3 hr (CPAx3),
CPA once hourly for 3 hr and at the fourth hour yohimbine
(CPAx3, Yo), and CPA once hourly for 3 hr
(CPAx3) on mechanical paw withdrawal threshold in the
rat.
[View Larger Version of this Image (17K GIF file)]
Bidirectional cross-withdrawal for µ, A1, and
2 tolerance/antinociception
In paws made tolerant to clonidine, administration of the µ- and
A1-antagonists, naloxone and PACPX, respectively,
precipitated withdrawal hyperalgesia. In paws made tolerant to DAMGO
and CPA, yohimbine precipitated withdrawal hyperalgesia (Fig.
2B). These observations suggest that there is
bidirectional cross-withdrawal between µ, A1, and
2 after the development of peripheral tolerance to their
peripheral antinociceptive effects.
Multiple receptors involved in µ, A1, and
2 antinociception
Naloxone, yohimbine, and PACPX dose-dependently blocked the
antinociceptive effects of their homologous agonists DAMGO, clonidine, and CPA, respectively (Fig. 3A-C). However,
in addition, naloxone (200 ng) also blocked clonidine antinociception
but not CPA antinociception (Fig.
4A,C), and PACPX (100 ng) blocked
clonidine antinociception but not DAMGO antinociception (Fig.
4A,B). Yohimbine (100 ng) blocked clonidine, DAMGO,
and CPA antinociception (Fig. 4A-C). These data
suggest that the 2 receptor is involved not only in 2 antinociception but also in µ and A1
antinociception. In addition, the data suggest that the µ and
A1 receptors are involved in 2 antinociception.
Fig. 3.
µ, 2, and A1
antagonists dose-dependently block µ, 2, and
A1 antinociception, respectively. A,
Naloxone dose-dependently blocks DAMGO antinociception. Effect of
PGE2 (E2), DAMGO plus PGE2
(D+E2) and various doses of naloxone (1 ng to 1 µg),
and DAMGO plus PGE2 (N+D+E2), on mechanical
paw withdrawal threshold in the rat. B, Yohimbine
dose-dependently blocks clonidine antinociception. Effect of
PGE2 (E2), clonidine plus PGE2
(Cl+E2), and various doses of yohimbine (1 ng to 1 µg)
and clonidine plus PGE2 (Yo+Cl+E2) on
mechanical paw withdrawal threshold in the rat. C, PACPX
dose-dependently blocks CPA antinociception. Effect of PGE2
(E2), DAMGO plus PGE2 (CPA+E2), and various doses of PACPX (1 ng to 1 µg) and CPA plus PGE2 (PACPX+CPA+E2)
on mechanical paw withdrawal threshold in the rat.
[View Larger Version of this Image (11K GIF file)]
Fig. 4.
Multiple receptors are involved in µ,
2, and A1 antinociception. A,
Clonidine 2 antinociception is blocked not only by
yohimbine but also by naloxone and PACPX. Effect of PGE2
(E2), clonidine plus PGE2
(Cl+E2), yohimbine plus clonidine plus PGE2
(Yo+Cl+E2), naloxone plus clonidine plus
PGE2 (N+Cl+E2), and PACPX plus clonidine plus PGE2 (PACPX+Cl+E2) on mechanical paw
withdrawal threshold in the rat. B, DAMGO µ antinociception is blocked not only by naloxone but also by yohimbine.
Effect of PGE2 (E2), DAMGO plus PGE2 (D+E2), naloxone plus DAMGO plus
PGE2 (N+D+E2), yohimbine plus DAMGO plus
PGE2 (Yo+D+E2), and PACPX plus DAMGO plus
PGE2 (PACPX+D+E2) on mechanical paw
withdrawal threshold in the rat. C, CPA A1
antinociception is blocked not only by PACPX but also by yohimbine.
Effect of PGE2 (E2), CPA plus
PGE2 (CPA+E2), PACPX plus CPA plus
PGE2 (PACPX+CPA+E2), naloxone plus CPA plus
PGE2 (N+CPA+E2), and yohimbine plus CPA plus
PGE2 (Yo+CPA+E2) on mechanical paw
withdrawal threshold in the rat.
[View Larger Version of this Image (15K GIF file)]
Multiple receptors involved in µ, A1, and
2 tolerance and withdrawal
A similar profile of receptor interactions was seen for tolerance
and withdrawal to µ, A1, and 2
antinociception. This was demonstrated by examining which receptor
agonists (µ, A1, and 2) could block
antagonist-induced withdrawal hyperalgesia. Yohimbine-induced withdrawal, in clonidine-tolerant paws, was blocked by coadministration of clonidine with yohimbine, as well as by coadministration of DAMGO
and CPA with yohimbine (Fig. 5A).
Naloxone-induced withdrawal, in DAMGO-tolerant paws, was blocked by
coinjection of DAMGO with naloxone or clonidine with naloxone, but was
not blocked by coadministration of CPA with naloxone (Fig.
5B). Similarly, PACPX-induced withdrawal in CPA-tolerant
paws was blocked by coinjection of CPA with PACPX or clonidine with
PACPX, but was not blocked by coadministration of DAMGO with PACPX
(Fig. 5C). These data suggest, as in previous experiments,
that µ, 2, and A1 receptors are involved
in 2 antinociception, tolerance, and withdrawal; that µ and 2 receptors are involved in µ antinociception,
tolerance, and withdrawal; and that A1 and 2
are involved in A1 antinociception, tolerance, and
withdrawal.
Fig. 5.
Multiple receptors are involved in
2, µ, and A1 tolerance and withdrawal.
A, Yohimbine withdrawal is blocked not only by clonidine
but also by DAMGO and CPA. Effect of clonidine once hourly for 3 hr and
at the fourth hour yohimbine (Clx3,Yo), clonidine once
hourly for 3 hr and at the fourth hour clonidine plus yohimbine (Clx3,Cl+Yo), clonidine once hourly for 3 hr and at the
fourth hour DAMGO plus yohimbine (Clx3,D+Yo), and
clonidine once hourly for 3 hr and at the fourth hour CPA plus
yohimbine (Clx3,CPA+Yo) on mechanical paw withdrawal
threshold in the rat. B, Naloxone withdrawal is blocked
not only by DAMGO but also by clonidine. Effect of DAMGO once hourly
for 3 hr and at the fourth hour naloxone (Dx3,N),
DAMGO once hourly for 3 hr and at the fourth hour DAMGO plus naloxone
(Dx3,D+N), DAMGO once hourly for 3 hr and at the fourth hour clonidine plus naloxone (Dx3,Cl+N),
and DAMGO once hourly for 3 hr and at the fourth hour CPA plus naloxone
(Dx3,CPA+N) on mechanical paw withdrawal
threshold in the rat. C, PACPX withdrawal is blocked not
only by CPA but also by clonidine. Effect of CPA once hourly for 3 hr
and at the fourth hour PACPX (CPAx3,PACPX), CPA
once hourly for 3 hr and at the fourth hour CPA plus PACPX (CPAx3,CPA+PACPX), CPA once hourly for 3 hr and
at the fourth hour clonidine plus PACPX
(CPAx3,Cl+PACPX), and CPA once hourly for 3 hr
and at the fourth hour DAMGO plus naloxone
(CPAx3,D+PACPX) on mechanical paw withdrawal
threshold in the rat.
[View Larger Version of this Image (13K GIF file)]
Antisense ODN treatment supports the hypothesis that multiple
receptors are involved in µ, 2, and A1
antinociception
Antisense µ-opioid receptor ODN significantly attenuated not
only the µ antinociception but also 2 antinociception
24 hr after the last injection of the antisense ODN. In
contrast, A1 antinociception was unaffected by µ ODN
treatment (Fig. 6A-C). Sense
µ-opioid receptor ODN was without effect on PGE2
hyperalgesia, µ antinociception, or 2 antinociception
(Fig. 6A-C).
Fig. 6.
Antisense µ ODN treatment blocks not only µ antinociception but also 2 antinociception.
A1 antinociception is unaffected. A, Effect
of PGE2 (E2), DAMGO plus PGE2
(D+E2), µ-antisense (AS) ODN 1 µg
intrathecally on alternate days × 3 and DAMGO plus
PGE2 [µ-(AS)x3,D+E2], µ-sense
(S) ODN 1 µg intrathecally on alternate days × 3, and DAMGO plus PGE2 [µ-(S)x3,D+E2] on
mechanical paw-withdrawal threshold. B, Effect of
PGE2 (E2), clonidine plus PGE2
(Cl+E2), µ-(AS) ODN 1 µg intrathecally on alternate
days × 3, and clonidine plus PGE2
[µ-(AS)x3,Cl+E2], µ-(S) ODN 1 µg intrathecally
on alternate days × 3, and clonidine plus PGE2
[µ-(S)x3,Cl+E2] on mechanical paw-withdrawal
threshold. C, Effect of PGE2
(E2), CPA plus PGE2 (CPA+E2),
µ-(AS) ODN 1 µg intrathecally on alternate days × 3, CPA plus
PGE2 [µ-(AS)x3,CPA+E2], µ-(S) ODN 1 µg intrathecally on alternate days × 3, and CPA plus
PGE2 [µ-(S)x3,CPA+E2] on mechanical paw
withdrawal threshold in the rat.
[View Larger Version of this Image (14K GIF file)]
Antisense ODN for the 2C-adrenergic receptor
significantly attenuated not only 2 antinociception but
also µ and A1 antinociception (Fig.
7A-C). Sense 2C-adrenergic
receptor ODN was without effect on PGE2 hyperalgesia, µ antinociception, or 2 antinociception.
Fig. 7.
Antisense 2C ODN treatment blocks
not only 2 antinociception but also µ and
A1 antinociception. A, Effect of
PGE2 (E2), clonidine plus PGE2
(Cl+E2), 2-(AS) ODN 1 µg intrathecally
on alternate days × 3, and clonidine plus PGE2
[ 2-(AS)x3,CCl+E2], 2-(S) ODN
1 µg intrathecally on alternate days × 3, and clonidine plus
PGE2 [ 2-(S)x3,Cl+E2] on
mechanical paw withdrawal threshold in the rat. B,
Effect of PGE2 (E2), DAMGO plus
PGE2 (D+E2), 2-(AS) ODN 1 µg intrathecally on alternate days × 3, and DAMGO plus
PGE2 [ 2-(AS)x3,D+E2],
2-(S) ODN 1 µg intrathecally on alternate days × 3, and DAMGO plus PGE2
[ 2-(S)x3,D+E2] on mechanical paw withdrawal threshold in the rat. C, Effect of PGE2
(E2), CPA plus PGE2 (CPA + E2), 2-(AS) ODN 1 µg intrathecally on alternate days × 3, and CPA plus
PGE2 [ 2-(AS)x3,CPA+E2],
2-(S) ODN 1 µg intrathecally on alternate days × 3, and CPA plus PGE2
[ 2-(S)x3,CPA+E2] on mechanical paw
withdrawal threshold in the rat.
[View Larger Version of this Image (14K GIF file)]
The data from these antisense ODN experiments suggest that
2-adrenergic receptors are required for µ and
A1 antinociception. In addition, they suggest that the
µ-opioid receptor is required for 2 antinociception.
Thus, multiple receptors are involved in the production of
antinociception by µ, 2, and A1
agonists.
DISCUSSION
In this study, we tested the hypothesis that peripheral
antinociception produced by µ, 2, and A1
agonists exhibit cross-tolerance after repeated exposure to these
agents. This hypothesis arose from previous data demonstrating that
µ, 2, and A1 receptors can signal via a
common second messenger, namely activation of an inhibitory G-protein
(Sharma et al., 1975 ; Law et al., 1981 ; Childers and Rivere, 1989;
Mankmann et al., 1988). In all experiments evaluating cross-tolerance
and cross-dependence, complete symmetry was found for µ,
2, and A1. These findings support the
hypothesis that there is a common signaling pathway for these three
receptors. Although the mechanisms of tolerance and dependence in
primary afferent nociceptors is unknown, in other systems the protein kinase C second messenger system has been implicated (Mao et al., 1995 ;
Mayer et al., 1995 ). The role of this second messenger system in the
tolerance and dependence to peripheral antinociception is currently
being investigated. These data also suggest that clinically these
pharmacologies may not be cross-substituted in dependent
individuals.
As a control for the cross-withdrawal experiments, we tested whether
there was blockade of antinociception by heterologous antagonists in
naive animals. Unexpectedly, we found that the 2
antagonist blocked not only 2 antinociception but also
A1 and µ antinociception, that both µ and
A1 antagonists blocked 2 antinociception,
and that there was no such heterologous antagonism between µ and
A1 ligands in antinociception. The absence of an interaction between µ and A1 antinociception is unlikely
to be a result of an inadequate dose of antagonist because even at a very high dose (1 µg) no cross-antagonism was observed (unpublished observations).
There are known mechanisms by which antagonists can heterologously
antagonize the actions of an agonist at another receptor class. First,
when a receptor ligand is not highly selective, at sufficiently high
doses it will bind to another receptor to displace a heterologous
ligand (Cicero et al., 1974 ; Spiehler et al., 1978 ; Blank et al.,
1983 ). However, clonidine binding is not displaced from neuronal
membranes by morphine or naloxone (Golombiowska-Nikitkin et al., 1980 ).
Second, there may be physical interactions between the receptors in the
cell membrane. Such interactions have been suggested to explain effects
of agonist combinations that are greater than additive (synergistic) or
less than additive (antagonistic) than the effects seen at the
different receptors. For example, an 2 agonist
attenuates both A1 and µ mediated inhibition of
norepinephrine release from sympathetic nerve endings; this interaction
has been suggested to occur at the level of the receptor (Bucher et
al., 1992 ). Furthermore, Bentley et al. (1983) have hypothesized that
-adrenoceptor and opioid receptors may be linked, either via second
messenger systems or physically in the membrane.
We hypothesize from the data in our experiments that the
2 receptor is arranged topologically between the µ and
A1 receptors to form a receptor complex (Fig.
8). This hypothesis is supported by the observation that
antisense oligodeoxynucleotides against µ-opioid receptor reduced not
only µ antinociception, but also 2 antinociception,
while preserving A1 antinociception, whereas the
2C antisense oligodeoxynucleotide reduced the
antinociceptive effects of all three receptor systems,
2, A1, and µ. The preservation of
A1 antinociception after µ antisense treatment but not
after 2C antisense treatment suggests that the effect of
receptor attenuation in the terminal is of short-range topologically.
The same profile of interactions between 2, µ, and
A1 were found in assessing the ability of a heterologous
agonist to block withdrawal induced by the homologous antagonist in a
tolerant paw.
Fig. 8.
Schematic diagram of hypothesized
topological/physical arrangement of the three receptors for peripheral
antinociception in the cell membrane. µ (DAMGO),
2C (Clonidine), and A1
(CPA) agonism all result in peripheral antinociception
mediated through a common second messenger pathway, leading to complete
symmetrical cross-tolerance and cross-dependence. However, the
asymmetrical interactions are proposed to be a result of the central
position of the 2C receptor leading to bidirectional
interactions between this receptor and the two other receptors but no
interaction between the µ and A1 receptors.
[View Larger Version of this Image (83K GIF file)]
In summary, we have demonstrated that there is a symmetry for the three
agonists for production of tolerance and dependence. There was also an
unexpected interaction, which seems to occur at the level of the
receptor, between 2 and µ receptors and
2 and A1 receptors, but not between µ and
A1 receptors. The results suggest the hypothesis that these
three receptors may be coupled physically in the plasma membrane.
FOOTNOTES
Received Sept. 3, 1996; revised Oct. 22, 1996; accepted Oct. 25, 1996.
Correspondence should be addressed to Dr. Jon D. Levine, Department of
Anatomy, University of California-San Francisco, 521 Parnassus Avenue,
San Francisco, CA 94143-0452.
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