Exaggerated nociceptive responses on morphine withdrawal: roles of protein kinase C epsilon and gamma

Pain. 2004 Jul;110(1-2):281-9. doi: 10.1016/j.pain.2004.04.004.

Abstract

On withdrawal from opioids many patients experience a heightened sensitivity to stimuli and an exaggerated pain response. The phenomenon has been little studied in infants. We present evidence that in postnatal day 7 rats an exaggerated nociceptive ventral root response of spinal cords in vitro and withdrawal-associated thermal hyperalgesia in vivo are dependent on protein kinase C (PKC), and we document the roles of PKC and gamma isozymes. In vitro, the slow ventral root potential (sVRP) is a nociceptive-related response in spinal cord that is depressed by morphine and recovers to levels significantly above control on administration of naloxone. A broad-spectrum PKC antagonist, GF109213X, blocked withdrawal hyperresponsiveness of the sVRP whereas an antagonist specific to Ca(++)-dependent isozymes, Go69076, did not. Consistent with this finding, a specific peptide inhibitor of calcium-independent PKC, but not an inhibitor of calcium-dependent PKC gamma, blocked withdrawal hyperresponsiveness of the sVRP. Similarly, in vivo in 7-day-old rat pups, inhibition of PKC, but not PKC gamma, prevented thermal hyperalgesia precipitated by naloxone at 30 min post-morphine. In contrast, thermal hyperalgesia during spontaneous withdrawal was inhibited by both PKC and gamma inhibitors. The consistency between the in vivo and in vitro findings with respect to naloxone-precipitated withdrawal provides further evidence that the sVRP reflects nociceptive neurotransmission. In addition the difference between naloxone-precipitated and spontaneous withdrawal in vivo suggests that in postnatal day 7 rats, morphine exposure produces an early phase of primary afferent sensitization dependent upon PKC translocation, followed by a later phase involving spinal sensitization mediated by PKC gamma.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Analysis of Variance
  • Animals
  • Animals, Newborn
  • Behavior, Animal
  • Drug Interactions
  • Enzyme Inhibitors / pharmacology
  • Female
  • Hyperalgesia / drug therapy
  • Hyperalgesia / physiopathology
  • In Vitro Techniques
  • Indoles / pharmacology
  • Male
  • Maleimides / pharmacology
  • Membrane Potentials / drug effects
  • Morphine / pharmacology*
  • Naloxone / pharmacology
  • Narcotic Antagonists / pharmacology
  • Narcotics / pharmacology
  • Neurons / drug effects
  • Neurons / physiology
  • Pain / etiology*
  • Peptides / pharmacology
  • Protein Kinase C / physiology*
  • Protein Kinase C-epsilon
  • Rats
  • Rats, Sprague-Dawley
  • Reaction Time / physiology
  • Spinal Nerve Roots / cytology
  • Spinal Nerve Roots / drug effects
  • Spinal Nerve Roots / physiopathology
  • Substance Withdrawal Syndrome / enzymology
  • Substance Withdrawal Syndrome / physiopathology*

Substances

  • Enzyme Inhibitors
  • Indoles
  • Maleimides
  • Narcotic Antagonists
  • Narcotics
  • Peptides
  • Naloxone
  • Morphine
  • Prkce protein, rat
  • protein kinase C gamma
  • Protein Kinase C
  • Protein Kinase C-epsilon
  • bisindolylmaleimide I