Molecular mechanisms underlying the enhanced analgesic effect of oxycodone compared to morphine in chemotherapy-induced neuropathic pain

PLoS One. 2014 Mar 11;9(3):e91297. doi: 10.1371/journal.pone.0091297. eCollection 2014.

Abstract

Oxycodone is a μ-opioid receptor agonist, used for the treatment of a large variety of painful disorders. Several studies have reported that oxycodone is a more potent pain reliever than morphine, and that it improves the quality of life of patients. However, the neurobiological mechanisms underlying the therapeutic action of these two opioids are only partially understood. The aim of this study was to define the molecular changes underlying the long-lasting analgesic effects of oxycodone and morphine in an animal model of peripheral neuropathy induced by a chemotherapic agent, vincristine. Using a behavioural approach, we show that oxycodone maintains an optimal analgesic effect after chronic treatment, whereas the effect of morphine dies down. In addition, using DNA microarray technology on dorsal root ganglia, we provide evidence that the long-term analgesic effect of oxycodone is due to an up-regulation in GABAB receptor expression in sensory neurons. These receptors are transported to their central terminals within the dorsal horn, and subsequently reinforce a presynaptic inhibition, since only the long-lasting (and not acute) anti-hyperalgesic effect of oxycodone was abolished by intrathecal administration of a GABAB receptor antagonist; in contrast, the morphine effect was unaffected. Our study demonstrates that the GABAB receptor is functionally required for the alleviating effect of oxycodone in neuropathic pain condition, thus providing new insight into the molecular mechanisms underlying the sustained analgesic action of oxycodone.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / pharmacology*
  • Animals
  • Antineoplastic Agents / adverse effects
  • Behavior, Animal / drug effects
  • Disease Models, Animal
  • Ganglia, Spinal / drug effects
  • Ganglia, Spinal / metabolism
  • Gene Expression Profiling
  • Gene Expression Regulation / drug effects
  • Male
  • Morphine / administration & dosage
  • Morphine / pharmacology*
  • Neuralgia / chemically induced
  • Neuralgia / drug therapy*
  • Neuralgia / etiology*
  • Oxycodone / administration & dosage
  • Oxycodone / pharmacology*
  • Protein Transport
  • Receptors, GABA-B / genetics
  • Receptors, GABA-B / metabolism
  • Spinal Cord / drug effects
  • Spinal Cord / metabolism

Substances

  • Analgesics, Opioid
  • Antineoplastic Agents
  • Receptors, GABA-B
  • Morphine
  • Oxycodone

Grants and funding

This work was supported by the “Institut UPSA de la douleur” and the “Centre National de la Recherche Scientifique”, CNRS. KT received a two year doctoral fellowship from Mundipharma laboratory (ML). KT received one year of post-doctoral fellowship from “Fondation pour la Recherche Medicale”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.