背景:临床证据表明,Esketamine(ESK)是抑郁症的有效治疗方法。然而,依维他明治疗神经性疼痛引起的抑郁样行为的效果尚不清楚。潜在的分子机制需要进一步研究,为临床神经病理性疼痛相关抑郁症的治疗提供新的治疗靶点。
方法:建立保留神经损伤(SNI)大鼠神经病理性疼痛相关抑郁模型。雄性SD大鼠随机分为4组:假手术组,SNI集团,SNI+生理盐水(NS)组和SNI+ESK5mg/kg组。测量机械性疼痛阈值以评估SNI大鼠的疼痛敏感性。在手术后第14天,使用强迫游泳测试和蔗糖偏好测试来评估每组大鼠的抑郁样行为。Further,蛋白质组学分析用于定量差异表达的蛋白质。分析了基因本体论(GO)和京都基因和基因组百科全书(KEGG)途径,以探索内侧前额叶皮层SNI的主要蛋白质靶标。蛋白质印迹法检测蛋白质的表达。
结果:建立神经性疼痛相关抑郁模型。与Sham组相比,机械痛阈值显著降低(13.2±1.0vs.0.7±0.01gn=8),而强迫游泳试验的不动性也降低了(93.1±7.4vs.169.5±9.6sn=8),蔗糖偏好率显着提高(98.8±0.3vs.SNI组大鼠73.1±1.4n=7)。与SNI+NS组相比,机械痛阈值无统计学意义,而强迫游泳试验的不动性明显下降(161.1±11.6vs.77.9±5.0sn=8),蔗糖偏好率显着提高(53.1±8.9vs.SNI+ESK5mg/kg组大鼠96.1±1.4n=7)。为了进一步研究潜在的机制,我们使用蛋白质组学来鉴定各组内表达水平差异超过1.2倍(P<0.05)的蛋白质,用于后续分析.相对于Sham组,在SNI组中鉴定出88个下调蛋白和104个上调蛋白,而与SNI+NS组相比,依克他明治疗组的120和84种蛋白质上调和下调。与Sham组相比,SNI组内侧前额叶皮质(mGluR5)和Homer1a的表达上调(mGluR5:0.97±0.05vs1.47±0.15,Homer1a:1.03±0.06vs1.46±0.16n=6),并在使用Esketamine干预后下调(mGluR5:1.54±0.11vs1.06±0.07,Homer1a:1.51±0.13vs1.12±0.34n=6)。
结论:低剂量依氯他明可缓解神经性疼痛引起的抑郁样行为。Homer1a-mGluR5信号通路可能是依维他明抗抑郁作用的机制。
BACKGROUND: Clinical evidence suggests that Esketamine (ESK) is an effective treatment for depression. However, the effects of Esketamine in treating depression-like behavior induced by neuropathic pain is unclear. The underlying molecular mechanisms require further investigation to provide new therapeutic targets for the treatment of clinical neuropathic pain-related depression.
METHODS: A neuropathic pain-related depression model was established in rats with spared nerve injury (SNI). Male Sprague-Dawley rats were randomly divided into four groups: Sham Group, SNI group, SNI + Normal Saline (NS) Group and SNI + ESK5mg/kg Group. Mechanical pain thresholds were measured to assess pain sensitivity in SNI rats. On the 14th day after surgery a forced swim test and sucrose preference test were used to evaluate the depressive-like behavior of rats in each group. Further, a proteomic analysis was used to quantify differentially expressed proteins. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were analyzed to explore the main protein targets of SNI in the medial prefrontal cortex. The expression of proteins was detected by Western blotting.
RESULTS: A neuropathic pain-related depression model was established. Compared with the Sham group, the mechanical pain threshold was decreased significantly (13.2 ± 1.0 vs. 0.7 ± 0.01 g n = 8), while immobility on the forced swim test was also decreased (93.1 ± 7.4 vs. 169.5 ± 9.6 s n = 8), and sucrose preference rate was significantly increased (98.8 ± 0.3 vs. 73.1 ± 1.4n = 7) in SNI group rats. Compared with the SNI + NS group, the mechanical pain threshold was not statistically significant, while immobility on the forced swim test was clearly decreased (161.1 ± 11.6 vs. 77.9 ± 5.0 s n = 8), and sucrose preference rate was significantly increased (53.1 ± 8.9 vs. 96.1 ± 1.4n = 7) in SNI + ESK5mg/kg group rats. To further investigate the underlying mechanism, we employed proteomics to identify proteins exhibiting more than a 1.2-fold difference (P < 0.05) in expression levels within each group for subsequent analysis. Relative to the Sham group, 88 downregulated and 104 up-regulated proteins were identified in the SNI group, while 120 and 84 proteins were up- and down-regulated in the Esketamine treatment group compared with the SNI + NS group. Compared with Sham group, the expressions of
mGluR5 and Homer1a were up-regulated in the medial prefrontal cortex (mPFC) in SNI group (
mGluR5:0.97 ± 0.05 vs 1.47 ± 0.15, Homer1a:1.03 ± 0.06 vs 1.46 ± 0.16n = 6), and down-regulated after intervention with Esketamine (
mGluR5:1.54 ± 0.11 vs 1.06 ± 0.07, Homer1a:1.51 ± 0.13 vs 1.12 ± 0.34n = 6).
CONCLUSIONS: Low-dose Esketamine appeared to relieve depression-like behavior induced by neuropathic pain. The Homer1a-
mGluR5 signaling pathway might be the mechanism of antidepressant effect of Esketamine.