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만성 허혈 후 통증모델에서 발생한 건측의 이질통과 척수의 중추감작
곽경화 ( Kyung Hwa Kwak ),정경영 ( Kyung Young Jung ),최지영 ( Jy Young Choi ),류태하 ( Tae Ha Ryu ),여진석 ( Jin Seok Yeo ),박성식 ( Sung Sik Park ),임동건 ( Dong Gun Lim ),김시오 ( Si Oh Kim ),백운이 ( Woon Yi Baek ),홍정길 ( Ju 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.4
Background: Mirror-image allodynia is a mysterious phenomenon that occurs in association with many clinical pain syndromes including complex regional pain syndromes (CRPS). Underlying mechanisms for the development of such pain are still a matter of investigation. Several studies suggest that activation of the N-methyl-D-aspartate (NMDA) receptor is essential for central sensitization as a base for persistent pain. The aim is to assess whether alteration of NMDA receptor expression correlates with the contralateral allodynia in the chronic post-ischemia pain (CPIP) model rats representing CRPS-Type I. Methods: Application of a tight-fitting tourniquet for a period of 3 hours before reperfusion produced CPIP in male Sprague-Dawley rats. The mechanical paw withdrawal thresholds to von Frey stimuli (using a dynamic plantar aesthesiometer) were measured as pain indicators in ipsilateral and contralateral hindpaws. Phosphorylation of the NMDA receptor 1 subunit (pNR1), assessed with Western blot, was measured in the contralateral L4-6 spinal cord. Results: Ipsilateral and contralateral mechanical allodynia is present at 4 hours after reperfusion, peaked at 3 days, and continued for 7 days after reperfusion. The relative density of pNR1 of CPIP rats significantly decreased in the contralateral L4-6 spinal cord compared to baseline value (P<0.05). There was significant correlation between paw withdrawal threshold and the relative density of pNR1 (ipsilateral; R2=0.75, P<0.01, contralateral; R2=0.60, P<0.01). Conclusions: These data suggest that pNR1 is correlated to the contralateral mechanical allodynia in CPIP rats. (Korean J Anesthesiol 2009;56:419~24)