Fast non-genomic effects of progesterone-derived neurosteroids on nociceptive thresholds and pain symptoms

Pain. 2008 Oct 31;139(3):603-609. doi: 10.1016/j.pain.2008.06.016. Epub 2008 Jul 9.

Abstract

Fast Inhibitory controls mediated by glycine (GlyRs) and GABAA receptors (GABAARs) play an important role to prevent the apparition of pathological pain symptoms of allodynia and hyperalgesia. The use of positive allosteric modulators of these receptors, specifically expressed in the spinal cord, may represent an interesting strategy to limit or block pain expression. In this study, we have used stereoisomers of progesterone metabolites, acting only via non-genomic effects, in order to evaluate the contribution of GlyRs and GABAARs for the reduction of mechanical and thermal heat hypernociception. We show that 3alpha neurosteroids were particularly efficient to elevate nociceptive thresholds in naive animal. It also reduced mechanical allodynia and thermal heat hyperalgesia in the carrageenan model of inflammatory pain. This effect is likely to be mediated by GABAA receptors since 3beta isomer was inefficient. More interestingly, 3alpha5beta neurosteroid was only efficient on mechanical allodynia while having no effect on thermal heat hyperalgesia. We characterized these paradoxical effects of 3alpha5beta neurosteroid using the strychnine and bicuculline models of allodynia. We clearly show that 3alpha5beta neurosteroid exerts an antinociceptive effect via a positive allosteric modulation of GABAARs but, at the same time, is pronociceptive by reducing GlyR function. This illustrates the importance of the inhibitory amino acid receptor channels and their allosteric modulators in spinal pain processing. Moreover, our results indicate that neurosteroids, which are synthesized in the dorsal horn of the spinal cord and have limited side effects, may be of significant interest in order to treat pathological pain symptoms.

Publication types

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

MeSH terms

  • Allosteric Regulation
  • Analgesics, Non-Narcotic / pharmacology
  • Analgesics, Non-Narcotic / therapeutic use*
  • Animals
  • Bicuculline / toxicity
  • Carrageenan / toxicity
  • Drug Evaluation, Preclinical
  • Hot Temperature / adverse effects
  • Hyperalgesia / drug therapy*
  • Hyperalgesia / physiopathology
  • Inflammation / chemically induced
  • Inflammation / drug therapy
  • Inflammation / physiopathology
  • Male
  • Molecular Conformation
  • Pain Threshold / drug effects*
  • Pain Threshold / physiology
  • Pregnanolone / chemistry
  • Pregnanolone / pharmacology
  • Pregnanolone / therapeutic use*
  • Rats
  • Rats, Sprague-Dawley
  • Receptors, GABA-A / drug effects*
  • Receptors, Glycine / drug effects*
  • Spinal Cord / drug effects
  • Stereoisomerism
  • Structure-Activity Relationship
  • Strychnine / toxicity
  • Touch

Substances

  • Analgesics, Non-Narcotic
  • Receptors, GABA-A
  • Receptors, Glycine
  • Carrageenan
  • Pregnanolone
  • Strychnine
  • Bicuculline