Increase in morphine antinociceptive activity by a P-glycoprotein inhibitor in cisplatin-induced neuropathy

Neurosci Lett. 2009 Nov 6;465(1):108-12. doi: 10.1016/j.neulet.2009.09.003. Epub 2009 Sep 4.

Abstract

Pain from anticancer drugs-induced neuropathies is difficult to treat and can significantly alter the patient's quality of life. These neuropathies are considered relatively resistant to conventional analgesic drugs (opioids). Opioids are also P-glycoprotein substrates and it has been demonstrated that the P-glycoprotein is linked to the integrity of blood-brain barrier protecting the nervous system. Previous works presented an increase of P-glycoprotein in vincristine- and cisplatin-induced neuropathy which could potentially decrease opioid efficiency. To test this hypothesis, the efflux inhibition of P-glycoprotein and the antinociceptive effect of morphine were assessed in normal and cisplatin-induced neuropathic rats after the administration of the P-glycoprotein inhibitor (R101933). R101933 (20 mg/kg) inhibited significantly the efflux transporter under the condition of the study and had no analgesic effect. Nociceptive thresholds were measured by the paw pressure test. R101933 (20 mg/kg) enhanced antinociceptive activity of morphine (0.5 mg/kg) to a maximum of +58% and +35%, respectively compared with control animals and animals treated by morphine alone (0.5 mg/kg). R101933 increased morphine (2 mg/kg) antinociceptive activity to a maximum of +105% compared with control animals and to a maximum of +41% compared with morphine alone (2 mg/kg). This study demonstrated that cisplatin-induced neuropathy may present a particular pathophysiology with a multidrug resistance, of the central nervous system, to analgesics. This resistance can be blocked by a P-glycoprotein inhibitor which may enhance analgesia of low doses of morphine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / antagonists & inhibitors*
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / pharmacology*
  • Animals
  • Benzazepines / administration & dosage
  • Benzazepines / pharmacology*
  • Brain / drug effects
  • Brain / metabolism
  • Cisplatin
  • Drug Synergism
  • Ganglia, Spinal / drug effects
  • Ganglia, Spinal / metabolism
  • Male
  • Morphine / administration & dosage
  • Morphine / pharmacology*
  • Pain / chemically induced
  • Pain / drug therapy*
  • Pain Measurement
  • Pressure
  • Quinolines / administration & dosage
  • Quinolines / pharmacology*
  • Rats
  • Rats, Sprague-Dawley
  • Sciatic Nerve / drug effects
  • Sciatic Nerve / metabolism
  • Spinal Cord / drug effects
  • Spinal Cord / metabolism
  • Technetium Tc 99m Sestamibi

Substances

  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • Analgesics, Opioid
  • Benzazepines
  • Quinolines
  • Morphine
  • Technetium Tc 99m Sestamibi
  • laniquidar
  • Cisplatin