A substance P receptor (NK 1) antagonist can reverse vascular and nociceptive abnormalities in a rat model of complex regional pain syndrome type II

• Published in: Pain (Amsterdam) Vol. 104; no. 1; pp. 75 - 84
• Main Authors: Kingery, Wade S, Davies, M.Frances, Clark, J.David
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.07.2003; Elsevier
• Subjects: Animals; Biological and medical sciences; Causalgia - drug therapy; Causalgia - physiopathology; Complex regional pain syndrome; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Disease Models, Animal; Edema; Indoles - pharmacology; Indoles - therapeutic use; Male; Medical sciences; Nerve injury; Nervous system (semeiology, syndromes); Neurogenic extravasation; Neurokinin-1 Receptor Antagonists; Neurology; Osteopenia; Osteoporosis; Pain Measurement - drug effects; Pain Measurement - methods; Piperidines - pharmacology; Piperidines - therapeutic use; Rats; Rats, Sprague-Dawley; Receptors, Neurokinin-1 - physiology; Sciatic Neuropathy - drug therapy; Sciatic Neuropathy - physiopathology; Substance P; Vascular Diseases - drug therapy; Vascular Diseases - physiopathology; Edema; Osteoporosis; Neurogenic extravasation; Substance P; Complex regional pain syndrome; Nerve injury; Osteopenia; Nervous system diseases; Causalgia; NK1 Tachykinin receptor; Rat; Rodentia; Diseases of the osteoarticular system; Neuropeptide; Section; Hyperalgesia; Vertebrata; Mammalia; Pain; Animal; Extravasation; Peripheral nerve disease; Tachykinin; Sciatic nerve
• ISSN: 0304-3959; 1872-6623
• DOI: 10.1016/S0304-3959(02)00467-0

Sciatic nerve section in rats evokes chronic hindlimb edema, pain behavior, and hyperalgesia, a syndrome resembling complex regional pain syndrome (CRPS II) in man. Furthermore, there is an increase in spontaneous protein extravasation in the hindpaw skin of rats after sciatic transection, similar to the increased protein extravasation observed in the edematous limbs of CRPS patients. Now we demonstrate that sciatic nerve section also generates chronic hindlimb warmth, distal articular tenderness, allodynia, and periarticular osteoporosis, sequelae of nerve injury resembling those observed in CRPS. We postulated that facilitated substance P signaling may contribute to these vascular and nociceptive abnormalities and attempted to reverse these changes with the long acting substance P receptor (NK 1) antagonist LY303870. Hindpaw spontaneous extravasation was inhibited by LY303870. Systemic administration of LY303870 also reversed hindpaw edema and cutaneous warmth. Intrathecal, but not systemic administration of LY303870 reversed soft tissue and articular mechanical hyperalgesia in the hindpaw. Collectively, these data further support the hypothesis that the sciatic nerve transection model closely resembles CRPS and that substance P contributes to the spontaneous extravasation, edema, warmth, and mechanical hyperalgesia observed in this model.