Abstract:
BACKGROUND:Human immunodeficiency virus (HIV)-related painful sensory neuropathies primarily consist of the HIV infection-related distal sensory polyneuropathy and antiretroviral toxic neuropathies. Pharmacotherapy provides only partial relief of pain in patients with HIV/acquired immune deficiency syndrome because little is known about the exact neuropathological mechanisms for HIV-associated neuropathic pain (NP). Hypofunction of γ-aminobutyric acid (GABA) GABAergic inhibitory mechanisms has been reported after peripheral nerve injury. In this study, we tested the hypothesis that HIV gp120 combined with antiretroviral therapy reduces spinal GABAergic inhibitory tone and that restoration of GABAergic inhibitory tone will reduce HIV-related NP in a rat model. METHODS:The application of recombinant HIV-1 envelope protein gp120 into the sciatic nerve plus systemic ddC (one antiretroviral drug) induced mechanical allodynia. The hind paws of rats were inoculated with replication-defective herpes simplex virus (HSV) vectors genetically encoding gad1 gene to express glutamic acid decarboxylase 67 (GAD67), an enzyme that catalyzes the decarboxylation of glutamate to GABA. Mechanical threshold was tested using von Frey filaments before and after treatments with the vectors. The expression of GAD67 in both the lumbar spinal cord and the L4-5 dorsal root ganglia was examined using western blots. The expression of mitochondrial superoxide in the spinal dorsal horn was examined using MitoSox imaging. The immunoreactivity of spinal GABA, pCREB, and pC/EBPβ was tested using immunohistochemistry. RESULTS:In the gp120 with ddC-induced neuropathic pain model, GAD67 expression mediated by the HSV vector caused an elevation of mechanical threshold that was apparent on day 3 after vector inoculation. The antiallodynic effect of the single HSV vector inoculation expressing GAD67 lasted >28 days. The area under the time-effect curves in the HSV vector expressing GAD67 was increased compared with that in the control vectors (P = 0.0005). Intrathecal GABA-A/B agonists elevated mechanical threshold in the pain model. The HSV vectors expressing GAD67 reversed the lowered GABA immunoreactivity in the spinal dorsal horn in the neuropathic rats. HSV vectors expressing GAD67 in the neuropathic rats reversed the increased signals of mitochondrial superoxide in the spinal dorsal horn. The vectors expressing GAD67 reversed the upregulated immunoreactivity expression of pCREB and pC/EBPβ in the spinal dorsal horn in rats exhibiting NP. CONCLUSIONS:Based on our results, we suggest that GAD67 mediated by HSV vectors acting through the suppression of mitochondrial reactive oxygen species and transcriptional factors in the spinal cord decreases pain in the HIV-related neuropathic pain model, providing preclinical evidence for gene therapy applications in patients with HIV-related pain states.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Kanao M,Kanda H,Huang W,Liu S,Yi H,Candiotti KA,Lubarsky DA,Levitt RC,Hao Sdoi
10.1213/ANE.0000000000000729subject
Has Abstractpub_date
2015-06-01 00:00:00pages
1394-404issue
6eissn
0003-2999issn
1526-7598journal_volume
120pub_type
杂志文章abstract::The alpha 2-adrenergic receptor agonist dexmedetomidine produces an anesthetic state in a variety of species. Although its effects on cerebral blood flow and the electroencephalogram have been investigated, the effect of this drug on intracranial pressure (ICP) has not been reported previously. Dexmedetomidine therefo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199208000-00014
更新日期:1992-08-01 00:00:00
abstract::The low solubility of desflurane contributes to rapid emergence after outpatient anesthesia. Compared with isoflurane, recovery times to eye opening, response to verbal commands, and orientation to person, place, and time have been significantly shorter. Even when compared with the rapid, short-acting intravenous anes...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:
更新日期:1992-10-01 00:00:00
abstract::Newer generation anesthesia machines are equipped with a pressure support mode of ventilation, which can be used to support spontaneous ventilation in anesthetized patients. The Drager Apollo anesthesia machine uses an inspiratory limb hot-wire flow sensor to measure inspiratory flow rates. Detected flow rates that ex...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181a9d75a
更新日期:2009-08-01 00:00:00
abstract::Two concentrations of etidocaine (1 and 1.5%) and of pH-adjusted bupivacaine (0.5 and 0.75%, pH 6.8), all fortified with hyaluronidase, were compared as local anesthetics in regional ophthalmic surgery for cataract extraction. The series comprised 160 patients assigned randomly to four groups (n = 40). Each patient re...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199307000-00026
更新日期:1993-07-01 00:00:00
abstract::The evolution of modern anesthesia and surgical practices has been accompanied by enhanced supportive procedures in blood banking and transfusion medicine. There is increased focus on the preparation and the use of blood components including, but not limited to, preventing unnecessary type and screen/crossmatch orders...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0000000000000619
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Premedication with midazolam is commonly used in children to reduce anxiety and improve cooperation before anesthesia. However, it has the potential to alter respiratory function because of its muscle relaxant properties. We assessed functional residual capacity (FRC), ventilation homogeneity, using a lung c...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181a324c3
更新日期:2009-06-01 00:00:00
abstract::The purpose of this study was to compare meperidine to meperidine with bupivacaine when used for patient-controlled epidural analgesia (PCEA) after thoracotomy. For 3 days after thoracotomy patients received thoracic PCEA with meperidine 0.1% plain or with added bupivacaine 0.1% or 0.01%. No background infusion was us...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199607000-00014
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:Research information for children is often presented in a manner that is difficult to understand. We designed this study, therefore, to examine the effect of improved readability and processability of written study information on children's understanding. METHODS:One-hundred-ninety children aged 7-17 yr who...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000270326.44507.11
更新日期:2007-08-01 00:00:00
abstract::The effects of enflurane and halothane anesthesia on systolic time intervals were studied in 12 healthy patients. Cardiovascular measurements were made at equipotent levels of anesthesia: enflurane 1.23% end-tidal and halothane 0.65% end-tidal. These agents were studied first with 50% N2O and then without N2O. Systoli...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197603000-00031
更新日期:1976-03-01 00:00:00
abstract::Delirium is an acute change in cognition and attention, which may include alterations in consciousness and disorganized thinking. Although delirium may affect any age group, it is most common in older patients, especially those with preexisting cognitive impairment. Patients with delirium after surgery recover more sl...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e3182147f6d
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Isoflurane activates vascular adenosine triphosphate sensitive potassium (K(ATP)) channels, and may induce vasodilation. In the present study, we investigated whether hyperglycemia modifies isoflurane activation of vascular K(ATP) channel. METHODS:We used a cell-attached patch-clamp configuration to test th...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318163fd5b
更新日期:2008-03-01 00:00:00
abstract::The nasal route is preferred for fiberoptic intubation. Placing a lubricated endotracheal tube through the nostril can guide the fiberoptic scope towards the larynx. It would be helpful for optimal visualization of the vocal cord when the scope is passed through the endotracheal tube if the length of nares-vocal cord ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000149900.68354.33
更新日期:2005-05-01 00:00:00
abstract::Continuous peripheral nerve blockade is often used for the management of postoperative pain, even in ambulatory patients. The reported incidence of infectious complications after continuous nerve blockade is low. We report a case of Staphylococcus aureus sepsis after total shoulder arthroplasty in a patient who presen...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181cf03b4
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Rates of hypothermia for women undergoing spinal anesthesia for cesarean delivery are high and prevention is desirable. This trial compared the effectiveness of preoperative warming versus usual care among women receiving intrathecal morphine, which is thought to exacerbate perioperative heat loss. METHODS:...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000002026
更新日期:2018-01-01 00:00:00
abstract:UNLABELLED:Many drugs are tested intrathecally to investigate alternatives to opioids. We aimed to explore the analgesic and possible neurotoxic effects of chronic intrathecally-administered ketorolac tromethamine in rats. Catheters were placed via atlantoaxial interval in 28 Wistar rats under anesthesia of intraperito...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000093226.75543.90
更新日期:2004-01-01 00:00:00
abstract:UNLABELLED:To evaluate the possible effects of outpatient preoperative evaluation (OPE) for new surgical patients who will be inpatients, we conducted an observational study at a university hospital in The Netherlands. Various outcomes before and after the introduction of an OPE clinic were compared. The study populati...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200203000-00030
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Propofol-evoked injection site pain is not observed with fospropofol. We hypothesized that unlike propofol, fospropofol does not activate the irritant receptor, transient receptor potential 1 (TRPA1). METHODS:We tested the hypothesis using electrophysiology and behavioral studies. RESULTS:Our data demonstr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318258b9db
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Hypotension after spinal anesthesia for cesarean delivery is common. Previous studies have demonstrated that a crystalloid fluid "coload" (rapid administration of a fluid bolus starting at the time of intrathecal injection) is superior to the conventional crystalloid preload (fluid administered before the in...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e3181b2bd6b
更新日期:2009-10-01 00:00:00
abstract::A number of important clinical trials focusing on critically ill patients have been completed in the last few years. These trials have been among the first critical care clinical trials to demonstrate mortality reduction in the critically ill. As in any adaptation of evidence-based medicine, it is essential to closely...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/01.ANE.0000123494.40145.B3
更新日期:2004-08-01 00:00:00
abstract::Sevoflurane reduces autonomic neural control, which plays a significant role in cerebral autoregulation. Therefore, we hypothesized that sevoflurane influences cerebral autoregulation. We investigated the effects of sevoflurane on dynamic cerebral blood flow (CBF) autoregulation by using spectral and transfer function...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000189056.96273.48
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Superoxide, nitric oxide (NO), and peroxynitrite are important mediators in the pathogenesis of ischemia-reperfusion (I/R) injury. We tested the renoprotective effects of allopurinol (ALP), a xanthine oxidase inhibitor, N-nitro-L-arginine methyl ester (L-NAME), and 5,10,15,20-tetrakis (N-methyl-4-pyridyl) po...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001565
更新日期:2017-01-01 00:00:00
abstract::The traditional tests that have been used for the past 30 yr to determine plasma cholinesterase phenotype--measurement of esterase activity with a variety of substrates, dibucaine inhibition, fluoride inhibition, and Ro2-0683 inhibition--are inadequate for identifying some variants of this enzyme and leave many cases ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/00000539-199377020-00027
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:As orexinergic (OXergic) neurons have been reported to mediate emotional changes, benzodiazepines might interact with OXergic neurons. METHODS:We examined the interactions between OXergic neurons and benzodiazepine receptors in orexin-A (100 nM) and K+ (25 mM)-evoked norepinephrine release from rat cerebroc...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000252413.62821.2e
更新日期:2007-02-01 00:00:00
abstract:UNLABELLED:We compared the recovery profile and postoperative SpO(2) after the administration of general anesthesia with either sevoflurane-remifentanil or sevoflurane-sufentanil in 30 healthy patients undergoing upper abdominal surgery. They were randomly allocated to receive general anesthesia with sevoflurane and sm...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200011000-00040
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Inhibitors of cyclooxygenase, which block the formation of prostaglandin (PG) E2, are the standard treatment of inflammatory pain. These drugs, however, have serious gastrointestinal, renal, and cardiovascular side effects that limit their clinical use. Cyclodextrins are neutral glucose oligomers that form a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001674
更新日期:2017-02-01 00:00:00
abstract::Acid-base status and blood levels of bupivacaine were determined in 16 diabetic parturients and their infants after epidural anesthesia for cesarean section. The newborn infants were divided into two groups based on umbilical artery pH at birth. Group A consisted of 10 infants who had a pH of less than 7.2 and group B...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1981-08-01 00:00:00
abstract:BACKGROUND:In this study, our objective was to determine whether a perioperative hemodynamic protocol based on noninvasive cardiac output monitoring decreases the incidence of postoperative complications and hospital length of stay in major abdominal surgery patients requiring intensive care unit admission. Secondary o...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1213/ANE.0000000000000295
更新日期:2014-09-01 00:00:00
abstract::To further investigate possible prolongation of the frequency-corrected QT interval (QTc interval) after administration of droperidol (DRO), we studied 40 surgical patients who were randomly assigned to one of three groups, receiving an intravenous (IV) injection of either 0.1 mg/kg (Group 1, n = 10), 0.175 mg/kg (Gro...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199411000-00028
更新日期:1994-11-01 00:00:00
abstract::Previous studies have shown that bolus doses of fentanyl (50 and 100 micrograms) with epidural bupivacaine delay gastric emptying by up to 45 min. We studied the effect of the addition of small-dose fentanyl to epidural bupivacaine infusions on gastric emptying during labor. The acetaminophen absorption technique was ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199603000-00032
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Sedatives and analgesics, in doses that alter consciousness in the intensive care unit (ICU), contribute to delirium and mortality. Pain, agitation, and delirium can be monitored in ICU patients. These symptoms were noted before (PRE) and after (POST) a protocol to alleviate undesirable symptoms. Analgesia a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181d7e1b8
更新日期:2010-08-01 00:00:00