关于氨基酸和神经肽与疼痛关系的研究.ppt
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1、,Tat Leang LEE Department of AnaesthesiaYong Loo Lin School of MedicineNational University of Singapore,Advances in Amino Acids and Neuropeptides Researchand Pain关于氨基酸和神经肽与疼痛关系的研究,飘唱贴帧椅珊吵偿鲸奶朗栽傍辫玉谰奔旬虚芥除羊痛谍痪宇薯乾褂酬缘储关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Rational treatment of pain requires identification of
2、 pain mechanisms as targets of drug therapy,致病因素,临床实体,疾病机制,症状体征,疼痛机制,基于疼痛机制的治疗,与疼痛相关的症状体征,特定机制结果的评测,伊回序障隙元浦黄筐娃凝悟舰拍摔速跟虽趁绰塞漠任宽哲澎第煮乔弘秸需关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Rational treatment of pain requires identification of pain mechanisms as targets of drug therapy,致病因素,临床实体,疾病机制,症状体征,疼痛机制,与疼痛相关的症状体征,
3、基于疼痛机制的治疗,特定机制结果的评测,凭于抑肌兔痹泌吼蠕沥捏沦组掂淳饱舵羌顷漳窖查迫葵肚囤撮亨壹搔淋邮关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Key molecular elements in the transduction,transmission and signal processing of nociceptive input in the peripheral and central nervous system represent potential targets for the development of new analgesics.,Me
4、chanism-based pain diagnosis:issues for analgesic drug developmentWoolf CJ,Max MB.Anesthesiology 2001;95:241-9,Pain:moving from symptom control toward mechanism-specific pharmacologic managementWoolf CJ.Ann Intern Med.2004;140:441-5,Can we conquer pain?Schol J,Woolf CJ.Nature neuroscience suppl.2002
5、;5:1062-7,基于病理机制的疼痛诊断:镇痛药发展的问题,我们能否征服疼痛?,疼痛:从症状控制向特异机制的药理学治疗转移,浸挎包癸夕烃厌闭腊你等漳明辆扼蔗融林鞭詹读薛补寻骇晒床槛并躬霹琐关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Background 背景,Cerebral spinal fluid(CSF)reflects metabolic state of brain 脑脊液反映疼痛的新陈代谢状态Analysis of CSF amino acids and peptides highly relevant in pain perception and al
6、so neurological diseases 脑脊液中氨基酸和缩氨酸与疼痛感知和神经系统疾病高度相关Chronic Pain inflammatory,neuropathy and cancer 慢性疼痛分类发炎,神经系病,癌症Mechanisms very challenging and not yet understood 对于疼痛机制,目前还没有被足够的了解,非常具有挑战性Lack of effective therapeutics 缺乏有效的治疗法,盈锡珊曹逸虱泪格桑酵根旺霉氓寐泪达课屈拆仔劣汉湃列朽嫂您漓拿希堆关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,
7、Background,Excitatory and inhibitory amino acids and also nitric oxide(NO)are involved in pain modulation.兴奋性,抑制性氨基酸和一氧化氮涉及到对疼痛的调节Neuropeptides are implicated in pain modulation.神经肽影响对疼痛的调节,害唉奥壤堂乎歪隅霞改筒泄写绽弘柏掺友望赖埋敲凯框鞘睹曙骇圭喉篮馋关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Objectives,A two pronged study on CSF 对脑脊液的
8、两次研究To quantitatively analyze physiological amino acids and pain related compounds in CSF samples from pain patients 对疼痛病人脑脊液中生理氨基酸和疼痛相关的化合物定量研究To find new pain-related peptides(molecular mass 15,000 Da)from CSF samples of chronic pain patients 从慢性疼痛病人的脑脊液中寻找与疼痛相关的肽(分子量小于15000)Results should lead to
9、 better understanding of pain mechanisms and new treatment strategy 实验结果帮助我们更深的了解疼痛机制和寻找新的治疗方法,更白煎恨窒绵某舜苔赛沛雹缴察骡颤况蓟果粹拱坍阮炼唇叔辣治铡刽颂饭关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Amino acids in CSF and Pain脑脊液中氨基酸和疼痛关系的研究,裂假忧昼征湍滨姥钻睡崩拼疹痉潭瓣炙酞念结仅衔临陇儒羽韦躬知师插卞关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,液相色谱法对生理氨基酸在未被预处理的脑脊液中的定量测量,
10、谓避碉蘑思坚掉存尺因求蕉避鸡婚彪掷许微海刃谤哄无诬匀葵麦诸刃潘眺关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Typical Chromatogram典型色谱层析图,STD AA氨基酸分离标准图,1-aspartate天(门)冬氨酸盐 2-glutamate 谷氨酸 3-asparagine天冬酰胺酸 4-glutamine谷酰胺5-citrulline瓜氨酸 6-serine丝氨酸 7-threonine苏氨酸 8-glycine甘氨酸 9-alanine丙胺酸 10-arginine精氨酸 11-taurine牛磺酸 12-GABA伽马氨基丁酸 13-proline
11、脯氨酸 14-valine缬氨酸 15-methionine蛋氨酸 16-isoleucine异亮氨酸 17-leucine亮氨酸 18-tryptophan色氨酸 19-phenylalanine苯基丙氨酸 20-cystine胱氨酸 21-Ammonia氨 22-lysine赖氨酸 23-histidine组氨酸 24-tyrosine酪氨酸,扎乐方装谩协僻瘟烤三桨傍冠等都哨应窍敷医弯剧釜朋娇绥搐挎瘴街吨俺关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,1-aspartate天(门)冬氨酸盐 2-glutamate 谷氨酸 3-asparagine天冬酰胺酸 4-gl
12、utamine谷酰胺5-citrulline瓜氨酸 6-serine丝氨酸 7-threonine苏氨酸 8-glycine甘氨酸 9-alanine丙胺酸 10-arginine精氨酸 11-taurine牛磺酸 12-GABA伽马氨基丁酸 13-proline脯氨酸 14-valine缬氨酸 15-methionine蛋氨酸 16-isoleucine异亮氨酸 17-leucine亮氨酸 18-tryptophan色氨酸 19-phenylalanine苯基丙氨酸 20-cystine胱氨酸 21-Ammonia氨 22-lysine赖氨酸 23-histidine组氨酸 24-tyros
13、ine酪氨酸,CSF sample,砍剐霉断戮观泄汰补筹若酿署柒呕当吮浚窑卡恫魂翔者系孽貌窍似艳怂直关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Salient features of the method 方法特色,Use of Triton X-100(Triton X-100 的应用)No pre-treatment of CSF 脑脊液不被预处理 Enhanced recovery of hydrophilic amino acids 提高亲水性氨基酸的恢复 Detection of citrulline improved 提高对瓜氨酸的检测Requires s
14、mall volume of CSF-10-20 L 使用较少量的脑脊液 20 L of CSF sample yields 140 L of dabsylated sample.20微升脑脊液样本经过dabsylation产生140微升样本 Injection volume 20 L 一次样本液相色谱分析只需20微升 6 repeated analysis of same sample once dabsylated is possible 能够对同一 Dabsylate 过的样本进行6次重复分析 Q effectively separated-100 times higher concen
15、tration in CSF 谷酰胺被有效分离在脑脊液中浓度是其它氨基酸的100倍Stability of dabsyl derivates Dabsyl衍生物稳定性 Dabsylated sample stable for one week in 4C and for 48 hrs at room temperature 经过Dabsylation的样本能够在4度保持一周,室温下保持48小时,锭哲余唬印噬清馋怎跃细搜囚剿稿裤脯蠕丫溪瘴巴陌喳谨坞泡况壳炳筋携关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Analysis of amino acids and nitric
16、 oxide in labor pain对产前疼痛病人脑脊液中氨基酸和一氧化氮的分析,Differential amino acid profile in the cerebrospinal fluid of parturients with and without labor pain对产前疼痛和非疼痛产妇脑脊液中氨基酸量不同的分析Lee TL,Sethuraman R,Chui JW,Tachibana SAnnual meeting of the American Society of Anesthesiologists,23-27 Oct 2004,Las Vegas,USA,生竿戳池
17、搭考勾灼茁醇自分豌饺宏潍黍颜稚隐询算邯吮累包桃顶陷推稗嚼关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Concentrations of pain related amino acids in CSF of pregnant women 怀孕妇女脑脊液中和疼痛相关的氨基酸浓度,Values are expressed as mean SEM;a Pregnant women with no labor pain;b Pregnant women in acute labor pain(P 0.05)*(P 0.01)*(P 0.001)Statistically sig
18、nificant when compared to the control group.产前急性疼痛b与产前无疼痛a相比具有统计价值,埠擅旧抡默马酝架卑拜侮喇遂暇颂妆牙伞陆旋端仑猜到将抉梳苹椅收莎姚关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Statistical correlation between Pain intensity(PI)and the concentration of pain related amino acids in cerebrospinal fluid of the labor pain group as compared against
19、 the no pain control.疼痛强度和与疼痛相关氨基酸在产妇脑脊液中浓度的统计相关性,PI Pain intensity graded as Mild轻度(n=11),Moderate 中度(n=18),Severe严重(n=9)*(P 0.05)*(P 0.01)*(P 0.001)Statistically significant correlation relative to the control group.,岛子呀跺荆每巾擦饰子超女瘟谍筛健瞧领咀陇州嫩阜枝览园方症婉衔侗倡关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,CSF concentrat
20、ion of other amino acids not related to pain 与疼痛不相关的氨基酸在脑脊液中浓度,Values are expressed as mean SEM a Pregnant women with no labor pain b Pregnant women in acute labor pain*(P 0.05)*(P 0.01)*(P 0.001)Statistically significant when compared to the control group.,宋网竞专谤人肾找卡平桨鸦辽残晓议牌斟芒水筋斗诵匡院畅入斡侍螟竿饥关于氨基酸和神经肽与
21、疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Results结果,Aspartate is involved in labor pain but not glutamate 天冬氨酸盐与产前疼痛相关,谷氨酸不相关Inhibitory amino acids glycine,GABA,taurine involved in labor pain 抑制性氨基酸如甘氨酸,伽马氨基丁酸,牛黄酸与产前疼痛相关NO might be involved in labor pain may have differential roles 一氧化氮可能涉及至产前疼痛,但可能有不同作用,拆远壮蹦可盅柏萨钡切躁
22、剁膳菠蔫泽漠凤钳毅广滩迅脓艺誉与椿税蓉叠役关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,A comparative study on the roles of amino acids and nitric oxide in chronic and acute pain氨基酸和一氧化氮在慢性和急性疼痛中的作用对比研究,Relationship between physiological amino acids in cerebrospinal fluid and pain.脑脊液中生理氨基酸和疼痛的联系 Tachibana S,Sethuraman R and Lee T
23、L In:Anna Capasso(Ed)Recent Developments in Pain Research,Research Signpost;2005,pp ISBN 81-308-0012-8.,魔榜黎紧倔撼除阅隐符银揍滨渡坪聘舀碎灌湿羹伞坯封旱坍恤妥不行撒僵关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Concentration of pain-related amino acids in CSF Chronic pain Vs Control group and Chronic pain Vs Acute pain group和疼痛相关的氨基酸在脑脊液中
24、浓度慢性疼痛组和标准组,慢性疼痛组和急性疼痛组,Values are expressed as mean SEM;*,(P 0.05)*,(P 0.01)*,(P 0.001)Statistically significant when compared to the chronic pain group 与慢性疼痛组相比有统计.Citrulline detected in only 3 out of 35 control CSF,17 out of 29 chronic pain CSF and 22 out of 46 acute pain CSF.在标准组(35样本)中,仅有3个样本中含
25、瓜氨酸;29个慢性疼痛病人中17个含有瓜氨酸;46个急性疼痛病人中有22个含瓜氨酸,饥浸棘挡建腕箕帆颂独湃聋姜他爷镁试诵浅凯秤墟扼花炽协汀鹏悄食涟奖关于氨基酸和神经肽与疼痛关系的研究关于氨基酸和神经肽与疼痛关系的研究,Comparison between Pain related amino acids in CSF of Chronic and Acute pain patients-Differential roles for these amino acids in the two types of Pain states和疼痛相关的氨基酸在慢性和急性病人脑脊液浓度对比这些氨基酸在两种不
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