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Kim MJ, Lee JH, Jang JU, et al. The efficacy of combination treatment of gabapentin and electro-acupuncture on paclitaxel-induced neuropathic pain. Korean J Physiol Pharmacol. 2017;21(6):657-666doi: 10.4196/kjpp.2017.21.6.657.
Kim, M. J., Lee, J. H., Jang, J. U., Quan, F. S., Kim, S. K., & Kim, W. (2017). The efficacy of combination treatment of gabapentin and electro-acupuncture on paclitaxel-induced neuropathic pain. The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology, 21(6), 657-666. https://doi.org/10.4196/kjpp.2017.21.6.657
Kim, Min Joon, et al. "The efficacy of combination treatment of gabapentin and electro-acupuncture on paclitaxel-induced neuropathic pain." The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology vol. 21,6 (2017): 657-666. doi: https://doi.org/10.4196/kjpp.2017.21.6.657
Kim MJ, Lee JH, Jang JU, Quan FS, Kim SK, Kim W. The efficacy of combination treatment of gabapentin and electro-acupuncture on paclitaxel-induced neuropathic pain. Korean J Physiol Pharmacol. 2017 Nov;21(6):657-666. doi: 10.4196/kjpp.2017.21.6.657. Epub 2017 Oct 30. PMID: 29200909; PMCID: PMC5709483.
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Korean J Physiol Pharmacol. 2017 Nov;21(6):657-666. doi: 10.4196/kjpp.2017.21.6.657. Epub 2017 Oct 30.

The efficacy of combination treatment of gabapentin and electro-acupuncture on paclitaxel-induced neuropathic pain.

The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology

Min Joon Kim, Ji Hwan Lee, Jo Ung Jang, Fu Shi Quan, Sun Kwang Kim, Woojin Kim

Affiliations

  1. Department of East-West Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea.
  2. Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea.
  3. Department of Medical Zoology, School of Medicine, Kyung Hee University, Seoul 02447, Korea.
  4. Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea.

PMID: 29200909 PMCID: PMC5709483 DOI: 10.4196/kjpp.2017.21.6.657

Abstract

Paclitaxel, a chemotherapeutic drug, induces severe peripheral neuropathy. Gabapentin (GBT) is a first line agent used to treat neuropathic pain, and its effect is mediated by spinal noradrenergic and muscarinic cholinergic receptors. Electro-acupuncture (EA) is used for treating various types of pain via its action through spinal opioidergic and noradrenergic receptors. Here, we investigated whether combined treatment of these two agents could exert a synergistic effect on paclitaxel-induced cold and mechanical allodynia, which were assessed by the acetone drop test and von Frey filament assay, respectively. Significant signs of allodynia were observed after four paclitaxel injections (a cumulative dose of 8 mg/kg, i.p.). GBT (3, 30, and 100 mg/kg, i.p.) or EA (ST36, Zusanli) alone produced dose-dependent anti-allodynic effects. The medium and highest doses of GBT (30 and 100 mg/kg) provided a strong analgesic effect, but they induced motor dysfunction in Rota-rod tests. On the contrary, the lowest dose of GBT (3 mg/kg) did not induce motor weakness, but it provided a brief analgesic effect. The combination of the lowest dose of GBT and EA resulted in a greater and longer effect, without inducing motor dysfunction. This effect on mechanical allodynia was blocked by spinal opioidergic (naloxone, 20 μg), or noradrenergic (idazoxan, 10 μg) receptor antagonist, whereas on cold allodynia, only opioidergic receptor antagonist blocked the effect. In conclusion, the combination of the lowest dose of GBT and EA has a robust and enduring analgesic action against paclitaxel-induced neuropathic pain, and it should be considered as an alternative treatment method.

Keywords: Cold allodynia; Electro-acupuncture; Gabapentin; Mechanical allodynia; Paclitaxel

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