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BJA Advance Access published online on November 18, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei271
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted October 3, 2005

Laboratory Investigation

Local anaesthetics inhibit signalling of human NMDA receptors recombinantly expressed in Xenopus laevis oocytes: role of protein kinase C

K. Hahnenkamp 1 *, M. E. Durieux 2, A. Hahnenkamp 3, S. K. Schauerte 1, C. W. Hoenemann 4, V. Vegh 5, G. Theilmeier 1, and M. W. Hollmann 6

1 Department of Anaesthesiology and Intensive Care, University Hospital, Münster, Germany
2 Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA
3 Institute of Physiological Chemistry and Pathobiochemistry, University Hospital, Münster, Germany
4 Department of Pharmaceutical Chemistry, Comenius University, Bratislava, Slovakia
5 Department of Anaesthesiology and Intensive Care, University Hospital, Münster, Germany; Department of Pharmaceutical Chemistry, Comenius University, Bratislava, Slovakia
6 Department of Anesthesiology, University of Amsterdam, Amsterdam, The Netherlands

* To whom correspondence should be addressed.
K. Hahnenkamp, E-mail: hahnenkamp{at}anit.uni-muenster.de


  Abstract

Background. N-methyl-D-aspartate (NMDA)-receptor activation contributes to postoperative hyperalgesia. Studies in volunteers have shown that intravenous local anaesthetics (LAs) prevent the development of hyperalgesic pain states. One potential explanation for this beneficial effect is the inhibition of NMDA receptor activation. Therefore, we studied the effects of LA on NMDA receptor function.

Methods. The human NR1A/NR2A NMDA receptor was expressed recombinantly in Xenopus laevis oocytes. Peak currents were measured by voltage clamp in Mg- and Ca2+-free, Ba2+-containing Tyrode's solution. Holding potential was -70 mV. Oocytes were stimulated with glutamate/glycine (at EC50) with or without 10 min prior incubation in bupivacaine, levobupivacaine, S-(-)-ropivacaine, or lidocaine (all at 10-9-10-4 M), procaine (10-4 M), R-(+)-ropivacaine (10-4 M), QX314 (permanently charged, 5x10-4 M) extracellularly or intracellularly or benzocaine (permanently uncharged, 5x10-3 M). We also determined the effect of the protein kinase C (PKC) inhibitors chelerythrine (5x10-5 M), calphostin C (3x10-6 M) and Ro 31-8220 (10-7 M), and the effect of PKC activation with phorbolester (10-6 M).

Results. Non-injected oocytes were unresponsive to agonist application, but oocytes expressing NMDA receptors responded with inward currents (1.1±0.08 µA). All LA concentration-dependently inhibited agonist responses. The inhibition was reversible and stereoselective. Intracellular QX314 reduced responses to 59% of control, but extracellular QX314 was without effect. Benzocaine reduced responses to 33% of control. PKC inhibitors had no additional inhibitory effect beyond that of bupivacaine. The effect of PKC activation was abolished in the presence of bupivacaine.

Conclusion. All LA tested inhibited the activation of human NMDA receptors in a concentration dependent fashion. This effect may contribute to reduced hyperalgesia and opiate tolerance observed after systemic administration of LA. The effect is independent of the charge of LA; site of action is intracellular. The mechanism of action may be mediated by inhibition of PKC.

Keywords: anaesthetics; local; complications, hyperalgesia; oocytes; Xenopus laevis; protein kinase C; receptors, NMDA.
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