Papers of the Week

Intrathecal administration of agmatine, an NMDA receptor (NMDAr) antagonist and nitric oxide synthase inhibitor, prevents neuropathic pain behavior in a dose-dependent manner by acting at the GluN2B subunit of the NMDAr. The present study investigated the pharmacological mechanism of agmatine’s inhibitory effect using calcium imaging and an in vivo assay of nociceptive responses induced by NMDA. The application of NMDA-evoked calcium transients in the mouse spinal cord dorsal horn slice was inhibited by the NMDAr antagonist, 2-amino-5-phosphonovalerate. Agmatine also concentration-dependently inhibited NMDA-evoked calcium responses. To evaluate the role of the GluN2B subunit of the NMDAr in the agmatine response, we conditionally knocked-down Grin2B, the gene encoding GluN2B, in spinal cord dorsal horn neurons (GluN2B knockdown [GluN2B-KD]). In control spinal cord slices, ifenprodil inhibited NMDAr-mediated calcium transients, but it was not effective in GluN2B-KD. Surprisingly, agmatine was equally effective in reducing calcium transients in control and GluN2B-KD mouse spinal cord slices. To determine whether the effect of agmatine could be attributed to an action downstream of the NMDAr (eg, neuronal nitric oxide synthase [nNOS]), we used the PSD95-nNOS tethering inhibitor, IC87201, to disrupt the link between NMDAr and nNOS. In the presence of IC87201, agmatine’s attenuation of NMDA-evoked calcium transients in ex vivo spinal cord dorsal horn was significantly reversed as was agmatine’s antihyperalgesic effect in the intrathecal NMDA-evoked thermal hyperalgesia in vivo model. These results indicated that agmatine requires an intact NMDAr-PSD95-nNOS pathway to attenuate NMDAr-mediated calcium transients and thermal hyperalgesia induced by intrathecal NMDA. SIGNIFICANCE STATEMENT: Chronic pain is an urgent public health concern, and effective long-term treatments are still needed. Agmatine reduces pain in preclinical models without the side effects of motor dysfunction or addiction. Clarifying the pharmacological mechanism of agmatine’s analgesic effect in spinal neurotransmission may facilitate the development of novel pain-alleviating therapeutics.