Adenosine A2A Receptor Agonist, Polydeoxyribonucleotide Treatment Improves Locomotor Function and Thermal Hyperalgesia Following Neuropathic Pain in Rats

Purpose: Lithotomy position has been widely used in the various urologic surgery. Occasionally sensory and motor problems of the lower extremities are occurred due to the lithotomy position and these deficits may be related with sciatic nerve injury (SNI). Inflammatory process is a factor to induce functional impairment after SNI. Therefore, we evaluated the role of adenos-ine A2A receptor agonists, polydeoxyribonucleotide (PDRN) showing anti-inflammatory effect on locomotor function follow-ing SNI in rats. Methods: Sciatic nerve was compressed with surgical clips for 1 minute after exposing of right sciatic nerve. After 3 days of SNI, PDRN (2, 4, and 8 mg/kg) was applied to the damaged area of sciatic nerve once daily for 10 days. Walking track analysis was conducted for locomotor function and plantar test was performed for thermal pain sensitivity. Level of cyclic adenosine-3 ',5 '-monophosphate (cAMP) were measured using enzyme-linked immunosorbent assay. Western blot analysis was per-formed for tumor necrosis factor (TNF)-alpha, interleukin (IL)-13, cAMP response element binding protein (CREP), vascular en-dothelial growth factor (VEGF). Immunofluorescence for neurofilament was also conducted. Results: Locomotor function was decreased and thermal pain sensitivity was increased by SNI. SNI enhanced proinflamma-tory cytokines' production, such as TNF-alpha and IL-13, while suppressed CREP phosphorylation and cAMP level. SNI also re-duced the expression of VEGF and neurofilaments. However, treatment with PDRN inhibited proinflammatory cytokines' production and upregulated CREP phosphorylation and cAMP expression. PDRN also enhanced the expression of VEGF and neurofilaments. As a result, PDRN improved locomotor function and alleviated thermal hyperalgesia after SNI. Conclusions: PDRN has shown potential to be used as an effective treatment for neuropathic pain.