article information

Jundishapur Journal of Natural Pharmaceutical Products: Vol.11, issue 3; e33433
published online: March 16, 2016
article type: Research Article
received: September 28, 2015
revised: February 14, 2016
accepted: February 24, 2016
DOI: https://doi.org/10.17795/jjnpp-33433
Crossmark

Involvement of Spinal CB1 Cannabinoid Receptors on the Antinociceptive Effect of Celecoxib in Rat Formalin Test

authors:

avatar Mohsen Rezaei 1 , avatar Hossein Rajabi Vardanjani 2 , avatar Marzieh Pashmforoosh 2 , avatar Davood Alipour 2 , avatar Ali Nesari 2 , avatar Zahra Mansourzade 3 , avatar Mohammad Javad Khodayar ORCID 2 , 3 , *

Department of Toxicology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
Department of Pharmacology and Toxicology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran

how to cite: Rezaei M, Rajabi Vardanjani H, Pashmforoosh M, Alipour D, Nesari A, et al. Involvement of Spinal CB1 Cannabinoid Receptors on the Antinociceptive Effect of Celecoxib in Rat Formalin Test. Jundishapur J Nat Pharm Prod. 2016;11(3):e33433. https://doi.org/10.17795/jjnpp-33433.

Abstract

Background:

The pivotal role of cyclooxygenase-2 (COX-2) inhibitors in inflammatory pain is well documented, but its mechanism is not entirely clear. Nonsteroidal anti-inflammatory drugs (NSAIDs) as inhibitors of COX could inhibit fatty acid amide hydrolase, the enzyme responsible for the metabolism of endocannabinoids. Therefore, it is expected that celecoxib administration (selective COX-2 inhibitor) preserve the increased level of endocannabinoids after noxious stimuli, which leads to more pain suppression.

Objectives:

This study was designed to evaluate the interaction between the intrathecally administered celecoxib in combination with rimonabant, a selective cannabinoid CB1 receptor antagonist/reverse agonist on the pain behavior induced by formalin test in rat.

Materials and Methods:

Male Wistar rats with inserted lumbar intrathecal catheters were randomly grouped and tested in blinded manner by the same experimenter. Antinociceptive effects of different intrathecally doses of celecoxib (0.5, 5 and 10 µg/rat) in absence and with pretreatment of rimonabant at doses of 100 and 200 µg/rat were examined on the formalin test.

Results:

Celecoxib reduced the pain behavior in both phases of the formalin test, but this antinociceptive effect was a dose-dependent manner in the late phase. Rimonabant alone induced hyperalgesia as compared with the control group and pretreatment of rats with rimonabant reversed the analgesic activity of celecoxib.

Conclusions:

Antinociceptive effect of celecoxib may be mediated partly through the cannabinoid system. These effects are possibly attributed to inhibition of endocannabinoid degradation and consequently enhancement of endocannabinoids concentration at the spinal cord level. However, the hyperalgesic effects of rimonabant are not fully responsible for the reversal of celecoxib analgesia. Accordingly, NSAIDs intensify their effects through maintenance of the endocannabinoid tone. Therefore, combination of NSAIDs and cannabinoid agents could be used for synergistic effects.

1. Background

Celecoxib is a cyclooxygenase type 2 (COX2) inhibitor, which belongs to the non-steroidal anti-inflammatory drugs (NSAIDs). This drug has different pharmacological effects such as analgesic, anti-pyretic and anti-inflammatory (1-3). A previous study indicated that celecoxib exhibited central, not peripheral analgesia after systemic administration and its effect seemed to be mediated by opioid system rather than prostaglandin generation inhibition (4). Furthermore, it has been shown that other mechanisms (5, 6) including endogenous cannabinoids have contributed to the antinociceptive effect of celecoxib in intracerebroventricular (ICV) administration (6-8).

The endocannabinoid system has a key role in pain perception. Activation of CB1 and CB2 receptors in peripheral, spinal and supraspinal sites is responsible for antinociceptive effects of cannabinoids (9, 10).

It is revealed that endocannabinoids are metabolized by COX-2 and fatty-acid amide hydrolase (FAAH); so, probably, inhibition of COX-2 and FAAH by celecoxib could lead to raised endogenous cannabinoids level (11-13). However, other studies showed that endogenous cannabinoids contributed to antinociceptive effects of celecoxib in intracerebroventricular administration (6-8).

2. Objectives

Since the role of spinal cannabinoid receptors in antinociceptive effect of celecoxib is not clear, the aim of this study was to evaluate the possible involvement of spinal cannabinoid receptor in the antinociceptive effect of celecoxib in formalin test by the use of intrathecal administration of rimonabant, the CB1 selective receptor antagonist.

3. Materials and Methods

3.1. Animals

Male Wistar rats (140 - 180 g) were purchased from the central animal house of Jundishapur University of Medical Sciences (Ahvaz, Iran). The animals were maintained under 12-hours light/dark cycles in a temperature (20°C - 22°C) and humidity-controlled room with food and water provided ad libitum. Rats were acclimatized to the laboratory for at least one hour before testing and were used only once during the experiments. All the tests were carried out according to the institutional animal care and we used committee and ethical guidelines for investigations of experimental pain in conscious animals (14).

3.2. Drugs and Chemicals

Celecoxib (Razak Pharmaceutical Co., Iran), rimonabant (Sanofi Recherche, France) formaldehyde (Merck Co., Germany), and dimethyl sulfoxide (DMSO) (Sigma-Aldrich Co., St. Louis, MO, USA) were purchased. Celecoxib was dissolved in DMSO and administrated intrathecally (IT) in a volume of 10 μL/rat. Rimonabant was dissolved in DMSO and injected in a volume of 10 μL/rat IT.

3.2. Intrathecal Injections

IT catheterization was performed as described by Yaksh and Rudy (15). Animals were anesthetized with a mixture of ketamine hydrochloride (50 mg/kg) and xylazine (5 mg/kg) intraperitoneally. After creating the incision over the cervical spine, a polyethylene catheter (PE-10 (OD 0.55 mm, ID 0.30 mm) was inserted through an opening in the cisterna magna into the lumbar subarachnoid space (7.5 cm), and then the rift was closed. Rats with neurological disturbances were removed from the experimental procedures. IT drugs injection was performed by the use of microinjection syringe (OD 0.5 mm) over a 10-second period in a single injection in a volume of 10 μL followed by a flush of 10 μL normal saline (NS) in awake rats. For control group, vehicle was administrated as same as the treatment groups.

3.3. Formalin Test

The formalin test was carried out for the assessment of antinociception (16). Briefly, formalin (2.5% v/v) was administered by intraplantar (ipl) injection into the rat right hind paw in a volume of 50 μL. The rats were returned to the experimental cage and nociceptive behaviors were assessed. Pain score was given, described by Dubuisson and Denni: 0 = normal weight bearing on the injected paw; 1 = limping during locomotion or resting the paw lightly on the floor; 2 = elevation of the injected paw so that at most the nail touches the floor; and 3 = licking, biting or grooming the injected paw. The first five minutes of post-formalin injection was recorded as the early phase (neurogenic) and the period between 15 - 60 minutes was recorded as the late phase (inflammatory). Pain behavior was estimated through the area under the curve in time-pain score graph in 15-second intervals by trapezoidal rule (17). Lastly, the animals were euthanized.

3.4. Experimental Design

The first series of experiments was conducted to evaluate the antinociceptive activity of celecoxib in rat formalin test. Animals received celecoxib IT at doses of 0.5, 5 and 10 μg/rat. Then, the possible effects of rimonabant (100 and 200 µg) were determined. At last, the effects of rimonabant on antinociceptive effective dose of celecoxib were examined. To evaluate the antinociceptive effect of celecoxib on formalin-induced pain, rimonabant was administrated in doses of 100 and 200 μg/rat 10 minutes before celecoxib or vehicle injection. Ten minutes after celecoxib, the formalin test was performed.

3.5. Statistical Analysis

The data were presented as the means ± SEM and analyzed with Graphpad Prism 6 software. To analyze the differences, one-way analysis of variance (ANOVA) was used with post hoc Tukey’s test at P < 0.05.

4. Results

4.1. Effect of Intrathecal Celecoxib Administration on Formalin Test

In the vehicle-treated group, subplantar formalin administration into the right hind paw made a common pattern of nociceptive behavior, described as a biphasic time course. The early phase of the nociception started after formalin injection and lasted for five minutes. Fifteen minutes after the formalin injection, the late phase initiated and continued about 45 minutes. The IT injection of celecoxib caused attenuation in the pain score dose-dependently during the late phase of formalin test (Figure 1B). IT administration of 5 μg/rat of celecoxib decreased the pain score significantly in the early phase as compared with the vehicle group (Figure 1A). The IT injection of 0.5, 5 and 10 μg/rat of celecoxib decreased the pain score significantly in the late phase as compared with the vehicle group (Figure 1B). There was no significant difference in the antinociceptive activity between 5 and 10 μg/rat doses of celecoxib in the late phase of formalin test (Figure 1B).

The Antinociceptive Effect of Intrathecal Administration of Celecoxib on Both Phases of Formalin Test
Data is expressed as the area under the curve of the score-time curve in both phases of formalin test. Bars are the mean ± SEM of the data obtained in eight animals. *P < 0.05 compared with the vehicle control group.

Data is expressed as the area under the curve of the score-time curve in both phases of formalin test. Bars are the mean ± SEM of the data obtained in eight animals. *P < 0.05 compared with the vehicle control group.

Figure 1.

The Antinociceptive Effect of Intrathecal Administration of Celecoxib on Both Phases of Formalin Test

4.2. Effect of Intrathecal Rimonabant Administration on Formalin Test

IT administration of 200 μg/rat of rimonabant increased the pain score significantly in the early phase compared with the vehicle group (Figure 2A), whereas IT injection of 100 and 200 μg/rat of rimonabant significantly raised the pain score in the late phase compared with the vehicle group (Figure 2B).

The Effect of Intrathecal Administration of Rimonabant on Both Phases of Formalin Test
Data is expressed as the area under the curve of score-time curve in both phases of formalin test. Bars are the mean ± SEM of the data obtained in eight animals. *P < 0.05 compared with the vehicle control group.

Data is expressed as the area under the curve of score-time curve in both phases of formalin test. Bars are the mean ± SEM of the data obtained in eight animals. *P < 0.05 compared with the vehicle control group.

Figure 2.

The Effect of Intrathecal Administration of Rimonabant on Both Phases of Formalin Test

4.3. Effect of Rimonabant on the Antinociceptive Effect of Celecoxib

To evaluate the involvement of cannabinoid receptor in celecoxib antinociceptive effect, rimonabant (100, 200 μg/rat) was administrated IT 10 minutes before either celecoxib (5 μg/rat) or vehicle injection. As shown in Figure 3A and B, rimonabant could significantly reverse the analgesic effects of celecoxib (5 μg/rat) in both phases of the formalin test.

The Effect of Rimonabant on the Intrathecal Antinociception Produced by Celecoxib on Both Phases of Formalin Test
Data is expressed as the area under the curve of score-time curve in both phases of formalin test. Bars are the mean ± SEM of the data obtained in eight animals. Rimonabant or DMSO was administrated 10 minutes before celecoxib or vehicle. *P < 0.05 compared with the vehicle control group. #P < 0.05 compared with the non-treated celecoxib group.

Data is expressed as the area under the curve of score-time curve in both phases of formalin test. Bars are the mean ± SEM of the data obtained in eight animals. Rimonabant or DMSO was administrated 10 minutes before celecoxib or vehicle. *P < 0.05 compared with the vehicle control group. #P < 0.05 compared with the non-treated celecoxib group.

Figure 3.

The Effect of Rimonabant on the Intrathecal Antinociception Produced by Celecoxib on Both Phases of Formalin Test

5. Discussion

In this study, the role of spinal cannabinoid receptors in antinociceptive effect of IT administered celecoxib was evaluated, using formalin test. The constant nociceptive afferent barrage can lead to a progressive production of arachidonic acid in the dorsal horn available for conversion to mediators (18). The formalin test can lead to the increase of the arachidonic acid metabolites, which can affect the nociception responses (19). It was shown that anandamide could entirely inhibit the carrageenan-induced heat hyperalgesia (20).

The antinociceptive effects of NSAIDs are mediated through inhibiting the COX enzymes. Furthermore, other antinociceptive mechanisms such as interactions with endocannabinoids metabolism, leading to higher concentration of anandamide through shift of arachidonic acid metabolism to endocannabinoid production are involved (21-24). In addition, it was shown that NSAIDs could inhibit the enzymatic hydrolysis of anandamide by FAAH (21, 25); so, increased anandamide level may result in the reduction of pain behavior (13).

IT celecoxib (5 μg/rat) administration decreased the score of pain in early and late phases of formalin test. However, the IT injection of celecoxib (10 μg/rat) had no effect on the score of pain in early phase of formalin test. The study indicated that IT celecoxib had antinociceptive activity in late phase of formalin test in a dose-dependent manner. These data are in agreement with other studies in which IT celecoxib administration could inhibit nociception in both phases of formalin test (26-30).

Cannabinoid CB1 receptors are the major cannabinoid isoform receptors recognized in the central nervous system. Cannabinoid agonists and endocannabinoids exhibited strong antinociceptive activity via activation of CB1 in spinal cord level in different animal models of pain (31-33).

IT administration of rimonabant (100 and 200 µg/rat) resulted in hyperalgesia in late phase of formalin test; but in the early phase, only 200 µg/rat of rimonabant could induce hyperalgesia. This effect may be either a result of intrinsic inverse agonist of rimonabant in blocking the action of CB1 receptor or the inhibitory effect of rimonabant on antinociceptive function of endocannabinoids which was evoked by formalin test (34-37). However, it was reported that rimonabant could not produce hyperalgesia in rats (38).

Pretreatment with rimonabant (200 µg/rat) could reverse the antinociceptive effect of IT celecoxib (5 µg/rat) in both phases of the formalin test compared to the celecoxib group. These results revealed that the main antinociceptive effect of celecoxib was mediated by the cannabinoid system at the spinal cord level.

A probable interaction between the antinociceptive effect of COX inhibitors and endocannabinoids was investigated in previous studies. IT pretreatment with AM-251, the selective cannabinoid CB1 receptor antagonist, blocked the analgesic effects of indomethacin and flurbiprofen in animal pain models (22). The inhibition of COX-2 at the spinal cord level decreased both prostaglandin generation and endocannabinoid degradation and indicated that the endocannabinergic mechanisms was more responsible for their antinociceptive activities than the inhibition of spinal prostaglandin synthesis (39). Overall, the possible reaction pathways of celecoxib in this study are shown in Figure 4.

Graphical Abstract Regarding Additional Reaction Pathways of Celecoxib Action in Spinal Cord
Generally, celecoxib inhibits COX II, the enzyme responsible for the conversion of arachidonic acid to prostaglandins and subsequently induction of the inflammatory pain. Furthermore, in the scheme, celecoxib prevents the metabolism of anandamide via inhibition of fatty acid amide hydrolase (FAAH) and COX II. These inhibitions increase the anandamide levels and subsequently cause more activation of CB1 cannabinoid receptors and more antinociception.

Generally, celecoxib inhibits COX II, the enzyme responsible for the conversion of arachidonic acid to prostaglandins and subsequently induction of the inflammatory pain. Furthermore, in the scheme, celecoxib prevents the metabolism of anandamide via inhibition of fatty acid amide hydrolase (FAAH) and COX II. These inhibitions increase the anandamide levels and subsequently cause more activation of CB1 cannabinoid receptors and more antinociception.

Figure 4.

Graphical Abstract Regarding Additional Reaction Pathways of Celecoxib Action in Spinal Cord

In conclusion, the present study suggested that endocannabinoids exhibited a key role in celecoxib antinociception at the spinal level in formalin test. Consistent with this, the antinociceptive effects of celecoxib was antagonized by CB1 receptor antagonist. Accordingly, the maintenance of the endocannabinoid level by COX II inhibition can potentiate the analgesic effects of celecoxib or other NSAIDs and highlight the importance combination use of cannabinoid agents and NSAIDs to increase their safety and efficacy.

Acknowledgements

References

  • 1.

    Burian M, Geisslinger G. COX-dependent mechanisms involved in the antinociceptive action of NSAIDs at central and peripheral sites. Pharmacol Ther. 2005;107(2):139-54. [PubMed ID: 15993252]. https://doi.org/10.1016/j.pharmthera.2005.02.004.

  • 2.

    Cashman JN. The mechanisms of action of NSAIDs in analgesia. Drugs. 1996;52 Suppl 5:13-23. [PubMed ID: 8922554].

  • 3.

    Khanna IK, Weier RM, Yu Y, Xu XD, Koszyk FJ, Collins PW, et al. 1,2-Diarylimidazoles as potent, cyclooxygenase-2 selective, and orally active antiinflammatory agents. J Med Chem. 1997;40(11):1634-47. [PubMed ID: 9171873]. https://doi.org/10.1021/jm9700225.

  • 4.

    Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res Clin Pract. 2000;47(2):123-8. https://doi.org/10.1016/S0168-8227(99)00112-6.

  • 5.

    Zhao FY, Spanswick D, Martindale JC, Reeve AJ, Chessell IP. GW406381, a novel COX-2 inhibitor, attenuates spontaneous ectopic discharge in sural nerves of rats following chronic constriction injury. Pain. 2007;128(1-2):78-87. [PubMed ID: 17055166]. https://doi.org/10.1016/j.pain.2006.08.032.

  • 6.

    Rezende RM, Paiva-Lima P, Dos Reis WG, Camelo VM, Faraco A, Bakhle YS, et al. Endogenous opioid and cannabinoid mechanisms are involved in the analgesic effects of celecoxib in the central nervous system. Pharmacology. 2012;89(3-4):127-36. [PubMed ID: 22415159]. https://doi.org/10.1159/000336346.

  • 7.

    Rezende RM, Dos Reis WG, Duarte ID, Lima PP, Bakhle YS, de Francischi JN. The analgesic actions of centrally administered celecoxib are mediated by endogenous opioids. Pain. 2009;142(1-2):94-100. [PubMed ID: 19186002]. https://doi.org/10.1016/j.pain.2008.12.005.

  • 8.

    Correa JD, Paiva-Lima P, Rezende RM, Dos Reis WG, Ferreira-Alves DL, Bakhle YS, et al. Peripheral mu-, kappa- and delta-opioid receptors mediate the hypoalgesic effect of celecoxib in a rat model of thermal hyperalgesia. Life Sci. 2010;86(25-26):951-6. [PubMed ID: 20451533]. https://doi.org/10.1016/j.lfs.2010.04.012.

  • 9.

    Guindon J, Hohmann AG. Cannabinoid CB2 receptors: a therapeutic target for the treatment of inflammatory and neuropathic pain. Br J Pharmacol. 2008;153(2):319-34. [PubMed ID: 17994113]. https://doi.org/10.1038/sj.bjp.0707531.

  • 10.

    Gutierrez T, Crystal JD, Zvonok AM, Makriyannis A, Hohmann AG. Self-medication of a cannabinoid CB2 agonist in an animal model of neuropathic pain. Pain. 2011;152(9):1976-87. [PubMed ID: 21550725]. https://doi.org/10.1016/j.pain.2011.03.038.

  • 11.

    Karlsson J, Fowler CJ. Inhibition of endocannabinoid metabolism by the metabolites of ibuprofen and flurbiprofen. PLoS One. 2014;9(7). eeee103589. [PubMed ID: 25061885]. https://doi.org/10.1371/journal.pone.0103589.

  • 12.

    Fowler CJ. NSAIDs: eNdocannabinoid stimulating anti-inflammatory drugs? Trends Pharmacol Sci. 2012;33(9):468-73. [PubMed ID: 22664342]. https://doi.org/10.1016/j.tips.2012.05.003.

  • 13.

    Guindon J, LoVerme J, De Lean A, Piomelli D, Beaulieu P. Synergistic antinociceptive effects of anandamide, an endocannabinoid, and nonsteroidal anti-inflammatory drugs in peripheral tissue: a role for endogenous fatty-acid ethanolamides? Eur J Pharmacol. 2006;550(1-3):68-77. [PubMed ID: 17027744]. https://doi.org/10.1016/j.ejphar.2006.08.045.

  • 14.

    Zimmermann M. Ethical guidelines for investigations of experimental pain in conscious animals. Pain. 1983;16(2):109-10. https://doi.org/10.1016/0304-3959(83)90201-4.

  • 15.

    Yaksh TL, Rudy TA. Chronic catheterization of the spinal subarachnoid space. Physiol Behav. 1976;17(6):1031-6. [PubMed ID: 14677603].

  • 16.

    Dubuisson D, Dennis SG. The formalin test: a quantitative study of the analgesic effects of morphine, meperidine, and brain stem stimulation in rats and cats. Pain. 1977;4(2):161-74. [PubMed ID: 564014].

  • 17.

    Adibpour N, Poornajjari A, Khodayar MJ, Rezaee S. Antinociceptive effect of some biuret derivatives on formalin test in mice. Adv Pharm Bull. 2014;4(2):179-83. [PubMed ID: 24511482]. https://doi.org/10.5681/apb.2014.026.

  • 18.

    Malmberg AB, Yaksh TL. Hyperalgesia mediated by spinal glutamate or substance P receptor blocked by spinal cyclooxygenase inhibition. Science. 1992;257(5074):1276-9. [PubMed ID: 1381521].

  • 19.

    McMahon S, Koltzenburg M, Tracey I, Turk DC. Wall and Melzack's Textbook of Pain. USA: Elsevier Health Sciences; 2013.

  • 20.

    Richardson JD, Aanonsen L, Hargreaves KM. Antihyperalgesic effects of spinal cannabinoids. Eur J Pharmacol. 1998;345(2):145-53. https://doi.org/10.1016/S0014-2999(97)01621-X.

  • 21.

    Fowler CJ, Stenstrom A, Tiger G. Ibuprofen inhibits the metabolism of the endogenous cannabimimetic agent anandamide. Pharmacol Toxicol. 1997;80(2):103-7. https://doi.org/10.1111/j.1600-0773.1997.tb00291.x.

  • 22.

    Gühring H, Hamza M, Sergejeva M, Ates M, Kotalla CE, Ledent C, et al. A role for endocannabinoids in indomethacin-induced spinal antinociception. Eur J Pharmacol. 2002;454(2):153-63. https://doi.org/10.1016/S0014-2999(02)02485-8.

  • 23.

    Ates M, Hamza M, Seidel K, Kotalla CE, Ledent C, Guhring H. Intrathecally applied flurbiprofen produces an endocannabinoid-dependent antinociception in the rat formalin test. Eur J Neurosci. 2003;17(3):597-604. [PubMed ID: 12581177].

  • 24.

    Seidel K, Hamza M, Ates M, Gühring H. Flurbiprofen inhibits capsaicin induced calcitonin gene related peptide release from rat spinal cord via an endocannabinoid dependent mechanism. Neurosci Lett. 2003;338(2):99-102. https://doi.org/10.1016/S0304-3940(02)01366-6.

  • 25.

    Fowler CJ, Janson U, Johnson RM, Wahlstrom G, Stenstrom A, Norstrom K, et al. Inhibition of anandamide hydrolysis by the enantiomers of ibuprofen, ketorolac, and flurbiprofen. Arch Biochem Biophys. 1999;362(2):191-6. [PubMed ID: 9989926].

  • 26.

    Franca DS, Ferreira-Alves DL, Duarte ID, Ribeiro MC, Rezende RM, Bakhle YS, et al. Endogenous opioids mediate the hypoalgesia induced by selective inhibitors of cyclo-oxygenase 2 in rat paws treated with carrageenan. Neuropharmacology. 2006;51(1):37-43. [PubMed ID: 16620880]. https://doi.org/10.1016/j.neuropharm.2006.02.012.

  • 27.

    Francischi JN, Chaves CT, Moura AC, Lima AS, Rocha OA, Ferreira-Alves DL, et al. Selective inhibitors of cyclo-oxygenase-2 (COX-2) induce hypoalgesia in a rat paw model of inflammation. Br J Pharmacol. 2002;137(6):837-44. [PubMed ID: 12411415]. https://doi.org/10.1038/sj.bjp.0704937.

  • 28.

    Lu ZH, Xiong XY, Zhang BL, Lin GC, Shi YX, Liu ZG, et al. Evaluation of 2 celecoxib derivatives: analgesic effect and selectivity to cyclooxygenase-2/1. Acta Pharmacol Sin. 2005;26(12):1505-11. [PubMed ID: 16297351]. https://doi.org/10.1111/j.1745-7254.2005.00222.x.

  • 29.

    Nishiyama T. Analgesic effects of intrathecally administered celecoxib, a cyclooxygenase-2 inhibitor, in the tail flick test and the formalin test in rats. Acta Anaesthesiol Scand. 2006;50(2):228-33. [PubMed ID: 16430547]. https://doi.org/10.1111/j.1399-6576.2006.00921.x.

  • 30.

    Yamamoto T, Nozaki-Taguchi N. The role of cyclooxygenase-1 and -2 in the rat formalin test. Anesth Analg. 2002;94(4):962-7. table of contents. [PubMed ID: 11916805].

  • 31.

    Howlett AC. The cannabinoid receptors. Prostaglandins Other Lipid Mediat. 2002;(68):619-31. https://doi.org/10.1016/S0090-6980(02)00060-6.

  • 32.

    Bagues A, Martin MI, Sanchez-Robles EM. Involvement of central and peripheral cannabinoid receptors on antinociceptive effect of tetrahydrocannabinol in muscle pain. Eur J Pharmacol. 2014;745:69-75. [PubMed ID: 25446925]. https://doi.org/10.1016/j.ejphar.2014.10.016.

  • 33.

    Mackie K. Cannabinoid receptors as therapeutic targets. Annu Rev Pharmacol Toxicol. 2006;46:101-22. [PubMed ID: 16402900]. https://doi.org/10.1146/annurev.pharmtox.46.120604.141254.

  • 34.

    Fernandez JR, Allison DB. Rimonabant Sanofi-Synthelabo. Curr Opin Investig Drugs. 2004;5(4):430-5. [PubMed ID: 15134285].

  • 35.

    Strangman NM, Patrick SL, Hohmann AG, Tsou K, Walker JM. Evidence for a role of endogenous cannabinoids in the modulation of acute and tonic pain sensitivity. Brain Res. 1998;813(2):323-8. https://doi.org/10.1016/S0006-8993(98)01031-2.

  • 36.

    Richardson JD, Aanonsen L, Hargreaves KM. SR 141716A, a cannabinoid receptor antagonist, produces hyperalgesia in untreated mice. Eur J Pharmacol. 1997;319(2-3):R3-4. [PubMed ID: 9042616].

  • 37.

    Richardson JD, Aanonsen L, Hargreaves KM. Hypoactivity of the spinal cannabinoid system results in NMDA-dependent hyperalgesia. J Neurosci. 1998;18(1):451-7. [PubMed ID: 9412521].

  • 38.

    Naderi N, Shafaghi B, Khodayar MJ, Zarindast MR. Interaction between gamma-aminobutyric acid GABAB and cannabinoid CB1 receptors in spinal pain pathways in rat. Eur J Pharmacol. 2005;514(2-3):159-64. [PubMed ID: 15910802]. https://doi.org/10.1016/j.ejphar.2005.03.037.

  • 39.

    Telleria-Diaz A, Schmidt M, Kreusch S, Neubert AK, Schache F, Vazquez E, et al. Spinal antinociceptive effects of cyclooxygenase inhibition during inflammation: Involvement of prostaglandins and endocannabinoids. Pain. 2010;148(1):26-35. [PubMed ID: 19879047]. https://doi.org/10.1016/j.pain.2009.08.013.