Our research showed that the pain-relieving effect of a dose of 10 mg/kg polydatin is mediated by the NO/cGMP/K
ATP channel signaling pathway in both phases of nociceptive pain evaluated by the formalin test (
Figure 7). The results indicated a U-shaped dose-nociception (inverted U-shaped dose-anti-nociceptive effect) response of polydatin. A U-shaped curve in pharmacodynamics, as related to hormesis, implies that the effect of a substance varies with dose in a biphasic manner: Low doses stimulate a beneficial or stimulatory effect, while high doses produce an inhibitory, toxic, or adverse effect, with an optimal intermediate dose producing the best response. This non-linear dose-response relationship means both too little and too much of a substance can be ineffective or harmful, while a moderate dose is optimal (
30). Accordingly, the dose of 10 mg/kg of polydatin showed more promising anti-nociceptive effects in mice. From a mechanistic point of view, we showed that the anti-nociceptive effects of polydatin are mediated by the NO/cGMP/K
ATP pathway.
Pain is a multifaceted sensation that can greatly affect one's quality of life. It can stem from different causes such as tissue damage, inflammation, and neuropathy. Effectively managing pain has always been a persistent challenge for healthcare providers. Consequently, there is an ongoing demand for reliable and secure pain-relieving medications (
31). Polydatin is a naturally occurring compound found in various plants, such as
Polygonum cuspidatum and grapes. It is a potent stilbenoid polyphenol and a resveratrol derivative with improved bioavailability (
13). Previous studies did not provide a comprehensive understanding of the mechanisms involved in the anti-nociceptive effects triggered by polydatin. The findings from our study indicate that the pain experienced during both phases of the formalin test is diminished following the administration of various doses of polydatin. From a mechanistic point of view, the L-Arg/NO/cGMP/K
ATP channel signaling pathway is a complex molecular cascade involved in pain perception. This pathway starts with the conversion of L-Arg into NO by the enzyme NOS (
32). In this regard, our results showed that pretreatment of mice with L-NAME as a NO blocker inhibited the analgesic effects of polydatin, while pretreatment with SNAP as a NO donor was associated, but not meaningfully, with increasing the anti-nociceptive effects of polydatin. Our study also indicated that pretreatment with L-Arg could not meaningfully decrease nociception. However, no significant concerns have been raised about the limited penetration of L-Arg into the brain, and the expected pharmacological effects have been consistently reported using this compound (
26-
28). The role of L-Arg in nociception is complex and context-dependent. Some studies show L-Arg can exert both anti-nociceptive and nociceptive effects via different pathways in the brain. It may reduce pain through the kyotorphin-Met-enkephalin opioid pathway but also facilitate nociception via NO and cGMP signaling pathways (
33). This procedure on the non-responsiveness of L-Arg and SNAP on the nociceptive effect of polydatin could also be due to the dual role of NO in pain transmission and control (
7); in low doses, it could help the anti-nociceptive responses, while higher doses may facilitate nociception. Inhibitory effects of polydatin on higher doses and pathogenesis dosage of NO have also been shown in RAW 264.7 cells (
34). According to this L-Arg/NO/cGMP/K
ATP channel mechanism, in our study, glibenclamide as a K
ATP channel inhibitor hindered the analgesic effects of polydatin. During another in vivo report, the potential of polydatin in the opening of K
ATP channels was presented by Miao et al. (
35). Glibenclamide, a sulfonylurea, blocks K
ATP channels by binding to their sulfonylurea receptor, preventing their opening and thus increasing neuronal excitability (
36,
37). In the formalin test, which consists of neurogenic and inflammatory pain phases, K
ATP channel activation helps inhibit nociceptive signaling. When glibenclamide attenuates analgesic effects in this test, it indicates that K
ATP channels are actively mediating anti-nociception, suggesting their role in both peripheral and central pain processes. This blockade reinforces the idea that K
ATP channels serve as endogenous regulators of pain transmission, further supported by other studies showing that K
ATP channel openers reduce pain responses. A study showed that glibenclamide attenuated trigeminal pain transmission in rats, indicating its role in K
ATP channel-mediated pain modulation. It also discusses the effects of glibenclamide on hypersensitivity induced by migraine triggers and highlights K
ATP channel subtype specificity in pain (
38). Another study on the anti-nociceptive effect of pregabalin in the formalin test shows glibenclamide’s inhibitory impact on analgesia, supporting the role of K
ATP channels in regulating peripheral neuronal excitability and neurotransmitter release in spinal pain pathways (
39).
In a more recent study, polydatin attenuated neuroinflammation but not mechanical hypersensitivity in mice (
21). Confirming the analgesic effect of polydatin, Guan et al. reported that polydatin can inhibit the production of pro-inflammatory cytokines and chemokines as well as the activation of inflammatory pathways such as NF-κB. By reducing inflammation, polydatin could help in reducing pain. They also emphasized that polydatin may affect the release and activity of neurotransmitters involved in pain signaling, such as serotonin and glutamate, potentially altering pain perception and providing analgesic effects (
21). Another research trial demonstrated that when polydatin is combined with palmitoylethanolamide, an endogenous fatty acid amide known for its anti-inflammatory properties, it could effectively reduce pain in women suffering from chronic pelvic pain and improve their overall quality of life (
23). Polydatin normalized mitochondrial superoxides, improved neurite outgrowth, and facilitated Nrf2-directed antioxidant signaling. It also alleviated oxidative damage and elevated mitochondrial biogenesis in experimental diabetic neuropathy (
40). Xu et al. also found that polydatin attenuated spinal cord injury in rats, and its effects are associated with the activation of astrocytic mu-opioid receptors, which cause conditioned place preference (
41).