Tapentadol inhibits calcitonin gene-related peptide release from rat brainstem in vitro

We have previously developed an in vitro model of rat brainstem explants. The latter release sizable amounts of calcitonin gene-related peptide (CGRP); basal release can be stimulated by such secretagogues as high KCl concentrations, veratridine or capsaicine. In this paradigm we investigated the activity of the analgesic agent tapentadol; the effects of tapentadol were compared to those of a classical opioid receptor agonist, morphine, and the selective noradrenaline reuptake inhibitor reboxetine. Morphine inhibited basal CGRP release, with statistical significance from 1nM onward and maximal (-44%) inhibition at 100μM. Morphine also inhibited K(+)-stimulated peptide release, with a significant effect from 1μM and maximal (-39%) decrease at 100μM, but failed to inhibit release stimulated by 10μM capsaicin. At variance, reboxetine had no effect on baseline CGRP outflow, but was able to inhibit both K(+)-stimulated [significant inhibition from 1μM onward and maximal (-37%) decrease at 100μM], and capsaicin-stimulated release [significant effect from 1μM and maximal (-31%) decrease at 100μM]. Likewise, tapentadol had no effect on baseline CGRP release up to 100μM, but decreased secretion stimulated by 56mM KCl or capsaicin, with significant effects from 0.1 and 1μM respectively; maximal inhibition over 56mM KCl and capsaicin stimuli was -29% and -31%, respectively. Naloxone antagonized the effect of morphine, but not those of reboxetine and tapentadol, on K(+)-stimulated CGRP secretion. In conclusion the present study provides consistent pharmacological evidence that tapentadol acts as a noradrenaline reuptake inhibitor agent in this experimental model.