趋化因子介导的神经炎症反应和神经病理性疼痛

各种疾病引起的神经系统的损伤或功能障碍致使全球数以百万计的人们患有神经性病理性疼痛。目前的方法对神经病理性疼痛的疗效不佳且有副作用,需要开发有效的治疗方法。近年来人们逐渐认识到,脊髓中胶质细胞（如小胶质细胞和星形胶质细胞）能通过释放强效的神经调质,如促炎细胞因子和趋化因子,在神经性病理性疼痛的产生和维持中起重要作用。近期的证据显示,趋化因子是疼痛调控中的新成员。该文综述了一些趋化因子和受体（如CCL2／CCR2、CXCL1／CXCR2、CX3CL1／CX3CR1、CCL21／CXCR3）作为神经元和胶质细胞相互调控的介质参与神经病理性疼痛的调节。靶向趋化因子介导的神经炎症反应将成为治疗神经病理性疼痛的新方向。     

Spinal macrophages resolve nociceptive hypersensitivity after peripheral injury

1. Download : Download high-res image (190KB)
2. Download : Download full-size image

     

基于纳米酶的脊髓损伤治疗

创伤性脊髓损伤是由外部冲击引起的椎管内神经结构损害,其发病率及致残率较高。目前临床治疗主要采用手术、激素冲击等方法,由于缺乏针对性治疗药物,无法实现实质性的功能恢复。针对脊髓损伤病理进程中氧化应激及神经炎症等特点,开发可持续降解自由基、抑制氧化应激、调节神经炎症的疗法成为研究热点。纳米酶具有与天然酶类似的催化活性,且在生理条件下稳定,可以持续抑制氧化应激和神经炎症,对脊髓损伤治疗具有重要意义。本文聚焦基于纳米酶的脊髓损伤治疗,介绍了脊髓损伤的病理生理学特点,纳米酶的分类、性质及纳米酶治疗脊髓损伤的研究进展,阐述了纳米酶对脊髓损伤治疗的推动作用,尤其使脊髓损伤治疗从单纯缓解症状的姑息治疗向神经再生的转变,展现了纳米酶作为脊髓损伤治疗平台的多功能性和潜在应用前景。     

Inhibiting astrocytic activation: a novel analgesic mechanism of ketamine at the spinal level?

Although ketamine is widely used as an analgesic agent and has an anti-allodynic effect on neuropathic pain, the underlying analgesic mechanisms are not fully explained by the modern 'neuronal-based' theories. As emerging studies have focused on the critical role of spinal astrocytes in the pathological pain states, we have hypothesized that there exist some 'astrocytes-related' mechanisms in the analgesic function of ketamine. In the present study, using the spinal nerve ligation (SNL) pain model, we investigated the anti-nociceptive effects of intraperitoneal or intrathecal ketamine on SNL-induced neuropathic pain response, meanwhile, we investigated the astrocytic activation after ketamine administration on SNL rats. Behavioral data showed that either intraperitoneal or intrathecal ketamine inhibited SNL-induced allodynia, however, immunohistochemistry showed that SNL induced astrocytic activation was suppressed by intrathecal but not intraperitoneal ketamine. Using quantitative Western blot analysis, our report showed that intrathecal ketamine down-regulated glial fibrillary acidic protein expression, suggesting inhibition of SNL-induced astrocytic activation, which wasn't influenced by intraperitoneal administration. We conclude that intraperitoneal ketamine could alleviate SNL-induced neuropathic pain via the classical 'neuronal-based' mechanisms, but in addition, 'astrocytes-related' mechanisms were also important underlying the anti-allodynic effect of intrathecal ketamine.     

Serotonin in pain and analgesia

The purpose of this article is to summarize recent findings on the role of serotonin in pain processing in the peripheral nervous system. Serotonin (5-hydroxtryptamine [5-HT]) is present in central and peripheral serotonergic neurons, it is released from platelets and mast cells after tissue injury, and it exerts algesic and analgesic effects depending on the site of action and the receptor subtype. After nerve injury, the 5-HT content in the lesioned nerve increases. 5-HT receptors of the 5-HT₃ and 5-HT_2A subtype are present on C-fibers. 5-HT, acting in combination with other inflammatory mediators, may ectopically excite and sensitize afferent nerve fibers, thus contributing to peripheral sensitization and hyperalgesia in inflammation and nerve injury.     

NGF通过抑制内质网应激途径保护SCs在高糖环境诱导的凋亡

已知神经生长因子 (nerve growth factor, NGF) 对糖尿病外周神经病变 (diabetic peripheral neuropathy, DPN) 患者具有良好的治疗效果,内质网应激 (endoplasmic reticulum stress, ERS) 在调控DPN 的发生发展方面扮演着重要的角色。然而,二者间的关系未知。本研究以30 mmol/L的高糖处理RSC-96大鼠雪旺细胞 (RSC96 Schwann cells, SCs),模拟DPN患者外周神经的内环境。研究结果证实,在高糖条件下,NGF通过抑制SCs内 ERS的过度激活进而保护SCs的存活且这种抑制作用依靠P13K/AKT/GSK-3β和ERK1/2两条信号通路的调节实现。MTT检测细胞的存活率,结果显示高糖环境培养的SCs在24 h发生最佳程度的抑制,且此时间点加入的NGF浓度为50 ng/mL 时,其存活率最高。Western 印迹检测ERS和相关蛋白质的表达揭示,高糖能够过度激活SCs内ERS蛋白 (GRP-78、ATF-6、ATF-4、XBP-1、CHOP),给予 50 ng/mL的NGF处理后,ERS蛋白的表达水平大幅下调并接近正常,且此时p-AKT、p-ERK1/2、p-GSK3β蛋白的检测水平明显升高。流式细胞术检测细胞凋亡显示,NGF能显著抑制SCs的早期凋亡。上述结果证明,高糖诱导SCs的凋亡增加是由于自身的ERS被过度激活,NGF可通过调节P13K/AKT/GSK-3β和ERK1/2两条信号通路来抑制ERS的过度激活,达到保护SCs存活的目的。此机制为临床治疗 DPN 提供新的理论基础。     

Retrograde determination of motoneuron properties and their synaptic input

Both motoneurons and the muscle fibers that they innervate can vary widely in their properties. The finding that these properties are highly correlated indicates that these cells are not specified independently, but rather interact in some manner to achieve the observed coherence. The direction of the interaction, i.e., whether orthograde or retrograde, required analysis beyond the simple observation of these correlated properties. Evidence, largely from experiments involving reinnervation of muscle by the original or a foreign motor nerve, suggests the action of retrogradely transported factors from the muscle as well as orthograde ones. Various possible factors, specifically neurotrophins, are advanced as possible candidates for retrograde specification. In addition, synaptic input to motoneurons also varies in a coordianted fashion in a manner that suggests a retrograde determination from the muscle. However, motoneuron properties and their synaptic input change after peipheral nerve manipulations such that they are no longer in register. This indicates some independence in retrograde specification of motoneurons and their synaptic input. 1994 John Wiley & Sons, Inc.     

Toll-like receptor (TLR)-2 and TLR-4 regulate inflammation, gliosis, and myelin sparing after spinal cord injury

Activation of macrophages via toll-like receptors (TLRs) is important for inflammation and host defense against pathogens. Recent data suggest that non-pathogenic molecules released by trauma also can trigger inflammation via TLR2 and TLR4. Here, we tested whether TLRs are regulated after sterile spinal cord injury (SCI) and examined their effects on functional and anatomical recovery. We show that mRNA for TLR1, 2, 4, 5, and 7 are increased after SCI as are molecules associated with TLR signaling (e.g. MyD88, NFkappaB). The significance of in vivo TLR2 and TLR4 signaling was evident in SCI TLR4 mutant (C3H/HeJ) and TLR2 knockout (TLR2-/-) mice. In C3H/HeJ mice, sustained locomotor deficits were observed relative to SCI wild-type control mice and were associated with increased demyelination, astrogliosis, and macrophage activation. These changes were preceded by reduced intraspinal expression of interleukin-1beta mRNA. In TLR2-/- mice, locomotor recovery also was impaired relative to SCI wild-type controls and novel patterns of myelin pathology existed within ventromedial white matter--an area important for overground locomotion. Together, these data suggest that in the absence of pathogens, TLR2 and TLR4 are important for coordinating post-injury sequelae and perhaps in regulating inflammation and gliosis after SCI.     

The regenerative effects of electromagnetic field on spinal cord injury

Traumatic spinal cord injury (SCI) is typically the result of direct mechanical impact to the spine, leading to fracture and/or dislocation of the vertebrae along with damage to the surrounding soft tissues. Injury to the spinal cord results in disruption of axonal transmission of signals. This primary trauma causes secondary injuries that produce immunological responses such as neuroinflammation, which perpetuates neurodegeneration and cytotoxicity within the injured spinal cord. To date there is no FDA-approved pharmacological agent to prevent the development of secondary SCI and induce regenerative processes aimed at healing the spinal cord and restoring neurological function. An alternative method to electrically activate spinal circuits is the application of a noninvasive electromagnetic field (EMF) over intact vertebrae. The EMF method of modulating molecular signaling of inflammatory cells emitted in the extra-low frequency range of <100 Hz, and field strengths of <5 mT, has been reported to decrease inflammatory markers in macrophages, and increase endogenous mesenchymal stem cell (MSC) proliferation and differentiation rates. EMF has been reported to promote osteogenesis by improving the effects of osteogenic media, and increasing the proliferation of osteoblasts, while inhibiting osteoclast formation and increasing bone matrix in vitro. EMF has also been shown to increase chondrogenic markers and collagen and induce neural differentiation, while increasing cell viability by over 50%. As advances are made in stem cell technologies, stabilizing the cell line after differentiation is crucial to SCI repair. Once cell-seeded scaffolds are implanted, EMF may be applied outside the wound for potential continued adjunct treatment during recovery.     

Effect of tempol on peripheral neuropathy in diet-induced obese and high-fat fed/low-dose streptozotocin-treated C57Bl6/J mice

In this study, we sought to determine the efficacy of tempol on multiple neuropathic endpoints in a diet-induced obese mouse, a model of pre-diabetes, and a high-fat fed low-dose streptozotocin treated mouse, a model of type 2 diabetes. Tempol (4-hydroxy-2,2,6,6-tetramethylpiperdine -1-oxyl) is a low molecular weight, water soluble, membrane permeable, and metal-independent superoxide dismutase mimetic that has been widely used in cellular studies for the removal of intracellular and extracellular superoxide. This in vivo study was designed to be an early intervention. Fourteen weeks post-high-fat diet (6 weeks post-hyperglycemia) control, obese, and diabetic mice were divided into no treatment and treatment groups. The treated mice received tempol by gavage (150?mg/kg in water), while the untreated mice received vehicle. The diet-induced obese and the diabetic mice were maintained on the high-fat diet for the duration of the study, while the control group was maintained on the standard diet. Obesity and diabetes caused slowing of motor and sensory nerve conduction, reduction in intraepidermal nerve fiber density, thermal hypoalgesia, and mechanical allodynia. Treatment with tempol partially or completely protected obese and diabetic mice from these deficits. These studies suggest that tempol or other effective scavengers of reactive oxygen species may be a viable option for treating neural complications associated with obesity or type 2 diabetes.