脊髓p38丝裂原活化蛋白激酶激活参与坐骨神经压迫性损伤所致神经病理性痛

本研究旨在观察脊髓p38丝裂原活化蛋白激酶（p38 mitogen-activated protein kinase,p38 MAPK）在坐骨神经压迫性损伤所致神经病理性痛中的作用。雄性Sprague-Dawley大鼠鞘内置管后,4-0丝线松结扎左侧坐骨神经制作慢性压迫性损伤（chronic constriction injury,CCI）模型。CCI后第5天,鞘内注射不同剂量的p38 MAPK特异性抑制剂SB203580,并在给药前及给药后不同时间点,分别用von Frey机械痛敏监测仪和热辐射刺激仪监测大鼠损伤侧后爪机械和热刺激反应闽值,用免疫印迹技术（Western blot）观察给药前后脊髓磷酸化p38 MAPK（p-p38 MAPK）和磷酸化环磷酸腺苷反应元件结合蛋白（phosphorylated cAMP response element binding protein,pCREB）表达变化。结果发现：坐骨神经压迫性损伤引起脊髓p-p38 MAPK蛋白表达明显增加;鞘内注射SB203580能剂量依赖性逆转CCI引起的机械性痛觉异常和热痛觉过敏及脊髓水平p-p38 MAPK表达的增加,也明显抑制CCI引起的脊髓pCREB表达的增加。结果提示,脊髓水平p38 MAPK激活参与坐骨神经压迫性损伤所致神经病理性痛的发展,其作用可能通过pCREB介导。     

脊髓水平细胞外信号调节激酶激活参与吗啡依赖的形成及戒断反应的表达

在大鼠吗啡依赖和戒断模型上,采用行为学、免疫组织化学和Western blot方法观察吗啡依赖及戒断大鼠脊髓神经元磷酸化细胞外信号调节激酶（phospho-extracellular signal-regulated kinase,pERK）表达的变化,及鞘内注射促分裂原活化蛋白激酶激酶（mitogen-activated protein kinase kinase,MEK）抑制剂U0126或ERK反义寡核苷酸对吗啡依赖大鼠纳洛酮催促戒断反应、触诱发痛及脊髓神经元pERK表达的影响,探讨脊髓水平pERK在介导吗啡依赖和戒断过程中的作用。结果显示：（1）在吗啡依赖形成过程中,大鼠脊髓胞浆与胞核非磷酸化ERK表达没有改变,但pERK表达逐渐增加,纳洛酮催促戒断后,仍有进一步增加的趋势,戒断1h后,其表达量明显下降,但仍高于对照组。（2）鞘内预先注射MEK抑制剂U0126或ERK反义寡核苷酸能明显抑制吗啡戒断反应和戒断引起的痛觉异常;与行为学结果一致,脊髓背角pERK阳性神经元表达与脊髓胞浆和胞核pERK表达也明显降低。上述结果提示,脊髓水平ERK激活和核转位参与吗啡依赖的形成及戒断反应的表达。     

NO参与介导吗啡戒断大鼠脊髓神经元敏感化

运用Fos免疫组织化学、NADPH－d组织化学、F/NADPH－d双标、鞘内注射和反义寡核苷酸技术,观察吗啡戒断大鼠脊髓神经元活动变化及NO在其中的作用,结果发现：非吗啡依赖大鼠急性应用纳洛酮和吗啡依赖大鼠脊髓水平Fos-LI和NADPH－d阳性神经元表达与对照组相比无明显变化,二者也无Fos／NADPH－d双标神经元表达;吗啡依赖纳洛酮催促戒断大鼠脊髓Fos-LI、NADPH－d阳性神经元、纤维和终末表达明显增加,且出现Fos／NADPH－d双标神经元表达。Fos-LI和Fos／NADPH－d双标神经元呈现双侧脊髓全层分布,NADPH－d阳性神经元、纤维和终末主要位于双侧脊髓背角浅层。鞘内注射NOS抑制剂L－NA和nNOS反义寡核苷酸均明显降低吗啡依赖大鼠纳洛酮催促戒断症状评分,减少吗啡戒断大鼠脊髓Fos-LI表达。上述结果提示：NO参与介导吗啡戒断大鼠脊髓神经元敏感化。     

右美托咪啶对神经痛大鼠脊髓背角pERK、pCREB表达的影响

目的:评价右美托咪啶对神经病理性痛大鼠脊髓背角神经元磷酸化胞外反应激酶(phosphoryltion of extracellular regulated protein kinases,p ERK)、磷酸化c AMP反应元件结合蛋白(phosphoryltion of Camp response element bound protein,p CREB)蛋白表达的影响。方法:健康成年雄性Wistar大鼠54只,6~8周龄,体重180~220 g,采用随机数字表法,将其分为3组(n=18):假手术组(S组)、慢性神经病理性痛组(C组)和右美托咪啶组(D组)。S组仅分离坐骨神经但不结扎,C组和D组采用结扎坐骨神经的方法制备大鼠坐骨神经慢性压迫性损伤(chronic constriction injury,CCI)的神经病理性痛模型,D组于术后即刻开始至处死前1d腹腔注射右美托咪啶50μg/kg,1次/d,S组和C组注射等容量生理盐水。于术前1 d、术后3、7、14 d时以缩足阈值(paw withdrawal threshold,PWT)测定大鼠机械痛阈和辐射热的缩足潜伏期(paw withdrawl latency,PWL)测定大鼠的热痛阈,并于术后测定痛阈后灌注处死大鼠,取L4-6脊髓组织,采用免疫组织化学法检测脊髓背角神经元p ERK、p CREB的表达水平。结果:与S组比较,C组和D组术后3、7、14 d时MWT降低,TWL缩短,脊髓背角p ERK、p CREB表达上调(P0.05);与C组比较,D组术后3、7、14 d时MWT升高,TWL延长,脊髓背角p ERK、p CREB表达下调(P0.05)。与术前1 d比较,C组和D组术后3、7、14 d时MWT降低,TWL缩短;与术后3 d时比较,C组和D组7、14 d时MWT降低,TWL缩短,脊髓背角p ERK、p CREB表达上调(P0.05)。结论:右美托咪啶可减轻大鼠慢性神经病理性痛,抑制p ERK、p CREB的表达可能是其作用机制之一。     

高压氧处理抑制神经病理性疼痛大鼠炎性细胞因子的表达

目的观察高压氧(hyperbaric oxygen,HBO)对坐骨神经慢性结扎损伤(chronic constriction injury,CCI)神经病理性疼痛大鼠TNF-α,IL-1β,IL-6炎性因子的影响,探讨其镇痛机制。方法 30只SD大鼠随机分为假手术组(S),坐骨神经结扎组(CCI)和结扎后高压氧组(CCI+HBO)3组,CCI术后每天都进行疼痛行为学评分,并在术后7天,用ELISA及脊髓的免疫组织化学方法检测各组大鼠炎性因子的表达水平。结果 CCI大鼠的疼痛行为学评分明显降低,高压氧处理可改善CCI大鼠疼痛行为学评分;ELISA检测到CCI大鼠TNF-α、IL-1β和IL-6血清含量明显升高,高压氧处理可减少CCI大鼠TNF-α、IL-1β和IL-6血清含量的升高;免疫组织化学检测发现CCI大鼠脊髓背角Ⅰ、Ⅱ层内TNF-α、IL-1β、IL-6阳性神经元数量增加,高压氧处理的CCI大鼠脊髓背角Ⅰ、Ⅱ层内TNF-α、IL-1β、IL-6阳性神经元数量的增加明显少于单纯CCI小鼠。结论高压氧可以抑制炎性因子的表达,这可能与其缓解神经病理性疼痛有关。     

靶向毁损触液核对大鼠痛行为及脊髓背角5-HT和c-Fos表达的影响

目的：观察缺失触液核（CSF-contacting nucleus）对大鼠痛行为及脊髓背角痛相关物质5-羟色胺（5-HT）和c—Fas表达的影响,为触液核参与疼痛调制及机制提供实验依据。方法：成年雄性SD大鼠随机分为正常组（Control）,假手术组（Sham）,霍乱毒素亚单位B与辣根过氧化酶复合物（CB—HRP）组和毁损触液核组（Damage）。以机械缩足阈值（MWT）和热缩足潜伏期（耶儿）测定大鼠痛行为。免疫荧光法检测脊髓背角5-HT和c—Fos表达,并进行痛行为阈值与物质变化趋势的相关分析。结果：与Control、Sham和CB—HRP组相比,Damage组大鼠MWT和TWL明显降低（P〈0．05）。免疫荧光结果显示,正常大鼠触液核神经元高表达5-HT;Damage组大鼠触液核神经元数量随毁损天数延续逐渐减少,且在给予毁损剂CB—SAP第10天完全消失。与此同时脊髓背角5-HT和c—Fos表达量日趋增加,且与痛行为阈值变化趋势成负相关。结论：CB—SAP能科学可靠靶向毁损触液核,缺失触液核可致大鼠痛行为阈值减低,而脊髓背角5-HT和c—Fos表达量增加。本研究提示触液核参与了疼痛调制,且5-HT和c—Fos在此调制中发挥了重要作用。     

姜黄素下调脊髓Toll样受体4及下游细胞因子减弱大鼠神经病理性痛

观察鞘内注射姜黄素对坐骨神经慢性压迫性损伤(CCI)大鼠痛阈和脊髓组织Toll样受体4(TLR4)及TNF-α、IL-1β和IL-10表达的影响．鞘内置管的120只大鼠随机均分为4组：假手术组(Sham),CCI组,溶剂对照组(SC),姜黄素治疗组(Cur,100 μg/天),建立CCI大鼠疼痛模型,术后第1、3、7、10和14天鞘内给药并测定痛阈,第3、7天取腰段脊髓第4～6节段(L4～L6)以Real-time PCR与Western blotting方法检测TLR4、HMGB1 mRNA和蛋白质的表达,ELISA法观察脊髓组织中TNF-α、IL-1β及IL-10表达变化．与Sham组相比,CCI组大鼠机械性痛阈与热痛阈显著降低(均P<0.05),同时脊髓组织TLR4、HMGB1 mRNA和蛋白质的表达明显增加(均P<0.05),TNF-α、IL-1β与IL-10的含量也明显升高(均P<0.05);鞘内注射姜黄素明显降低脊髓TLR4、高迁移率族蛋白1(HMGB1),TNF-α和IL-1β的表达,显著升高脊髓IL-10的表达,同时明显改善CCI大鼠疼痛行为(P<0.05)．姜黄素减轻神经病理性疼痛可能与下调TLR4途径促炎症因子表达有关,抑制TLR4途径有望成为治疗神经病理性疼痛的新策略．     

鞘内注射U0126对吗啡戒断大鼠脊髓神经元磷酸化CREB表达的影响

目的：研究鞘内注射细胞外信号调节激酶（ERK）抑制剂U0126对吗啡依赖大鼠纳洛酮催促戒断反应、脊髓磷酸化cAMP反应元件结合蛋白（p-CREB）表达的影响。方法：建立大鼠吗啡依赖和戒断模型,分为正常对照组、吗啡依赖组、吗啡戒断组、U0126组、溶媒（DMSO）组,采用行为学（n=8）、免疫组织化学（n=6）和Western blot（n=4）方法观察鞘内应用U0126对吗啡依赖大鼠纳洛酮催促戒断反应、脊髓p-CREB表达的影响。结果：①鞘内注射u0126可明显减轻吗啡依赖大鼠戒断症状,戒断组戒断症状评分为28．6±4．89,U0126组为22．5±4．09（P〈0．05）;戒断组促诱发痛评分（TEAscore）为13．5±2．55,U0126组为10．0±2．76（P〈0．05）。②鞘内注射U0126可明显减少胸腰段脊髓背角p-CREB阳性神经元的数目,U0126组为287±54,低于戒断组（380±71,P〈0．05）。 ③westem blot结果显示：鞘内注射U0126明显抑制吗啡戒断期间脊髓p-CREB表达的增加。结论：鞘内注射U0126能明显抑制吗啡戒断大鼠脊髓神经元p-CREB的表达。     

脊髓水平nNOS和iNOS在吗啡戒断反应中的作用差异

目的:观察鞘内注射选择性一氧化氮合酶(nNOS)和诱导型一氧化氮合酶(iNOS)抑制剂对吗啡依赖大鼠纳洛酮催促戒断反应、脊髓Fos蛋白表达和脊髓神经元nNOS和iNOS表达的影响,以探讨nNOS和iNOS在吗啡依赖和戒断反应中的作用。方法:在大鼠吗啡依赖和戒断模型上,采用行为学、免疫组织化学和Western blot方法观察鞘内应用nNOS抑制剂7-硝基吲哚(7-Ni)和iNOS抑制剂氨基胍(AG)对吗啡依赖大鼠纳洛酮催促戒断反应、脊髓Fos蛋白表达和脊髓神经元nNOS和iNOS表达的影响。结果:①鞘内注射7-Ni、AG可明显减轻吗啡依赖大鼠戒断症状,戒断组戒断症状评分为28.6±4.89,7-Ni组为16.2±3.99(P<0.01),AG组为22.94±4.0(P<0.05);戒断组TEA评分为13.5±2.55,7-Ni、AG组分别为7.5±2.56、10.5±2.71(P<0.05);②鞘内注射7-Ni、AG可减少脊髓背角Fos阳性神经元的数目,7-Ni、AG组为228.2±49.5、296.8±50.6,低于戒断组(380±71,P<0.05);③7-Ni、AG组nNOS和iNOS阳性神经元的数目分别为169±32、10.2±2.85,均低于戒断组(239±45,16.8±5.1,P<0.05),两给药组脊髓NOS蛋白的表达也显著减少。结论:nNOS和iNOS抑制剂能减轻吗啡依赖及戒断大鼠的戒断症状和在脊髓水平抑制nNOS和iNOS的表达,nNOS起主要作用而iNOS可能起辅助作用。     

神经病理性疼痛增强HCN2通道在大鼠触液核的表达

本文旨在研究超极化激活环核苷酸门控通道亚型2(hyperpolarization-activated cyclic nucleotide-gated channels subtype2,HCN2)在触液核的分布及其在神经病理性疼痛条件下的表达变化,以期为揭示触液核的生物学功能及神经病理性疼痛的调控机制提供实验依据。以Sprague-Dawley(SD)大鼠为实验动物,用坐骨神经慢性压迫损伤(chronic constriction injury,CCI)法制作神经病理性疼痛模型,用侧脑室注射辣根过氧化物酶标记的霍乱毒素B亚单位复合物(CB-HRP)特异性标记触液核神经元,用热缩足潜伏期及机械缩足阈值作为定量指标研究痛行为,用免疫荧光法及Western blot检测触液核HCN2通道蛋白及c-Fos蛋白的表达量。结果显示,与正常大鼠相比,接受侧脑室CB-HRP注射的大鼠痛阈及触液核HCN2、c-Fos表达均无明显变化;而CCI术后第7、14天,神经病理性疼痛模型大鼠痛阈显著下降,且触液核神经元的HCN2通道蛋白及c-Fos蛋白的表达显著增加。使用HCN2阻断剂ZD7288后,CCI致痛大鼠痛阈显著提高,触液核神经元HCN2通道蛋白及c-Fos蛋白的表达较相应时间点模型组显著降低,以术后第7、14天为明显。以上结果提示,触液核可能参与了神经病理性疼痛的调制,且通过HCN2通道发挥重要作用。     

MiR-183-5p Alleviates Chronic Constriction Injury-Induced Neuropathic Pain Through Inhibition of TREK-1

MicroRNAs have been implicated in nerve injury and neuropathic pain. In the previous study we had shown that miR-96 can attenuate neuropathic pain through inhibition of Nav1.3. In this study, we investigated the role of miR-183, a same cluster member of microRNA with miR-96, in neuropathic pain and its potential mechanisms. We found that the expression level of miR-183-5p in dorsal root ganglion was decreased with the development of neuropathic pain induced by chronic constriction sciatic nerve injury (CCI). By contrast, the TREK-1, a K⁺ channel, was increased. Further investigation identified that intrathecal injection of miR-183-5p mimic efficiently ameliorated neuropathic pain and inhibited the expression of TREK-1, a predicted target gene of miR-183-5p. Luciferase assays confirmed the binding of miR-183-5p and TREK-1. In addition, over-expression of TREK-1 blocked the roles of miR-183-5p in neuropathic pain. Our findings suggested that miR-183-5P participated in the regulation of CCI-induced neuropathic pain through inhibiting the expression of TREK-1.     

Intrathecal Administration of Tempol Reduces Chronic Constriction Injury-Induced Neuropathic Pain in Rats by Increasing SOD Activity and Inhibiting NGF Expression

We investigate the antinociceptive effect of intrathecal and intraperitoneal tempol administration in a rat model of chronic constriction injury (CCI)-induced neuropathic pain and explore the underlying antinociceptive mechanisms of tempol. Rats were randomly assigned to four groups (n = 8 per group): sham group, CCI group, Tem1 group (intrathecal injection of tempol), and Tem2 group (intraperitoneal injection of tempol). Neuropathic pain was induced by CCI of the sciatic nerve. Tempol was intrathecally or intraperitoneally administered daily for 7 days beginning on postoperative day one. The mechanical withdrawal threshold and thermal withdrawal latency were tested on preoperative day 3 and postoperative days 1, 3, 5, 7, 10, 14, and 21. Structural changes were examined by hematoxylin and eosin staining, toluidine blue staining, and electron microscopy. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were determined using the thiobarbituric acid and nitroblue tetrazolium methods, respectively. Nerve growth factor (NGF) expression levels were determined by immunohistochemistry and Western blot. Intrathecal, but not intraperitoneal, injection of tempol produced a persistent antinociceptive effect. Intraperitoneal injection of tempol did not result in high enough concentration of tempol in the cerebrospinal fluid. Intrathecal, but not intraperitoneal, injection of tempol inhibited CCI-induced structural damage in the spinal cord reduced MDA levels, and increased SOD activities in the spinal cord. Furthermore, intrathecal, but not intraperitoneal, injection of tempol further downregulated the expression of NGF in the spinal cord following CCI, and this effect was blocked by p38MAPK inhibitor. Intrathecal injection of tempol produces antinociceptive effects and reduces CCI-induced structural damage in the spinal cord by increasing SOD activities and downregulating the expression of NGF via the p38MAPK pathway. Intraperitoneal administration of tempol does not exhibit antinociceptive effects.     

Endogenous CBS–H<Subscript>2</Subscript>S Pathway Contributes to the Development of CCI-Induced Neuropathic Pain

Studies showed a complex relationship between hydrogen sulfide (H₂S) and neuropathic pain. In this study, the relationship between endogenous CBS–H₂S pathway in L_4–6 spinal cord and neuropathic pain was explored. A total of 163 adult Kunming mice were used in this study. CBS expression and H₂S formation in L_4–6 spinal cord were detected in the development of neuropathic pain firstly. Then, effect of AOAA, an CBS inhibitor, on treatment of neuropathic pain by chronic construction injury surgery (CCI) was detected. Pain thresholds and activation of NF-κB(p65), ERK1/2 and CREB were measured as biomarks of neuropathic pain. Results showed that CCI surgery significantly upregulated protein expression of CBS and H₂S formation. Correlation analysis showed pain thresholds had negative relationships with protein expression of CBS and H₂S formation. Treatment with AOAA, a CBS inhibitor, inhibited CCI-induced upregulation of CBS expression and H₂S formation (P < 0.05). Further, AOAA significantly decreased activation of NF-κB(p65), ERK1/2 and CREB pathway, and reversed CCI-induced allodynia (P < 0.05). This indicated that CBS–H₂S pathway promoted the development of neuropathic pain. CBS–H₂S pathway could be a promising target for treatment of neuropathic pain.     

Antinociceptive effect of intrathecal administration of hypotaurine in rat models of inflammatory and neuropathic pain

Hypotaurine is an intermediate in taurine biosynthesis from cysteine in astrocytes. Although hypotaurine functions as an antioxidant and organic osmolyte, its physiological role in the central nervous system remains unclear. This study used behavioral assessments to determine whether hypotaurine influenced nociceptive transmission in acute, inflammatory, and neuropathic pain. The tail flick, paw pressure, and formalin tests were performed in male Sprague-Dawley rats to examine the effects of the intrathecal administration of hypotaurine (100, 200, 400, 600?μg) on thermal, mechanical, and chemical nociception. Chronic constriction injury (CCI) to the sciatic nerve was induced in the rats, and the electronic von Frey test and plantar test were performed to assess the effects on neuropathic pain. To determine which neurotransmitter pathway(s) was involved in the action of hypotaurine, in this study, we examined how the antagonists of spinal pain processing receptors altered the effect of 600?μg hypotaurine. To explore whether hypotaurine affected motor performance, the Rotarod test was conducted. Hypotaurine had antinociceptive effects on thermal, mechanical, and chemical nociception in the spinal cord. In CCI rats, hypotaurine alleviated mechanical allodynia and thermal hyperalgesia. These effects were reversed completely by pretreatment with an intrathecal injection of strychnine, a glycine receptor antagonist. Conversely, hypotaurine did not affect motor performance. This study demonstrated that intrathecal hypotaurine suppressed acute, inflammatory, and neuropathic pain. Hypotaurine may regulate nociceptive transmission physiologically by activating glycinergic neurons in the spinal cord, and it is a promising candidate for treating various pain states.     

Simvastatin Attenuates Neuropathic Pain by Inhibiting the RhoA/LIMK/Cofilin Pathway

Neuropathic pain occurs due to deleterious changes in the nervous system caused by a lesion or dysfunction. Currently, neuropathic pain management is unsatisfactory and remains a challenge in clinical practice. Studies have suggested that actin cytoskeleton remodeling may be associated with neural plasticity and may involve a nociceptive mechanism. Here, we found that the RhoA/LIM kinase (LIMK)/cofilin pathway, which regulates actin dynamics, was activated after chronic constriction injury (CCI) of the sciatic nerve. Treatments that reduced RhoA/LIMK/cofilin pathway activity, including simvastatin, the Rho kinase inhibitor Y-27632, and the synthetic peptide Tat-S3, attenuated actin filament disruption in the dorsal root ganglion and CCI-induced neuropathic pain. Over-activation of the cytoskeleton caused by RhoA/LIMK/cofilin pathway activation may produce a scaffold for the trafficking of nociceptive signaling factors, leading to chronic neuropathic pain. Here, we found that simvastatin significantly decreased the ratio of membrane/cytosolic RhoA, which was significantly increased after CCI, by inhibiting the RhoA/LIMK/cofilin pathway. This effect was highly dependent on the function of the cytoskeleton as a scaffold for signal trafficking. We conclude that simvastatin attenuated neuropathic pain in rats subjected to CCI by inhibiting actin-mediated intracellular trafficking to suppress RhoA/LIMK/cofilin pathway activity.

     

E3 Ubiquitin Ligase c-cbl Inhibits Microglia Activation After Chronic Constriction Injury

E3 ubiquitin ligase c-Caritas B cell lymphoma (c-cbl) is associated with negative regulation of receptor tyrosine kinases, signal transduction of antigens and cytokine receptors, and immune response. However, the expression and function of c-cbl in the regulation of neuropathic pain after chronic constriction injury (CCI) are unknown. In rat CCI model, c-cbl inhibited the activation of spinal cord microglia and the release of pro-inflammatory factors including tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β) and interleukin 6 (IL-6), which alleviated mechanical and heat pain through down-regulating extracellular signal-regulated kinase (ERK) pathway. Additionally, exogenous TNF-α inhibited c-cbl protein level vice versa. In the primary microglia transfected with c-cbl siRNA, when treated with TNF-α or TNF-α inhibitor, the corresponding secretion of IL-1β and IL-6 did not change. In summary, CCI down-regulated c-cbl expression and induced the activation of microglia, then activated microglia released inflammatory factors via ERK signaling to cause pain. Our data might supply a novel molecular target for the therapy of CCI-induced neuropathic pain.