糖皮质激素与miRNA关系的研究现状

糖皮质激素(glucocorticoid,GC)因具有抗炎、抑制免疫反应、调节能量代谢和细胞增殖凋亡等作用而广泛使用于临床。作为非编码RNA,内源性miRNA通过影响靶基因的表达水平在机体发育和疾病发生中发挥广泛的调控作用。目前研究发现,糖皮质激素能通过糖皮质激素受体(glucocorticoid receptor,GR)介导调节miRNA的表达,而miRNA也能通过影响糖皮质激素受体的表达水平调节细胞对糖皮质激素的反应性。在许多疾病模型中,miRNA和糖皮质激素受体之间通过密切互作关系共同影响疾病的发生发展。     

糖皮质激素非基因组效应的研究

在过去的几十年间,人们认为糖皮质激素（glucocorticoid,GC）仅仅是通过改变基因的表达来发挥其生理作用,这个过程需要几个小时来完成。然而,近年来越来越多的证据表明GC对激素分泌、神经元兴奋性、机体行为及细胞形态、糖类代谢等具备快速效应,这些过程往往在数秒钟或者分种内完成,这种作用机制被称为GC的非基因组作用机制。GC的非基因组作用主要可能通过两种不同的机制起作用：（1）通过细胞膜上或者细胞质内结构未知的糖皮质激素受体（glucocorticoid Recptor,GR）来发挥非基因组作用,即为特异性非基因组效应,（2）GC主要通过改变细胞膜理化作用来发挥效应。也称为非特异性非基因组效应（non-specific nongenomic effects,NSNE）。本文通过阐述近年来GC的非基因组的作用的最新研究进展并且讨论了这些非基因组作用临床治疗过程中的联系。对糖皮质激素基因组和非基因组作用机制的深入了解有助于指导我们在临床合理用药并减少其副作用。     

糖皮质激素受体的研究进展

糖皮质激素受体(glucocorticoid receptor,GR)在机体的生命活动中具有重要作用.它是激素核受体家族中的一个主要成员,同时也是一种重要的核转录因子,转录调控多种基因表达.糖皮质激素作用的发挥必须与糖皮质激素受体结合.糖皮质激素受体不仅能参与机体应激反应,而且具有抗炎抗免疫作用和促细胞凋亡作用.目前已知的GR有三种类型,分别为α、β和P型,糖皮质激素受体在应激及GC抵抗中扮演着重要的角色.     

新标准“注射用克痛宁”临床应用镇痛效果观察

目的　评估按国家药品生物制品检定所修订的国家标准生产的“注射用克痛宁” (电泳纯和免疫纯 )的临床应用效果及毒副作用。方法　各种中、重度急慢性疼痛患者 92例 ,肌肉注射给药 ,70 μg/次 ,70～ 1 40 μg/天。慢性疼痛病例一般按疗程用药 ,每疗程 5天 ,急性疼痛病例及部分慢性疼痛病例疼痛消失即停药。以病人曾用过的镇痛药疗效作为历史对照。结果　总有效率 96 .7% ,总显效率 82 .6 % ,首支总有效率 93.5 %。对癌痛组的首支有效率稍低 ,为 84 .2 %。一般在肌注后 30～ 6 0 min起效 ;对急性疼痛疗效可持续 6～ 1 0 h,对慢性疼痛大多可持续 1 2 h或 2 4 h以上。对阿片类药物成瘾患者也有良好效果。少数病人出现轻度口干、恶心、头晕等不良反应。结论　新标准“注射用克痛宁”对各种急慢性疼痛均有良好的镇痛效果 ,起效快、镇痛作用强而持久、不成瘾、毒副作用小 ,且具有潜在的戒毒作用。优于原地方标准的“克痛宁”。     

测定大鼠完整脾细胞中糖皮质激素受体的微量过滤法

近年来,开展神经内分泌免疫调节网络(NEI)的研究日趋广泛,已知糖皮质激素(GC)在其中起重要作用。淋巴细胞足GC的靶细胞之一,GC必须通过和靶细胞中糖皮质激素受体(GCR)结合,才能发挥生物效应。现在通用的淋巴细胞中GCR的测定方法是1ml反应体系的离心分离法,我们以研究NEI常用的大鼠为实验对象,对其方法进行了改进,采用微量过滤法,比较经济、简便、适用。     

钙调蛋白激酶Ⅱ在神经病理痛中的作用及其痛觉调控通路概况

钙调蛋白激酶Ⅱ(Ca^2+/calmodulin-dependent protein kinase,CaMKⅡ)是一种多功能的丝氨酸/苏氨酸蛋白激酶,在神经元中大量存在,广泛参与疼痛调制。神经病理痛是一种由疾病或躯体感觉系统的损伤引起的慢性难治性疼痛。钙调蛋白激酶Ⅱ在中枢、外周神经病理痛、代谢型神经病理痛和药物引起神经病理痛等各种类型的神经病理痛的发生发展中发挥着重要的作用。本文拟将从钙调激酶Ⅱ介导的各型神经病理痛及其上下游的调控两个方面进行综述,以期为今后钙调蛋白激酶Ⅱ在神经病理痛领域的研究提供一定参考。     

疼痛患者脊髓脑脊液中强啡肽含量的分析

本文观察了疼痛患者脊髓脑脊液中强啡肽含量的变化。共收集３１例急性疼痛患者和１４例慢性疼痛患者的脊髓脑脊液,测定其中的强啡肽含量,与２７例无痛患者的结果进行比较,并结合被测者的性别、年龄、体重、血压、脉搏、体温等一般情况进行分析。结果表明,慢性痛患者脑脊液中强啡肽含量显著升高,而急性痛患者则略有降低。判别分析表明,急性痛患者的强啡肽含量及其他临床资料有明显的特点（判别准确率８２％）;慢性痛患者未见明显特征。作者认为,在更广泛地收集临床资料和检验结果的基础上,进一步研究不同病因的疼痛患者的临床特征,可能有助于对疼痛疾病进行鉴别诊断     

应激抑郁发生中糖皮质激素对BDNF信号通路的影响

脑源性神经营养因子(brain derived neurotrophic factor,BDNF)是一个关键性的神经营养因子,它既影响突触的形成和重构,又可以通过突触前和突触后机制改变突触传递的效能,从而对神经结构和功能可塑性发挥调节作用。BDNF主要通过结合TrkB受体激活细胞内信号系统来发挥它积极的生物学效应。研究表明,中枢神经系统BDNF表达或功能的变化与抑郁症的发生相关,而应激引起糖皮质激素(glucocorticoid,GC)的增加也是导致抑郁发生的重要原因之一。值得注意的是,GCs的增加会影响BDNF,一方面GCs降低BDNF的表达,另一方面GCs受体GR与BNDF受体TrkB相互作用。过多的GCs干扰了BDNF信号,使BDNF功能受到影响,导致抑郁患者脑内,尤其是海马结构的损害。就抑郁发生中糖皮质激素对BDNF功能影响的研究进展作一介绍。     

神经病理性疼痛研究进展

神经病理胜疼痛是指神经系统的损伤或功能障碍引起的疼痛,占到了各类慢性疼痛的30%以上。第四军医大学完成的—项研究成果成功揭示了神经病理性痛的发生机制,创建两种能够分别模拟神经病理性痛不同临床表现的动物模型为研究神经病理性痛和制定治疗策略奠定了基础。     

电针镇痛时人脑脊液中β-内啡肽样免疫活性物质的含量与痛阈的关系

用β-内啡肽放射免疫分析法测定10例无疼痛主诉的患者电针前后侧脑室脑脊液中B-内啡肽样免疫活性物质(B-EPIS)的含量,其中6例用弹簧棒测定了痛阈和耐痛阈。结果表明,每 ml 脑脊液中β-EPIS 的含量比针前增加126.7 fmol/ml(P<0.02),病人的痛阈比针前升高29.5%,耐痛阈升高28.1%(P<0.05)。β-EPIS 含量的增加量与痛阈、耐痛阈的升高值呈直线相关,r_1=0.776,r_2=0.741(P<0.05)。表明电针能促使脑内释放β-内啡肽,释放增加的β-内啡肽参与镇痛作用,这可能是电针镇痛机制的重要环节之一。     

Role of Astrocytes in Pain

Over the last decade, a series of studies has demonstrated that glia in the central nervous system play roles in many aspects of neuronal functioning including pain processing. Peripheral tissue damage or inflammation initiates signals that alter the function of the glial cells (microglia and astrocytes in particular), which in turn release factors that regulate nociceptive neuronal excitability. Like immune cells, these glial cells not only react at sites of central and/or peripheral nervous system damage but also exert their action at remote sites from the focus of injury or disease. As well as extensive evidence of microglial involvement in various pain states, there is also documentation that astrocytes are involved, sometimes seemingly playing a more dominant role than microglia. The interactions between astrocytes, microglia and neurons are now recognized as fundamental mechanisms underlying acute and chronic pain states. This review focuses on recent advances in understanding of the role of astrocytes in pain states.     

Tenascins and inflammation in disorders of the nervous system

In vitro and in vivo studies on the role of tenascins have shown that the two paradigmatic glycoproteins of the tenascin family, tenascin-C (TnC) and tenascin-R (TnR) play important roles in cell proliferation and migration, fate determination, axonal pathfinding, myelination, and synaptic plasticity. As components of the extracellular matrix, both molecules show distinct, but also overlapping dual functions in inhibiting and promoting cell interactions depending on the cell type, developmental stage and molecular microenvironment. They are expressed by neurons and glia as well as, for TnC, by cells of the immune system. The functional relationship between neural and immune cells becomes relevant in acute and chronic nervous system disorders, in particular when the blood brain and blood peripheral nerve barriers are compromised. In this review, we will describe the functional parameters of the two molecules in cell interactions during development and, in the adult, in synaptic activity and plasticity, as well as regeneration after injury, with TnC being conducive for regeneration and TnR being inhibitory for functional recovery. Although not much is known about the role of tenascins in neuroinflammation, we will describe emerging knowledge on the interplay between neural and immune cells in autoimmune diseases, such as multiple sclerosis and polyneuropathies. We will attempt to point out the directions of experimental approaches that we envisage would help gaining insights into the complex interplay of TnC and TnR with the cells that express them in pathological conditions of nervous and immune systems.     

Contribution of macrophages to peripheral neuropathic pain pathogenesis

Neuropathic pain pathogenesis is not only confined to changes in the activity of neuronal systems, but also involves neuro-immune interactions mediated by inflammatory cytokines and chemokines. Among the immune cells involved in these interactions, macrophages and their central nervous system counterparts – microglia – are actively involved in the generation of peripheral neuropathic pain. Depending on the type of lesion (traumatic, metabolic, neurotoxic, infections or tumor invasion), the profile of the activated macrophages and microglia in terms of time, place and subtype can substantially vary, due to their remarkable plasticity that allows tuning their physiology according to microenvironmental signals. Knowing what and when specific macrophages activate after a peripheral nerve lesion could help in creating a pattern that can be further used to target the macrophages with cell-specific therapeutics and remit chronicization and complications of neuropathic pain. This minireview summarizes recent findings on the specific contribution of macrophages in different neuropathic pain models.     

Cortical Overexpression of Neuronal Calcium Sensor-1 Induces Functional Plasticity in Spinal Cord Following Unilateral Pyramidal Tract Injury in Rat

Following trauma of the adult brain or spinal cord the injured axons of central neurons fail to regenerate or if intact display only limited anatomical plasticity through sprouting. Adult cortical neurons forming the corticospinal tract (CST) normally have low levels of the neuronal calcium sensor-1 (NCS1) protein. In primary cultured adult cortical neurons, the lentivector-induced overexpression of NCS1 induces neurite sprouting associated with increased phospho-Akt levels. When the PI3K/Akt signalling pathway was pharmacologically inhibited the NCS1-induced neurite sprouting was abolished. The overexpression of NCS1 in uninjured corticospinal neurons exhibited axonal sprouting across the midline into the CST-denervated side of the spinal cord following unilateral pyramidotomy. Improved forelimb function was demonstrated behaviourally and electrophysiologically. In injured corticospinal neurons, overexpression of NCS1 induced axonal sprouting and regeneration and also neuroprotection. These findings demonstrate that increasing the levels of intracellular NCS1 in injured and uninjured central neurons enhances their intrinsic anatomical plasticity within the injured adult central nervous system.     

Interactions between the immune and nervous systems in pain

Immune cells and glia interact with neurons to alter pain sensitivity and to mediate the transition from acute to chronic pain. In response to injury, resident immune cells are activated and blood-borne immune cells are recruited to the site of injury. Immune cells not only contribute to immune protection but also initiate the sensitization of peripheral nociceptors. Through the synthesis and release of inflammatory mediators and interactions with neurotransmitters and their receptors, the immune cells, glia and neurons form an integrated network that coordinates immune responses and modulates the excitability of pain pathways. The immune system also reduces sensitization by producing immune-derived analgesic and anti-inflammatory or proresolution agents. A greater understanding of the role of the immune system in pain processing and modulation reveals potential targets for analgesic drug development and new therapeutic opportunities for managing chronic pain.     

The Sciatic Nerve Cuffing Model of Neuropathic Pain in Mice

Neuropathic pain arises as a consequence of a lesion or a disease affecting the somatosensory system. This syndrome results from maladaptive changes in injured sensory neurons and along the entire nociceptive pathway within the central nervous system. It is usually chronic and challenging to treat. In order to study neuropathic pain and its treatments, different models have been developed in rodents. These models derive from known etiologies, thus reproducing peripheral nerve injuries, central injuries, and metabolic-, infectious- or chemotherapy-related neuropathies. Murine models of peripheral nerve injury often target the sciatic nerve which is easy to access and allows nociceptive tests on the hind paw. These models rely on a compression and/or a section. Here, the detailed surgery procedure for the "cuff model" of neuropathic pain in mice is described. In this model, a cuff of PE-20 polyethylene tubing of standardized length (2 mm) is unilaterally implanted around the main branch of the sciatic nerve. It induces a long-lasting mechanical allodynia, i.e., a nociceptive response to a normally non-nociceptive stimulus that can be evaluated by using von Frey filaments. Besides the detailed surgery and testing procedures, the interest of this model for the study of neuropathic pain mechanism, for the study of neuropathic pain sensory and anxiodepressive aspects, and for the study of neuropathic pain treatments are also discussed.     

Peripheral Nerve Injury Modulates Neurotrophin Signaling in the Peripheral and Central Nervous System

Peripheral nerve injury disrupts the normal functions of sensory and motor neurons by damaging the integrity of axons and Schwann cells. In contrast to the central nervous system, the peripheral nervous system possesses a considerable capacity for regrowth, but regeneration is far from complete and functional recovery rarely returns to pre-injury levels. During development, the peripheral nervous system strongly depends upon trophic stimulation for neuronal differentiation, growth and maturation. The perhaps most important group of trophic substances in this context is the neurotrophins (NGF, BDNF, NT-3 and NT-4/5), which signal in a complex spatial and timely manner via the two structurally unrelated p75^NTR and tropomyosin receptor kinase (TrkA, Trk-B and Trk-C) receptors. Damage to the adult peripheral nerves induces cellular mechanisms resembling those active during development, resulting in a rapid and robust increase in the synthesis of neurotrophins in neurons and Schwann cells, guiding and supporting regeneration. Furthermore, the injury induces neurotrophin-mediated changes in the dorsal root ganglia and in the spinal cord, which affect the modulation of afferent sensory signaling and eventually may contribute to the development of neuropathic pain. The focus of this review is on the expression patterns of neurotrophins and their receptors in neurons and glial cells of the peripheral nervous system and the spinal cord. Furthermore, injury-induced changes of expression patterns and the functional consequences in relation to axonal growth and remyelination as well as to neuropathic pain development will be reviewed.     

The importance of the neuro‐immuno‐cutaneous system on human skin equivalent design

The skin is a highly complex organ, responsible for sensation, protection against the environment (pollutants, foreign proteins, infection) and thereby linked to the immune and sensory systems in the neuro‐immuno‐cutaneous (NIC) system. Cutaneous innervation is a key part of the peripheral nervous system; therefore, the skin should be considered a sensory organ and an important part of the central nervous system, an ‘active interface’ and the first connection of the body to the outside world. Peripheral nerves are a complex class of neurons within these systems, subsets of functions are conducted, including mechanoreception, nociception and thermoception. Epidermal and dermal cells produce signalling factors (such as cytokines or growth factors), neurites influence skin cells (such as via neuropeptides), and peripheral nerves have a role in both early and late stages of the inflammatory response. One way this is achieved, specifically in the cutaneous system, is through neuropeptide release and signalling, especially via substance P (SP), neuropeptide Y (NPY) and nerve growth factor (NGF). Cutaneous, neuronal and immune cells play a central role in many conditions, including psoriasis, atopic dermatitis, vitiligo, UV‐induced immunosuppression, herpes and lymphomas. Therefore, it is critical to understand the connections and interplay between the peripheral nervous system and the skin and immune systems, the NIC system. Relevant in vitro tissue models based on human skin equivalents can be used to gain insight and to address impact across research and clinical needs.     

Neuromedin U receptor 2-deficient mice display differential responses in sensory perception, stress, and feeding

Neuromedin U (NMU) is a highly conserved neuropeptide with a variety of physiological functions mediated by two receptors, peripheral NMUR1 and central nervous system NMUR2. Here we report the generation and phenotypic characterization of mice deficient in the central nervous system receptor NMUR2. We show that behavioral effects, such as suppression of food intake, enhanced pain response, and excessive grooming induced by intracerebroventricular NMU administration were abolished in the NMUR2 knockout (KO) mice, establishing a causal role for NMUR2 in mediating NMU's central effects on these behaviors. In contrast to the NMU peptide-deficient mice, NMUR2 KO mice appeared normal with regard to stress, anxiety, body weight regulation, and food consumption. However, the NMUR2 KO mice showed reduced pain sensitivity in both the hot plate and formalin tests. Furthermore, facilitated excitatory synaptic transmission in spinal dorsal horn neurons, a mechanism by which NMU stimulates pain, did not occur in NMUR2 KO mice. These results provide significant insights into a functional dissection of the differential contribution of peripherally or centrally acting NMU system. They suggest that NMUR2 plays a more significant role in central pain processing than other brain functions including stress/anxiety and regulation of feeding.     

Central mechanisms of pathological pain

Chronic pain is a major challenge to clinical practice and basic science. The peripheral and central neural networks that mediate nociception show extensive plasticity in pathological disease states. Disease-induced plasticity can occur at both structural and functional levels and is manifest as changes in individual molecules, synapses, cellular function and network activity. Recent work has yielded a better understanding of communication within the neural matrix of physiological pain and has also brought important advances in concepts of injury-induced hyperalgesia and tactile allodynia and how these might contribute to the complex, multidimensional state of chronic pain. This review focuses on the molecular determinants of network plasticity in the central nervous system (CNS) and discusses their relevance to the development of new therapeutic approaches.