Neonatal repetitive needle pricking: Plasticity of the spinal nociceptive circuit and extended postoperative pain in later life

Repetitive exposure of neonates to noxious events is inherent to their health status monitoring in neonatal intensive care units (NICU). Altered basal nociception in the absence of an injury in later life has been demonstrated in ex‐NICU children, but the impact on pain hypersensitivity following an injury in later life is unknown. Also, underlying mechanisms for such long‐term changes are relatively unknown. The objective of this study is to investigate acute and long‐term effects of neonatal repetitive painful skin‐breaking procedures on nociception and to investigate plasticity of the nociceptive circuit. The repetitive needle prick animal model was used in which neonatal rats received four needle pricks into the left hind paw per day during the first postnatal week and control animals received nonpainful tactile stimuli. Repetitive needle pricking during the first week of life induced acute hypersensitivity to mechanical stimuli. At the age of 8 weeks, increased duration of postoperative hypersensitivity to mechanical stimuli after ipsilateral hind paw incision was shown in needle prick animals. Basal nociception from 3 to 8 weeks of age was unaffected by neonatal repetitive needle pricking. Increased calcitonin gene‐related peptide expression was observed in the ipsilateral and contralateral lumbar spinal cord but not in the hind paw of needle prick animals at the age of 8 weeks. Innervation of tactile Aβ‐fibers in the spinal cord was not affected. Ourresults indicate both acute and long‐term effects of repetitive neonatal skin breaking procedures on nociception and long‐term plasticity of spinal but not peripheral innervation of nociceptive afferents. © 2012 Wiley Periodicals, Inc. Develop Neurobiol, 2013     

脊髓细胞外调节激酶1/2在大鼠后足切割痛中的表达和作用

目的：探讨大鼠后足切割后脊髓ERK的表达情况。方法：以大鼠右后足切割作为急性疼痛模型;用免疫组织化学法测试脊髓磷酸化ERK（pERK）表达情况。ERK抑制剂U0126（1μg）在切割前20min或切割后20min鞘内注射。用von Frey纤维测试大鼠机械性痛敏。结果：大鼠后足切割后1min,在切割侧L4-L5脊髓浅层背侧角（板层Ⅰ和板层Ⅱ）ERK被迅速地激活,并在5min达到峰值,随后恢复到基础值。切割前鞘内给予U0126能显著减轻机械性痛敏,然而,切割后鞘内给予U0126对机械性痛敏的作用并不明显。结论：脊髓ERK在大鼠后足切割痛中产生机械性痛敏发挥了重要的作用。     

福尔马林致痛提高大鼠中枢μ阿片受体密度及电针的加强作用

用放射自显影方法观察到;（１）大鼠脚掌注射福尔马林后,某些与镇痛有关的脑区如尾核头部、伏隔核、杏仁核、中央灰质、脚间核、中缝大核、脊髓背角等结构中μ阿片受体密度明显增加（Ｐ＜０．０５,Ｐ＜０．０１）;（２）给予电针抑制痛反应的大鼠,在其大部分上述结构及扣带回、隔区、视前内侧区、内膝体、上丘、中缝背核及中央上核受体密度明显增加;与福尔马林注射组相比,脚间核、中央灰质尾端腹外侧区、腰膨大背角的受体密度进一步增加。从而在受体水平支持伤害性刺激可以激活体内内阿片肽能活动,而电针可以加强这一活动的设想。     

强电针穴位对背角神经元镇痛效应广泛性的中枢机制

实验用雄性大鼠,玻璃微电极细胞外记录Ｔ１２－Ｌ１脊髓背角会聚神经元对后爪伤害性刺激的反应,观察到低强度（２Ｖ）电针作用于与痛源接近的“足三里”穴对背角神经元的伤害性反应有明显的抑制作用,而远隔穴位“下关”穴则无效。而当采用超过Ｃ类纤维阈值１８Ｖ电针时,则远隔穴位“下关”也有明显的镇痛作用。表现为强电针穴位镇痛作用的广泛性。而损毁ＮＲＭ后,强电针（１８Ｖ）远节段“下关”穴的镇痛作用消失,而近节段“足     

Glial Activation and Segmental Upregulation of Interleukin-1β (IL-1β) in the Rat Spinal Cord after Surgical Incision

The present study investigated the expression patterns of glial cells and interleukin-1β (IL-1β) in the rat spinal cord after a surgical incision, which is closely related with clinical postoperative pain. Microglia and astrocytes became activated in the spinal cord following incision. Real-time polymerase chain reaction (PCR) and immunohistochemisty showed that IL-1β mRNA and protein level in the spinal cord was transiently upregulated after surgical incision. The increased IL-1β-immunoreactivity (IR) was mainly localized in neurons but not the activated microglia or astrocytes. Although obvious increase in IL-1β-IR could be observed in the lumbar segments of the spinal cord ipsilateral to a hind paw incision, significant upregulation of IL-1β was not detected in the lumbar segments following thoracic incision. The present study indicated that surgical incision could induce glial activation and segmental upregulation of IL-1β in the spinal cord. The activated glial cells and upregulated IL-1β, in turn, may be involved in the incision-induced pain hypersensitivity.     

Behavioral and Electrophysiological Evidence for the Differential Functions of TRPV1 at Early and Late Stages of Chronic Inflammatory Nociception in Rats

We previously reported that vanilloid receptor type 1 (VR1, or TRPV1) was up-regulated in dorsal root ganglion (DRG) and the spinal dorsal horn after chronic inflammatory pain produced by complete Freund’s adjuvant (CFA) injection into the plantar of rat hind paw. In the present study, we found that subcutaneous or intrathecal application of capsazepine (CPZ), a TRPV1 competitive antagonist, could inhibit thermal hyperalgesia on day 1 and on day 14 but not on day 28 after CFA injection. With extracellular electrophysiological recording, the effect of CPZ on noxious electrical or heat stimulation evoked responses of wide dynamic range (WDR) neurons in the deep layers of the spinal dorsal horn was evaluated. Under noxious electrical stimulation to sciatic nerve, CPZ applied to the spinal cord produced an inhibition on Aδ- and C-fiber evoked responses of WDR neurons on day 1 and 14, but not on day 28. Under radiant heat stimulation to the receptive field skin, subcutaneous application of CPZ significantly inhibited the background activity and extended the response latency of WDR neurons on day 14. These results provide new evidence for the functional significance of TRPV1 at the early stage, but not the late stage, in the rat model of CFA-induced inflammatory pain. Special issue article in honor of Dr. Ji-Sheng Han. Hao Luo, Isabella Shi Xu, Yi Chen are Co-first authors.     

Increase of nociceptive threshold induced by intrathecal injection of interleukin-1beta in normal and carrageenan inflammatory rat

The present study was to investigate the effect of intrathecal (i.t.) injection of interleukin-1 beta (IL-1 beta) on nociception in normal and inflammatory rats. Peripheral inflammation was induced by intraplantar injection (i.pl.) of carrageenan into unilateral hind paw. The nociceptive threshold to noxious thermal stimulation was measured by the paw withdrawal latency (PWL). Intrathecal injection of IL-1 beta (10 ng, 100 ng) significantly increased PWL in normal rats, the peak occurred at 5 min and the effect lasted for 30 min. Similarly, IL-1 beta (10 ng, 100 ng, i.t.) significantly increased the PWL and lasted for more than 60 min in inflammatory rats. Both in normal and inflammatory rats, the IL-1 beta-induced antinociceptive effect was completely abolished by IL-1ra (50 ng, i.t.), and apparently attenuated by naloxone (10 microg, i.t.) or mianserin (20 microg, i.t.). These results suggest that IL-1 beta produces antinociceptive effect by binding IL-1 receptor at the spinal level, and is related to the activation of opioid and 5-HT systems.     

CGRP受体拮抗剂CGRP8-37对甲醛炎性痛大鼠自发痛反应及脊髓后角NOS表达和NO含量的影响

目的:探讨CGRP受体拮抗剂CGRP8-37对甲醛炎性痛大鼠自发痛反应及脊髓后角NOS表达和NO含量的影响.方法:大鼠足底注射甲醛制造炎性痛模型;计数缩足反射次数反映自发痛程度;NADPH-d组织化学法观察脊髓后角NOS表达;硝酸还原酶法测定NO-3/NO-2含量以反映NO含量.结果:足底注射甲醛后,动物出现自发痛反应行为.足底注射甲醛后24 h,双侧脊髓后角NOS表达及NO含量明显增加.预先鞘内注射CGRP8-37可使甲醛诱导的自发性缩足反射次数明显减少,并可明显抑制甲醛炎性痛诱导的脊髓后角NOS表达及NO含量的增加.结论:甲醛炎性痛时,脊髓后角CGRP受体激活可促进NOS活性表达及NO的产生.     

异丙酚对正常大鼠脊髓背角感觉神经元反应性的抑制作用

脊髓背角感觉神经元不仅在感觉信息的传递和调节中起到重要作用,也是各种内源性和外源性药物的作用靶位.为了解静脉麻醉剂异丙酚是否对背角感觉神经元的反应性具有调节作用,本实验采用在体单细胞胞外记录技术,观察了脊髓背表面直接滴注0.5 μmol异丙酚对戊巴比妥钠麻醉大鼠脊髓背角广动力域(WDR)神经元和低阈值机械感受型(LTM)神经元反应性的影响.实验发现,异丙酚能抑制背角WDR神经元由施加于外周感受野伤害性热刺激(45、47、49和53℃,15 s)和夹捏机械刺激(10 s)诱发的反应性,与DMSO对照组比较具有显著性统计学差异(P＜0.05);同样,异丙酚对非伤害性机械刺激诱发的WDR或LTM神经元的反应性也具有显著的抑制作用(P＜0.05).本结果提示,异丙酚可直接作用于正常大鼠脊髓背角神经元,对由非伤害性和伤害性纤维介导的神经元反应性均产生抑制作用,因此异丙酚的脊髓抗伤害作用可能不是特异性的.     

Freezing of Enkephalinergic Functions by Multiple Noxious Foci: A Source of Pain Sensitization?

Background

The functional significance of proenkephalin systems in processing pain remains an open question and indeed is puzzling. For example, a noxious mechanical stimulus does not alter the release of Met-enkephalin-like material (MELM) from segments of the spinal cord related to the stimulated area of the body, but does increase its release from other segments.

Methodology/Principal Findings

Here we show that, in the rat, a noxious mechanical stimulus applied to either the right or the left hind paw elicits a marked increase of MELM release during perifusion of either the whole spinal cord or the cervico-trigeminal area. However, these stimulatory effects were not additive and indeed, disappeared completely when the right and left paws were stimulated simultaneously.

Conclusion/Significance

We have concluded that in addition to the concept of a diffuse control of the transmission of nociceptive signals through the dorsal horn, there is a diffuse control of the modulation of this transmission. The “freezing” of Met-enkephalinergic functions represents a potential source of central sensitization in the spinal cord, notably in clinical situations involving multiple painful foci, e.g. cancer with metastases, poly-traumatism or rheumatoid arthritis.     

MK—801降低炎性痛在鼠脊髓NOS表达和NO含量

用NADPH-d组织化学法,观察鞘内注射NMDA受体拮抗剂MK-801对大鼠右后掌皮下注射甲醛诱发的炎症性痛及痛过敏过程中脊髓后角一氧化氮合酶(NOS)表达的影响,同时测定一氧化氮(NO)代谢终产物     

大鼠脑前扣带皮层(ACC)兴奋性与厌恶情绪的行为-电生理学观察*

目的:探讨激活大鼠ACC脑区的阿片受体降低伤害刺激引起厌恶情绪的作用。方法:将实验大鼠随机分为7组,完全弗氏佐剂(CFA)+生理盐水(NS)组,生理盐水(NS)+生理盐水(NS)组,生理盐水(NS)+μ-阿片受体激动剂([DAla², NMe-Phe⁴, Gly-ol⁵]enkephinlin, DAMGO)组,完全弗氏佐剂(CFA)+ 0.01/0.04/0.2/1 μg/μl DAMGO组(n=6)。实验周期为3 d,第1日测量基础值,第2日预先通过ACC区域给药1 μl,然后将0.08 ml完全弗氏佐剂(CFA)注射到大鼠左后脚掌,第3日观察大鼠的CPA反应、缩足反射潜伏期(PWL)和ACC脑区的电活动。结果:①皮下注射CFA的大鼠,注射前与注射后相比,PWL明显减少(P＜0.05);②在笼具痛侧,CFA组大鼠停留的时间明显少于非痛侧(P＜0.05);③在ACC脑区预先注射0.04/0.2/1 μg/μl DAMGO可明显减弱C-CPA反应(P＜0.05);④在ACC脑区预先注射0.04/0.2/1 μg/μl DAMGO可以降低CFA诱发ACC脑区放电频率的增加(P＜0.05)。结论:激活了大鼠ACC脑区上的μ-阿片受体可以降低伤害性刺激诱发的厌恶情绪的发生。     

Ethyl Pyruvate Attenuates Formalin-induced Inflammatory Nociception by Inhibiting Neuronal ERK Phosphorylation

ABSTRACT: BACKGROUND: Ethyl pyruvate (EP) possesses anti-inflammatory activity. However, the potential anti-nociceptive value of EP for the treatment of the inflammatory nociception is largely unknown. We investigated whether EP could have any anti-nociceptive effect on inflammatory pain, after systemic administration of EP (10, 50, and 100 mg/kg, i.p.), 1 hour before formalin (5%, 50 mul) injection into the plantar surface of the hind paws of rats. RESULTS: EP significantly decreased formalin-induced nociceptive behavior during phase II, the magnitude of paw edema, and the activation of c-Fos in L4-L5 spinal dorsal horn. EP also attenuated the phosphorylation of extracellular signal-regulated kinase (ERK) in the neurons of L4-L5 spinal dorsal horn after formalin injection. Interestingly, the i.t. administration of PD-98059, an ERK upstream kinase (MEK) inhibitor, completely blocked the formalin-induced inflammatory nociceptive responses. CONCLUSIONS: These results demonstrate that EP may effectively inhibit formalin-induced inflammatory nociception via the inhibition of neuronal ERK phosphorylation in the spinal dorsal horn, indicating its therapeutic potential in suppressing acute inflammatory pain.     

Neuropathic Pain in Rats with a Partial Sciatic Nerve Ligation Is Alleviated by Intravenous Injection of Monoclonal Antibody to High Mobility Group Box-1

High mobility group box-1 (HMGB1) is associated with the pathogenesis of inflammatory diseases. A previous study reported that intravenous injection of anti-HMGB1 monoclonal antibody significantly attenuated brain edema in a rat model of stroke, possibly by attenuating glial activation. Peripheral nerve injury leads to increased activity of glia in the spinal cord dorsal horn. Thus, it is possible that the anti-HMGB1 antibody could also be efficacious in attenuating peripheral nerve injury-induced pain. Following partial sciatic nerve ligation (PSNL), rats were treated with either anti-HMGB1 or control IgG. Intravenous treatment with anti-HMGB1 monoclonal antibody (2 mg/kg) significantly ameliorated PSNL-induced hind paw tactile hypersensitivity at 7, 14 and 21 days, but not 3 days, after ligation, whereas control IgG had no effect on tactile hypersensitivity. The expression of HMGB1 protein in the spinal dorsal horn was significantly increased 7, 14 and 21 days after PSNL; the efficacy of the anti-HMGB1 antibody is likely related to the presence of HMGB1 protein. Also, the injury-induced translocation of HMGB1 from the nucleus to the cytosol occurred mainly in dorsal horn neurons and not in astrocytes and microglia, indicating a neuronal source of HMGB1. Markers of astrocyte (glial fibrillary acidic protein (GFAP)), microglia (ionized calcium binding adaptor molecule 1 (Iba1)) and spinal neuron (cFos) activity were greatly increased in the ipsilateral dorsal horn side compared to the sham-operated side 21 days after PSNL. Anti-HMGB1 monoclonal antibody treatment significantly decreased the injury-induced expression of cFos and Iba1, but not GFAP. The results demonstrate that nerve injury evokes the synthesis and release of HMGB1 from spinal neurons, facilitating the activity of both microglia and neurons, which in turn leads to symptoms of neuropathic pain. Thus, the targeting of HMGB1 could be a useful therapeutic strategy in the treatment of chronic pain.     

In vivo catechol activity in the rat locus coeruleus following different nociceptive stimuli and naloxone.

The nucleus locus coeruleus (LC) has been implicated in the processing of spinal reflexes following noxious stimuli. It has been demonstrated that noxious stimuli activate LC neuronal firing, but little is known about the neurochemical changes that might occur following such activation. To determine the effects of different noxious stimuli on LC neuronal activity, anaesthetized rats were exposed to mechanical (tail pinch), thermal (55 degrees C water), and chemical (5% Formalin injected in the hind paw) stimuli; the catechol oxidation current (CA.OC), an index of noradrenergic neuronal activity, in the locus coeruleus was monitored using differential normal pulse voltammetry. In addition, the effect of the opioid antagonist naloxone on the CA.OC in the LC was examined. Exposure to both mechanical and chemical stimuli significantly increased CA.OC indicating an increase in LC noradrenergic neuronal activity, while the thermal stimulus had no effect. Treatment with naloxone (1 mg/kg i.v.) had no effect on CA.OC in the LC. The results show a differential responsiveness of LC noradrenergic neurons to different modes of noxious stimuli and fail to demonstrate a tonic opioid regulation of these neurons in the anaesthetized rat.     

Supraspinal injection of Substance P attenuates allodynia and hyperalgesia in a rat model of inflammatory pain

The neuropeptide Substance P (SP), that has a high affinity for the neurokinin 1 (NK1) receptor, is involved in modulation of pain transmission. Although SP is thought to have excitatory actions and promote nociception in the spinal cord, the peptide induces analgesia at the supraspinal level. The aim of this study was to evaluate the role of supraspinal SP and the NK1 receptor in inflammatory pain induced by injection of carrageenan in the hind paw of the rat. There are two nociceptive behavioral responses associated with this pain state: mechanical allodynia and heat hyperalgesia. Because the NK1 receptor colocalizes with the MOP receptor in supraspinal sites involved in pain modulation, we also decided to study the possible involvement of the opioid system on SP-induced analgesia. We found that treatment with SP, at doses of 3.5, 5 and 7 μg/5 μl/rat i.c.v., clearly showed inhibition of allodynia and hyperalgesia. Pretreatment with the selective NK1 antagonist L-733,060 (10mg/kg i.p.) blocked the SP-induced analgesia, suggesting the involvement of the NK1 receptor. This SP-induced analgesia was significantly reduced by administration of the opioid antagonist naloxone (3mg/kg s.c.). This reduction occurred when SP was administered either before or after the carrageenan injection. These results suggest a significant antinociceptive role for SP and the NK1 receptor in inflammatory pain at the supraspinal level, possibly through the release of endogenous opioids.     

脑源性神经营养因子在大鼠后足切割疼痛中的作用

目的:观察脑源性神经营养因子(BDNF)对大鼠后足切割疼痛的影响。方法:采用纵行切割大鼠后足作为疼痛模型,运用免疫组织化学与免疫荧光双标记方法,观察大鼠后足切割后不同时间点(1-72hr)BDNF在相应节段背根神经节与脊髓内表达的变化。腹腔或鞘内注射BDNF抗体中和内源性BDNF后,以Von Frey尼龙纤维刺激后足行机械痛敏评价。结果:大鼠后足切割后1-24hr内,BDNF在切割侧L42-L5脊髓后角表达明增加,BDNF主要位于后角神经元内与神经末梢,星形胶质细胞与小胶质细胞内未见明显表达;在L42-L5背根神经节,BNDF免疫阳性细胞百分比在切割后1-24hr内也明显增加,增加的主要为大直经神经元;鞘内给予BDNF抗体可明显增加大鼠后足切割后的缩足阈值,而腹腔给予BDNF抗体对大鼠的缩足阈值影响较小。结论:BDNF参与了大鼠后足切割后机械痛敏的过程。     

甲醛炎性痛对大鼠脊髓HO-1表达的影响

目的:观察足底注射甲醛引起的外周组织炎性疼痛是否可诱导大鼠脊髓血红素氧合酶-1(HO-1)表达发生改变以及变化的时程特征。方法:健康雄性SD大鼠随机分为7组(n=6):对照组(control组)、甲醛6 h组(F6 h组)、甲醛12 h(F12 h组)、甲醛1 d组(F1 d组)、甲醛2 d组(F2 d组)、甲醛3 d组(F3 d组)和甲醛7 d组(F7 d组)。采用足底注射甲醛溶液复制炎性痛模型,采用免疫组织化学方法检测左、右两侧脊髓后角以及中央管周围灰质HO-1蛋白的表达。结果:Control组大鼠HO-1免疫反应阳性细胞在脊髓后角及中央管周围灰质仅有少量分布,且这些细胞染色较浅。足底注射甲醛后6 h,L5节段双侧脊髓后角和中央管周围灰质HO-1免疫反应阳性细胞数目即有所增多,足底注射甲醛后12 h时,双侧脊髓后角和中央管周围灰质HO-1免疫反应阳性细胞数目进一步增多,阳性细胞染色明显加深,1 d时阳性细胞数目和染色深度均达到高峰,7 d时仍高于control组水平。各时间点双侧脊髓后角比较,阳性细胞数目和阳性细胞染色深度均无明显差异。结论:大鼠足底注射甲醛引起的炎性痛可诱导双侧脊髓后角和中央管周围灰质HO-1表达增多,以注射甲醛后1 d时增多最为明显。     

Neural representation of cutaneous aftersensations by spinothalamic tract neurons.

Temporal summation of second pain and long-lasting tactile-evoked aftersensations are examples of sensory phenomenons that cannot be explained on the basis of responses of primary afferents. Two distinct classes of monkey spinothalamic tract neurons have responses to controlled natural stimuli that parallel and thus could account for the above phenomenons. One class, termed wide-dynamic-range, receives excitatory effects from sensitive mechanoreceptive afferents and from various nociceptive afferents including Adelta and C mechanothermal nociceptive afferents. Another class, termed nociceptive-specific, receives excitatory effects exclusively from primary nociceptive afferents. Both classes respond with an early and late response to a single noxious heat pulse (peak temperature = 51 C). The late response, unlike C nociceptive afferents but like second pain, summates in magnitude with each successive heat pulse. Gentle moving tactile stimuli evoke long-lasting (20-56 sec) after-discharges only in wide dynamic range neurons, and are similar in duration to the tactile after-sensation evoked by similar stimuli. Both the after-discharges and after-sensations can be abruptly terminated by rubbing the affected region. Temporal summation of second pain and cutaneous after-sensations are at least partly subserved by spinal cord mechanisms within the dorsal horn and are manifested in the output of spinothalamic tract neurons.