Regulation of increased glutamatergic input to spinal dorsal horn neurons by mGluR5 in diabetic neuropathic pain

Diabetic neuropathic pain is associated with increased glutamatergic input in the spinal dorsal horn. Group I metabotropic glutamate receptors (mGluRs) are involved in the control of neuronal excitability, but their role in the regulation of synaptic transmission in diabetic neuropathy remains poorly understood. Here we studied the role of spinal mGluR5 and mGluR1 in controlling glutamatergic input in a rat model of painful diabetic neuropathy induced by streptozotocin. Whole-cell patch-clamp recordings of lamina II neurons were performed in spinal cord slices. The amplitude of excitatory post-synaptic currents (EPSCs) evoked from the dorsal root and the frequency of spontaneous EPSCs (sEPSCs) were significantly higher in diabetic than in control rats. The mGluR5 antagonist 2-methyl-6-(phenylethynyl)-pyridine (MPEP) inhibited evoked EPSCs and sEPSCs more in diabetic than in control rats. Also, the percentage of neurons in which sEPSCs and evoked EPSCs were affected by MPEP or the group I mGluR agonist was significantly higher in diabetic than in control rats. However, blocking mGluR1 had no significant effect on evoked EPSCs and sEPSCs in either groups. The mGluR5 protein level in the dorsal root ganglion, but not in the dorsal spinal cord, was significantly increased in diabetic rats compared with that in control rats. Furthermore, intrathecal administration of MPEP significantly increased the nociceptive pressure threshold only in diabetic rats. These findings suggest that increased mGluR5 expression on primary afferent neurons contributes to increased glutamatergic input to spinal dorsal horn neurons and nociceptive transmission in diabetic neuropathic pain.     

Roles of extracellular signal-regulated protein kinases 5 in spinal microglia and primary sensory neurons for neuropathic pain

Neuropathic pain that occurs after peripheral nerve injury is poorly controlled by current therapies. Increasing evidence shows that mitogen-activated protein kinase (MAPK) play an important role in the induction and maintenance of neuropathic pain. Here we show that activation of extracellular signal-regulated protein kinases 5 (ERK5), also known as big MAPK1, participates in pain hypersensitivity caused by nerve injury. Nerve injury increased ERK5 phosphorylation in spinal microglia and in both damaged and undamaged dorsal root ganglion (DRG) neurons. Antisense knockdown of ERK5 suppressed nerve injury-induced neuropathic pain and decreased microglial activation. Furthermore, inhibition of ERK5 blocked the induction of transient receptor potential channels and brain-derived neurotrophic factor expression in DRG neurons. Our results show that ERK5 activated in spinal microglia and DRG neurons contributes to the development of neuropathic pain. Thus, blocking ERK5 signaling in the spinal cord and primary afferents has potential for preventing pain after nerve damage.     

Direct evidence for spinal cord microglia in the development of a neuropathic pain-like state in mice

The present study was undertaken to further investigate the role of glial cells in the development of the neuropathic pain-like state induced by sciatic nerve ligation in mice. At 7 days after sciatic nerve ligation, the immunoreactivities (IRs) of the specific astrocyte marker glial fibrillary acidic protein (GFAP) and the specific microglial marker OX-42, but not the specific oligodendrocyte marker O4, were increased on the ipsilateral side of the spinal cord dorsal horn in nerve-ligated mice compared with that on the contralateral side. Furthermore, a single intrathecal injection of activated spinal cord microglia, but not astrocytes, caused thermal hyperalgesia in naive mice. Furthermore, 5-bromo-2'-deoxyuridine (BrdU)-positive cells on the ipsilateral dorsal horn of the spinal cord were significantly increased at 7 days after nerve ligation and were highly co-localized with another microglia marker, ionized calcium-binding adaptor molecule 1 (Iba1), but neither with GFAP nor a specific neural nuclei marker, NeuN, in the spinal dorsal horn of nerve-ligated mice. The present data strongly support the idea that spinal cord astrocytes and microglia are activated under the neuropathic pain-like state, and that the proliferated and activated microglia directly contribute to the development of a neuropathic pain-like state in mice.     

CCL-1 in the spinal cord contributes to neuropathic pain induced by nerve injury

Cytokines such as interleukins are known to be involved in the development of neuropathic pain through activation of neuroglia. However, the role of chemokine (C-C motif) ligand 1 (CCL-1), a well-characterized chemokine secreted by activated T cells, in the nociceptive transmission remains unclear. We found that CCL-1 was upregulated in the spinal dorsal horn after partial sciatic nerve ligation. Therefore, we examined actions of recombinant CCL-1 on behavioural pain score, synaptic transmission, glial cell function and cytokine production in the spinal dorsal horn. Here we show that CCL-1 is one of the key mediators involved in the development of neuropathic pain. Expression of CCL-1 mRNA was mainly detected in the ipsilateral dorsal root ganglion, and the expression of specific CCL-1 receptor CCR-8 was upregulated in the superficial dorsal horn. Increased expression of CCR-8 was observed not only in neurons but also in microglia and astrocytes in the ipsilateral side. Recombinant CCL-1 injected intrathecally (i.t.) to naive mice induced allodynia, which was prevented by the supplemental addition of N-methyl-𝒟-aspartate (NMDA) receptor antagonist, MK-801. Patch-clamp recordings from spinal cord slices revealed that application of CCL-1 transiently enhanced excitatory synaptic transmission in the substantia gelatinosa (lamina II). In the long term, i.t. injection of CCL-1 induced phosphorylation of NMDA receptor subunit, NR1 and NR2B, in the spinal cord. Injection of CCL-1 also upregulated mRNA level of glial cell markers and proinflammatory cytokines (IL-1β, TNF-α and IL-6). The tactile allodynia induced by nerve ligation was attenuated by prophylactic and chronic administration of neutralizing antibody against CCL-1 and by knocking down of CCR-8. Our results indicate that CCL-1 is one of the key molecules in pathogenesis, and CCL-1/CCR-8 signaling system can be a potential target for drug development in the treatment for neuropathic pain.     

Time-dependent and selective microglia-mediated removal of spinal synapses in neuropathic pain

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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。     

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。     

鞘内注射干扰素调节因子8小干扰RNA对术后持续性疼痛大鼠痛阈及脊髓小胶质细胞活化的影响*

目的: 探究鞘内注射干扰素调节因子8小干扰RNA(IRF8 SiRNA)对PPsP大鼠痛阈及脊髓小胶质细胞活化的影响。方法: 120只雄性SD大鼠随机分为假手术组(SH,n=12),模型组(SM,n=48),溶媒组(SD,n=12)和IRF8沉默组(SS,n=48),其中,SM组于大鼠后足中部隐静脉内侧按皮肤/肌肉切开牵拉(SMIR)法建立术后持续性疼痛(PPsP)模型,SH组仅切开不牵拉;SD组与SS组建模前一周先于L4/5椎间隙行鞘内置管术, SS组于建模后第5、6日连续鞘内给予IRF8 SiRNA溶液20 μl(溶于DEPC水中,150 pmol),SD组给予等量DEPC水。测量并记录建模前(D0),建模后第1(D1)、3(D3)、7(D7)、12(D12)、22(D22)、33(D33)日等时点各组大鼠术侧后足机械刺激缩足反应阈值 (PWT); 建模后第12日各取6只,Western blot法检测脊髓背角Iba-1蛋白表达情况,并取SH组和SM组各3只,取术野隐神经行电镜观察其超微结构改变;再取SM组和SS组于上述各时点各6只,流式细胞术检测脊髓背角小胶质细胞活化情况。结果: 与D0相比, SM组在D1～D22PWT降低(P＜0.05或P＜0.01),并在D33恢复至正常水平(P＞0.05);与SH组相比,SM组PWT在D1～D22均降低(P＜0.05或P＜0.01);与SD组相比,SS组PWT在D7～D22增高(P＜0.05或P＜0.01);与SH组相比,SS组D7～D22降低(P＜0.05或P＜0.01);隐神经髓鞘平均厚度: SH组为(377.03± 69.60) nm,SM组为(369.50±73.26) nm,两组间相比无统计学意义(P＞0.05);与SH组相比,SM组Iba-1明显上调(P＜0.01);与SD组相比,SS组Iba-1表达受到抑制(P＜0.05),与SH组相比,SS组Iba-1表达也具有统计学差异(P＜0.05),而SM组与SD组之间,Iba-1的表达无统计学意义(P＞0.05);与D0相比,SM组小胶质细胞活化比率在D3～D22均显著增加(P＜0.01),而SS组小胶质细胞活化于D3达到高峰(P＜0.01);鞘内给药后,SS组脊髓背角小胶质细胞活化比率明显下降,与SM组相比,在D7～D12显著下降(P＜0.01)。结论: SMIR诱导的PPsP大鼠显著且持续的机械痛觉过敏为非明显的外周神经损伤所致,可能是基于脊髓背角小胶质细胞活化所介导,而鞘内给予IRF8小干扰RNA可抑制脊髓背角小胶质细胞的激活,并逆转SMIR诱导的痛觉过敏。     

DGCR5 attenuates neuropathic pain through sponging miR-330-3p and regulating PDCD4 in CCI rat models

Neuropathic pain caused by somatosensory nervous system dysfunction is a serious public health problem. Some long noncoding RNAs (lncRNAs) can participate in physiological processes involved in neuropathic pain. However, the effects of lncRNA DGCR5 in neuropathic pain have not been explored. Therefore, in our current study, we concentrated on the biological roles of DGCR5 in neuropathic pain. Here, it was observed that DGCR5 was significantly decreased in chronic sciatic nerve injury (CCI) rat models. DGCR5 overexpression was able to alleviate neuropathic pain development including mechanical and thermal hyperalgesia. In addition, the current understanding of miR-330-3p function in neuropathic pain remains largely incomplete. Here, we found that miR-330-3p was greatly increased in CCI rats and DGCR5 can modulate miR-330-3p expression negatively. Upregulation of DGCR5 repressed inflammation-correlated biomarkers including interleukin 6 (IL-6), tumor necrosis factor α, and IL-1β in CCI rats by sponging miR-330-3p. The negative correlation between DGCR5 and miR-330-3p was confirmed in our current study. Inhibition of miR-330-3p suppressed neuropathic pain progression by restraining neuroinflammation in vivo. In addition, PDCD4 was predicted as a downstream target of miR-330-3p. Furthermore, PDCD4 was significantly increased in CCI rats and DGCR5 regulated PDCD4 expression through sponging miR-330-3p in CCI rat models. Taken these together, it was implied that DGCR5/miR-330-3p/PDCD4 axis participated in neuropathic pain treatment.     

大鼠脑实质内远位触液神经元中5-HT1A受体的分布及其在神经病理性痛中的表达

本文旨在探讨大鼠脑实质内远位触液神经元中5-HT1A受体的分布及其在神经病理性痛中的作用.慢性结扎损伤坐骨神经建立大鼠神经病理性痛模型,分别以缩足潜伏期(paw withdrawal latency,PWL)和缩足阈值(paw withdrawal threshold,PWT)对大鼠热痛敏和机械触诱发痛反应进行评分,以可靠CB-HRP(cholera toxin subunit B with horseradish peroxidase)法追踪标记脑实质内远位触液神经元,用CB-HRP/5-HT1A受体免疫组织化学双重标记技术定位、鉴别5-HT1A受体在远位触液神经元中的表达,并计数分析5-HT1A受体分布和表达变化与痛行为表现之间的关系.结果表明,在神经病理性痛第1、3、A7、14天,大鼠的PWL分别为19.37±2.74、12.04±1.77、8.74±1.15、12.31±1.94,PWT分别为18.58±3.62、13.05±1.81、6.66±1.43、1 1.55±2.01.CB-HRP标记细胞出现的位置和数量恒定.每只动物CB-HRP/5-HT1A受体双重标记的细胞数量分别为276.14±36.00、161.72±28.41、108.64±6.8l、139.76±44.64,分别占该动物CB-HRP标记细胞总数的95%、60%、40%和55%.与对照组相比,神经病理性痛大鼠PWL、PWT及CB.HRP/5-HT1A受体双标细胞数均有显著性差异(P<0.01).结果提示,大鼠脑实质的特定部位恒定存在远位触液神经元,该类神经元大多含有5-HT1A受体,该受体的表达与神经病理性痛行为表现之间呈负相关关系.     

Slow modulation of synaptic transmission by brain-derived neurotrophic factor leads to the central sensitization associated with neuropathic pain

Chronic constriction injury (CCI) of the rat sciatic nerve increases the dorsal horn excitability. This “central sensitization” leads to behavioral manifestations analogous to those related to human neuropathic pain. We found, using whole-cell recording from acutely isolated spinal cord slices, that 7-to 10-day-long CCI increases excitatory synaptic drive to putative excitatory “delay”-firing neurons in the substantia gelatinosa but attenuates that to putative inhibitory “tonic”-firing neurons. A defined-medium organotypic culture (DMOTC) system was used to investigate the long-term actions of brain-derived neurotrophic factor (BDNF) as a possible instigator of these changes. When all five neuronal types found in the substantia gelatinosa were considered, BDNF and CCI produced similar patterns, or “footprints,” of changes across the whole population. This pattern was not seen with another putative “pain mediator,” interleukin 1β. Thus, BDNF decreased synaptic drive to “tonic” neurons and increased synaptic drive to “delay” neurons. Actions of BDNF on “delay” neurons were presynaptic and involved increased mEPSC frequency and amplitude without changes in the function of postsynaptic AMPA receptors. By contrast, BDNF exerted both pre-and post-synaptic actions on “ tonic” cells to reduce the mEPSC frequency and amplitude. These differential actions of BDNF on excitatory and inhibitory neurons contributed to a global increase in the dorsal horn network excitability as assessed by the amplitude of depolarization-induced increases in the intracellular [Ca²⁺]. Experiments with the BDNF-binding protein TrkB-d5 provided additional evidence for BDNF as a harbinger of neuropathic pain. Thus, the cellular processes altered by BDNF likely contribute to “central sensitization” and hence to the onset of neuropathic pain. Neirofiziologiya/Neurophysiology, Vol. 39, Nos. 4/5, pp. 315–326, July–October, 2007.     

Progranulin contributes to endogenous mechanisms of pain defense after nerve injury in mice

Progranulin haploinsufficiency is associated with frontotemporal dementia in humans. Deficiency of progranulin led to exaggerated inflammation and premature aging in mice. The role of progranulin in adaptations to nerve injury and neuropathic pain are still unknown. Here we found that progranulin is up-regulated after injury of the sciatic nerve in the mouse ipsilateral dorsal root ganglia and spinal cord, most prominently in the microglia surrounding injured motor neurons. Progranulin knockdown by continuous intrathecal spinal delivery of small interfering RNA after sciatic nerve injury intensified neuropathic pain-like behaviour and delayed the recovery of motor functions. Compared to wild-type mice, progranulin-deficient mice developed more intense nociceptive hypersensitivity after nerve injury. The differences escalated with aging. Knockdown of progranulin reduced the survival of dissociated primary neurons and neurite outgrowth, whereas addition of recombinant progranulin rescued primary dorsal root ganglia neurons from cell death induced by nerve growth factor withdrawal. Thus, up-regulation of progranulin after neuronal injury may reduce neuropathic pain and help motor function recovery, at least in part, by promoting survival of injured neurons and supporting regrowth. A deficiency in this mechanism may increase the risk for injury-associated chronic pain.     

ATP receptors in pain sensation: Involvement of spinal microglia and P2X<Subscript>4</Subscript> receptors

There is abundant evidence that extracellular ATP and other nucleotides have an important role in pain signaling at both the periphery and in the CNS. At first, it was thought that ATP was simply involved in acute pain, since ATP is released from damaged cells and excites directly primary sensory neurons by activating their receptors. However, neither blocking P2X/Y receptors pharmacologically nor suppressing the expression of P2X/Y receptors molecularly in sensory neurons or in the spinal cord had an effect on acute physiological pain. The focus of attention now is on the possibility that endogenous ATP and its receptor system might be activated in pathological pain states, particularly in neuropathic pain. Neuropathic pain is often a consequence of nerve injury through surgery, bone compression, diabetes or infection. This type of pain can be so severe that even light touching can be intensely painful; unfortunately, this state is generally resistant to currently available treatments. An important advance in our understanding of the mechanisms involved in neuropathic pain has been made by a recent work demonstrating the crucial role of ATP receptors (i.e., P2X₃ and P2X₄ receptors). In this review, we summarize the role of ATP receptors, particularly the P2X₄ receptor, in neuropathic pain. The expression of P2X₄ receptors in the spinal cord is enhanced in spinal microglia after peripheral nerve injury, and blocking pharmacologically and suppressing molecularly P2X₄ receptors produce a reduction of the neuropathic pain behaviour. Understanding the key roles of ATP receptors including P2X₄ receptors may lead to new strategies for the management of neuropathic pain.