外周神经损伤引起的神经病理性痛：对神经损伤的一种适应不良反应

外周神经损伤可引起对神经系统的一种适应不良反应,其产生神经病理性痛的主要特点为痛觉增敏和异常疼痛。目前文献报道多种机制涉及此反应,包括离子通道改变引起的异常放电、突触易化、多种轴突水平抑制作用缺失导致的中枢敏化、神经元细胞的凋亡以及异常的突触连接等结构的改变,另外神经损伤引起的神经免疫之间的相互作用在神经病理性痛的持续性发展中发挥着不可替代的作用。了解外周神经损伤引起的神经病理性的发病机制将对我们寻找治疗靶点和治疗策略提供坚实的理论基础。     

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。     

HCN2在大鼠外周神经病理性疼痛发生中的作用

目的：初步探讨超极化激活的环核苷酸门控通道2型（HCN2）在外周神经病理性疼痛发生中的作用。方法：将24只健康成年大鼠进行随机分组（n=12）：假手术组（Sham）大鼠仅分离左侧L4、L5脊神经,模型组（SNL）分离脊神经后进行相应的结扎处理,手术7 d后用行为学方法进行模型评价;将造模成功的大鼠进行随机分组（n=6）：①阴性对照组（Saline）,左侧足底注射生理盐水;②阳性对照组（GBPT）,腹腔注射加巴喷丁;③实验组（ZD7288）,左侧足底注射HCN非特异性阻断剂ZD7288。在给药前以及给药后1 h、4 h、24 h、48 h用疼痛行为学实验检测其对神经病理性疼痛的作用;分别取手术前对照组（Control）、假手术组（Sham）和模型组（SNL）大鼠的背根神经节（DRG）（n=6）,利用qPCR和Western blot的方法研究造模前后大鼠DRG内HCN2的表达的变化情况。结果：①成功建立大鼠神经痛模型;②与Saline组比较,GBPT组和ZD7288组在注射1 h后,均能明显的减轻大鼠神经病理性疼痛的症状（P<0.01）,而GBPT组和ZD7288组之间比较则无差异;③与Control组和Sham组相比较,SNL组大鼠DRG内的HCN2 mRNA表达量明显增加（P<0.01）;与Control组和Sham组相比较,SNL组大鼠DRG内的HCN2通道蛋白表达量显著增加（P<0.05）。结论：HCN2参与外周神经病理性疼痛的发生,并有可能成为治疗神经病理性疼痛一个潜在的新靶点。     

脊髓自噬功能激活与大鼠2型糖尿病神经病理性疼痛的关系

目的：探讨脊髓自噬功能与大鼠2型糖尿病神经病理性疼痛（DNP）的关系。方法：雄性SD大鼠（42只）高糖高脂饲养8周,腹腔单次注射链脲佐菌素（STZ）制备大鼠2型糖尿病模型。两周后检测机械缩足阈值（MWT）和热缩足潜伏期（TWL）,降至基础值80%以下者为2型糖尿病神经病理性疼痛大鼠,记为DNP组（24只）;未降至基础值80%以下者为2型糖尿病无神经病理性疼痛大鼠,记为DA组（18只）。另取18只大鼠为对照（control,C）组,普通饲料喂养。于确定DA与DNP分组后的第3、7和14天,测定机械缩足阈值（MWT）和热缩足潜伏期（TWL）,并在行为学检测结束后各组随机取6只大鼠处死,取L4~L6脊髓膨大,采用Western blot法检测自噬特异性蛋白微管相关蛋白1（Beclin-1）、微管相关蛋白1轻链3（LC3）和P62的表达。另取6只7 d DNP组大鼠采用免疫荧光双染法检测脊髓背角P62与小胶质细胞、星形胶质细胞、神经元的共表达情况。结果：连续8周喂养高糖高脂饲料的SD大鼠的血浆胰岛素水平升高,胰岛素敏感指数下调,表明出现胰岛素抵抗;在腹腔注射STZ后,血糖升高达到2型糖尿病诊断标准（≥16.7 mmol/L）;与C组、DA组比较,DNP组大鼠在第3、7和14天时MWT降低,TWL缩短,并且脊髓背角LC3-Ⅱ、Beclin-1表达上调,P62表达下降（P<0.05）。免疫荧光双染色显示,P62在脊髓背角表达,主要与神经元共存,少量与小胶质细胞共存,几乎不与星形胶质细胞共表达。结论：2型糖尿病神经病理性疼痛大鼠脊髓LC3-Ⅱ、Beclin-1和P62表达的改变提示脊髓自噬功能激活;脊髓背角中神经元自噬激活在2型糖尿病大鼠DNP的发生和发展起着关键作用。     

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。     

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.     

Characterization of traumatic spinal cord injury model in relation to neuropathic pain in the rat

Purpose/aim: Neuropathic pain following spinal cord injury (SCI) has a tremendous impact on patient’s quality of life, and frequently is the most limiting aspect of the disease. In view of the severity of this condition and the absence of effective treatments, the establishment of a reliable animal model that reproduces neuropathic pain after injury is crucial for a better understanding of the pathophysiology and for the development of new therapeutic strategies. Thus, the objective of the present study was to standardize the traumatic SCI model in relation to neuropathic pain.

Materials and methods: Wistar rats were submitted to SCI of mild intensity (pendulum height 12.5?mm) or moderate intensity (pendulum height 25?mm) using the New York University Impactor equipment. Behavioural assessment was performed during 8 weeks. Thereafter, spinal cords were processed for immunohistochemistry.

Results: The animals of the moderate injury group in comparison with mild injury had a greater motor function deficit, worse mechanical allodynia, and latter bladder recovery; moreover, histological analysis revealed more extensive lesions with lower neuronal population.

Conclusions: Our study suggests that moderate SCI causes a progressive and long-lasting painful condition (at least 8 weeks), in addition to motor impairment, and thus represents a reliable animal model for the study of chronic neuropathic pain after SCI.     

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.     

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。     

甲醛炎性痛及痛过敏诱导大鼠脊髓后角环氧化酶-2表达的变化

目的:观察甲醛炎性痛及痛过敏过程中脊髓后角环氧化酶-2 (COX-2)表达的变化及其时间特征.方法:采用大鼠甲醛疼痛模型,用免疫组化法观察脊髓COX-2表达的变化.结果:与对照组相比,注射甲醛后4 h,1 d及3 d组脊髓后角Ⅰ-Ⅵ板层COX-2免疫反应阳性细胞的数目及染色深度均显著增加,以1 d组增加最为明显.结论:脊髓后角COX-2参与甲醛炎性痛及痛过敏.     

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