Obata Koichi, Tsujino Hiroaki, Yamanaka Hiroki, Yi Dai, Fukuoka Tetsuo, Hashimoto Norio, Yonenobu Kazuo, Yoshikawa Hideki, Noguchi Koichi
Department of Anatomy and Neuroscience, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
Pain. 2002 Sep;99(1-2):121-32. doi: 10.1016/s0304-3959(02)00068-4.
A variety of molecules released by inflammatory reactions in the dorsal root and dorsal root ganglion (DRG) may play important roles in the pathology of neuronal abnormalities in lumbar disc herniation. In order to elucidate the pathophysiological mechanisms of painful radiculopathy, secondary to lumbar disc herniation, we evaluated pain-related behavior and the change of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) expression in the DRG and dorsal root using a rat model of lumbar disc herniation. In the nucleus pulposus (NP) group, the left L4/5 nerve roots were exposed after hemilaminectomies and autologous intervertebral discs, which were obtained from coccygeal intervertebral discs, were implanted on each of the exposed nerve roots without mechanical compression. Rats in the NP group, but not the sham-operated rats, developed mechanical allodynia on the ipsilateral hind paw for 1 day after surgery and showed a significant increase in the number of NGF-immunoreactive (IR) cells in the nerve root and DRG. NGF-IR cells in the nerve root and DRG included macrophages and Schwann cells, because these cells were labeled for NGF and ED-1 or glial fibrillary acid protein by dual immunostaining. A significant increase in the percentage of BDNF-IR neurons in the DRG was observed in the NP group at 3 days after surgery and the increase in BDNF mRNA expression was confirmed using in situ hybridization histochemistry and reverse transcription-polymerase chain reaction. We also injected NGF into the endoneurial space of the normal rat spinal nerve root and found that the NGF injection produced dose-dependent mechanical allodynia on the ipsilateral hind paw at 1 day after surgery and an increase in the percentage of BDNF-IR neurons in the DRG at 3 days after surgery compared to the group receiving saline injection. These findings suggest that in the lumbar disc herniation model, i.e. neuritis of the nerve root, increased NGF produced by the inflammatory responses in the dorsal root and DRG tissues may affect the production of BDNF in the DRG and may play important roles in the modulation of the dorsal horn neurons. These changes in neurotrophic factors in the primary afferents may be involved in the pathophysiological mechanisms of neuropathic pain produced by lumbar disc herniation.
背根和背根神经节(DRG)中炎症反应释放的多种分子可能在腰椎间盘突出症神经元异常的病理过程中发挥重要作用。为了阐明腰椎间盘突出症继发的疼痛性神经根病的病理生理机制,我们使用腰椎间盘突出症大鼠模型评估了疼痛相关行为以及DRG和背根中神经生长因子(NGF)和脑源性神经营养因子(BDNF)表达的变化。在髓核(NP)组中,半椎板切除术后暴露左侧L4/5神经根,并将取自尾椎椎间盘的自体椎间盘植入每个暴露的神经根上,无机械压迫。NP组大鼠术后1天出现同侧后爪机械性异常疼痛,而假手术组大鼠未出现,且神经根和DRG中NGF免疫反应性(IR)细胞数量显著增加。神经根和DRG中的NGF-IR细胞包括巨噬细胞和雪旺细胞,因为通过双重免疫染色这些细胞被标记为NGF和ED-1或胶质纤维酸性蛋白。术后3天NP组DRG中BDNF-IR神经元百分比显著增加,并且使用原位杂交组织化学和逆转录-聚合酶链反应证实了BDNF mRNA表达增加。我们还将NGF注入正常大鼠脊神经根的神经内膜间隙,发现与接受盐水注射的组相比,NGF注射在术后1天产生同侧后爪剂量依赖性机械性异常疼痛,术后3天DRG中BDNF-IR神经元百分比增加。这些发现表明,在腰椎间盘突出症模型中,即神经根神经炎,背根和DRG组织中的炎症反应产生的NGF增加可能影响DRG中BDNF的产生,并可能在背角神经元的调节中发挥重要作用。初级传入神经中这些神经营养因子的变化可能参与腰椎间盘突出症所致神经性疼痛的病理生理机制。