Mönnikes Hubert, Rüter Jens, König Matthias, Grote Christoph, Kobelt Peter, Klapp Burghard F, Arnold Rudolf, Wiedenmann Bertram, Tebbe Johannes J
Department of Internal Medicine, Charité, Humboldt-Universität, Berlin, Germany.
Brain Res. 2003 Mar 21;966(2):253-64. doi: 10.1016/s0006-8993(02)04197-5.
Experimental animal models have been established to gain insight into the pathogenesis and the mechanisms of visceral hyperalgesia in the irritable bowel syndrome (IBS). However, data about the mechanisms and pathways involved in the induction of neuronal activity in forebrain and midbrain structures by a physiological GI stimulus, like colonic distension (CD), in the range from non-noxious to noxious intensities are scarce. Thus, the effect of proximal CD with non-noxious (10 mmHg) and noxious (40 and 70 mmHg) stimulus intensities on neuronal activity in brain nuclei, as assessed by c-fos expression, was established. In additional studies, the role of vagal and non-vagal afferent sensory C-fibers and 5-HT(3) receptors in the mediation of visceral nociception was investigated in this experimental model at noxious colonic distension (70 mmHg). At CD, the number of c-Fos like immunoreactivity (c-FLI)-positive neurons increased pressure-dependently in the nucleus of the solitary tract (NTS), rostral ventrolateral medulla (RVLM), nucleus cuneiformis (NC), periaqueductal gray (PAG), and the amygdala (AM). In the dorsomedial (DMH) and ventromedial nucleus (VMH) of the hypothalamus, as well as in the thalamus (TH), neuronal activity was also increased after CD, but independently of stimulus intensities. A decrease of the CD-induced c-fos expression after sensory vagal denervation by perivagal capsaicin treatment was only observed in brainstem nuclei (NTS and RVLM). In all other activated brain nuclei examined, the CD-related induction of c-fos expression was diminished only after systemic neonatal capsaicin treatment. In the NTS and RVLM, a trend of decrease of c-fos expression was also observed after systemic neonatal capsaicin treatment. In order to assess the role of the 5-HT(3) receptor in CD-induced neuronal activation of brain nuclei, animals were pretreated with the 5-HT(3) receptor antagonist granisetron (1250 microg/kg, i.p. within 18 h before CD). Pretreatment with granisetron significantly reduced the number of c-FLI-positive cells/section in the NTS by 40%, but had no significant effect on the CD-induced c-fos expression in other brain areas. The data suggest that distinct afferent pathways and transmitters are involved in the transmission of nociceptive information from the colon to the brain nuclei activated by proximal colonic distension. Activation of NTS neurons at such a condition seems to be partially mediated via capsaicin-sensitive vagal afferents and 5-HT(3) receptors. In contrast, activation of brain nuclei in the di- and telencephalon by nociceptive mechanical stimulation of the proximal colon, as assessed by c-fos expression, is partially mediated by capsaicin-sensitive, non-vagal afferents, and independent of neurotransmission via 5-HT(3) receptors. The modulation of CD-induced c-fos expression exclusively in the NTS by granisetron points to a role of 5-HT(3) receptor antagonists in the modulation of vago-vagal sensomotoric reflexes rather than an influence on forebrain nuclei involved in nociception.
已经建立了实验动物模型,以深入了解肠易激综合征(IBS)中内脏痛觉过敏的发病机制和机制。然而,关于生理胃肠道刺激(如结肠扩张(CD))在从无害到有害强度范围内诱导前脑和中脑结构中神经元活动的机制和途径的数据很少。因此,通过c-fos表达评估了非有害(10 mmHg)和有害(40和70 mmHg)刺激强度的近端CD对脑核中神经元活动的影响。在其他研究中,在该实验模型中,在有害结肠扩张(70 mmHg)时,研究了迷走神经和非迷走神经传入感觉C纤维和5-HT(3)受体在内脏痛觉传导中的作用。在CD时,孤束核(NTS)、延髓头端腹外侧区(RVLM)、楔状核(NC)、导水管周围灰质(PAG)和杏仁核(AM)中c-Fos样免疫反应性(c-FLI)阳性神经元的数量随压力依赖性增加。在丘脑(TH)以及下丘脑的背内侧(DMH)和腹内侧核(VMH)中,CD后神经元活动也增加,但与刺激强度无关。仅在脑干核(NTS和RVLM)中观察到经迷走神经周围辣椒素处理后感觉迷走神经去神经支配后CD诱导的c-fos表达降低。在所有其他检查的活化脑核中,仅在全身性新生期辣椒素处理后,CD相关的c-fos表达诱导才减弱。在NTS和RVLM中,全身性新生期辣椒素处理后也观察到c-fos表达有下降趋势。为了评估5-HT(3)受体在CD诱导的脑核神经元激活中的作用,动物在CD前18小时内腹腔注射5-HT(3)受体拮抗剂格拉司琼(1250 μg/kg)进行预处理。格拉司琼预处理使NTS中c-FLI阳性细胞/切片的数量显著减少40%,但对其他脑区CD诱导的c-fos表达没有显著影响。数据表明,不同的传入途径和递质参与了从结肠到近端结肠扩张激活的脑核的伤害性信息传递。在这种情况下,NTS神经元的激活似乎部分通过辣椒素敏感的迷走神经传入和5-HT(3)受体介导。相比之下,通过c-fos表达评估,近端结肠的伤害性机械刺激对间脑和端脑脑核的激活部分由辣椒素敏感的非迷走神经传入介导,且独立于通过5-HT(3)受体的神经传递。格拉司琼仅在NTS中对CD诱导的c-fos表达进行调节,这表明5-HT(3)受体拮抗剂在调节迷走-迷走感觉运动反射中起作用,而不是对参与痛觉的前脑核有影响。