Schäfers Maria, Lee Doo H, Brors Dominik, Yaksh Tony L, Sorkin Linda S
Anesthesiology Research Laboratory, University of California San Diego, La Jolla, California 92093-0818, USA.
J Neurosci. 2003 Apr 1;23(7):3028-38. doi: 10.1523/JNEUROSCI.23-07-03028.2003.
Tumor necrosis factor-alpha (TNF) is upregulated after nerve injury, causes pain on injection, and its blockade reduces pain behavior resulting from nerve injury; thus it is strongly implicated in neuropathic pain. We investigated responses of intact and nerve-injured dorsal root ganglia (DRG) neurons to locally applied TNF using parallel in vivo and in vitro paradigms. In vivo, TNF (0.1-10 pg/ml) or vehicle was injected into L5 DRG in naive rats and in rats that had received L5 and L6 spinal nerve ligation (SNL) immediately before injection. In naive rats, TNF, but not vehicle, elicited long-lasting allodynia. In SNL rats, subthreshold doses of TNF synergized with nerve injury to elicit faster onset of allodynia and spontaneous pain behavior. Tactile allodynia was present in both injured and adjacent uninjured (L4) dermatomes. Preemptive treatment with the TNF antagonist etanercept reduced SNL-induced allodynia by almost 50%. In vitro, the electrophysiological responses of naive, SNL-injured, or adjacent uninjured DRG to TNF (0.1-1000 pg/ml) were assessed by single-fiber recordings of teased dorsal root microfilaments. In vitro perfusion of TNF (100-1000 pg/ml) to naive DRG evoked short-lasting neuronal discharges. In injured DRG, TNF, at much lower concentrations, elicited earlier onset, markedly higher, and longer-lasting discharges. TNF concentrations that were subthreshold in naive DRG also elicited high-frequency discharges when applied to uninjured, adjacent DRG. We conclude that injured and adjacent uninjured DRG neurons are sensitized to TNF after SNL. Sensitization to endogenous TNF may be essential for the development and maintenance of neuropathic pain.
肿瘤坏死因子-α(TNF)在神经损伤后上调,注射时会引起疼痛,其阻断可减轻神经损伤导致的疼痛行为;因此,它与神经性疼痛密切相关。我们使用体内和体外并行的实验范式,研究了完整和神经损伤的背根神经节(DRG)神经元对局部应用TNF的反应。在体内,将TNF(0.1 - 10 pg/ml)或赋形剂注射到未处理的大鼠以及在注射前立即接受L5和L6脊神经结扎(SNL)的大鼠的L5 DRG中。在未处理的大鼠中,TNF而非赋形剂引发了持久的异常性疼痛。在SNL大鼠中,亚阈值剂量的TNF与神经损伤协同作用,引发更快发作的异常性疼痛和自发疼痛行为。触觉异常性疼痛在受伤和相邻未受伤(L4)皮节中均存在。用TNF拮抗剂依那西普进行预处理可使SNL诱导的异常性疼痛降低近50%。在体外,通过对分离的背根微丝进行单纤维记录,评估未处理、SNL损伤或相邻未受伤的DRG对TNF(0.1 - 1000 pg/ml)的电生理反应。向未处理的DRG体外灌注TNF(100 - 1000 pg/ml)可诱发短暂的神经元放电。在损伤的DRG中,TNF在低得多的浓度下即可引发更早发作、明显更高且更持久的放电。在未处理的DRG中低于阈值的TNF浓度应用于未受伤的相邻DRG时也会引发高频放电。我们得出结论,SNL后受伤和相邻未受伤的DRG神经元对TNF敏感。对内源性TNF的敏感化可能对神经性疼痛的发生和维持至关重要。