Jammes Yves, Trousse Delphine, Delpierre Stéphane
Laboratoire de Physiopathologie Respiratoire (UPRES EA 2201), Faculté de Médecine, Boulevard Pierre Dramard, 13916 cedex 20, Marseille, France.
J Physiol. 2005 Sep 1;567(Pt 2):641-50. doi: 10.1113/jphysiol.2005.089029. Epub 2005 Jun 23.
Although pain and dyspnoea are common symptoms in pleural diseases, there are few studies on the sensory innervation of the pleura. Using rabbits, after removal of all muscles in the intercostal space to be studied, we investigated the afferents of the internal intercostal nerve by applying to the internal thoracic wall pieces of gauze soaked in warmed (37 degrees C), buffered saline (mechanical stimulation) or solutions containing lactic acid, inflammatory mediators or capsaicin (chemical stimulation). The afferent conduction velocity ranged from 0.5 to 14 m s(-1). Most units (97%) were activated by mechanical stimulation of the pleura (local positive pressure range = 4.5-8.5 cmH2O) and we found a linear relationship between the discharge rate of afferents and the force applied to the thoracic wall. The majority of mechanosensitive units (70%) also responded to one or several chemical agents. Thus, the afferents were activated by lactic acid (49%) and/or a mixture of inflammatory mediators (50%). Local application of capsaicin elicited an initial increased or decreased background afferent activity in 57% of the afferents, a delayed decrease in firing rate being noted in some units initially activated by capsaicin. Capsaicin blocked the afferent response to a further application of inflammatory mediators but did not affect the mechanosensitive units. Thus, sensory endings connected with thin myelinated and unmyelinated fibres in the internal intercostal nerve detect the mechanical and chemical events of pleural diseases.
尽管疼痛和呼吸困难是胸膜疾病的常见症状,但关于胸膜感觉神经支配的研究却很少。我们以兔子为实验对象,在去除待研究肋间间隙的所有肌肉后,通过将浸泡在温热(37℃)缓冲盐水中的纱布片(机械刺激)或含有乳酸、炎症介质或辣椒素的溶液(化学刺激)应用于胸内壁,来研究肋间内神经的传入神经。传入神经传导速度范围为0.5至14米/秒。大多数单位(97%)通过胸膜的机械刺激(局部正压范围=4.5-8.5厘米水柱)被激活,并且我们发现传入神经放电率与施加于胸壁的力之间存在线性关系。大多数机械敏感单位(70%)也对一种或几种化学物质有反应。因此,传入神经被乳酸(49%)和/或炎症介质混合物(50%)激活。局部应用辣椒素在57%的传入神经中引起初始背景传入神经活动增加或减少,在一些最初被辣椒素激活的单位中注意到放电率延迟下降。辣椒素阻断了传入神经对进一步应用炎症介质的反应,但不影响机械敏感单位。因此,与肋间内神经中细有髓和无髓纤维相连的感觉末梢可检测胸膜疾病的机械和化学事件。