Zhuang Zhi-Ye, Wen Yeong-Ray, Zhang De-Ren, Borsello Tiziana, Bonny Christophe, Strichartz Gary R, Decosterd Isabelle, Ji Ru-Rong
Department of Anesthesiology, Pain Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
J Neurosci. 2006 Mar 29;26(13):3551-60. doi: 10.1523/JNEUROSCI.5290-05.2006.
Optimal management of neuropathic pain is a major clinical challenge. We investigated the involvement of c-Jun N-terminal kinase (JNK) in neuropathic pain produced by spinal nerve ligation (SNL) (L5). SNL induced a slow (>3 d) and persistent (>21 d) activation of JNK, in particular JNK1, in GFAP-expressing astrocytes in the spinal cord. In contrast, p38 mitogen-activated protein kinase activation was found in spinal microglia after SNL, which had fallen to near basal level by 21 d. Intrathecal infusion of a JNK peptide inhibitor, D-JNKI-1, did not affect normal pain responses but potently prevented and reversed SNL-induced mechanical allodynia, a major symptom of neuropathic pain. Intrathecal D-JNKI-1 also suppressed SNL-induced phosphorylation of the JNK substrate, c-Jun, in spinal astrocytes. However, SNL-induced upregulation of GFAP was not attenuated by spinal D-JNKI-1 infusion. Furthermore, SNL induced a rapid (<12 h) but transient activation of JNK in the L5 (injured) but not L4 (intact) DRG. JNK activation in the DRG was mainly found in small-sized C-fiber neurons. Infusion of D-JNKI-1 into the L5 DRG prevented but did not reverse SNL-induced mechanical allodynia. Finally, intrathecal administration of an astroglial toxin, l-alpha-aminoadipate, reversed mechanical allodynia. Our data suggest that JNK activation in the DRG and spinal cord play distinct roles in regulating the development and maintenance of neuropathic pain, respectively, and that spinal astrocytes contribute importantly to the persistence of mechanical allodynia. Targeting the JNK pathway in spinal astroglia may present a new and efficient way to treat neuropathic pain symptoms.
神经病理性疼痛的最佳管理是一项重大的临床挑战。我们研究了c-Jun氨基末端激酶(JNK)在脊髓神经结扎(SNL,L5)所致神经病理性疼痛中的作用。SNL诱导脊髓中表达胶质纤维酸性蛋白(GFAP)的星形胶质细胞中JNK,特别是JNK1的缓慢(>3天)且持续(>21天)激活。相比之下,SNL后脊髓小胶质细胞中发现p38丝裂原活化蛋白激酶激活,到21天时已降至接近基础水平。鞘内注射JNK肽抑制剂D-JNKI-1不影响正常疼痛反应,但能有效预防和逆转SNL诱导的机械性异常性疼痛,这是神经病理性疼痛的主要症状。鞘内注射D-JNKI-1还能抑制SNL诱导的脊髓星形胶质细胞中JNK底物c-Jun的磷酸化。然而,鞘内注射D-JNKI-1并未减弱SNL诱导的GFAP上调。此外,SNL在L5(受损)背根神经节(DRG)而非L4(完整)DRG中诱导JNK快速(<12小时)但短暂的激活。DRG中的JNK激活主要见于小型C纤维神经元。向L5 DRG注射D-JNKI-1可预防但不能逆转SNL诱导的机械性异常性疼痛。最后,鞘内注射星形胶质细胞毒素l-α-氨基己二酸可逆转机械性异常性疼痛。我们的数据表明,DRG和脊髓中的JNK激活分别在调节神经病理性疼痛的发生和维持中发挥不同作用,且脊髓星形胶质细胞对机械性异常性疼痛的持续存在起重要作用。靶向脊髓星形胶质细胞中的JNK通路可能是治疗神经病理性疼痛症状的一种新的有效方法。