糖尿病诱导的机械性痛觉过敏通过N-甲基-D-天冬氨酸依赖机制涉及神经元和小胶质细胞中脊髓丝裂原活化蛋白激酶的激活。
Diabetes-induced mechanical hyperalgesia involves spinal mitogen-activated protein kinase activation in neurons and microglia via N-methyl-D-aspartate-dependent mechanisms.
作者信息
Daulhac Laurence, Mallet Christophe, Courteix Christine, Etienne Monique, Duroux Eliane, Privat Anne-Marie, Eschalier Alain, Fialip Joseph
机构信息
Institut National de la Santé et de la Recherche Médicale U766, Facultéde de Médecine, Laboratoire de Pharmacologie, 28 Place Henri Dunant, BP38, 63001 Clermont-Ferrand Cedex 1, France.
出版信息
Mol Pharmacol. 2006 Oct;70(4):1246-54. doi: 10.1124/mol.106.025478. Epub 2006 Jul 25.
Molecular mechanisms underlying diabetes-induced painful neuropathy are poorly understood. We have demonstrated, in rats with streptozotocin-induced diabetes, that mechanical hyperalgesia, a common symptom of diabetic neuropathy, was correlated with an early increase in extracellular signal-regulated protein kinase (ERK), p38, and c-Jun N-terminal kinase (JNK) phosphorylation in the spinal cord and dorsal root ganglion at 3 weeks after induction of diabetes. This change was specific to hyperalgesia because nonhyperalgesic rats failed to have such an increase. Immunoblot analysis showed no variation of protein levels, suggesting a post-translational regulation of the corresponding kinases. In diabetic hyperalgesic rats, immunocytochemistry revealed that all phosphorylated mitogen-activated protein kinases (MAPKs) colocalized with both the neuronal (NeuN) and microglial (OX42) cell-specific markers but not with the astrocyte marker [glial fibrillary acidic protein (GFAP)] in the superficial dorsal horn-laminae of the spinal cord. In these same rats, a 7-day administration [5 microg/rat/day, intrathecal (i.t.)] of 1,4-diamino-2,3-dicyano-1,4-bis(2-aminophenylthio)butadiene (U0126), 4-(4-fluorophenyl)-2-(4-methylsulfinylphenyl)-5-(4-pyridyl)1H-imidazole (SB203580), and anthra(1,9-cd)pyrazol-6(2H)-one (SP600125), which inhibited MAPK kinase, p38, and JNK, respectively, suppressed mechanical hyperalgesia, and decreased phosphorylation of the kinases. To characterize the cellular events upstream of MAPKs, we have examined the role of the NMDA receptor known to be implicated in pain hypersensitivity. The prolonged blockade of this receptor during 7 days by (5R, 10S)-(+)-5-methyl-10, 11-dihydro-5H-dibenzo[a,d]-cyclohepten-5-10-imine hydrogen maleate (MK801; 5 microg/rat/day, i.t.), a noncompetitive NMDA receptor antagonist, reversed hyperalgesia developed by diabetic rats and blocked phosphorylation of all MAPKs. These results demonstrate for the first time that NMDA receptor-dependent phosphorylation of MAPKs in spinal cord neurons and microglia contribute to the establishment and longterm maintenance of painful diabetic hyperalgesia and that these kinases represent potential targets for pain therapy.
糖尿病性疼痛性神经病变的分子机制目前仍知之甚少。我们已经证明,在链脲佐菌素诱导的糖尿病大鼠中,机械性痛觉过敏作为糖尿病性神经病变的常见症状,与糖尿病诱导后3周脊髓和背根神经节中细胞外信号调节蛋白激酶(ERK)、p38和c-Jun氨基末端激酶(JNK)磷酸化的早期增加相关。这种变化是痛觉过敏所特有的,因为非痛觉过敏的大鼠没有这种增加。免疫印迹分析显示蛋白质水平没有变化,提示相应激酶存在翻译后调控。在糖尿病性痛觉过敏大鼠中,免疫细胞化学显示,在脊髓背角浅层板层中,所有磷酸化的丝裂原活化蛋白激酶(MAPK)均与神经元(NeuN)和小胶质细胞(OX42)特异性标记物共定位,但不与星形胶质细胞标记物[胶质纤维酸性蛋白(GFAP)]共定位。在这些相同的大鼠中,鞘内注射(i.t.)1,4-二氨基-2,3-二氰基-1,4-双(2-氨基苯硫基)丁二烯(U0126)、4-(4-氟苯基)-2-(4-甲亚磺酰基苯基)-5-(4-吡啶基)1H-咪唑(SB203580)和蒽(1,9-cd)吡唑-6(2H)-酮(SP600125),分别抑制MAPK激酶、p38和JNK,持续给药7天[5μg/大鼠/天],可抑制机械性痛觉过敏,并降低激酶的磷酸化水平。为了阐明MAPK上游的细胞事件,我们研究了已知与疼痛超敏反应有关的NMDA受体的作用。通过非竞争性NMDA受体拮抗剂(5R,10S)-(+)-5-甲基-10,11-二氢-5H-二苯并[a,d]-环庚烯-5,10-亚胺马来酸氢盐(MK801;5μg/大鼠/天,i.t.)对该受体进行7天的长期阻断,可逆转糖尿病大鼠产生的痛觉过敏,并阻断所有MAPK的磷酸化。这些结果首次证明,脊髓神经元和小胶质细胞中NMDA受体依赖性的MAPK磷酸化有助于糖尿病性疼痛性痛觉过敏的建立和长期维持,并且这些激酶是疼痛治疗的潜在靶点。