Wen Yeong-Ray, Suter Marc R, Kawasaki Yasuhiko, Huang Jin, Pertin Marie, Kohno Tatsuro, Berde Charles B, Decosterd Isabelle, Ji Ru-Rong
Pain Research Center, Department of Anesthesiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Anesthesiology. 2007 Aug;107(2):312-21. doi: 10.1097/01.anes.0000270759.11086.e7.
Current evidence indicates that p38 mitogen-activated protein kinase activation in spinal microglia contributes to the development of neuropathic pain. However, how nerve injury activates p38 in spinal microglia is incompletely unknown. Nerve injury-induced ectopic spontaneous activity is essential for the generation of neuropathic pain. The authors examined whether peripheral neural activity is necessary for p38 activation in spinal microglia.
To examine whether spinal microglia activation depends on peripheral activity in the rat spared nerve injury (SNI) model, the authors blocked conduction in the sciatic nerve before or 2 days after SNI. The block was produced by applying bupivacaine-loaded microspheres above the nerve injury site. The p38 activation was examined by p38 phosphorylation using a phosphorylated p38 antibody, and neuropathic pain-related behavior was evaluated before and after intrathecal infusion of a p38 inhibitor.
Three days after SNI, there was a marked p38 activation in the medial two thirds of the dorsal horn, where the injured tibial and peroneal nerves terminated and where isolectin B4 staining was lost. Phosphorylated p38 was only colocalized with the microglial surface marker OX-42, indicating a microglial localization of phosphorylated p38 in the SNI model. Bupivacaine microspheres produced persistent block (loss of sensory and motor function) of the sciatic nerve for the whole period of the study (3 days). This blockade prevented but did not reverse p38 activation in spinal microglia. Intrathecal infusion of the p38 inhibitor FR167653 prevented and reversed mechanical allodynia on post-SNI day 3.
After nerve injury, activity in the peripheral nerve is required for the induction but not the maintenance of p38 activation in spinal microglia.
目前的证据表明,脊髓小胶质细胞中p38丝裂原活化蛋白激酶的激活促成了神经性疼痛的发展。然而,神经损伤如何激活脊髓小胶质细胞中的p38尚不完全清楚。神经损伤诱导的异位自发放电对于神经性疼痛的产生至关重要。作者研究了外周神经活动对于脊髓小胶质细胞中p38激活是否必要。
为了研究在大鼠 spared 神经损伤(SNI)模型中脊髓小胶质细胞的激活是否依赖于外周活动,作者在SNI之前或之后2天阻断坐骨神经的传导。通过在神经损伤部位上方应用负载布比卡因的微球来产生阻断。使用磷酸化p38抗体通过p38磷酸化检测p38激活情况,并在鞘内注射p38抑制剂前后评估神经性疼痛相关行为。
SNI后3天,在背角内侧三分之二区域有明显的p38激活,此处为受损的胫神经和腓神经的终末部位且异凝集素B4染色消失。磷酸化p38仅与小胶质细胞表面标志物OX - 42共定位,表明在SNI模型中磷酸化p38定位于小胶质细胞。在整个研究期间(3天),布比卡因微球使坐骨神经产生持续阻断(感觉和运动功能丧失)。这种阻断可预防但不能逆转脊髓小胶质细胞中的p38激活。鞘内注射p38抑制剂FR167653可预防并逆转SNI后第3天的机械性异常性疼痛。
神经损伤后,外周神经活动是脊髓小胶质细胞中p38激活诱导所必需的,但不是维持激活所必需的。