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膈下迷走神经传入神经调节内脏痛。

Subdiaphragmatic vagal afferent nerves modulate visceral pain.

作者信息

Chen S L, Wu X Y, Cao Z J, Fan J, Wang M, Owyang C, Li Y

机构信息

Gastroenterology Research Unit, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109-0682, USA.

出版信息

Am J Physiol Gastrointest Liver Physiol. 2008 Jun;294(6):G1441-9. doi: 10.1152/ajpgi.00588.2007. Epub 2008 Apr 17.

Abstract

Activation of the vagal afferents by noxious gastrointestinal stimuli suggests that vagal afferents may play a complex role in visceral pain processes. The contribution of the vagus nerve to visceral pain remains unresolved. Previous studies reported that patients following chronic vagotomy have lower pain thresholds. The patient with irritable bowel syndrome has been shown alteration of vagal function. We hypothesize that vagal afferent nerves modulate visceral pain. Visceromotor responses (VMR) to graded colorectal distension (CRD) were recorded from the abdominal muscles in conscious rats. Chronic subdiaphragmatic vagus nerve sections induced 470, 106, 51, and 54% increases in VMR to CRD at 20, 40, 60 and 80 mmHg, respectively. Similarly, at light level of anesthesia, topical application of lidocaine to the subdiaphragmatic vagus nerve in rats increased VMR to CRD. Vagal afferent neuronal responses to low or high-intensity electrical vagal stimulation (EVS) of vagal afferent Adelta or C fibers were distinguished by calculating their conduction velocity. Low-intensity EVS of Adelta fibers (40 microA, 20 Hz, 0.5 ms for 30 s) reduced VMR to CRD at 40, 60, and 80 mmHg by 41, 52, and 58%, respectively. In contrast, high-intensity EVS of C fibers (400 microA, 1 Hz, 0.5 ms for 30 s) had no effect on VMR to CRD. In conclusion, we demonstrated that vagal afferent nerves modulate visceral pain. Low-intensity EVS that activates vagal afferent Adelta fibers reduced visceral pain. Thus EVS may potentially have a role in the treatment of chronic visceral pain.

摘要

有害的胃肠道刺激激活迷走神经传入纤维,这表明迷走神经传入纤维可能在内脏痛觉过程中发挥复杂作用。迷走神经在内脏痛中的作用仍未明确。既往研究报道,慢性迷走神经切断术后患者的痛阈降低。肠易激综合征患者已被证实存在迷走神经功能改变。我们推测迷走神经传入神经调节内脏痛。在清醒大鼠中,记录腹部肌肉对不同程度结肠扩张(CRD)的内脏运动反应(VMR)。慢性膈下迷走神经切断术分别使大鼠在20、40、60和80 mmHg压力下对CRD的VMR增加470%、106%、51%和54%。同样,在浅麻醉水平下,向大鼠膈下迷走神经局部应用利多卡因可增加对CRD的VMR。通过计算传导速度来区分迷走神经传入神经元对迷走神经传入Aδ或C纤维的低强度或高强度电迷走神经刺激(EVS)的反应。Aδ纤维的低强度EVS(40 μA,20 Hz,0.5 ms,持续30 s)使大鼠在40、60和80 mmHg压力下对CRD的VMR分别降低41%、52%和58%。相比之下,C纤维的高强度EVS(400 μA,1 Hz,0.5 ms,持续30 s)对CRD的VMR没有影响。总之,我们证明了迷走神经传入神经调节内脏痛。激活迷走神经传入Aδ纤维的低强度EVS可减轻内脏痛。因此,EVS可能在慢性内脏痛的治疗中具有潜在作用。

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