Lirk Philipp, Poroli Mark, Rigaud Marcel, Fuchs Andreas, Fillip Patrick, Huang Chun-Yuan, Ljubkovic Marko, Sapunar Damir, Hogan Quinn
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Anesth Analg. 2008 Aug;107(2):673-85. doi: 10.1213/ane.0b013e31817b7a73.
Chronic neuropathic pain resulting from neuronal damage remains difficult to treat, in part, because of incomplete understanding of underlying cellular mechanisms. We have previously shown that inward Ca2+ flux (I(Ca)) across the sensory neuron plasmalemma is decreased in a rodent model of chronic neuropathic pain, but the direct consequence of this loss of I(Ca) on function of the sensory neuron has not been defined. We therefore examined the extent to which altered membrane properties after nerve injury, especially increased excitability that may contribute to chronic pain, are attributable to diminished Ca2+ entry.
Intracellular microelectrode measurements were obtained from A-type neurons of dorsal root ganglia excised from uninjured rats. Recording conditions were varied to suppress or promote I(Ca) while biophysical variables and excitability were determined.
Both lowered external bath Ca2+ concentration and blockade of I(Ca) with bath cadmium diminished the duration and area of the after-hyperpolarization (AHP), accompanied by decreased current threshold for action potential (AP) initiation and increased repetitive firing during sustained depolarization. Reciprocally, elevated bath Ca2+ increased the AHP and suppressed repetitive firing. Voltage sag during neuronal hyperpolarization, indicative of the cation-nonselective H-current, diminished with decreased bath Ca2+, cadmium application, or chelation of intracellular Ca2+. Additional recordings with selective blockers of I(Ca) subtypes showed that N-, P/Q, L-, and R-type currents each contribute to generation of the AHP and that blockade of any of these, and the T-type current, slows the AP upstroke, prolongs the AP duration, and (except for L-type current) decreases the current threshold for AP initiation.
Taken together, our findings show that suppression of I(Ca) decreases the AHP, reduces the hyperpolarization-induced voltage sag, and increases excitability in sensory neurons, replicating changes that follow peripheral nerve trauma. This suggests that the loss of I(Ca) previously demonstrated in injured sensory neurons contributes to their dysfunction and hyperexcitability, and may lead to neuropathic pain.
神经元损伤导致的慢性神经性疼痛仍然难以治疗,部分原因是对潜在细胞机制的理解不完整。我们之前已经表明,在慢性神经性疼痛的啮齿动物模型中,感觉神经元质膜上的内向Ca2+通量(I(Ca))降低,但这种I(Ca)丧失对感觉神经元功能的直接后果尚未明确。因此,我们研究了神经损伤后膜特性改变,特别是可能导致慢性疼痛的兴奋性增加,在多大程度上归因于Ca2+内流减少。
从未受伤大鼠切除的背根神经节的A型神经元进行细胞内微电极测量。改变记录条件以抑制或促进I(Ca),同时测定生物物理变量和兴奋性。
降低细胞外浴液Ca2+浓度和用浴液镉阻断I(Ca)均减少了后超极化(AHP)的持续时间和面积,同时动作电位(AP)起始的电流阈值降低,持续去极化期间的重复放电增加。相反,升高浴液Ca2+增加了AHP并抑制了重复放电。神经元超极化期间的电压凹陷,指示阳离子非选择性H电流,随着浴液Ca2+降低、镉应用或细胞内Ca2+螯合而减弱。用I(Ca)亚型的选择性阻滞剂进行的额外记录表明,N型、P/Q型、L型和R型电流均有助于AHP的产生,阻断其中任何一种以及T型电流,都会减慢AP上升支,延长AP持续时间,并且(L型电流除外)降低AP起始的电流阈值。
综上所述,我们的研究结果表明,I(Ca)的抑制会减少AHP,降低超极化诱导的电压凹陷,并增加感觉神经元的兴奋性,复制外周神经损伤后的变化。这表明先前在受伤感觉神经元中证明的I(Ca)丧失导致其功能障碍和兴奋性过高,并可能导致神经性疼痛。