Lee Kathryn E, Davis Martin B, Winkelstein Beth A
Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6392, USA.
J Neurotrauma. 2008 Nov;25(11):1383-93. doi: 10.1089/neu.2008.0700.
Whiplash injury can produce pain in the neck, arm, and hand, and has been associated with inflammation. However, the relationship between inflammatory responses and pain symptoms remains unknown, hindering the development of appropriate therapeutics for whiplash symptoms. Two joint loading paradigms were used separately in an established rat model of painful cervical facet joint distraction to apply: (1) gross failure, and (2) subfailure distraction of the facet capsular ligament. Behavioral outcomes were compared to determine whether more severe mechanical loading produces greater pain by measuring mechanical hyperalgesia in the shoulder and forepaws. Inflammatory mediators (glia and cytokines) were quantified in the spinal cord and dorsal root ganglion (DRG) after injury. Subfailure loading produced sustained hyperalgesia in the shoulder and forepaw that was significantly greater (p < 0.042) than sham, while an induced capsule failure produced only transient, yet significant (p < 0.021), mechanical hyperalgesia. The absence of hyperalgesia after ligament failure suggests this type of injury may interrupt nociceptive input from the capsule, which is likely necessary to produce sustained pain symptoms. Glial mRNA was significantly increased (p < 0.043) in the spinal cord after ligament failure, but remained unchanged in the DRG. Cytokine mRNA levels in the spinal cord and DRG were also significantly elevated after facet ligament failure, but not after painful subfailure loading. Findings suggest that different joint loading scenarios produced varied inflammatory responses in the CNS. These data support existing clinical reports suggesting that therapeutic interventions directed at the facet capsule may be effective in treating this painful injury.
挥鞭样损伤可导致颈部、手臂和手部疼痛,并与炎症有关。然而,炎症反应与疼痛症状之间的关系仍不清楚,这阻碍了针对挥鞭样症状的适当治疗方法的开发。在已建立的疼痛性颈椎小关节牵张大鼠模型中,分别使用两种关节负荷模式来施加:(1) 完全破坏,以及 (2) 小关节囊韧带的亚破坏牵张。通过测量肩部和前爪的机械性痛觉过敏来比较行为结果,以确定更严重的机械负荷是否会产生更大的疼痛。损伤后,对脊髓和背根神经节 (DRG) 中的炎症介质(神经胶质细胞和细胞因子)进行定量。亚破坏负荷在肩部和前爪产生了持续的痛觉过敏,其程度明显大于假手术组(p < 0.042),而诱导的关节囊破坏仅产生短暂但显著的(p < 0.021)机械性痛觉过敏。韧带破坏后痛觉过敏的缺失表明这种类型的损伤可能会中断来自关节囊的伤害性输入,而这可能是产生持续疼痛症状所必需的。韧带破坏后,脊髓中的神经胶质细胞 mRNA 显著增加(p < 0.043),但在 DRG 中保持不变。小关节韧带破坏后,脊髓和 DRG 中的细胞因子 mRNA 水平也显著升高,但在疼痛性亚破坏负荷后未升高。研究结果表明,不同的关节负荷情况在中枢神经系统中产生了不同的炎症反应。这些数据支持了现有的临床报告,表明针对小关节囊的治疗干预可能对治疗这种疼痛性损伤有效。