Jia Hongbin, Feng Xiaomei, Li Weiyan, Hu Yufeng, Zeng Qiong, Liu Jian, Xu Jianguo
Department of Anesthesiology, Jinling Hospital, Nanjing Clinical Medical College of the Second Military Medical University, Nanjing, PR China.
Ann Clin Lab Sci. 2009 Winter;39(1):84-91.
Neuropathic pain is a complex syndrome resulting from damage to the peripheral nervous system. Central neuroimmune activation contributes to the generation and maintenance of chronic pain after nerve injury. The current study determined the effects of recombinant human erythropoietin (rhEPO) on behavioral hyperalgesia and neuroimmune activation in a rat model of neuropathic pain induced by L5 spinal nerve transection. Animals were randomly assigned into 3 groups: sham-operation with saline; L5 spinal nerve transection with rhEPO (5000 units/kg); or L5 transection with saline. The rhEPO or saline was given ip on the day before surgery and continued daily to day 7 post-transection. The paw pressure threshold and paw withdrawal latencies were measured before surgery and on days 1, 3, and 7 post-operation. Glial activation markers such as macrophage antigen complex-1 (Mac-1, OX-42) and glial fibrillary acidic protein (GFAP), production of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-10, as well as nuclear factor-kappa B (NF-kappaB) activation were determined in the lumbar spinal cord. Administration of rhEPO resulted in attenuation of mechanical and thermal hyperalgesia. Furthermore, rhEPO markedly inhibited neuroimmune activation characterized by glial activation, production of proinflammatory cytokines like TNF-alpha, IL-1beta, and NF-kappaB activation, but rhEPO enhanced the level of IL-10. These results support the significance of neuroinflammation and neuroimmune activation in the initiation and persistence of behavioral pain responses. The data indicate that rhEPO attenuates behavioral hyperalgesia and neuroimmune activation in neuropathic pain induced by L5 nerve transection.
神经性疼痛是一种由外周神经系统损伤引起的复杂综合征。中枢神经免疫激活促成了神经损伤后慢性疼痛的产生和维持。本研究确定了重组人促红细胞生成素(rhEPO)对L5脊髓神经横断诱导的神经性疼痛大鼠模型中行为性痛觉过敏和神经免疫激活的影响。动物被随机分为3组:假手术并给予生理盐水;L5脊髓神经横断并给予rhEPO(5000单位/千克);或L5横断并给予生理盐水。rhEPO或生理盐水在手术前一天腹腔注射给药,并在横断后每天持续给药至第7天。在手术前以及术后第1、3和7天测量爪部压力阈值和爪部缩足潜伏期。在腰脊髓中测定胶质细胞激活标志物,如巨噬细胞抗原复合物-1(Mac-1,OX-42)和胶质纤维酸性蛋白(GFAP)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β和IL-10的产生,以及核因子-κB(NF-κB)的激活情况。给予rhEPO可减轻机械性和热性痛觉过敏。此外,rhEPO显著抑制以胶质细胞激活、TNF-α和IL-1β等促炎细胞因子产生以及NF-κB激活为特征的神经免疫激活,但rhEPO提高了IL-10的水平。这些结果支持了神经炎症和神经免疫激活在行为性疼痛反应的起始和持续中的重要性。数据表明,rhEPO可减轻L5神经横断诱导的神经性疼痛中的行为性痛觉过敏和神经免疫激活。