Klusáková Ilona, Dubový Petr
Department of Anatomy, Division of Neuroanatomy, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic.
Ann Anat. 2009 Jun;191(3):248-59. doi: 10.1016/j.aanat.2009.02.007. Epub 2009 Apr 10.
Peripheral neuropathic pain (PNP) frequently occurs as a consequence of nerve injury and may differ depending upon the type of insult and the individual patient. Progress in our knowledge of PNP induction mechanisms depends upon the utilization of appropriate experimental models in rodents based on various types of peripheral nerve lesions. In this review, we draw attention to current knowledge on basic cellular and molecular events in various experimental models used to induce the PNP symptoms. Spontaneous ectopic activity of axotomized and non-axotomized primary sensory neurons, the bodies of which are located in the dorsal root ganglion (DRG), seems to be a key mechanism of PNP induction. The primary sensory neurons are directly affected by nerve injury or indirectly by activated satellite glial cells and adjoining immune cells that release a variety of molecules changing the microenvironment of the neurons. Recently, it has become clear that molecules produced during Wallerian degeneration play an important role not only in axon-promoting conditions distal to nerve injury but also in initiation of neuropathic pain. The molecules, transported by the blood, influence afferent neurons and their axons not only in DRG associated, but also those not directly associated with the injured nerve (i.e., in the contralateral DRG or at different spinal segments). Generally, all experimental PNP models based on a partial injury of peripheral nerve segments contain mechanisms initiated by signal molecules of Wallerian degeneration.
周围神经性疼痛(PNP)常因神经损伤而发生,且可能因损伤类型和个体患者的不同而有所差异。我们对PNP诱导机制的认识进展取决于在啮齿动物中基于各种类型的周围神经损伤建立合适的实验模型。在本综述中,我们关注用于诱导PNP症状的各种实验模型中基本细胞和分子事件的现有知识。轴突切断和未切断的初级感觉神经元(其胞体位于背根神经节(DRG))的自发异位活动似乎是PNP诱导的关键机制。初级感觉神经元直接受到神经损伤的影响,或间接受到活化的卫星胶质细胞和相邻免疫细胞的影响,这些细胞释放多种分子,改变神经元的微环境。最近,已经明确沃勒变性过程中产生的分子不仅在神经损伤远端的轴突促进条件中起重要作用,而且在神经性疼痛的起始中也起重要作用。这些由血液运输的分子不仅影响与DRG相关的传入神经元及其轴突,还影响那些与受损神经无直接关联的神经元及其轴突(即对侧DRG或不同脊髓节段中的神经元及其轴突)。一般来说,所有基于周围神经节段部分损伤的实验性PNP模型都包含由沃勒变性信号分子启动的机制。