Department of Neurology and Center for Neuroscience & Regeneration Research, Yale University School of Medicine, New Haven, CT 06510, USA.
J Pain. 2010 Feb;11(2):119-30. doi: 10.1016/j.jpain.2009.06.009. Epub 2009 Sep 9.
Pain after burn injury can be intense and long lasting. Treatment is often ineffective, and there is a need for increased knowledge of the underlying pain mechanisms. In the present study, we established a unilateral partial-thickness burn injury model, which produces ipsilateral mechanical allodynia soon after injury, followed by contralateral allodynia. Chronic bilateral allodynia lasts up to 8 weeks postinjury in this model. In addition to the change in pain behavior, electrophysiological analyses showed that dorsal horn neurons become hyperexcitable and display significantly increased evoked activity with enlarged receptive fields, initially on the side ipsilateral to the injury, and subsequently on both sides of the spinal cord. It is known that, following nerve injury, activation of p38 mitogen-activated protein kinase (MAPK) pathways within spinal microglia contributes to the pathogenesis of pain. In our burn injury model, rapid and prolonged activation of phospho-p38-expressing microglia occurs bilaterally in the spinal cord dorsal horn. Taken together, these data demonstrate that a unilateral peripheral burn injury can produce long-lasting allodynia that can spread to the contralateral limb, together with dorsal horn neuronal hyperexcitability and microglial activation on both ipsilateral and contralateral sides of the spinal cord. Our results suggest that central neuropathic mechanisms can contribute to pain after burn injury.
Mechanisms contributing to pain following burn injury are incompletely understood. In a novel animal model of burn injury, we have demonstrated hyperexcitability of second-order sensory neurons, activation of microglia, and chronic bilateral pain following the burn injury. This work identifies potential therapeutic targets to alleviate pain after burn injury.
烧伤后的疼痛可能强烈且持久。治疗通常无效,因此需要增加对潜在疼痛机制的了解。在本研究中,我们建立了单侧部分厚度烧伤损伤模型,该模型在损伤后不久即产生同侧机械性痛觉过敏,随后出现对侧痛觉过敏。在这种模型中,慢性双侧痛觉过敏可持续至损伤后 8 周。除疼痛行为的变化外,电生理分析表明,背角神经元变得过度兴奋,并表现出明显增加的诱发电活动和扩大的感受野,最初在损伤的同侧,随后在脊髓的两侧。众所周知,在神经损伤后,脊髓小胶质细胞中 p38 丝裂原活化蛋白激酶(MAPK)途径的激活有助于疼痛的发病机制。在我们的烧伤损伤模型中,磷酸化 p38 表达的小胶质细胞在脊髓背角中迅速且持续地双侧激活。总之,这些数据表明单侧外周烧伤损伤可产生持久的痛觉过敏,可扩散至对侧肢体,同时伴有脊髓背角神经元的过度兴奋和同侧及对侧脊髓小胶质细胞的激活。我们的研究结果表明,中枢神经病理性机制可能有助于烧伤后疼痛。
烧伤后疼痛的机制尚不完全清楚。在一种新的烧伤损伤动物模型中,我们已经证明了第二级感觉神经元的过度兴奋、小胶质细胞的激活以及烧伤后的慢性双侧疼痛。这项工作确定了减轻烧伤后疼痛的潜在治疗靶点。