Department of Anesthesiology, Transgenic and Molecular Immunogenetics Laboratory, Chang Gung Memorial Hospital and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Linkou, Taiwan.
Anesthesiology. 2011 Mar;114(3):660-72. doi: 10.1097/ALN.0b013e31820b8b1e.
Although inflammation induces pain, immune cells also produce mediators that can effectively counteract it. To further elucidate the role of the immune response, we analyzed the relationship of pain behavior, several inflammatory signals, and opioid peptides using partial sciatic nerve ligation in mice at different levels of immunocompromise.
Sciatic nerves of C57BL/6C, nonobese diabetic (NOD), or nonobese diabetic-severe combined immune deficiency (NOD-SCID) mice were partially ligated. Responses to mechanical and radiant heat stimuli were observed. Inflammation was detected by immunohistochemistry and flow cytometry. Inflammatory cytokines and opioid peptides were analyzed using real-time polymerase chain reaction and enzyme-linked immunosorbent assay or immunostaining.
Inflammation in immunocompromised mice was subordinate when compared with that seen in C57BL/6C mice. In addition, immunocompromised mice had less pain hypersensitivity at early stages. Whereas proinflammatory tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β), interleukin 6 (IL-6), and interferon-γ (IFN-γ), as well as antiinflammatory interleukin 1 receptor antagonist (IL-1Ra), interleukin 4 (IL-4), interleukin 10 (IL-10), and interleukin 13 (IL-13) cytokine expression and protein were increased in C57BL/6C mice, they were lower in immunocompromised mice. Although enkephalin, dynorphin, and β-endorphin messenger RNA expression also increased in C57BL/6C mice, peaking on day 14, this result was not observed in immunocompromised mice.
The contribution of inflammation to nerve injury is complex with biphasic modulation. During the early phase, a wide range of proinflammatory cytokines are released, leading to enhanced pain. In contrast, the analgesic effect of opioid peptides and antiinflammatory cytokines was more predominate in the later phases of injury, leading to attenuated pain responses.
尽管炎症会引起疼痛,但免疫细胞也会产生能有效对抗疼痛的介质。为了进一步阐明免疫反应的作用,我们在不同免疫抑制程度的小鼠中,通过部分坐骨神经结扎分析疼痛行为、几种炎症信号和阿片肽之间的关系。
结扎 C57BL/6C、非肥胖型糖尿病(NOD)或非肥胖型糖尿病-严重联合免疫缺陷(NOD-SCID)小鼠的坐骨神经。观察对机械和辐射热刺激的反应。通过免疫组织化学和流式细胞术检测炎症。使用实时聚合酶链反应和酶联免疫吸附试验或免疫染色分析炎症细胞因子和阿片肽。
与 C57BL/6C 小鼠相比,免疫抑制小鼠的炎症反应处于次要地位。此外,免疫抑制小鼠在早期阶段的疼痛敏感性较低。虽然促炎细胞因子肿瘤坏死因子-α(TNF-α)、白细胞介素 1β(IL-1β)、白细胞介素 6(IL-6)和干扰素-γ(IFN-γ)以及抗炎细胞因子白细胞介素 1 受体拮抗剂(IL-1Ra)、白细胞介素 4(IL-4)、白细胞介素 10(IL-10)和白细胞介素 13(IL-13)的细胞因子表达和蛋白在 C57BL/6C 小鼠中增加,但在免疫抑制小鼠中则较低。尽管 C57BL/6C 小鼠中脑啡肽、强啡肽和β-内啡肽信使 RNA 表达也增加,在第 14 天达到峰值,但在免疫抑制小鼠中没有观察到这种情况。
炎症对神经损伤的贡献是复杂的,具有双相调节作用。在早期阶段,释放了广泛的促炎细胞因子,导致疼痛加剧。相比之下,在损伤的后期阶段,阿片肽和抗炎细胞因子的镇痛作用更为明显,导致疼痛反应减弱。