Ghilardi Joseph R, Freeman Katie T, Jimenez-Andrade Juan M, Coughlin Kathleen A, Kaczmarska Magdalena J, Castaneda-Corral Gabriela, Bloom Aaron P, Kuskowski Michael A, Mantyh Patrick W
Minneapolis VA Medical Center, Minneapolis, Minnesota, USA.
Arthritis Rheum. 2012 Jul;64(7):2223-32. doi: 10.1002/art.34385.
Many forms of arthritis are accompanied by significant chronic joint pain. This study was undertaken to investigate whether there is significant sprouting of sensory and sympathetic nerve fibers in the painful arthritic knee joint and whether nerve growth factor (NGF) drives this pathologic reorganization.
A painful arthritic knee joint was produced by injection of Freund's complete adjuvant (CFA) into the knee joint of young adult mice. CFA-injected mice were then treated systemically with vehicle or anti-NGF antibody. Pain behaviors were assessed, and at 28 days following the initial CFA injection, the knee joints were processed for immunohistochemistry analysis using antibodies against calcitonin gene-related peptide (CGRP; sensory nerve fibers), neurofilament 200 kd (NF200; sensory nerve fibers), growth-associated protein 43 (GAP-43; sprouted nerve fibers), tyrosine hydroxylase (TH; sympathetic nerve fibers), CD31 (endothelial cells), or CD68 (monocyte/macrophages).
In CFA-injected mice, there was a significant increase in the density of CD68+ macrophages, CD31+ blood vessels, and CGRP+, NF200+, GAP-43+, and TH+ nerve fibers in the synovium, as well as a significant increase in joint pain-related behaviors. None of these findings were observed in sham-injected mice. Administration of anti-NGF reduced these pain-related behaviors and the ectopic sprouting of nerve fibers, but had no significant effect on the increase in density of CD31+ blood vessels or CD68+ macrophages.
These findings demonstrate that ectopic sprouting of sensory and sympathetic nerve fibers occurs in the painful arthritic joint and may be involved in the generation and maintenance of arthritic pain.
多种关节炎形式都伴有显著的慢性关节疼痛。本研究旨在调查在疼痛的关节炎膝关节中感觉神经纤维和交感神经纤维是否有显著的芽生,以及神经生长因子(NGF)是否驱动这种病理重组。
通过向年轻成年小鼠膝关节注射弗氏完全佐剂(CFA)制造疼痛的关节炎膝关节。然后给注射CFA的小鼠全身注射赋形剂或抗NGF抗体。评估疼痛行为,并在首次注射CFA后28天,使用抗降钙素基因相关肽(CGRP;感觉神经纤维)、神经丝200 kd(NF200;感觉神经纤维)、生长相关蛋白43(GAP - 43;芽生神经纤维)、酪氨酸羟化酶(TH;交感神经纤维)、CD31(内皮细胞)或CD68(单核细胞/巨噬细胞)的抗体对膝关节进行免疫组织化学分析。
在注射CFA的小鼠中,滑膜中CD68 +巨噬细胞、CD31 +血管以及CGRP +、NF200 +、GAP - 43 +和TH +神经纤维的密度显著增加,同时关节疼痛相关行为也显著增加。在假注射小鼠中未观察到这些结果。给予抗NGF可减少这些疼痛相关行为和神经纤维的异位芽生,但对CD31 +血管或CD68 +巨噬细胞密度的增加没有显著影响。
这些发现表明,感觉神经纤维和交感神经纤维的异位芽生发生在疼痛的关节炎关节中,可能参与了关节炎疼痛的产生和维持。