Department of Functional Anatomy and Neuroscience, Nagoya University Graduate School of Medicine, Japan.
Eur J Pain. 2012 Aug;16(7):953-65. doi: 10.1002/j.1532-2149.2011.00094.x. Epub 2011 Dec 23.
To clarify the mechanism of tenderness after bone injury, we investigated changes in the withdrawal threshold to mechanical stimuli, nerve distribution and nerve growth factor (NGF)-expression in a rat model of bone injury without immobilization for bone injury healing. Rats were divided into three groups as follows: (1) rats incised in the skin and periosteum, followed by drilling a hole in the tibia [bone lesion group (BLG)]; (2) those incised in the skin and periosteum without bone drilling [periosteum lesion group (PLG)]; and (3) those incised in the skin [skin lesion group (SLG)]. Mechanical hyperalgesia continued for 28 days at a lesion in the BLG, 21 days in PLG and 5 days in SLG after treatments, respectively. Endochondral ossification was observed on days 5-28 in BLG and on days 5-21 in PLG. Nerve growth appeared in deep connective tissue (DCT) at day 28 in BLG. Nerve fibres increased in both cutaneous tissue and DCT at day 7 in PLG, but they were not found at day 28. Mechanical hyperalgesia accompanied with endochondral ossification and nerve fibres increasing at the lesion in both BLG and PLG. NGF was expressed in bone-regenerating cells during the bone injury healing. Anti-NGF and trk inhibitor K252a inhibited hyperalgesia in the different time course. This study shows that localized tenderness coincides with the bone healing and involves NGF expression and nerve sprouting after bone injury. The findings present underlying mechanisms and provide pathophysiological relevance of local tenderness to determination of bone fracture and its healing.
为了阐明骨损伤后疼痛的机制,我们研究了在不固定促进骨损伤愈合的情况下,骨损伤大鼠模型中机械刺激撤回阈值、神经分布和神经生长因子(NGF)表达的变化。大鼠分为三组:(1)皮肤和骨膜切开,然后胫骨钻孔[骨损伤组(BLG)];(2)皮肤和骨膜切开但不钻孔[骨膜损伤组(PLG)];(3)皮肤切开[皮肤损伤组(SLG)]。在 BLG 中,在治疗后第 5-28 天,在 PLG 中第 5-21 天,在 SLG 中第 5-21 天,分别持续出现骨损伤 28 天、21 天和 5 天的机械性痛觉过敏。在 BLG 中观察到软骨内骨化在第 5-28 天,在 PLG 中在第 5-21 天。在 BLG 中第 28 天在深部结缔组织(DCT)中出现神经生长。在 PLG 中第 7 天,皮肤组织和 DCT 中神经纤维增加,但在第 28 天未发现。在 BLG 和 PLG 中,骨损伤和骨再生细胞中均表达 NGF,同时伴随着机械性痛觉过敏和神经纤维的增加。在骨损伤愈合过程中,抗 NGF 和 trk 抑制剂 K252a 抑制了不同时间点的痛觉过敏。本研究表明,局部压痛与骨愈合一致,涉及骨损伤后 NGF 表达和神经发芽。这些发现为局部压痛的潜在机制及其对骨折及其愈合的病理生理学相关性提供了依据。