Chu Haichen, Sun Junzhi, Xu Hongmei, Niu Zejun, Xu Mei
Department of Anesthesiology, Affiliated Hospital of Medical College, Qingdao University, China.
Neurol Res. 2012 Nov;34(9):871-88. doi: 10.1179/1743132812Y.0000000085. Epub 2012 Aug 13.
Substantial evidence shows that spinal melanocortin 4 receptor (MC4R) may participate in regulation of central sensitization and chronic pain condition induced by peripheral nerve injury. Periaqueductal gray (PAG) is an important component of descending pain facilitatory system and takes part in spinal nociceptive information. This research will choose PAG to discuss the effect of MC4R in pain facilitation induced by chronic constriction injury (CCI) and further discuss its effect in glial activity and inflammatory factor levels in nerve injury.
Behavior tests (von Frey test and hot-plate test), semi-quantitative reverse transcription polymerase chain reaction (RT-PCR), and immunohistochemistry were used in this research.
PAG injection of HS014 (a selective inhibitor of MC4R), not only significantly reduced the established mechanical allodynia and thermal hyperalgesia, but also delayed the development of pain facilitation. Semi-quantitative RT-PCR analysis revealed that MC4R and proopiomelanocortin (POMC) expression in PAG was significantly increased after CCI, but agouti-related protein (AgRP) expression decreased. Immunohistochemistry analysis showed that protein levels of astrocytic marker (GFAP), microglial marker (OX-42), tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6 were significantly increased, but there was little change of the protein levels of IL-10 following CCI. Furthermore, blockade of MC4R decreased immunoreactivity of glia cells and protein levels of pro-inflammatory cytokines, and increased protein levels of anti-inflammatory cytokine IL-10 after CCI.
This research suggests that activation of MC4R in PAG after peripheral nerve injury participates in pain facilitation by regulating the glial activation and inflammatory cytokines secretion.
大量证据表明,脊髓黑皮质素4受体(MC4R)可能参与中枢敏化调节以及由外周神经损伤诱发的慢性疼痛状态。中脑导水管周围灰质(PAG)是下行性疼痛易化系统的重要组成部分,并参与脊髓伤害性信息传递。本研究将选取PAG来探讨MC4R在慢性缩窄性损伤(CCI)诱发的疼痛易化中的作用,并进一步探讨其在神经损伤中对神经胶质细胞活性和炎症因子水平的影响。
本研究采用行为学测试(von Frey测试和热板测试)、半定量逆转录聚合酶链反应(RT-PCR)以及免疫组织化学方法。
向PAG注射HS014(一种MC4R的选择性抑制剂),不仅显著减轻了已形成的机械性异常性疼痛和热痛觉过敏,还延缓了疼痛易化的发展。半定量RT-PCR分析显示,CCI后PAG中MC4R和阿黑皮素原(POMC)的表达显著增加,但刺鼠相关蛋白(AgRP)的表达降低。免疫组织化学分析表明,星形胶质细胞标志物(GFAP)、小胶质细胞标志物(OX-42)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β和IL-6的蛋白水平在CCI后显著升高,但CCI后IL-10的蛋白水平变化不大。此外,阻断MC4R可降低神经胶质细胞的免疫反应性和促炎细胞因子的蛋白水平,并增加CCI后抗炎细胞因子IL-10的蛋白水平。
本研究表明,外周神经损伤后PAG中MC4R的激活通过调节神经胶质细胞激活和炎症细胞因子分泌参与疼痛易化过程。