Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226-0509, USA.
Mol Pain. 2013 Mar 4;9:9. doi: 10.1186/1744-8069-9-9.
Mechanisms underlying postoperative pain remain poorly understood. In rodents, skin-only incisions induce mechanical and heat hypersensitivity similar to levels observed with skin plus deep incisions. Therefore, cutaneous injury might drive the majority of postoperative pain. TRPA1 and TRPV1 channels are known to mediate inflammatory and nerve injury pain, making them key targets for pain therapeutics. These channels are also expressed extensively in cutaneous nerve fibers. Therefore, we investigated whether TRPA1 and TRPV1 contribute to mechanical and heat hypersensitivity following skin-only surgical incision.
Behavioral responses to mechanical and heat stimulation were compared between skin-incised and uninjured, sham control groups. Elevated mechanical responsiveness occurred 1 day post skin-incision regardless of genetic ablation or pharmacological inhibition of TRPA1. To determine whether functional changes in TRPA1 occur at the level of sensory neuron somata, we evaluated cytoplasmic calcium changes in sensory neurons isolated from ipsilateral lumbar 3-5 DRGs of skin-only incised and sham wild type (WT) mice during stimulation with the TRPA1 agonist cinnamaldehyde. There were no changes in the percentage of neurons responding to cinnamaldehyde or in their response amplitudes. Likewise, the subpopulation of DRG somata retrogradely labeled specifically from the incised region of the plantar hind paw showed no functional up-regulation of TRPA1 after skin-only incision. Next, we conducted behavior tests for heat sensitivity and found that heat hypersensitivity peaked at day 1 post skin-only incision. Skin incision-induced heat hypersensitivity was significantly decreased in TRPV1-deficient mice. In addition, we conducted calcium imaging with the TRPV1 agonist capsaicin. DRG neurons from WT mice exhibited sensitization to TRPV1 activation, as more neurons (66%) from skin-incised mice responded to capsaicin compared to controls (46%), and the sensitization occurred specifically in isolectin B4 (IB4)-positive neurons where 80% of incised neurons responded to capsaicin compared to just 44% of controls.
Our data suggest that enhanced TRPA1 function does not mediate the mechanical hypersensitivity that follows skin-only surgical incision. However, the heat hypersensitivity is dependent on TRPV1, and functional up-regulation of TRPV1 in IB4-binding DRG neurons may mediate the heat hypersensitivity after skin incision injury.
术后疼痛的发生机制仍不清楚。在啮齿动物中,单纯皮肤切口会引起类似于皮肤加深部切口引起的机械性和热敏感性增加。因此,皮肤损伤可能是术后疼痛的主要原因。TRPA1 和 TRPV1 通道被认为介导炎症和神经损伤疼痛,使其成为疼痛治疗的关键靶点。这些通道在皮肤神经纤维中也广泛表达。因此,我们研究了单纯皮肤手术切口后 TRPA1 和 TRPV1 是否与机械性和热敏感性增加有关。
比较了皮肤切口组和未损伤、假手术对照组对机械和热刺激的行为反应。无论 TRPA1 的基因缺失还是药理学抑制,皮肤切口后 1 天都会出现机械反应性升高。为了确定 TRPA1 的功能变化是否发生在感觉神经元胞体水平,我们评估了来自单侧 L3-5 背根神经节的感觉神经元的细胞质钙变化,这些神经元来自皮肤切口和假手术野生型(WT)小鼠,在肉桂醛(TRPA1 激动剂)刺激下。对肉桂醛反应的神经元比例或反应幅度没有变化。同样,从足底后爪切口区域逆行标记的 DRG 躯体亚群在单纯皮肤切口后没有 TRPA1 的功能上调。接下来,我们进行了热敏感性行为测试,发现单纯皮肤切口后第 1 天出现热敏感性增加。TRPV1 缺陷小鼠的皮肤切口引起的热敏感性明显降低。此外,我们进行了 TRPV1 激动剂辣椒素的钙成像。与对照组(46%)相比,WT 小鼠的 DRG 神经元对 TRPV1 激活的敏感性增加,来自皮肤切口的小鼠中有 66%的神经元对辣椒素有反应,而这种敏感性仅发生在异硫氰酸荧光素 B4(IB4)阳性神经元中,其中 80%的切口神经元对辣椒素有反应,而对照组只有 44%。
我们的数据表明,增强的 TRPA1 功能不会介导单纯皮肤手术切口后的机械性敏感性增加。然而,热敏感性依赖于 TRPV1,IB4 结合的 DRG 神经元中 TRPV1 的功能上调可能介导皮肤切口损伤后的热敏感性增加。