Department of Neurobiology, School of Basic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, PR China.
Mol Pain. 2013 Apr 3;9:18. doi: 10.1186/1744-8069-9-18.
Electroacupuncture (EA) is effective in relieving pain in patients with postherpetic neuralgia (PHN). However, the mechanism underlying the therapeutic effect of EA in PHN is still unclear. Systemic injection of resiniferatoxin (RTX), an ultrapotent analog of TRPV1 agonist, in adult rats can reproduce the clinical symptoms of PHN by ablating TRPV1-expressing sensory neurons. In this study, we determined the beneficial effect of EA and the potential mechanisms in this rat model of PHN.
PHN was induced in rats by a single injection of RTX. Thermal hyperalgesia was tested with a radiant heat stimulus, and mechanical allodynia was quantified with von Frey filaments. TRPV1 receptors were shown by using immunofluorescence labeling. The ultrastructural changes of the sciatic nerve were assessed by electron microscopic examination. The sprouting of myelinated primary afferent terminals into the spinal dorsal horn was mapped by using the transganglionic tracer cholera toxin B-subunit (CTB).
RTX injection diminished thermal sensitivity and gradually induced tactile allodynia within 3 weeks. EA applied to GB30 and GB34 at 2 and 15 Hz, but not 100 Hz, significantly increased the thermal sensitivity 4 weeks after treatment and decreased the tactile allodynia 2 weeks after treatment in RTX-treated rats. EA treatment at 2 and 15 Hz recovered the loss of TRPV1-positive dorsal root ganglion neurons and their central terminals of afferent fibers in the spinal superficial dorsal horn of RTX-treated rats. Moreover, EA significantly reduced the loss of unmyelinated fibers and the damage of the myelinated nerve fibers of RTX-treated rats. Furthermore, EA at 2 and 15 Hz inhibited the sprouting of myelinated primary afferent terminals into the spinal lamina II of RTX-treated rats.
EA treatment improves thermal perception by recovering TRPV1-positive sensory neurons and nerve terminals damaged by RTX. EA Also reduces RTX-induced tactile allodynia by attenuating the damage of myelinated afferent nerves and their abnormal sprouting into the spinal lamina II. Our study provides new information about the mechanisms of the therapeutic actions of EA in the treatment of PHN.
电针(EA)在缓解带状疱疹后神经痛(PHN)患者的疼痛方面具有疗效。然而,EA 在 PHN 中的治疗效果的机制仍不清楚。在成年大鼠中全身注射树突状细胞毒素(RTX),一种 TRPV1 激动剂的超强效类似物,通过消融 TRPV1 表达感觉神经元可以复制 PHN 的临床症状。在这项研究中,我们确定了 EA 在这种 PHN 大鼠模型中的有益作用及其潜在机制。
通过单次 RTX 注射诱导 PHN。使用辐射热刺激测试热痛觉过敏,使用冯·弗雷氏细丝定量机械性痛觉过敏。通过免疫荧光标记显示 TRPV1 受体。通过电子显微镜检查评估坐骨神经的超微结构变化。使用跨神经节示踪剂霍乱毒素 B 亚单位(CTB)映射有髓初级传入末梢的发芽情况。
RTX 注射会降低热敏感性,并在 3 周内逐渐引起触觉过敏。在 RTX 处理大鼠中,2 Hz 和 15 Hz 的 EA 应用于 GB30 和 GB34,但 100 Hz 的 EA 没有应用,在治疗后 4 周显著增加了热敏感性,并在治疗后 2 周降低了触觉过敏。2 Hz 和 15 Hz 的 EA 治疗恢复了 RTX 处理大鼠脊髓浅层背角中 TRPV1 阳性背根神经节神经元及其传入纤维的中央末端的丢失。此外,EA 显著减少了 RTX 处理大鼠中无髓纤维的丢失和有髓神经纤维的损伤。此外,2 Hz 和 15 Hz 的 EA 抑制了 RTX 处理大鼠脊髓 lamina II 中髓鞘初级传入末梢的发芽。
EA 治疗通过恢复 TRPV1 阳性感觉神经元和被 RTX 损伤的神经末梢来改善热感觉。EA 通过减轻有髓传入神经及其异常发芽进入脊髓 lamina II 的损伤,还降低了 RTX 引起的触觉过敏。我们的研究提供了关于 EA 在治疗 PHN 中的治疗作用的机制的新信息。