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三叉神经损伤诱导的血小板反应蛋白-4上调在大鼠模型中导致口面部神经性疼痛状态。

Trigeminal nerve injury-induced thrombospondin-4 up-regulation contributes to orofacial neuropathic pain states in a rat model.

作者信息

Li K-W, Kim D-S, Zaucke F, Luo Z D

机构信息

Departments of Anesthesiology and Perioperative Care, University of California, Irvine, USA.

出版信息

Eur J Pain. 2014 Apr;18(4):489-95. doi: 10.1002/j.1532-2149.2013.00396.x. Epub 2013 Sep 9.

Abstract

BACKGROUND

Injury to the trigeminal nerve often results in the development of chronic pain states including tactile allodynia, or hypersensitivity to light touch, in orofacial area, but its underlying mechanisms are poorly understood. Peripheral nerve injury has been shown to cause up-regulation of thrombospondin-4 (TSP4) in dorsal spinal cord that correlates with neuropathic pain development. In this study, we examined whether injury-induced TSP4 is critical in mediating orofacial pain development in a rat model of chronic constriction injury to the infraorbital nerve.

METHODS

Orofacial sensitivity to mechanical stimulation was examined in a unilateral infraorbital nerve ligation rat model. The levels of TSP4 in trigeminal ganglia and associated spinal subnucleus caudalis and C1/C2 spinal cord (Vc/C2) from injured rats were examined at time points correlating with the initiation and peak orofacial hypersensitivity. TSP4 antisense and mismatch oligodeoxynucleotides were intrathecally injected into injured rats to see if antisense oligodeoxynucleotide treatment could reverse injury-induced TSP4 up-regulation and orofacial behavioural hypersensitivity.

RESULTS

Our data indicated that trigeminal nerve injury induced TSP4 up-regulation in Vc/C2 at a time point correlated with orofacial tactile allodynia. In addition, intrathecal treatment with TSP4 antisense, but not mismatch, oligodeoxynucleotides blocked both injury-induced TSP4 up-regulation in Vc/C2 and behavioural hypersensitivity.

CONCLUSIONS

Our data support that infraorbital nerve injury leads to TSP4 up-regulation in trigeminal spinal complex that contributes to orofacial neuropathic pain states. Blocking this pathway may provide an alternative approach in management of orofacial neuropathic pain states.

摘要

背景

三叉神经损伤常导致慢性疼痛状态的发展,包括口面部区域的触觉异常性疼痛,即对轻触过敏,但其潜在机制尚不清楚。外周神经损伤已被证明会导致脊髓背角中血小板反应蛋白4(TSP4)上调,这与神经性疼痛的发展相关。在本研究中,我们在大鼠眶下神经慢性压迫损伤模型中研究了损伤诱导的TSP4在介导口面部疼痛发展中是否起关键作用。

方法

在单侧眶下神经结扎大鼠模型中检测口面部对机械刺激的敏感性。在与口面部超敏反应起始和峰值相关的时间点,检测损伤大鼠三叉神经节以及相关的脊髓尾侧亚核和C1/C2脊髓(Vc/C2)中TSP4的水平。将TSP4反义寡脱氧核苷酸和错配寡脱氧核苷酸鞘内注射到损伤大鼠体内,以观察反义寡脱氧核苷酸治疗是否能逆转损伤诱导的TSP4上调和口面部行为超敏反应。

结果

我们的数据表明,三叉神经损伤在与口面部触觉异常性疼痛相关的时间点诱导Vc/C2中TSP4上调。此外,鞘内注射TSP4反义寡脱氧核苷酸而非错配寡脱氧核苷酸可阻断损伤诱导的Vc/C2中TSP4上调和行为超敏反应。

结论

我们的数据支持眶下神经损伤导致三叉神经脊髓复合体中TSP4上调,这促成了口面部神经性疼痛状态。阻断该通路可能为口面部神经性疼痛状态的治疗提供一种替代方法。

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