Department of Anesthesiology and Department of Pharmacology/Toxicology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire 03755, and Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, South Carolina 29325.
J Neurosci. 2013 Oct 23;33(43):17182-7. doi: 10.1523/JNEUROSCI.5605-12.2013.
The mechanisms that drive the normal resolution of acute postoperative pain are not completely understood. We hypothesize a pivotal role of a major spinal mitogen-activated protein kinase (MAPKs) regulator, MAPK phosphatase (MKP)-3, in the resolution of postoperative pain. We used wild-type and MKP-3 knock-out (KO) mice, a paw incision model of acute postoperative pain, and behavioral and molecular biology experiments. We observed persistent mechanical allodynia in mice lacking MKP-3 (postoperative day 21), concurrently with persistent phosphorylation of spinal p38 and extracellular signal-regulated kinases (ERK)-1/2 on postoperative day 12, while both MAPK phosphorylation and allodynia resolved on postoperative day 7 in wild-type mice. Spinal p-ERK was expressed mainly in neurons and microglia, while spinal p-p38 was expressed mostly in microglia in MKP-3 KO mice, and their selective pharmacological inhibition reduced the persistent allodynia observed in these mice. Our findings strongly suggest that dysregulation of MKP-3 prevents spontaneous resolution of acute postoperative pain and drives its transition to persistent pain via persistent neuronal and microglial MAPK phosphorylation in the spinal cord.
目前尚未完全了解驱动急性术后疼痛正常缓解的机制。我们假设主要脊髓丝裂原活化蛋白激酶(MAPKs)调节剂 MAPK 磷酸酶(MKP)-3 在术后疼痛缓解中发挥关键作用。我们使用野生型和 MKP-3 敲除(KO)小鼠、急性术后疼痛的爪切口模型以及行为和分子生物学实验进行研究。我们观察到缺乏 MKP-3 的小鼠(术后第 21 天)出现持续的机械性痛觉过敏,同时在术后第 12 天脊髓 p38 和细胞外信号调节激酶(ERK)-1/2 的磷酸化持续存在,而在野生型小鼠中,两种 MAPK 磷酸化和痛觉过敏均在术后第 7 天得到缓解。脊髓 p-ERK 主要在神经元和小胶质细胞中表达,而脊髓 p-p38 在 MKP-3 KO 小鼠中主要在小胶质细胞中表达,其选择性药理学抑制可减轻这些小鼠中观察到的持续痛觉过敏。我们的研究结果强烈表明,MKP-3 的失调可阻止急性术后疼痛的自发缓解,并通过脊髓中神经元和小胶质细胞中持续的 MAPK 磷酸化导致其向持续性疼痛转变。