Department of Marine Biotechnology and Resources, Asia-Pacific Ocean Research Center, National Sun Yat-sen University, Kaohsiung, Taiwan; Division of Neurosurgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
J Pain. 2013 Dec;14(12):1671-85. doi: 10.1016/j.jpain.2013.08.010.
Previous studies have reported that the intrathecal (i.t.) administration of transforming growth factor β1 (TGF-β1) prevents and reverses neuropathic pain. However, only limited information is available regarding the possible role and effects of spinal TGF-β1 in neuropathic pain. We aimed to investigate the antinociceptive effects of exogenous TGF-β1 on chronic constriction injury (CCI)-induced neuropathic pain in rats. We demonstrated that sciatic nerve injury caused a downregulation of endogenous TGF-β1 levels on the ipsilateral side of the lumbar spinal dorsal gray matter, and that the i.t. administration of TGF-β1 (.01-10 ng) significantly attenuated CCI-induced thermal hyperalgesia in neuropathic rats. TGF-β1 significantly inhibited CCI-induced spinal neuroinflammation, microglial and astrocytic activation, and upregulation of tumor necrosis factor-α. Moreover, i.t. TGF-β1 significantly attenuated the CCI-induced downregulation of glutamate transporter 1, the glutamate aspartate transporter, and the excitatory amino acid carrier 1 on the ipsilateral side. Furthermore, i.t. TGF-β1 significantly decreased the concentrations of 2 excitatory amino acids, aspartate and glutamate, in the spinal dialysates in CCI rats. In summary, we conclude that the mechanisms of the antinociceptive effects of i.t. TGF-β1 in neuropathy may include attenuation of spinal neuroinflammation, attenuation, or upregulation of glutamate transporter downregulation, and a decrease of spinal extracellular excitatory amino acids.
Clinically, medical treatment is usually initiated after the onset of intractable pain. Therefore, in the present study, i.t. TGF-β1 was designed to be administered 2 weeks after the establishment of CCI pain. Compared to the continuous TGF-β1 infusion mode, single-dose administration seems more convenient and practical to use.
先前的研究报告称,转化生长因子β1(TGF-β1)鞘内(i.t.)给药可预防和逆转神经性疼痛。然而,关于脊髓 TGF-β1 在神经性疼痛中的可能作用和影响,仅有有限的信息。我们旨在研究外源性 TGF-β1 对慢性缩窄性损伤(CCI)诱导的大鼠神经性疼痛的镇痛作用。我们表明,坐骨神经损伤导致同侧腰脊髓背侧灰质中内源性 TGF-β1 水平下调,i.t.给予 TGF-β1(0.01-10ng)可显著减轻神经性疼痛大鼠的 CCI 诱导的热痛觉过敏。TGF-β1 显著抑制 CCI 诱导的脊髓神经炎症、小胶质细胞和星形胶质细胞激活以及肿瘤坏死因子-α的上调。此外,i.t. TGF-β1 显著减轻了 CCI 诱导的同侧谷氨酸转运体 1、谷氨酸天冬氨酸转运体和兴奋性氨基酸载体 1 的下调。此外,i.t. TGF-β1 显著降低了 CCI 大鼠脊髓透析液中 2 种兴奋性氨基酸天冬氨酸和谷氨酸的浓度。总之,我们得出结论,i.t. TGF-β1 在神经病变中的镇痛作用机制可能包括减轻脊髓神经炎症、减轻或上调谷氨酸转运体下调以及降低脊髓细胞外兴奋性氨基酸。
临床上,通常在难治性疼痛发作后才开始进行医学治疗。因此,在本研究中,设计在 CCI 疼痛建立 2 周后给予 i.t. TGF-β1。与连续 TGF-β1 输注模式相比,单次给药似乎更方便实用。