Wong Larry, Done Joseph D, Schaeffer Anthony J, Thumbikat Praveen
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Prostate. 2015 Jan;75(1):50-9. doi: 10.1002/pros.22891. Epub 2014 Sep 27.
The pathogenesis of chronic prostatitis/chronic pelvic pain syndrome is unknown and factors including the host's immune response and the nervous system have been attributed to the development of CP/CPPS. We previously demonstrated that mast cells and chemokines such as CCL2 and CCL3 play an important role in mediating prostatitis. Here, we examined the role of neuroinflammation and microglia in the CNS in the development of chronic pelvic pain.
Experimental autoimmune prostatitis (EAP) was induced using a subcutaneous injection of rat prostate antigen. Sacral spinal cord tissue (segments S14-S5) was isolated and utilized for immunofluorescence or QRT-PCR analysis. Tactile allodynia was measured at baseline and at various points during EAP using Von Frey fibers as a function for pelvic pain. EAP mice were treated with minocycline after 30 days of prostatitis to test the efficacy of microglial inhibition on pelvic pain.
Prostatitis induced the expansion and activation of microglia and the development of inflammation in the spinal cord as determined by increased expression levels of CCL3, IL-1β, Iba1, and ERK1/2 phosphorylation. Microglial activation in mice with prostatitis resulted in increased expression of P2X4R and elevated levels of BDNF, two molecular markers associated with chronic pain. Pharmacological inhibition of microglia alleviated pain in mice with prostatitis and resulted in decreased expression of IL-1β, P2X4R, and BDNF.
Our data show that prostatitis leads to inflammation in the spinal cord and the activation and expansion of microglia, mechanisms that may contribute to the development and maintenance of chronic pelvic pain.
慢性前列腺炎/慢性盆腔疼痛综合征的发病机制尚不清楚,宿主免疫反应和神经系统等因素被认为与慢性前列腺炎/慢性盆腔疼痛综合征的发生有关。我们之前证明肥大细胞和趋化因子如CCL2和CCL3在介导前列腺炎中起重要作用。在此,我们研究了神经炎症和中枢神经系统中的小胶质细胞在慢性盆腔疼痛发生中的作用。
通过皮下注射大鼠前列腺抗原来诱导实验性自身免疫性前列腺炎(EAP)。分离骶脊髓组织(S14 - S5节段)并用于免疫荧光或定量逆转录聚合酶链反应(QRT-PCR)分析。在EAP期间的基线和不同时间点,使用von Frey纤维测量触觉异常性疼痛,作为盆腔疼痛的指标。前列腺炎30天后,用米诺环素治疗EAP小鼠,以测试小胶质细胞抑制对盆腔疼痛的疗效。
前列腺炎导致小胶质细胞的扩增和激活以及脊髓炎症的发展,这通过CCL3、白细胞介素-1β(IL-1β)、离子钙结合衔接分子1(Iba1)和细胞外信号调节激酶1/2(ERK1/2)磷酸化表达水平的增加来确定。前列腺炎小鼠中的小胶质细胞激活导致P2X4受体(P2X4R)表达增加和脑源性神经营养因子(BDNF)水平升高,这是与慢性疼痛相关的两个分子标志物。小胶质细胞的药理学抑制减轻了前列腺炎小鼠的疼痛,并导致IL-1β、P2X4R和BDNF的表达降低。
我们的数据表明,前列腺炎导致脊髓炎症以及小胶质细胞的激活和扩增,这些机制可能有助于慢性盆腔疼痛的发生和维持。