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蛋白激酶Cγ中间神经元介导C纤维诱导的口面部继发性静态机械性异常性疼痛,但不介导C纤维诱导的伤害性感受行为。

Protein Kinase C γ Interneurons Mediate C-fiber-induced Orofacial Secondary Static Mechanical Allodynia, but Not C-fiber-induced Nociceptive Behavior.

作者信息

Peirs Cedric, Bourgois Nathalie, Artola Alain, Dallel Radhouane

机构信息

From the Clermont Université, Université d'Auvergne, Neuro-Dol, and Inserm U1107, Clermont-Ferrand, France (C.P., N.B., A.A., R.D.); and CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France (R.D.).

出版信息

Anesthesiology. 2016 May;124(5):1136-52. doi: 10.1097/ALN.0000000000001000.

Abstract

BACKGROUND

Tissue injury enhances pain sensitivity both at the site of tissue damage and in surrounding uninjured skin (secondary hyperalgesia). Secondary hyperalgesia encompasses several pain symptoms including pain to innocuous punctate stimuli or static mechanical allodynia. How injury-induced barrage from C-fiber nociceptors produces secondary static mechanical allodynia has not been elucidated.

METHODS

Combining behavioral, immunohistochemical, and Western blot analysis, the authors investigated the cell and molecular mechanisms underlying the secondary static mechanical allodynia in the rat medullary dorsal horn (MDH) using the capsaicin model (n = 4 to 5 per group).

RESULTS

Intradermal injection of capsaicin (25 μg) into the vibrissa pad produces a spontaneous pain and a secondary static mechanical allodynia. This allodynia is associated with the activation of a neuronal network encompassing lamina I-outer lamina III, including interneurons expressing the γ isoform of protein kinase C (PKCγ) within inner lamina II (IIi) of MDH. PKCγ is concomitantly phosphorylated (+351.4 ± 79.2%, mean ± SD; P = 0.0003). Mechanical allodynia and innocuous punctate stimulus-evoked laminae I to III neuronal activation can be replicated after intracisternally applied γ-aminobutyric acid receptor type A (GABAA) antagonist (bicuculline: 0.05 μg) or reactive oxygen species (ROS) donor (tert-butyl hydroperoxide: 50 to 250 ng). Conversely, intracisternal PKCγ antagonist, GABAA receptor agonist, or ROS scavenger prevent capsaicin-induced static mechanical allodynia and neuronal activation.

CONCLUSIONS

Sensitization of lamina IIi PKCγ interneurons is required for the manifestation of secondary static mechanical allodynia but not for spontaneous pain. Such sensitization is driven by ROS and GABAAergic disinhibition. ROS released during intense C-fiber nociceptor activation might produce a GABAAergic disinhibition of PKCγ interneurons. Innocuous punctate inputs carried by Aδ low-threshold mechanoreceptors onto PKCγ interneurons can then gain access to the pain transmission circuitry of superficial MDH, producing pain.

摘要

背景

组织损伤会增强损伤部位以及周围未损伤皮肤的疼痛敏感性(继发性痛觉过敏)。继发性痛觉过敏包括多种疼痛症状,如对无害点状刺激的疼痛或静态机械性异常性疼痛。C纤维伤害感受器损伤诱导的传入冲动如何产生继发性静态机械性异常性疼痛尚未阐明。

方法

作者采用辣椒素模型(每组n = 4至5只),结合行为学、免疫组织化学和蛋白质印迹分析,研究大鼠延髓背角(MDH)继发性静态机械性异常性疼痛的细胞和分子机制。

结果

向触须垫皮内注射辣椒素(25μg)会产生自发痛和继发性静态机械性异常性疼痛。这种异常性疼痛与一个神经元网络的激活有关,该网络包括I层至III层外侧,包括MDH II层内侧(IIi)中表达蛋白激酶C(PKCγ)γ亚型的中间神经元。PKCγ同时发生磷酸化(+351.4±79.2%,平均值±标准差;P = 0.0003)。在脑池内应用A型γ-氨基丁酸受体(GABAA)拮抗剂(荷包牡丹碱:0.05μg)或活性氧(ROS)供体(叔丁基过氧化氢:50至250ng)后,可重现机械性异常性疼痛和无害点状刺激诱发的I至III层神经元激活。相反,脑池内注射PKCγ拮抗剂、GABAA受体激动剂或ROS清除剂可预防辣椒素诱导的静态机械性异常性疼痛和神经元激活。

结论

IIi层PKCγ中间神经元的敏化是继发性静态机械性异常性疼痛表现所必需的,但自发痛并非如此。这种敏化由ROS和GABAA能去抑制驱动。强烈的C纤维伤害感受器激活过程中释放的ROS可能会产生对PKCγ中间神经元的GABAA能去抑制作用。然后,由Aδ低阈值机械感受器携带的无害点状传入冲动作用于PKCγ中间神经元,可进入浅表MDH的疼痛传递通路,产生疼痛。

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