Meng Fan Xing, Hou Jing Ming, Sun Tian Sheng
Third Military Medical University, No. 30 Gaotanyan Street, 400038, Chongqing, China.
Department of Orthopedics, Chinese PLA Army General Hospital, Dongcheng District, Nanmencang No. 5, 100700, Beijing, China.
J Orthop Surg Res. 2017 Feb 8;12(1):24. doi: 10.1186/s13018-017-0526-y.
Central pain (CP) is a common clinical problem in patients with spinal cord injury (SCI). Recent studies found the pathogenesis of CP was related to the remodeling of the brain. We investigate the roles of iron overload and subsequent oxidative stress in the remodeling of the brain after SCI.
We established a rat model of central pain after SCI. Rats were divided randomly into four groups: SCI, sham operation, SCI plus deferoxamine (DFX) intervention, and SCI plus nitric oxide synthase (NOS) inhibitor treatment. Pain behavior was observed and thermal pain threshold was measured regularly, and brain levels of iron, transferrin receptor 1 (TfR1), ferritin (Fn), and lactoferrin (Lf), were detected in the different groups 12 weeks after establishment of the model.
Rats demonstrated self-biting behavior after SCI. Furthermore, the latent period of thermal pain was reduced and iron levels in the hind limb sensory area, hippocampus, and thalamus increased after SCI. Iron-regulatory protein (IRP) 1 levels increased in the hind limb sensory area, while Fn levels decreased. TfR1 mRNA levels were also increased and oxidative stress was activated. Oxidative stress could be inhibited by ferric iron chelators and NOS inhibitors.
SCI may cause intracranial iron overload through the NOS-iron-responsive element/IRP pathway, resulting in central pain mediated by the oxidative stress response. Iron chelators and oxidative stress inhibitors can effectively relieve SCI-associated central pain.
中枢性疼痛(CP)是脊髓损伤(SCI)患者常见的临床问题。近期研究发现CP的发病机制与大脑重塑有关。我们研究铁过载及随后的氧化应激在SCI后脑重塑中的作用。
我们建立了SCI后中枢性疼痛的大鼠模型。大鼠被随机分为四组:SCI组、假手术组、SCI加去铁胺(DFX)干预组和SCI加一氧化氮合酶(NOS)抑制剂治疗组。定期观察疼痛行为并测量热痛阈值,在模型建立12周后检测不同组大鼠脑内铁、转铁蛋白受体1(TfR1)、铁蛋白(Fn)和乳铁蛋白(Lf)的水平。
SCI后大鼠出现自咬行为。此外,SCI后热痛潜伏期缩短,后肢感觉区、海马和丘脑铁水平升高。后肢感觉区铁调节蛋白(IRP)1水平升高,而Fn水平降低。TfR1 mRNA水平也升高,氧化应激被激活。氧化应激可被三价铁螯合剂和NOS抑制剂抑制。
SCI可能通过NOS-铁反应元件/IRP途径导致颅内铁过载,从而引发由氧化应激反应介导的中枢性疼痛。铁螯合剂和氧化应激抑制剂可有效缓解SCI相关的中枢性疼痛。