Department of Anesthesiology, Pain and Perioperative Medicine, Stanford University School of Medicine, Stanford, CA.
Department of Anesthesiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Mol Pain. 2017 Jan-Dec;13:1744806917730212. doi: 10.1177/1744806917730212.
Chronic pain after traumatic brain injury (TBI) is very common, but the mechanisms linking TBI to pain and the pain-related interactions of TBI with peripheral injuries are poorly understood. Chemokine receptors play an important role in both pain and brain injury. In the current work, we pursued the hypothesis that the epigenetically regulated CXC chemokine receptor 2 (CXCR2) is a crucial modulator of nociceptive sensitization induced by TBI. For these studies, we used the rat lateral fluid percussion model of TBI. Histone actyltransferase activity was blocked using anacardic acid beginning immediately following injury, or delayed for seven days prior to administration. The selective CXCR2 antagonist SCH527123 administered systemically or intrathecally was used to probe the role of chemokine signaling on mechanical hindpaw sensitization after TBI. The expression of the CXCR2 receptor was accomplished using real-time PCR, immunohistochemistry, and Western blotting, while epigenetic regulation was assessed using chromatin immunoprecipitation assay. The spinal levels of several pain-related mediators including CXCL1, an endogenous ligand for CXCR2, as well as brain-derived neurotrophic factor and prodynorphin were measured by enzyme-linked immunosorbent assay. We observed that anacardic acid potently blocked and reversed mechanical hindpaw sensitization after TBI. The same drug was able to prevent the upregulation of CXCR2 after TBI, but did not affect the spinal expression of other pain mediators. On the other hand, both systemically and intrathecally administered SCH527123 reversed hindpaw allodynia after TBI. Most of the spinal CXCR2 appeared to be expressed by spinal cord neurons. Chromatin immunoprecipitation experiments demonstrated TBI-enhanced association of the CXCR2 promoter with acetylated-H3K9 histone protein that was also reversible using anacardic acid. Taken together, our findings suggested that TBI causes the upregulation of spinal CXCR2 through an epigenetic mechanism ultimately supporting nociceptive sensitization. The use of CXCR2 antagonists may, therefore, be useful in pain resulting from TBI.
创伤性脑损伤 (TBI) 后的慢性疼痛非常常见,但将 TBI 与疼痛联系起来的机制以及 TBI 与外周损伤相关的疼痛相互作用仍知之甚少。趋化因子受体在疼痛和脑损伤中都起着重要作用。在目前的工作中,我们假设表观遗传调控的 CXC 趋化因子受体 2 (CXCR2) 是 TBI 诱导的伤害感受敏化的关键调节剂。为此,我们使用了大鼠外侧液动冲击模型进行研究。在受伤后立即或在给药前七天开始使用阿那卡酸阻断组蛋白乙酰转移酶活性。使用全身或鞘内给予选择性 CXCR2 拮抗剂 SCH527123 来探测趋化因子信号在 TBI 后机械性后爪敏化中的作用。通过实时 PCR、免疫组织化学和 Western blot 检测 CXCR2 受体的表达,通过染色质免疫沉淀测定评估表观遗传调控。通过酶联免疫吸附试验测量了几种与疼痛相关的介质的脊髓水平,包括 CXCL1,即 CXCR2 的内源性配体,以及脑源性神经营养因子和前原啡肽。我们发现,阿那卡酸能有效阻断和逆转 TBI 后的机械性后爪敏化。同样的药物能够阻止 TBI 后 CXCR2 的上调,但不影响其他疼痛介质的脊髓表达。另一方面,全身和鞘内给予 SCH527123 均可逆转 TBI 后的后爪痛觉过敏。大多数脊髓 CXCR2 似乎由脊髓神经元表达。染色质免疫沉淀实验表明,TBI 增强了 CXCR2 启动子与乙酰化 H3K9 组蛋白蛋白的结合,而阿那卡酸也可以逆转这种结合。总之,我们的研究结果表明,TBI 通过表观遗传机制导致脊髓 CXCR2 的上调,最终支持伤害感受敏化。因此,使用 CXCR2 拮抗剂可能对 TBI 引起的疼痛有用。