Tian Jinge, Yu Tingting, Xu Yongming, Pu Shaofeng, Lv Yingying, Zhang Xin, DU Dongping
1Pain Management Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, CHINA; 2Department of Anesthesiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, CHINA; and 3Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine, Durham, NC.
Med Sci Sports Exerc. 2018 Jan;50(1):54-61. doi: 10.1249/MSS.0000000000001411.
Neuroma formation after peripheral nerve transection leads to severe neuropathic pain in amputees. Previous studies suggested that physical exercise could bring beneficial effect on alleviating neuropathic pain. However, the effect of exercise on neuroma pain still remained unclear. In addition, long-term exercise can affect the expression of neurotrophins (NT), such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), which play key roles in nociceptor sensitization and nerve sprouting after nerve injury. Here, we investigated whether long-term swimming exercise could relieve neuroma pain by modulating NT expression.
We used a tibial neuroma transposition (TNT) rat model to mimic neuroma pain. After TNT surgery, rats performed swimming exercise for 5 wk. Neuroma pain and tactile sensitivities were detected using von Frey filaments. Immunofluorescence was applied to analyze neuroma formation. NGF and BDNF expressions in peripheral neuroma, dorsal root ganglion, and the spinal cord were measured using enzyme-linked immunosorbent assay and Western blotting.
TNT led to neuroma formation, induced neuroma pain, and mechanical allodynia in hind paw. Five-week swimming exercise inhibited neuroma formation and relieved mechanical allodynia in the hind paw and neuroma pain in the lateral ankle. The analgesic effect lasted for at least 1 wk, even when the exercise ceased. TNT elevated the expressions of BDNF and NGF in peripheral neuroma, dorsal root ganglion, and the spinal cord to different extents. Swimming also decreased the elevation of NT expression.
Swimming exercise not only inhibits neuroma formation induced by nerve transection but also relieves pain behavior. These effects might be associated with the modulation of NT.
周围神经横断后形成神经瘤会导致截肢患者出现严重的神经性疼痛。先前的研究表明,体育锻炼可能对缓解神经性疼痛有有益作用。然而,运动对神经瘤疼痛的影响仍不清楚。此外,长期运动可影响神经营养因子(NT)的表达,如神经生长因子(NGF)和脑源性神经营养因子(BDNF),它们在神经损伤后的伤害感受器敏化和神经芽生中起关键作用。在此,我们研究了长期游泳运动是否能通过调节NT表达来缓解神经瘤疼痛。
我们使用胫神经瘤移位(TNT)大鼠模型来模拟神经瘤疼痛。TNT手术后,大鼠进行5周的游泳运动。使用von Frey细丝检测神经瘤疼痛和触觉敏感性。应用免疫荧光分析神经瘤形成。使用酶联免疫吸附测定和蛋白质印迹法测量外周神经瘤、背根神经节和脊髓中NGF和BDNF的表达。
TNT导致神经瘤形成,诱发后爪神经瘤疼痛和机械性异常性疼痛。为期5周的游泳运动抑制了神经瘤形成,缓解了后爪的机械性异常性疼痛和外踝的神经瘤疼痛。即使运动停止,镇痛效果至少持续1周。TNT不同程度地升高了外周神经瘤、背根神经节和脊髓中BDNF和NGF的表达。游泳也降低了NT表达的升高。
游泳运动不仅抑制神经横断诱导的神经瘤形成,还能缓解疼痛行为。这些作用可能与NT的调节有关。