Department of Pharmacology, Institute of Neuroscience, School of Basic Medical Sciences, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Pharmacy, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Pain. 2018 Feb;159(2):273-283. doi: 10.1097/j.pain.0000000000001100.
Pain sensitization after partial infraorbital nerve transection (p-IONX) in mice not only presents in orofacial region, but also spreads to distant body parts. The roles of toll-like receptor 4 (TLR4) in orofacial pain and the spreading process are still unclear. Here, we found that mice with deficient TLR4 because of Tr4 gene point mutation (C3H/HeJ) or spontaneous deletion (C57BL/10ScNJ) developed tactile allodynia and thermal hyperalgesia in the vibrissal pad in a parallel way to their respective wild types (C3HeB/FeJ or C57BL/6J) after p-IONX. However, allodynia in the hind paw was absent in mice with TLR4 deficiency. Pharmacological antagonism of TLR4 with LPS-RS, administered either intracisternally or intrathecally, abrogated allodynia in the hind paw without affecting the hypersensitivity in the vibrissal pad and hyperalgesia in the hind paw. Although TNF-α expression was upregulated in both the medulla and lumbar cord, the expression of TLR4 downstream molecule MyD88 increased only in the lumbar cord after p-IONX in wild types. By contrast, hind paw hypersensitivity after partial sciatic nerve ligation was significantly attenuated by TLR4 deletion. The hypersensitivity, which did not spread to the vibrissal pad, was accompanied with upregulation of MyD88 in the lumbar cord rather than in the medulla. These results suggest that TLR4 participates in the spread of allodynia component of orofacial pain to distant body sites, but not trigeminal neuropathic pain or the spread of its hyperalgesia component. This study suggests that TLR4 may serve as a potential target for the management of widespread allodynia associated with orofacial pain.
眶下神经部分切断(p-IONX)后,小鼠不仅在口面部出现痛觉过敏,而且疼痛还会扩散到远处的身体部位。然而,TLR4 在口面部疼痛及其扩散过程中的作用仍不清楚。在这里,我们发现由于 Tr4 基因点突变(C3H/HeJ)或自发缺失(C57BL/10ScNJ)导致 TLR4 缺失的小鼠,在 p-IONX 后与各自的野生型(C3HeB/FeJ 或 C57BL/6J)一样,在触须垫上出现触觉过敏和热痛觉过敏。然而,TLR4 缺失的小鼠后爪出现痛觉过敏。TLR4 的药理学拮抗剂 LPS-RS,无论是鞘内还是椎管内给药,都能消除后爪的痛觉过敏,而不影响触须垫的超敏反应和后爪的痛觉过敏。尽管 TNF-α 在延髓和腰髓中均上调,但在野生型小鼠 p-IONX 后,TLR4 下游分子 MyD88 的表达仅在腰髓中增加。相比之下,部分坐骨神经结扎后,TLR4 缺失明显减轻后爪的敏感性。这种不扩散到触须垫的敏感性伴随着腰髓中 MyD88 的上调,而不是延髓。这些结果表明,TLR4 参与了口面部疼痛的痛觉过敏成分向远处身体部位的扩散,但不参与三叉神经病理性疼痛或其痛觉过敏成分的扩散。这项研究表明,TLR4 可能成为管理与口面部疼痛相关的广泛痛觉过敏的潜在靶点。