Li Zhisong, Li Yaru, Cao Jing, Han Xuemin, Cai Weihua, Zang Weidong, Xu Jitian, Zhang Wei
Department of Anesthesiology, the First Affiliated Hospital, Zhengzhou University, No 1, Jianshe Road, Zhengzhou, 450052, People's Republic of China.
Department of Anatomy, Basic Medical College, Zhengzhou University, No 100, Kexue Road, Zhengzhou, 450001, People's Republic of China.
BMC Anesthesiol. 2017 Nov 7;17(1):150. doi: 10.1186/s12871-017-0438-8.
BACKGROUND: Persistent post-surgical pain is a difficult clinical problem. In this study, we intend to explore the mechanism underlying the persistent post-surgical pain in SMIR (skin/muscle incision and retraction) rats. METHODS: First of all, the expression of membrane protein Nav1.7 and p-p65 (Phosphorylation of p65) were detected in ipsilateral L4-6 DRGs of SMIR rats by western-blot and immunostaining. Then with ProTx-II (Nav1.7 blocker) or PDTC (p65 inhibitor) were intrathecally injected while the change of Nav1.7 expression and mechanical withdrawal threshold were detected. Finally chromatin immunoprecipitation assay method was used to detect whether could p-p65 bind in the Nav1.7 gene promoter region directly. RESULTS: The results shows that mechanical hyperalgesia occurs following SMIR model, from 5 day (d) and lasted more than 20d after surgery. Meanwhile, the expression of Nav1.7 was up-regulated at 10d, 15d and 20d after surgery compared with naïve group. The expression of p-p65 was up-regulated at 10d and 15d compared with incision group. The mechanical hyperalgesia induced by SMIR was reversed after blocking Nav1.7 or inhibiting p65. Furthermore, Nav1.7 expression was down-regulated when p-p65 was inhibited and p-p65 could combine with the Nav1.7 gene promoter region directly. CONCLUSION: Membrane protein Nav1.7 could participate in the peripheral sensitization of persistent post-surgical pain, which may be regulated by p-p65.
背景:术后持续性疼痛是一个棘手的临床问题。在本研究中,我们旨在探究皮肤/肌肉切开并牵拉(SMIR)大鼠术后持续性疼痛的潜在机制。 方法:首先,通过蛋白质免疫印迹法和免疫染色检测SMIR大鼠同侧L4-6背根神经节(DRG)中膜蛋白Nav1.7和p-p65(p65磷酸化)的表达。然后鞘内注射ProTx-II(Nav1.7阻断剂)或PDTC(p65抑制剂),同时检测Nav1.7表达变化和机械缩足阈值。最后采用染色质免疫沉淀测定法检测p-p65是否能直接结合在Nav1.7基因启动子区域。 结果:结果显示,SMIR模型术后第5天出现机械性痛觉过敏,并持续超过20天。同时,与未手术组相比,术后第10天、15天和20天Nav1.7表达上调。与切开组相比,术后第10天和15天p-p65表达上调。阻断Nav1.7或抑制p65后,SMIR诱导的机械性痛觉过敏得到逆转。此外,抑制p-p65时Nav1.7表达下调,且p-p65可直接与Nav1.7基因启动子区域结合。 结论:膜蛋白Nav1.7可能参与术后持续性疼痛的外周敏化,这可能受p-p65调控。
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