MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; The First Affiliated Hospital of Zhejiang University, Hangzhou, China.
MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
J Pain. 2018 Jun;19(6):626-634. doi: 10.1016/j.jpain.2018.01.003. Epub 2018 Jan 31.
UNLABELLED: Orofacial neuropathic pain caused by trigeminal nerve injury is a debilitating condition with limited therapeutic options. Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels regulate neuronal excitability and are involved in the development and maintenance of chronic pain. However, the effect of HCN channel activity in the Gasserian ganglion on trigeminal neuropathic pain has not been examined. We evaluated nociceptive behaviors after microinjection of the HCN channel blockers ZD7288 or ivabradine into the Gasserian ganglion in rats with trigeminal nerve injury. Both blockers dose-dependently ameliorated evoked and spontaneous nociceptive behavior in rats with trigeminal neuropathic pain. Moreover, the clinically available HCN channel blocker ivabradine showed a prolonged antinociceptive effect. In the Gasserian ganglion, HCN1 and HCN2 are major HCN isoforms. After trigeminal nerve injury, the counts of HCN1 as well as HCN2 immuno-positive punctae were increased in the ipsilateral Gasserian ganglions. These results indicate that the increased HCN channel activity in the Gasserian ganglion directly contributes to neuropathic pain resulting from trigeminal nerve injury. PERSPECTIVE: Trigeminal nerve damage-induced orofacial pain is severe and more resistant to standard pharmacological treatment than other types of neuropathic pain. Our study suggests that targeting HCN channel activities in the Gasserian ganglion may provide an alternative treatment of trigeminal neuropathy including trigeminal neuralgia.
未加标签:由三叉神经损伤引起的口面神经性疼痛是一种使人虚弱的疾病,治疗选择有限。超极化激活环核苷酸门控 (HCN) 通道调节神经元兴奋性,并参与慢性疼痛的发展和维持。然而,尚未研究门冬氨酸神经节中 HCN 通道活性对三叉神经病理性疼痛的影响。我们评估了将 HCN 通道阻滞剂 ZD7288 或伊伐布雷定微注射到三叉神经损伤大鼠的门冬氨酸神经节后,疼痛行为的变化。两种阻滞剂均剂量依赖性地改善了三叉神经病理性疼痛大鼠的诱发和自发性疼痛行为。此外,临床可用的 HCN 通道阻滞剂伊伐布雷定显示出延长的镇痛作用。在门冬氨酸神经节中,HCN1 和 HCN2 是主要的 HCN 同工型。在三叉神经损伤后,同侧门冬氨酸神经节中 HCN1 和 HCN2 免疫阳性点的计数增加。这些结果表明,门冬氨酸神经节中 HCN 通道活性的增加直接导致三叉神经损伤引起的神经性疼痛。
观点:三叉神经损伤引起的口面疼痛是严重的,比其他类型的神经性疼痛更能抵抗标准的药物治疗。我们的研究表明,靶向门冬氨酸神经节中的 HCN 通道活性可能为包括三叉神经痛在内的三叉神经病变提供一种替代治疗方法。
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