Department of Anesthesiology, Bengbu Medical College, Bengbu 233000, China; Department of Anesthesiology and Pain Medicine, The First Affiliated Hospital of Jiaxing University, Jiaxing 314001, China.
Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical School of Nanjing University, Nanjing 210004, China.
Exp Neurol. 2018 May;303:80-94. doi: 10.1016/j.expneurol.2018.02.003. Epub 2018 Feb 8.
Bone cancer pain (BCP) remains a serious complication of malignancy, which is an intractable clinical problem due to the gap in knowledge of its underlying mechanisms. Recent studies have demonstrated that the major involvement of neuroinflammation, particularly high-mobility group box 1 (HMGB1), which was identified as a late mediator of inflammation, in a number of pain conditions. However, the underlying mechanisms and functions of HMGB1 release in spinal cord, and its contributions to the development of BCP as well, are poorly understood. In the present study, we examined the theory that PKC activation lead to nuclear translocation and cytosolic HMGB1 secretion, which subsequently induces spinal neuro inflammatory responses (cytokine release) causing hyperalgesia. Our results showed that PKC activation and HMGB1 release in spinal neurons as well as mechanical allodynia in BCP rats, were all attenuated by intrathecal administration of the PKC inhibitor Gö6983 and aggravated by its activator PMA. Intrathecal administration of anti-HMGB1 antibody also alleviated hypersensitivity caused by BCP. Meanwhile, phospho-PKC and cellular HMGB1 were found co-localized in neurons, but not in microglia and astrocytes, of the spinal dorsal horns of tumor-bearing rats. Additionally, we found that HMGB1 translocation from nuclei to cytoplasm may be the consequence of PKC translocation into the nuclei, which occurred 9 days after tumor inoculation. Total p-HMGB1 as well as nuclear and cytoplasmic HMGB1 expression levels were tested in response to broad-spectrum PKC inhibitor Gö6983 or activator PMA in BCP rats. Together, these findings suggest that bone cancer related hyperalgesia is driven by PKC induced phosphorylation of HMGB1, which results in its translocation from the nucleus, and releasing from the cytosol of the dorsal horn, and the activation of spinal pro-inflammatory mediators.
骨癌疼痛(BCP)仍然是恶性肿瘤的严重并发症,由于其潜在机制的知识差距,这是一个棘手的临床问题。最近的研究表明,神经炎症,特别是高迁移率族蛋白 1(HMGB1)的大量参与,特别是作为炎症的晚期介质,在许多疼痛情况下都有涉及。然而,HMGB1 在脊髓中的释放的潜在机制和功能,以及其对 BCP 发展的贡献,还知之甚少。在本研究中,我们检验了这样一种理论,即 PKC 激活导致核转位和胞浆 HMGB1 分泌,进而诱导脊髓神经炎症反应(细胞因子释放)导致痛觉过敏。我们的结果表明,PKC 激活和 HMGB1 释放以及 BCP 大鼠的机械性痛觉过敏,都可以通过鞘内给予 PKC 抑制剂 Gö6983 来减轻,而通过其激活剂 PMA 则会加重。鞘内给予抗 HMGB1 抗体也可减轻 BCP 引起的过敏反应。同时,我们发现磷酸化 PKC 和细胞内 HMGB1 在肿瘤大鼠脊髓背角的神经元中存在共定位,但在小胶质细胞和星形胶质细胞中不存在。此外,我们发现 HMGB1 从细胞核向细胞质的易位可能是 PKC 向细胞核转位的结果,这种转位发生在肿瘤接种后 9 天。在 BCP 大鼠中,我们测试了广谱 PKC 抑制剂 Gö6983 或激活剂 PMA 对总 p-HMGB1 以及核和细胞质 HMGB1 表达水平的影响。综上所述,这些发现表明,骨癌相关的痛觉过敏是由 PKC 诱导的 HMGB1 磷酸化驱动的,导致其从细胞核易位,并从背角的细胞质中释放,并激活脊髓前炎症介质。