Sumizono Megumi, Sakakima Harutoshi, Otsuka Shotaro, Terashi Takuto, Nakanishi Kazuki, Ueda Koki, Takada Seiya, Kikuchi Kiyoshi
Course of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
Kirishima Orthopedics, Kirishima, Japan.
J Pain Res. 2018 Feb 7;11:281-291. doi: 10.2147/JPR.S156326. eCollection 2018.
Exercise regimens are established methods that can relieve neuropathic pain. However, the relationship between frequency and intensity of exercise and multiple cellular responses of exercise-induced alleviation of neuropathic pain is still unclear. We examined the influence of exercise frequency on neuropathic pain and the intracellular responses in a sciatic nerve chronic constriction injury (CCI) model.
Rats were assigned to four groups as follows: CCI and high-frequency exercise (HFE group), CCI and low-frequency exercise (LFE group), CCI and no exercise (No-Ex group), and naive animals (control group). Rats ran on a treadmill, at a speed of 20 m/min, for 30 min, for 5 (HFE) or 3 (LFE) days a week, for a total of 5 weeks. The 50% withdrawal threshold was evaluated for mechanical sensitivity. The activation of glial cells (microglia and astrocytes), expression of brain-derived neurotrophic factor (BDNF) and μ-opioid receptor in the spinal dorsal horn and endogenous opioid in the midbrain were examined using immunohistochemistry. Opioid receptor antagonists (naloxone) were administered using intraperitoneal injection.
The development of neuropathic pain was related to the activation of glial cells, increased BDNF expression, and downregulation of the μ-opioid receptor in the ipsilateral spinal dorsal horn. In the No-Ex group, neuropathic pain showed the highest level of mechanical hypersensitivity at 2 weeks, which improved slightly until 5 weeks after CCI. In both exercise groups, the alleviation of neuropathic pain was accelerated through the regulation of glial activation, BDNF expression, and the endogenous opioid system. The expression of BDNF and endogenous opioid in relation to exercise-induced alleviation of neuropathic pain differed in the HFE and LFE groups. The effects of exercise-induced alleviation of mechanical hypersensitivity were reversed by the administration of naloxone.
The LFE and HFE program reduced neuropathic pain. Our findings indicated that aerobic exercise-induced alleviated neuropathic pain through the regulation of glial cell activation, expression of BDNF in the ipsilateral spinal dorsal horn, and the endogenous opioid system.
运动疗法是缓解神经性疼痛的既定方法。然而,运动频率和强度与运动诱导缓解神经性疼痛的多种细胞反应之间的关系仍不清楚。我们在坐骨神经慢性压迫损伤(CCI)模型中研究了运动频率对神经性疼痛和细胞内反应的影响。
将大鼠分为四组:CCI和高频运动组(HFE组)、CCI和低频运动组(LFE组)、CCI和不运动组(No-Ex组)以及正常动物组(对照组)。大鼠在跑步机上以20米/分钟的速度跑30分钟,每周跑5天(HFE组)或3天(LFE组),共5周。评估50%缩足阈值以检测机械敏感性。使用免疫组织化学法检测脊髓背角胶质细胞(小胶质细胞和星形胶质细胞)的激活、脑源性神经营养因子(BDNF)和μ-阿片受体的表达以及中脑内源性阿片类物质。通过腹腔注射给予阿片受体拮抗剂(纳洛酮)。
神经性疼痛的发展与胶质细胞的激活、BDNF表达增加以及同侧脊髓背角μ-阿片受体下调有关。在No-Ex组中,神经性疼痛在2周时表现出最高水平的机械性超敏反应,在CCI后5周时略有改善。在两个运动组中,通过调节胶质细胞激活、BDNF表达和内源性阿片系统,神经性疼痛的缓解加速。HFE组和LFE组中,与运动诱导缓解神经性疼痛相关的BDNF和内源性阿片类物质的表达有所不同。给予纳洛酮可逆转运动诱导缓解机械性超敏反应的作用。
LFE和HFE方案减轻了神经性疼痛。我们的研究结果表明,有氧运动通过调节胶质细胞激活、同侧脊髓背角BDNF表达和内源性阿片系统减轻了神经性疼痛。