Sun Ke-Fu, Feng Wan-Wen, Liu Yue-Peng, Dong Yan-Bin, Gao Li, Yang Hui-Lin
Department of Orthopedic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Orthopedics, Lianyungang Oriental Hospital, Lianyungang, Jiangsu, China.
J Pain Res. 2018 Mar 21;11:599-609. doi: 10.2147/JPR.S149470. eCollection 2018.
The analgesic effect on chronic pain of peripheral nerve stimulation (PNS) has been proven, but its underlying mechanism remains unknown. Therefore, this study aimed to assess the analgesic effect of PNS on bone cancer pain in a rat model and to explore the underlying mechanism.
PNS on sciatic nerves with bipolar electrode was performed in both naïve and bone cancer pain model rats. Then, the protein levels of activity-regulated cytoskeleton-associated protein (Arc), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid-type glutamate receptor 1 (GluA1), and phosphate -methyl-d-aspartic acid-type glutamate receptor subunit 2B (pGluNR2B) in spinal cord were evaluated by immunohistochemistry and Western blotting. Thermal paw withdraw latency and mechanical paw withdraw threshold were used to estimate the analgesic effect of PNS on bone cancer pain. Intrathecal administration of Arc shRNA was used to inhibit Arc expression in the spinal cord.
PNS at 60 and 120 Hz for 20 min overtly induced Arc expression in the spinal cord, increased thermal pain thresholds in naïve rats, and relieved bone cancer pain; meanwhile, 10 Hz PNS did not achieve those results. In addition, PNS at 60 and 120 Hz also reduced the expression of GluA1, but not pGluNR2B, in the spinal cord. Finally, the anti-nociceptive effect and GluA1 downregulation induced by PNS were inhibited by intrathecal administration of Arc shRNA.
PNS (60 Hz, 0.3 mA) can relieve bone-cancer-induced allodynia and hyperalgesia by upregulating Arc protein expression and then by decreasing GluA1 transcription in the spinal cord dorsal horn.
外周神经刺激(PNS)对慢性疼痛的镇痛作用已得到证实,但其潜在机制仍不清楚。因此,本研究旨在评估PNS对大鼠骨癌疼痛模型的镇痛作用,并探讨其潜在机制。
对正常大鼠和骨癌疼痛模型大鼠均采用双极电极对坐骨神经进行PNS。然后,通过免疫组织化学和蛋白质印迹法评估脊髓中活性调节细胞骨架相关蛋白(Arc)、α-氨基-3-羟基-5-甲基-4-异恶唑丙酸型谷氨酸受体1(GluA1)和磷酸化N-甲基-D-天冬氨酸型谷氨酸受体亚基2B(pGluNR2B)的蛋白水平。采用热足缩潜伏期和机械足缩阈值来评估PNS对骨癌疼痛的镇痛效果。鞘内注射Arc短发夹RNA(shRNA)以抑制脊髓中Arc的表达。
60 Hz和120 Hz的PNS持续20分钟可明显诱导脊髓中Arc表达,提高正常大鼠的热痛阈值,并缓解骨癌疼痛;同时,10 Hz的PNS未达到这些效果。此外,60 Hz和120 Hz的PNS还可降低脊髓中GluA1的表达,但不影响pGluNR2B。最后,鞘内注射Arc shRNA可抑制PNS诱导的抗伤害感受作用和GluA1下调。
PNS(60 Hz,0.3 mA)可通过上调Arc蛋白表达,进而降低脊髓背角GluA1转录,缓解骨癌引起的痛觉过敏和异常性疼痛。