Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin Research Institute of Anesthesiology, Tianjin 300052, China.
Department of Anesthesiology, Tianjin First Center Hospital, Tianjin Medical University First Center Clinical College, Tianjin 300192, China.
Neurosci Res. 2020 May;154:20-26. doi: 10.1016/j.neures.2019.05.003. Epub 2019 May 20.
Chronic postoperative pain might be a pivotal component hindering recovery and regains the function after bone fracture and orthopedic surgery. However, the underlying mechanisms remain largely unclear. AMPA receptor of excitatory synapses is considered due to its critical role in pathologic pain. Chemokine CCL1 related neuroinflammation plays a role in excitatory synaptic transmission and nociceptive transduction. This study examined whether spinal CCL1 is associated with fracture-associated postoperative pain via AMPA receptor. We herein discovered that the tibial fracture with orthopedic surgery initiated and maintained chronic postoperative pain along with spinal up-regulation of CCL1/CCR8 expression and phosphorylation of GluA1-containing AMPA receptor. Central CCL1/CCR8 inhibition impaired mechanical and cold allodynia, and phosphorylated GluA1-containing AMPA receptor in the spinal dorsal horn. Intrathecal injection of GluA1-containing AMPA receptor antagonist NASPM alleviated fracture-related postoperative pain. Also, exogenous CCL1 delivery facilitated acute pain behaviors and spinal phosphorylation of GluA1-containing AMPA receptor in naïve mice, reversing by co-application of NASPM. Our current results indicated that spinal CCL1/CCR8-mediated GluA1-containing AMPA receptor activation is vital in the pathogenesis of fracture associated postoperative pain in mice.
慢性术后疼痛可能是阻碍骨折和骨科手术后恢复和功能恢复的关键因素。然而,其潜在机制在很大程度上仍不清楚。兴奋性突触的 AMPA 受体因其在病理性疼痛中的关键作用而被认为与之相关。趋化因子 CCL1 相关的神经炎症在兴奋性突触传递和伤害性转导中起作用。本研究通过 AMPA 受体检查脊髓 CCL1 是否与骨折相关的术后疼痛有关。我们在此发现,骨科手术引起的胫骨骨折会引发并维持慢性术后疼痛,同时脊髓 CCL1/CCR8 表达和含 GluA1 的 AMPA 受体磷酸化上调。中枢 CCL1/CCR8 抑制会损害机械性和冷感觉过敏,以及脊髓背角中含 GluA1 的 AMPA 受体磷酸化。鞘内注射含 GluA1 的 AMPA 受体拮抗剂 NASPM 可减轻与骨折相关的术后疼痛。此外,外源性 CCL1 给药促进了在未处理的小鼠中的急性痛觉行为和脊髓中含 GluA1 的 AMPA 受体的磷酸化,通过联合应用 NASPM 可逆转这一过程。我们的研究结果表明,脊髓 CCL1/CCR8 介导的含 GluA1 的 AMPA 受体激活在小鼠骨折相关术后疼痛的发病机制中至关重要。
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