Center for Translational Pain Medicine, Department of Anesthesiology,
Center for Translational Pain Medicine, Department of Anesthesiology.
J Neurosci. 2019 Aug 28;39(35):6848-6864. doi: 10.1523/JNEUROSCI.3257-18.2019. Epub 2019 Jul 3.
Chemotherapy-induced peripheral neuropathy (CIPN) remains a pressing clinical problem; however, our understanding of sexual dimorphism in CIPN remains unclear. Emerging studies indicate a sex-dimorphic role of Toll-like receptor 4 (TLR4) in driving neuropathic pain. In this study, we examined the role of TLR9 in CIPN induced by paclitaxel in WT and mutant mice of both sexes. Baseline pain sensitivity was not affected in either mutant male or female mice. Intraplantar and intrathecal injection of the TLR9 agonist ODN 1826 induced mechanical allodynia in both sexes of WT and KO mice but failed to do so in mutant mice. Moreover, KO or C-fiber blockade by resiniferatoxin failed to affect intraplantar ODN 1826-induced mechanical allodynia. Interestingly, the development of paclitaxel-evoked mechanical allodynia was attenuated by TLR9 antagonism or mutation only in male mice. Paclitaxel-induced CIPN caused macrophage infiltration to DRGs in both sexes, and this infiltration was not affected by mutation. Paclitaxel treatment also upregulated TNF and CXCL1 in macrophage cultures and DRG tissues in both sexes, but these changes were compromised by mutation in male animals. Intraplantar adoptive transfer of paclitaxel-activated macrophages evoked mechanical allodynia in both sexes, which was compromised by mutation or by treatment with TLR9 inhibitor only in male animals. Finally, TLR9 antagonism reduced paclitaxel-induced mechanical allodynia in female nude mice (T-cell and B-cell deficient). Together, these findings reveal sex-dimorphic macrophage TLR9 signaling in chemotherapy-induced neuropathic pain. Chemotherapy-induced peripheral neuropathy (CIPN) is a major side effect in cancer patients undergoing clinical chemotherapy treatment regimens. The role of sex dimorphism with regards to the mechanisms of CIPN and analgesia against CIPN remains unclear. Previous studies have found that the infiltration of immune cells, such as macrophages into DRGs and their subsequent activation promote CIPN. Interestingly, the contribution of microglia to CIPN appears to be limited. Here, we show that macrophage TLR9 signaling promotes CIPN in male mice only. This study suggests that pathways in macrophages may be sex-dimorphic in CIPN. Our findings provide new insights into the role of macrophage signaling mechanisms underlying sex dimorphism in CIPN, which may inspire the development of more precise and effective therapies.
化疗诱导的周围神经病(CIPN)仍然是一个紧迫的临床问题;然而,我们对 CIPN 中性别二态性的理解仍不清楚。新兴研究表明 Toll 样受体 4(TLR4)在驱动神经病理性疼痛方面具有性别二态性作用。在这项研究中,我们检查了 TLR9 在紫杉醇诱导的 CIPN 中的作用在 WT 和 KO 雄性和雌性小鼠中。WT 和 KO 雄性和雌性小鼠的基础疼痛敏感性均不受影响。TLR9 激动剂 ODN 1826 的皮内和鞘内注射在 WT 和 KO 小鼠的两性中均引起机械性痛觉过敏,但在 KO 小鼠中则不能。此外,树脂毒素对 C 纤维的 KO 或阻断均不能影响皮内 ODN 1826 诱导的机械性痛觉过敏。有趣的是,TLR9 拮抗或 KO 仅在雄性小鼠中减弱了紫杉醇诱发的机械性痛觉过敏的发展。紫杉醇引起的 CIPN 引起 DRG 中巨噬细胞浸润,这种浸润不受 KO 影响。紫杉醇处理还上调了两性巨噬细胞培养物和 DRG 组织中的 TNF 和 CXCL1,但这些变化在雄性动物中受到 KO 的影响。皮内过继转移紫杉醇激活的巨噬细胞在两性中引起机械性痛觉过敏,而在雄性动物中仅通过 KO 或 TLR9 抑制剂处理会受到损害。最后,TLR9 拮抗作用降低了雌性裸鼠(T 细胞和 B 细胞缺乏)紫杉醇诱导的机械性痛觉过敏。总之,这些发现揭示了化疗诱导的神经病理性疼痛中性别二态性巨噬细胞 TLR9 信号传导。化疗诱导的周围神经病(CIPN)是接受临床化疗治疗方案的癌症患者的主要副作用。关于 CIPN 的机制和针对 CIPN 的镇痛作用的性别二态性的作用尚不清楚。先前的研究发现,免疫细胞(如巨噬细胞)浸润到 DRG 中及其随后的激活促进了 CIPN。有趣的是,小胶质细胞对 CIPN 的贡献似乎是有限的。在这里,我们表明巨噬细胞 TLR9 信号仅在雄性小鼠中促进 CIPN。这项研究表明,巨噬细胞中的途径可能在 CIPN 中具有性别二态性。我们的发现为 CIPN 中性别二态性的巨噬细胞信号转导机制提供了新的见解,这可能为更精确和有效的治疗方法提供启示。
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