Departments of Anatomy and Cell Biology and.
Anesthesiology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
Pain. 2020 Jan;161(1):211-219. doi: 10.1097/j.pain.0000000000001703.
A significant subset of patients with urologic chronic pelvic pain syndrome suffer from widespread, as well as pelvic, pain and experience mood-related disorders, including anxiety, depression, and panic disorder. Stress is a commonly reported trigger for symptom onset and exacerbation within these patients. The link between stress and pain is believed to arise, in part, from the hypothalamic-pituitary-adrenal axis, which regulates the response to stress and can influence the perception of pain. Previous studies have shown that stress exposure in anxiety-prone rats can induce both pelvic and widespread hypersensitivity. Here, we exposed female A/J mice, an anxiety-prone inbred murine strain, to 10 days of foot shock stress to determine stress-induced effects on sensitivity, anhedonia, and hypothalamic-pituitary-adrenal axis regulation and output. At 1 and 28 days after foot shock, A/J mice displayed significantly increased bladder sensitivity and hind paw mechanical allodynia. They also displayed anhedonic behavior, measured as reduced nest building scores and a decrease in sucrose preference during the 10-day foot shock exposure. Serum corticosterone was significantly increased at 1 day after foot shock, and bladder mast cell degranulation rates were similarly high in both sham- and shock-exposed mice. Bladder cytokine and growth factor mRNA levels indicated a persistent shift toward a proinflammatory environment after foot shock exposure. Together, these data suggest that chronic stress exposure in an anxiety-prone mouse strain may provide a useful translational model for understanding mechanisms that contribute to widespreadness of pain and increased comorbidity in a subset of patients with urologic chronic pelvic pain syndrome.
患有泌尿科慢性盆腔疼痛综合征的患者中有相当一部分人会出现广泛的盆腔疼痛,并伴有情绪相关障碍,包括焦虑、抑郁和恐慌症。压力是这些患者症状发作和恶化的常见诱因。人们认为,压力和疼痛之间的联系部分源于下丘脑-垂体-肾上腺轴,该轴调节对压力的反应,并且可以影响疼痛的感知。先前的研究表明,易焦虑大鼠的应激暴露会导致盆腔和广泛的敏感性增加。在这里,我们使易焦虑的近交系 A/J 小鼠暴露于 10 天的足底电击应激中,以确定应激对敏感性、快感缺失和下丘脑-垂体-肾上腺轴调节和输出的影响。在足底电击后 1 天和 28 天,A/J 小鼠表现出明显增加的膀胱敏感性和后爪机械性痛觉过敏。它们还表现出快感缺失行为,表现为筑巢评分降低和在 10 天足底电击暴露期间蔗糖偏好降低。足底电击后 1 天血清皮质酮显著升高,并且无论是在假手术组还是在电击组,膀胱肥大细胞脱颗粒率都很高。膀胱细胞因子和生长因子 mRNA 水平表明,在足底电击暴露后,环境向促炎状态持续转变。总的来说,这些数据表明,在易焦虑的小鼠品系中进行慢性应激暴露可能为理解导致一部分泌尿科慢性盆腔疼痛综合征患者疼痛广泛存在和合并症增加的机制提供一个有用的转化模型。