Department of Anesthesiology, Center for Translational Pain Medicine, Duke University School of Medicine, Durham, United States.
Division of Meridian and Structural Medicine, School of Korean Medicine, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea.
Pain. 2020 Feb;161(2):446-458. doi: 10.1097/j.pain.0000000000001734.
Low levels of catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines, and stress, which potentiates catecholamine release from sympathetic nerves, are fundamental to chronic functional pain syndromes and comorbid depression, which predominantly affect females. Here, we sought to examine the independent and joint contributions of low COMT and stress to chronic functional pain and depression at the behavioral and molecular level. Male and female C57BL/6 mice received sustained systemic delivery of the COMT inhibitor OR486 over 14 days and underwent a swim stress paradigm on days 8 to 10. Pain and depressive-like behavior were measured over 14 days, and brain-derived neurotrophic factor (BDNF; a factor involved in nociception and depression) and glucocorticoid receptor (GR; a stress-related receptor) expression were measured on day 14. We found that stress potentiates the effect of low COMT on functional pain and low COMT potentiates the effect of stress on depressive-like behavior. The joint effects of low COMT and stress on functional pain and depressive-like behavior were significantly greater in females vs males. Consistent with behavioral data, we found that stress potentiates COMT-dependent increases in spinal BDNF and low COMT potentiates stress-dependent decreases in hippocampal BDNF in females, but not males. Although low COMT increases spinal GR and stress increases hippocampal GR expression, these increases are not potentiated in the OR486 + stress group and are not sex-specific. These results suggest that genetic and environmental factors that enhance catecholamine bioavailability cause abnormalities in BDNF signaling and increase risk of comorbid functional pain and depression, especially among females.
低水平的儿茶酚-O-甲基转移酶(COMT),一种代谢儿茶酚胺的酶,以及应激,它增强来自交感神经的儿茶酚胺释放,是慢性功能性疼痛综合征和共病抑郁症的基础,这些疾病主要影响女性。在这里,我们试图在行为和分子水平上检查低 COMT 和应激对慢性功能性疼痛和抑郁的独立和共同贡献。雄性和雌性 C57BL/6 小鼠接受了 14 天的持续全身 OR486 (COMT 抑制剂)给药,并在第 8 天至第 10 天接受了游泳应激范式。在 14 天内测量疼痛和抑郁样行为,在第 14 天测量脑源性神经营养因子(BDNF;一种与疼痛和抑郁有关的因子)和糖皮质激素受体(GR;一种与应激有关的受体)的表达。我们发现,应激增强了低 COMT 对功能性疼痛的影响,低 COMT 增强了应激对抑郁样行为的影响。低 COMT 和应激对功能性疼痛和抑郁样行为的共同影响在女性中明显大于男性。与行为数据一致,我们发现应激增强了 COMT 依赖性的脊髓 BDNF 增加,而低 COMT 增强了应激依赖性的海马 BDNF 减少,这只在女性中发生,而不在男性中发生。虽然低 COMT 增加了脊髓 GR 的表达,应激增加了海马 GR 的表达,但这些增加在 OR486 + 应激组中没有增强,也没有性别特异性。这些结果表明,增强儿茶酚胺生物利用度的遗传和环境因素导致 BDNF 信号异常,并增加共病功能性疼痛和抑郁的风险,尤其是在女性中。