From the Department of Anaesthesiology and Intensive Care Medicine, Charite Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany (D.M.M., M. Shaqura, X.L., S.T., M. Schäfer, S.A.M.) Department of Zoology, Faculty of Science, Aswan University, Aswan, Egypt (D.M.M.) the Departments of Anatomy (M. Shakibaei) Anaesthesiology (A.B.), Ludwig Maximilian University of Munich, Munich, Germany.
Anesthesiology. 2020 Apr;132(4):867-880. doi: 10.1097/ALN.0000000000003127.
Recent emerging evidence suggests that extra-adrenal synthesis of aldosterone occurs (e.g., within the failing heart and in certain brain areas). In this study, the authors investigated evidence for a local endogenous aldosterone production through its key processing enzyme aldosterone synthase within peripheral nociceptive neurons.
In male Wistar rats (n = 5 to 8 per group) with Freund's complete adjuvant hind paw inflammation, the authors examined aldosterone, aldosterone synthase, and mineralocorticoid receptor expression in peripheral sensory neurons using quantitative reverse transcriptase-polymerase chain reaction, Western blot, immunohistochemistry, and immunoprecipitation. Moreover, the authors explored the nociceptive behavioral changes after selective mineralocorticoid receptor antagonist, canrenoate-K, or specific aldosterone synthase inhibitor application.
In rats with Freund's complete adjuvant-induced hind paw inflammation subcutaneous and intrathecal application of mineralocorticoid receptor antagonist, canrenoate-K, rapidly and dose-dependently attenuated nociceptive behavior (94 and 48% reduction in mean paw pressure thresholds, respectively), suggesting a tonic activation of neuronal mineralocorticoid receptors by an endogenous ligand. Indeed, aldosterone immunoreactivity was abundant in peptidergic nociceptive neurons of dorsal root ganglia and colocalized predominantly with its processing enzyme aldosterone synthase and mineralocorticoid receptors. Moreover, aldosterone and its synthesizing enzyme were significantly upregulated in peripheral sensory neurons under inflammatory conditions. The membrane mineralocorticoid receptor consistently coimmunoprecipitated with endogenous aldosterone, confirming a functional link between mineralocorticoid receptors and its endogenous ligand. Importantly, inhibition of endogenous aldosterone production in peripheral sensory neurons by a specific aldosterone synthase inhibitor attenuated nociceptive behavior after hind paw inflammation (a 32% reduction in paw pressure thresholds; inflammation, 47 ± 2 [mean ± SD] vs. inflammation + aldosterone synthase inhibitor, 62 ± 2).
Local production of aldosterone by its processing enzyme aldosterone synthase within peripheral sensory neurons contributes to ongoing mechanical hypersensitivity during local inflammation via intrinsic activation of neuronal mineralocorticoid receptors.
最近出现的证据表明,醛固酮在肾上腺外合成(例如,在衰竭的心脏和某些大脑区域)。在这项研究中,作者研究了通过其关键的加工酶醛固酮合酶在周围伤害性神经元中产生内源性醛固酮的证据。
在雄性 Wistar 大鼠(每组 5 至 8 只)的弗氏完全佐剂后爪炎症模型中,作者使用定量逆转录聚合酶链反应、Western blot、免疫组织化学和免疫沉淀法检查外周感觉神经元中的醛固酮、醛固酮合酶和盐皮质激素受体表达。此外,作者还探索了选择性盐皮质激素受体拮抗剂坎利酮-K 或特异性醛固酮合酶抑制剂应用后的伤害性行为变化。
在弗氏完全佐剂诱导的后爪炎症大鼠中,皮下和鞘内应用盐皮质激素受体拮抗剂坎利酮-K 可迅速且剂量依赖性地减轻伤害性行为(平均爪压力阈值分别降低 94%和 48%),表明内源性配体对神经元盐皮质激素受体的紧张激活。事实上,醛固酮免疫反应性在背根神经节的肽能伤害性神经元中丰富,主要与醛固酮合酶和盐皮质激素受体共定位。此外,在炎症条件下,外周感觉神经元中的醛固酮及其合成酶显著上调。膜状盐皮质激素受体与内源性醛固酮一致地共同免疫沉淀,证实了盐皮质激素受体与其内源性配体之间的功能联系。重要的是,外周感觉神经元中内源性醛固酮产生的特异性醛固酮合酶抑制剂抑制可减轻后爪炎症后的伤害性行为(爪压力阈值降低 32%;炎症时为 47 ± 2[均值 ± SD],炎症+醛固酮合酶抑制剂时为 62 ± 2)。
外周伤害性神经元中醛固酮的内源性合成及其加工酶醛固酮合酶通过神经元盐皮质激素受体的内在激活,有助于局部炎症期间持续的机械性过敏。