Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, 600 W Tianhe Rd, Guangzhou, 510630, China.
Pain Research Center and Department of Physiology, Zhongshan School of Medicine, Sun Yat-sen University, 74 Zhongshan Rd. 2, Guangzhou, 510080, China.
J Neuroinflammation. 2020 Apr 2;17(1):99. doi: 10.1186/s12974-020-01786-5.
Bladder-related pain symptoms in patients with bladder pain syndrome/interstitial cystitis (BPS/IC) are often accompanied by depression and memory deficits. Magnesium deficiency contributes to neuroinflammation and is associated with pain, depression, and memory deficits. Neuroinflammation is involved in the mechanical allodynia of cyclophosphamide (CYP)-induced cystitis. Magnesium-L-Threonate (L-TAMS) supplementation can attenuate neuroinflammation. This study aimed to determine whether and how L-TAMS influences mechanical allodynia and accompanying depressive symptoms and memory deficits in CYP-induced cystitis.
Injection of CYP (50 mg/kg, intraperitoneally, every 3 days for 3 doses) was used to establish a rat model of BPS/IC. L-TAMS was administered in drinking water (604 mg·kg·day). Mechanical allodynia in the lower abdomen was assessed with von Frey filaments using the up-down method. Forced swim test (FST) and sucrose preference test (SPT) were used to measure depressive-like behaviors. Novel object recognition test (NORT) was used to detect short-term memory function. Concentrations of Mg in serum and cerebrospinal fluid (CSF) were measured by calmagite chronometry. Western blot and immunofluorescence staining measured the expression of tumor necrosis factor-α/nuclear factor-κB (TNF-α/NF-κB), interleukin-1β (IL-1β), and N-methyl-D-aspartate receptor type 2B subunit (NR2B) of the N-methyl-D-aspartate receptor in the L6-S1 spinal dorsal horn (SDH) and hippocampus.
Free Mg was reduced in the serum and CSF of the CYP-induced cystitis rats on days 8, 12, and 20 after the first CYP injection. Magnesium deficiency in the serum and CSF correlated with the mechanical withdrawal threshold, depressive-like behaviors, and short-term memory deficits (STMD). Oral application of L-TAMS prevented magnesium deficiency and attenuated mechanical allodynia (n = 14) and normalized depressive-like behaviors (n = 10) and STMD (n = 10). The upregulation of TNF-α/NF-κB signaling and IL-1β in the L6-S1 SDH or hippocampus was reversed by L-TAMS. The change in NR2B expression in the SDH and hippocampus in the cystitis model was normalized by L-TAMS.
Normalization of magnesium deficiency by L-TAMS attenuated mechanical allodynia, depressive-like behaviors, and STMD in the CYP-induced cystitis model via inhibition of TNF-α/NF-κВ signaling and normalization of NR2B expression. Our study provides evidence that L-TAMS may have therapeutic value for treating pain and comorbid depression or memory deficits in BPS/IC patients.
膀胱疼痛综合征/间质性膀胱炎(BPS/IC)患者的膀胱相关疼痛症状常伴有抑郁和记忆缺陷。镁缺乏会导致神经炎症,并与疼痛、抑郁和记忆缺陷有关。神经炎症参与环磷酰胺(CYP)诱导的膀胱炎的机械性痛觉过敏。镁-L-苏糖醇(L-TAMS)补充可以减轻神经炎症。本研究旨在确定 L-TAMS 是否以及如何影响 CYP 诱导的膀胱炎中的机械性痛觉过敏以及伴随的抑郁症状和记忆缺陷。
腹腔注射 CYP(50mg/kg,每 3 天一次,共 3 次)建立 BPS/IC 大鼠模型。L-TAMS 通过饮用水给药(604mg·kg·day)。使用 von Frey 纤维通过上下法评估下腹的机械性痛觉过敏。强迫游泳试验(FST)和蔗糖偏好试验(SPT)用于测量抑郁样行为。新物体识别试验(NORT)用于检测短期记忆功能。血清和脑脊液(CSF)中的镁浓度采用钙镁试剂计时法测定。Western blot 和免疫荧光染色测定 L6-S1 脊髓背角(SDH)和海马中肿瘤坏死因子-α/核因子-κB(TNF-α/NF-κB)、白细胞介素-1β(IL-1β)和 N-甲基-D-天冬氨酸受体 2B 亚基(NR2B)的表达。
CYP 诱导的膀胱炎大鼠在第一次 CYP 注射后第 8、12 和 20 天,血清和 CSF 中的游离镁减少。血清和 CSF 中的镁缺乏与机械性撤回阈值、抑郁样行为和短期记忆缺陷(STMD)相关。口服 L-TAMS 可预防镁缺乏并减轻机械性痛觉过敏(n=14)和正常化抑郁样行为(n=10)和短期记忆缺陷(n=10)。L-TAMS 逆转了 L6-S1 SDH 或海马中 TNF-α/NF-κB 信号和 IL-1β 的上调。L-TAMS 使膀胱炎模型中 SDH 和海马中 NR2B 表达的变化正常化。
L-TAMS 通过抑制 TNF-α/NF-κB 信号和使 NR2B 表达正常化,纠正镁缺乏,减轻 CYP 诱导的膀胱炎模型中的机械性痛觉过敏、抑郁样行为和 STMD。我们的研究表明,L-TAMS 可能对治疗 BPS/IC 患者的疼痛和共病性抑郁或记忆缺陷具有治疗价值。