Wolfson Centre for Age Related Diseases, King's College London, London, United Kingdom.
Laboratory of Metabolic Biochemistry Unit, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Pain. 2020 Sep 1;161(9):2155-2166. doi: 10.1097/j.pain.0000000000001908.
Rheumatoid arthritis-associated pain is poorly managed, often persisting when joint inflammation is pharmacologically controlled. Comparably, in the mouse K/BxN serum-transfer model of inflammatory arthritis, hind paw nociceptive hypersensitivity occurs with ankle joint swelling (5 days after immunisation) persisting after swelling has resolved (25 days after immunisation). In this study, lipid mediator (LM) profiling of lumbar dorsal root ganglia (DRG), the site of sensory neuron cell bodies innervating the ankle joints, 5 days and 25 days after serum transfer demonstrated a shift in specialised proresolving LM profiles. Persistent nociception without joint swelling was associated with low concentrations of the specialised proresolving LM Maresin 1 (MaR1) and high macrophage numbers in DRG. MaR1 application to cultured DRG neurons inhibited both capsaicin-induced increase of intracellular calcium ions and release of calcitonin gene-related peptide in a dose-dependent manner. Furthermore, in peritoneal macrophages challenged with lipopolysaccharide, MaR1 reduced proinflammatory cytokine expression. Systemic MaR1 administration caused sustained reversal of nociceptive hypersensitivity and reduced inflammatory macrophage numbers in DRG. Unlike gabapentin, which was used as positive control, systemic MaR1 did not display acute antihyperalgesic action. Therefore, these data suggest that MaR1 effects observed after K/BxN serum transfer relate to modulation of macrophage recruitment, more likely than to direct actions on sensory neurons. Our study highlights that, in DRG, aberrant proresolution mechanisms play a key role in arthritis joint pain dissociated from joint swelling, opening novel approaches for rheumatoid arthritis pain treatment.
类风湿关节炎相关的疼痛管理不善,即使在关节炎症得到药物控制时,疼痛也常常持续存在。类似地,在 K/BxN 血清转移的小鼠炎症性关节炎模型中,后爪痛觉过敏与踝关节肿胀(免疫后 5 天)同时发生,并在肿胀消退后(免疫后 25 天)持续存在。在这项研究中,对腰椎背根神经节(DRG)的脂质介质(LM)谱分析,DRG 是支配踝关节的感觉神经元细胞体的部位,在血清转移后 5 天和 25 天,发现专门的促解决 LM 谱发生了转变。没有关节肿胀的持续性疼痛与 DRG 中特殊的促解决 LM maresin 1(MaR1)浓度较低和巨噬细胞数量较多有关。MaR1 应用于培养的 DRG 神经元,以剂量依赖的方式抑制辣椒素诱导的细胞内钙离子增加和降钙素基因相关肽的释放。此外,在脂多糖刺激的腹腔巨噬细胞中,MaR1 降低了促炎细胞因子的表达。系统给予 MaR1 可持续逆转痛觉过敏,并减少 DRG 中的炎症性巨噬细胞数量。与用作阳性对照的加巴喷丁不同,系统给予 MaR1 没有表现出急性抗痛觉过敏作用。因此,这些数据表明,K/BxN 血清转移后观察到的 MaR1 作用与巨噬细胞募集的调节有关,而不是与感觉神经元的直接作用有关。我们的研究强调,在 DRG 中,异常的促解决机制在与关节肿胀分离的关节炎关节疼痛中起着关键作用,为类风湿关节炎疼痛治疗开辟了新的途径。