Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
Pittsburgh Center for Pain Research, University of Pittsburgh, Pittsburgh, PA, United States.
Pain. 2021 Apr 1;162(4):1126-1134. doi: 10.1097/j.pain.0000000000002110.
Visceral pain is a prevalent symptom of inflammatory bowel disease that can be difficult to treat. Pain and hypersensitivity are mediated by extrinsic primary afferent neurons (ExPANs) that innervate the colon. Recent studies indicate that the colon epithelium contributes to initiating ExPAN firing and nociceptive responses. Based on these findings, we hypothesized that the epithelium contributes to inflammation-induced hypersensitivity. A key prediction of this hypothesis is that inhibition of the epithelium would attenuate nociceptive signaling and inflammatory hypersensitivity. To test this hypothesis, the inhibitory yellow light-activated protein archaerhodopsin was targeted to the intestinal epithelium (villin-Arch) or the ExPANs (TRPV1-Arch) that innervate the colon. Visceral sensitivity was assessed by measuring the visceromotor response (VMR) to colorectal distension (CRD), with and without yellow light illumination of the colon lumen. Inhibition of the colon epithelium in healthy villin-Arch mice significantly diminished the CRD-induced VMR. Direct inhibition of ExPANs during CRD using TRPV1-Arch mice showed that ExPAN and epithelial inhibition were similarly effective in reducing the VMR to CRD. We then investigated the effect of epithelial and ExPAN inhibition in the dextran sulfate sodium model of inflammatory bowel disease. Inhibition of the colon epithelium significantly decreased dextran sulfate sodium-induced hypersensitivity and was comparable with the inhibition of ExPANs. Together, these results reveal the potential of targeting the colon epithelium for the treatment of pain.
内脏痛是炎症性肠病的一种常见症状,很难治疗。疼痛和超敏反应是由支配结肠的外原性初级传入神经元(ExPANs)介导的。最近的研究表明,结肠上皮有助于引发 ExPAN 放电和伤害性反应。基于这些发现,我们假设上皮有助于炎症引起的超敏反应。这一假设的一个关键预测是,上皮的抑制会减弱伤害性信号和炎症超敏反应。为了验证这一假设,将抑制性黄色光激活蛋白 archaerhodopsin 靶向到肠上皮(villin-Arch)或支配结肠的外原性初级传入神经元(TRPV1-Arch)。通过测量对结直肠扩张(CRD)的内脏运动反应(VMR)来评估内脏敏感性,同时对结肠管腔进行黄色光照射和不进行黄色光照射。在健康的 villin-Arch 小鼠中抑制结肠上皮,显著降低了 CRD 诱导的 VMR。在使用 TRPV1-Arch 小鼠进行 CRD 时直接抑制 ExPANs,表明 ExPAN 和上皮抑制在降低 CRD 引起的 VMR 方面同样有效。然后,我们研究了上皮和 ExPAN 抑制在葡聚糖硫酸钠诱导的炎症性肠病模型中的作用。抑制结肠上皮显著降低了葡聚糖硫酸钠诱导的超敏反应,与抑制 ExPANs 相当。这些结果共同揭示了靶向结肠上皮治疗疼痛的潜力。