Department of Experimental Pain Research, MCTN, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
J Physiol. 2021 Mar;599(5):1595-1610. doi: 10.1113/JP280269. Epub 2021 Jan 15.
C-nociceptors are generally assumed to have a low maximum discharge frequency of 10-30 Hz. However, only mechano-insensitive 'silent' C-nociceptors cannot follow electrical stimulation at 5 Hz (75 pulses) whereas polymodal C-nociceptors in the pig follow stimulation at up to 100 Hz without conduction failure. Sensitization by nerve growth factor increases the maximum following frequency of 'silent' nociceptors in pig skin and might thereby contribute in particular to intense pain sensations in chronic inflammation. A distinct class of C-nociceptors with mechanical thresholds >150 mN resembles 'silent' nociceptors at low stimulation frequencies in pigs and humans, but is capable of 100 Hz discharge and thus is suited to encode painfulness of noxious mechanical stimuli.
Using extracellular single-fibre recordings from the saphenous nerve in pig in vivo, we investigated peak following frequencies (5-100 Hz) in different classes of C-nociceptors and their modulation by nerve growth factor. Classes were defined by sensory (mechano-sensitivity) and axonal characteristics (activity dependent slowing of conduction, ADS). Mechano-insensitive C-nociceptors (CMi) showed the highest ADS (34% ± 8%), followed only 66% ± 27% of 75 pulses at 5 Hz and increasingly blocked conduction at higher frequencies. Three weeks following intradermal injections of nerve growth factor, peak following frequency increased specifically in the sensitized mechano-insensitive nociceptors (20% ± 16% to 38% ± 23% response rate after 72 pulses at 100 Hz). In contrast, untreated polymodal nociceptors with moderate ADS (15.2% ± 10.2%) followed stimulation frequencies of 100 Hz without conduction failure (98.5% ± 6%). A distinct class of C-nociceptors was exclusively sensitive to strong forces above 150 mN. This class had a high ADS (27.2% ± 7.6%), but displayed almost no propagation failure even at 100 Hz stimulation (84.7% ± 17%). Also, among human mechanosensitive nociceptors (n = 153) those with thresholds above 150 mN (n = 5) showed ADS typical of silent nociceptors. C-fibres with particularly high mechanical thresholds and high following frequency form a distinct nociceptor class ideally suited to encode noxious mechanical stimulation under normal conditions when regular silent nociceptors are inactive. Sensitization by nerve growth factor increases maximum discharge frequency of silent nociceptors, thereby increasing the frequency range beyond their physiological limit, which possibly contributes to excruciating pain under inflammatory conditions.
C 型伤害感受器的最大放电频率通常被认为较低,为 10-30 Hz。然而,只有机械不敏感的“沉默”C 型伤害感受器不能跟随 5 Hz(75 个脉冲)的电刺激,而猪的多模式 C 型伤害感受器在不发生传导失败的情况下可跟随高达 100 Hz 的刺激。神经生长因子的敏化作用增加了猪皮肤中“沉默”伤害感受器的最大跟随频率,这可能特别有助于慢性炎症中的剧烈疼痛感觉。一类机械阈值 >150 mN 的明显 C 型伤害感受器在猪和人类中类似于低刺激频率下的“沉默”伤害感受器,但能够进行 100 Hz 的放电,因此适合编码有害机械刺激的疼痛。
本研究使用活体猪隐静脉的体外单纤维记录,研究了不同 C 型伤害感受器类别的峰值跟随频率(5-100 Hz)及其对神经生长因子的调制。通过感觉(机械敏感性)和轴突特征(活动依赖性传导减慢,ADS)来定义类。机械不敏感的 C 型伤害感受器(CMi)表现出最高的 ADS(34%±8%),仅能跟随 5 Hz 时 75 个脉冲的 66%±27%,并随着频率的升高而逐渐阻断传导。在皮内注射神经生长因子三周后,敏化的机械不敏感伤害感受器的峰值跟随频率特异性增加(100 Hz 时 72 个脉冲的反应率为 20%±16%至 38%±23%)。相比之下,未经处理的多模式伤害感受器的 ADS 中度(15.2%±10.2%),可在 100 Hz 刺激下无传导失败(98.5%±6%)。一个独特的 C 型伤害感受器类别仅对 150 mN 以上的强力敏感。该类别的 ADS 很高(27.2%±7.6%),但即使在 100 Hz 刺激下也几乎没有传播失败(84.7%±17%)。此外,在 153 名人类机械敏感伤害感受器(n=153)中,阈值高于 150 mN(n=5)的伤害感受器表现出与“沉默”伤害感受器相似的 ADS。具有特别高的机械阈值和高跟随频率的 C 纤维形成了一个独特的伤害感受器类别,在正常情况下,当常规的“沉默”伤害感受器不活跃时,该类别非常适合编码有害的机械刺激。神经生长因子的敏化作用增加了“沉默”伤害感受器的最大放电频率,从而增加了其生理极限之外的频率范围,这可能有助于炎症条件下的剧痛。