Bourassa Valerie, Deamond Haley, Yousefpour Noosha, Fitzcharles Mary-Ann, Ribeiro-da-Silva Alfredo
Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada.
Alan Edwards Center for Research on Pain, McGill University, Montreal, QC, Canada.
Pain Rep. 2020 Aug 25;5(5):e846. doi: 10.1097/PR9.0000000000000846. eCollection 2020 Sep-Oct.
Osteoarthritis (OA)-associated pain is often poorly managed, as our understanding of the underlying pain mechanisms remains limited. The known variability from patient to patient in pain control could be a consequence of a neuropathic component in OA.
We used a rat monoiodoacetate model of the ankle joint to study the time-course of the development of pain-related behavior and pathological changes in the joint, dorsal root ganglia (DRG), and spinal cord, and to investigate drug treatments effects.
Mechanical hypersensitivity and loss of mobility (as assessed by treadmill) were detected from 4 weeks after monoiodoacetate. Cold allodynia was detected from 5 weeks. Using histology and x-ray microtomography, we confirmed significant cartilage and bone degeneration at 5 and 10 weeks. We detected increased nociceptive peptidergic and sympathetic fiber innervation in the subchondral bone and synovium at 5 and 10 weeks. Sympathetic blockade at 5 weeks reduced pain-related behavior. At 5 weeks, we observed, ipsilaterally only, DRG neurons expressing anti-activating transcription factor 3, a neuronal stress marker. In the spinal cord, there was microgliosis at 5 and 10 weeks, and astrocytosis at 10 weeks only. Inhibition of glia at 5 weeks with minocycline and fluorocitrate alleviated mechanical allodynia.
Besides a detailed time-course of pathology in this OA model, we show evidence of contributions of the sympathetic nervous system and dorsal horn glia to pain mechanisms. In addition, late activating transcription factor 3 expression in the DRG that coincides with these changes provides evidence in support of a neuropathic component in OA pain.
骨关节炎(OA)相关疼痛的管理往往不佳,因为我们对其潜在疼痛机制的了解仍然有限。OA患者疼痛控制存在个体差异,这可能是由于OA存在神经病理性因素。
我们使用踝关节单碘乙酸盐大鼠模型,研究疼痛相关行为的发展时程以及关节、背根神经节(DRG)和脊髓的病理变化,并研究药物治疗效果。
单碘乙酸盐处理4周后检测到机械性超敏反应和运动能力丧失(通过跑步机评估)。5周后检测到冷痛觉过敏。通过组织学和X射线显微断层扫描,我们证实5周和10周时软骨和骨有明显退变。我们在5周和10周时检测到软骨下骨和滑膜中伤害感受性肽能和交感神经纤维支配增加。5周时进行交感神经阻滞可减轻疼痛相关行为。5周时,仅在同侧观察到表达神经元应激标志物抗激活转录因子3的DRG神经元。在脊髓中,5周和10周时有小胶质细胞增生,仅在10周时有星形细胞增生。5周时用米诺环素和氟柠檬酸抑制神经胶质可减轻机械性异常性疼痛。
除了该OA模型详细的病理时程外,我们还证明了交感神经系统和背角神经胶质对疼痛机制的作用。此外,DRG中晚期激活转录因子3的表达与这些变化一致,为OA疼痛中的神经病理性因素提供了证据支持。