Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
J Pain. 2022 Dec;23(12):2167-2178. doi: 10.1016/j.jpain.2022.08.005. Epub 2022 Sep 9.
The spinal mechanisms of visceral hypersensitivity are poorly understood, particularly when there is an interaction with somatic systems. Recently we demonstrated that rats which were pretreated with neonatal bladder inflammation (NBI) and subsequently pretreated as adults with bladder re-inflammation had augmented reflex and neuronal responses to urinary bladder distension via a corticotropin-releasing factor receptor type II (CRFR2) mechanism. Another insult producing similar augmented responses is somatic inflammation induced by Complete Freund's Adjuvant (CFA) in the hindlimb. Using neurochemical measures and both reflex and neuronal responses to urinary bladder distension as endpoints, the present study probed the role of CRFR2-related mechanisms in bladder hyperalgesia secondary to NBI and CFA-induced hindlimb inflammation. ELISA measures of the lumbosacral spinal cord demonstrated increased CRFR2 protein following pretreatment with NBI+CFA. Intrathecal CRFR2 antagonists blocked the augmentation of visceromotor responses to distension following pretreatment with both NBI+CFA. Lumbosacral dorsal horn neuronal responses to bladder distension in rats pretreated with NBI+CFA were attenuated by the spinal topical administration of a CRFR2 antagonist. These findings are the first demonstration of a somatovisceral interaction working via CRFR2 receptors and support the therapeutic value of these agents in the treatment of painful bladder disorders, particularly when triggered by somatic events. (Word Count 199). PERSPECTIVE: Bladder hypersensitivity occurs following neonatal cystitis and an adult insult such as somatic inflammation. This paper demonstrates that CRFR2-related mechanisms are associated with this hypersensitivity. This supports the therapeutic value of these agents in the treatment of painful bladder disorders, particularly when triggered by somatic events.
内脏感觉过敏的脊柱机制尚未完全清楚,尤其是当它与躯体系统相互作用时。最近我们发现,经过新生期膀胱炎症(NBI)预处理并随后在成年期进行膀胱再炎症预处理的大鼠,通过促肾上腺皮质释放因子受体 2(CRFR2)机制,对膀胱扩张的反射和神经元反应增强。另一种产生类似增强反应的刺激是完全弗氏佐剂(CFA)引起的后肢躯体炎症。本研究使用神经化学测量以及膀胱扩张的反射和神经元反应作为终点,探讨了 CRFR2 相关机制在 NBI 和 CFA 诱导的后肢炎症继发的膀胱痛觉过敏中的作用。腰骶脊髓的 ELISA 测量显示,NBI+CFA 预处理后 CRFR2 蛋白增加。鞘内给予 CRFR2 拮抗剂阻断了 NBI+CFA 预处理后对扩张的内脏运动反应的增强。NBI+CFA 预处理大鼠的腰骶部背角神经元对膀胱扩张的反应,通过脊髓局部给予 CRFR2 拮抗剂减弱。这些发现首次证明了通过 CRFR2 受体进行躯体-内脏相互作用,并支持这些药物在治疗疼痛性膀胱疾病中的治疗价值,尤其是当由躯体事件触发时。(199 字)观点:新生儿膀胱炎和成年期躯体炎症等成人损伤后会发生膀胱过敏。本文证明了与这种过敏相关的 CRFR2 相关机制。这支持了这些药物在治疗疼痛性膀胱疾病中的治疗价值,尤其是当由躯体事件触发时。