Department of Anesthesiology, Eye and ENT Hospital, Fudan University, Shanghai, China.
Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
Genes Brain Behav. 2023 Apr;22(2):e12842. doi: 10.1111/gbb.12842. Epub 2023 Mar 8.
Dry eye disease (DED) affects nearly 55% of people worldwide; several studies have proposed that central sensitization and neuroinflammation may contribute to the developing corneal neuropathic pain of DED, while the underlying mechanisms of this contribution remain to be investigated. Excision of extra orbital lacrimal glands established the dry eye model. Corneal hypersensitivity was examined through chemical and mechanical stimulation, and open field test measured the anxiety levels. Restingstate fMRI is a method of functional magnetic resonance imaging (rs-fMRI) was performed for anatomical involvement of the brain regions. The amplitude of low-frequency fluctuation (ALFF) determined brain activity. Immunofluorescence testing and Quantitative real-time polymerase chain reaction were also performed to further validate the findings. Compared with the Sham group, ALFF signals in the supplemental somatosensory area, secondary auditory cortex, agranular insular cortex, temporal association areas, and ectorhinal cortex brain areas were increased in the dry eye group. This change of ALFF in the insular cortex was linked with the increment in corneal hypersensitivity (p < 0.01), c-Fos (p < 0.001), brain-derived neurotrophic factor (p < 0.01), TNF-α, IL-6, and IL-1β (p < 0.05). In contrast, IL-10 levels (p < 0.05) decreased in the dry eye group. DED-induced corneal hypersensitivity and upregulation of inflammatory cytokines could be blocked by insular cortex injection of Tyrosine Kinase receptor B agonist cyclotraxin-B (p < 0.01) without affecting anxiety levels. Our study reveals that the functional activity of the brain associated with corneal neuropathic pain and neuroinflammation in the insular cortex might contribute to dry eye-related corneal neuropathic pain.
干眼症(DED)影响全球近 55%的人群;几项研究表明,中枢敏化和神经炎症可能导致 DED 角膜神经病理性疼痛的发展,而其潜在机制仍有待研究。眶外泪腺切除术建立了干眼症模型。通过化学和机械刺激来检测角膜敏感性,通过旷场试验来测量焦虑水平。静息态功能磁共振成像(rs-fMRI)是一种功能磁共振成像(rs-fMRI)方法,用于研究大脑区域的解剖学参与情况。低频振幅(ALFF)确定大脑活动。还进行了免疫荧光检测和定量实时聚合酶链反应,以进一步验证研究结果。与 Sham 组相比,干眼症组补充体感区、次级听觉皮层、无颗粒岛叶皮质、颞叶联合区和外侧梨状皮质的 ALFF 信号增加。岛叶皮质的这种 ALFF 变化与角膜敏感性增加(p<0.01)、c-Fos(p<0.001)、脑源性神经营养因子(p<0.01)、TNF-α、IL-6 和 IL-1β(p<0.05)相关。相反,干眼症组的 IL-10 水平(p<0.05)下降。岛叶皮质注射酪氨酸激酶受体 B 激动剂环托辛-B 可阻断 DED 诱导的角膜敏感性增加和炎症细胞因子的上调(p<0.01),而不影响焦虑水平。我们的研究表明,与角膜神经病理性疼痛和岛叶皮质神经炎症相关的大脑功能活动可能导致与干眼症相关的角膜神经病理性疼痛。