Department of Orthopedics, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Department of Orthopedics, The Hospital of People's Liberation Army Hong Kong Garrison, Hong Kong, China; Department of Orthopedics, The 941 Hospital of Chinese People's Liberation Army, Xining, China.
Pain Physician. 2024 Jan;27(1):E131-E145.
Peripheral neuropathic pain (NeP), induced by surgical intervention, is a well-known complication or sequela that remains a clinical challenge with few effective treatments. Ideal animal models that can recapitulate surgery-associated NeP remain to be established for both mechanistic studies and drug discovery.
We aimed to establish a new rat model of postsurgical NeP and describe its characteristics, as well as screen-promising therapeutic analgesics.
Experimental research in rats.
The research took place in the laboratory of Xinqiao Hospital of the Third Military Medical University.
To mimic the surgical procedure associated with peripheral nerve injury (PNI), we established a transient compression injury (TCI) in the sciatic nerve. Behavioral tests of nociception were used to confirm the effect and the time course of this pain model. Histological assessments (transmission electron microscopy evaluation and immunohistochemistry) were performed to observe the neuropathological and immunological features. RNA sequencing (RNA-seq) of injured nerves and dorsal root ganglia (DRGs) was conducted to reveal the underlying mechanism in the newly established animal model and screen promising therapeutic targets.
We established a rat model of TCI of the PN and detected nociceptive hypersensitivity of the injured (ipsilateral) nerve by behavioral tests. This animal model of NeP was further confirmed by observing time-dependent changes in mechanical allodynia and thermal hyperalgesia, as well as by examining the activation of microglia in the ipsilateral spinal dorsal horn. Pathophysiologically, TCI induced macroscopic nerve swelling and demyelination, which resulted in inflammatory responses in ipsilateral nerves. We also found inflammatory cell infiltration in the ipsilateral nerve that was sustained for several weeks, which further exacerbated local inflammation and oxidative stress. Moreover, RNA-seq revealed remarkably upregulated inflammatory reactions in PNs and the DRGs. Notably, the overexpression of inflammatory mediators and the infiltration of macrophages and microglia triggered remote immune responses in DRGs. Based on the RNA-seq results, we also confirmed that gabapentin (GBP) exerts therapeutic effects in TCI-induced NeP by regulating alpha2delta-1.
We did not compare the new rat model with the classical pain model (like chronic constriction injury or spared nerve injury) in histology or transcriptomics.
We established a new rat model of NeP and thoroughly characterized neuroinflammation in the injured nerve and DRGs. Based on the upregulated genes in DRGs in this model, we screened a promising analgesic (GBP) capable of reducing pain hypersensitivity in surgery-associated NeP.
外周神经病理性疼痛(NeP)是一种由手术干预引起的已知并发症或后遗症,目前仍缺乏有效治疗方法,是临床面临的挑战。对于术后 NeP 的机制研究和药物发现,仍需要建立能够重现手术相关 NeP 的理想动物模型。
建立一种新的大鼠术后神经病理性疼痛模型,并描述其特征,同时筛选有希望的治疗性镇痛药物。
大鼠实验研究。
第三军医大学新桥医院实验室。
通过对坐骨神经的短暂压迫损伤(TCI)来模拟与外周神经损伤(PNI)相关的手术过程。使用疼痛行为学测试来确认该疼痛模型的效果及其时间过程。进行组织学评估(透射电子显微镜评估和免疫组织化学)以观察神经病理学和免疫学特征。对损伤神经和背根神经节(DRG)进行 RNA 测序(RNA-seq)以揭示新建立的动物模型中的潜在机制并筛选有希望的治疗靶点。
我们建立了一种大鼠的 PNI 模型,并通过行为学测试检测到损伤(对侧)神经的痛觉过敏。通过观察机械性痛觉过敏和热痛觉的时间依赖性变化,以及观察同侧脊髓背角小胶质细胞的激活,进一步证实了这种神经病理性疼痛模型。在病理生理学上,TCI 导致了神经的宏观肿胀和脱髓鞘,从而导致同侧神经的炎症反应。我们还发现,同侧神经中的炎症细胞浸润持续数周,进一步加剧了局部炎症和氧化应激。此外,RNA-seq 显示 PNs 和 DRGs 中炎症反应显著上调。值得注意的是,炎症介质的过度表达以及巨噬细胞和小胶质细胞的浸润触发了 DRGs 中的远程免疫反应。基于 RNA-seq 的结果,我们还证实加巴喷丁(GBP)通过调节 alpha2delta-1 对 TCI 诱导的 NeP 发挥治疗作用。
我们没有在组织学或转录组学上将新的大鼠模型与经典疼痛模型(如慢性缩窄性损伤或 spared 神经损伤)进行比较。
我们建立了一种新的大鼠神经病理性疼痛模型,并彻底描述了损伤神经和 DRGs 中的神经炎症。基于该模型中 DRGs 中上调的基因,我们筛选出一种有希望的镇痛药物(GBP),能够减轻手术相关神经病理性疼痛的痛觉过敏。