From the Department of Anesthesiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Anesth Analg. 2024 Nov 1;139(5):1086-1096. doi: 10.1213/ANE.0000000000006964. Epub 2024 Mar 20.
Neuropathic pain (NP) is a highly challenging condition with complex pathological mechanisms, and the spinal gamma aminobutyric acid A receptor receptor plays a crucial role in its progression. Recent studies have revealed a potential interaction between neuroplastin 65 (NP65) and gamma aminobutyric acid A receptor α2 subunit (GABAAR-α2) on the cell surface. We hypothesize that NP65 is involved in the pathogenesis of NP by regulating the level of GABAAR-α2.
A chronic constrictive injury (CCI) pain model was established in male Sprague-Dawley rats to verify the change in spinal NP65 expression. Alterations in pain behavior and GABAAR-α2 protein expression were observed after intrathecal injection of NP65 overexpressing adeno-associated virus (AAV) in CCI rats. In vitro investigations on Neuroblastoma 2a cells, the effect of NP65 on GABAAR-α2 expression via the calcineurin-nuclear factor of activated T-cell 4 (CaN-NFATc4) signaling pathway was evaluated by manipulating NP65 expression.
The expression level of NP65 protein and mRNA in the CCI group were significantly decreased ( P < .05; analysis of variance [ANOVA]). After intrathecal injection of NP65, overexpression of AAV and pain behavior in CCI rats were significantly alleviated, and levels of GABAAR-α2 were upregulated. In vitro experiments verified alterations in the expression of GABAAR-α2, CaN, and phosphorylated NFATc4 on the application of NP65 with plasmid or small interfering RNA, respectively. After the application of the specific CaN inhibitor cyclosporine A (CsA), the changes in NP65 expression did not produce subsequent alterations in the expression of GABAAR-α2, CaN, or phosphorylated NFATc4 proteins.
NP65 modulates the level of GABAAR-α2 through the CaN-NFATc4 signaling pathway, which may serve as the underlying mechanism of NP.
神经病理性疼痛(NP)是一种具有复杂病理机制的极具挑战性的病症,脊髓γ-氨基丁酸 A 受体(GABAAR)受体在其进展中起着至关重要的作用。最近的研究揭示了神经胶质纤维酸性蛋白 65(NP65)与细胞表面 GABAAR-α2 亚基(GABAAR-α2)之间存在潜在的相互作用。我们假设 NP65 通过调节 GABAAR-α2 的水平参与 NP 的发病机制。
建立雄性 Sprague-Dawley 大鼠慢性压迫性损伤(CCI)疼痛模型,以验证脊髓 NP65 表达的变化。在 CCI 大鼠鞘内注射过表达 NP65 的腺相关病毒(AAV)后,观察疼痛行为和 GABAAR-α2 蛋白表达的变化。通过操纵 NP65 的表达,在神经母细胞瘤 2a 细胞中研究 NP65 对 GABAAR-α2 表达的影响,评估 NP65 通过钙调神经磷酸酶-活化 T 细胞核因子 4(CaN-NFATc4)信号通路对 GABAAR-α2 表达的影响。
CCI 组 NP65 蛋白和 mRNA 的表达水平明显降低(P<0.05;方差分析)。鞘内注射 NP65 后,AAV 过表达和 CCI 大鼠的疼痛行为明显减轻,GABAAR-α2 水平上调。体外实验验证了 NP65 应用质粒或小干扰 RNA 后 GABAAR-α2、钙调神经磷酸酶和磷酸化 NFATc4 表达的变化。应用特异性钙调神经磷酸酶抑制剂环孢素 A(CsA)后,NP65 表达的变化不会导致 GABAAR-α2、钙调神经磷酸酶或磷酸化 NFATc4 蛋白表达的后续变化。
NP65 通过 CaN-NFATc4 信号通路调节 GABAAR-α2 的水平,这可能是 NP 的潜在机制。