Yeh Yu-An, Liao Hsien-Yin, Hsiao I-Han, Hsu Hsin-Cheng, Lin Yi-Wen
Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 404328, Taiwan.
Department of Chinese Traumatology Medicine, China Medical University Hospital, Taichung 404327, Taiwan.
Brain Sci. 2024 Aug 28;14(9):869. doi: 10.3390/brainsci14090869.
Fibromyalgia (FM) is a widespread musculoskeletal pain associated with psychological disturbances, the etiopathogenesis of which is still not clear. One hypothesis implicates inflammatory cytokines in increasing central and peripheral sensitization along with neuroinflammation, leading to an elevation in pro-inflammatory cytokines, e.g., interleukin-17A (IL-17A), enhanced in FM patients and animal models. The intermittent cold stress (ICS)-induced FM-like model in C57BL/6 mice has been developed since 2008 and proved to have features which mimic the clinical pattern in FM patients such as mechanical allodynia, hyperalgesia, and female predominance of pain. Electroacupuncture (EA) is an effective treatment for relieving pain in FM patients, but its mechanism is not totally clear. It was reported as attenuating pain-like behaviors in the ICS mice model through the transient receptor potential vanilloid 1 (TRPV1) pathway. Limited information indicates that TRPV1-positive neurons trigger IL-17A-mediated inflammation. Therefore, we hypothesized that the IL-17A would be inactivated by EA and TRPV1 deletion in the ICS-induced FM-like model in mice. We distributed mice into a control (CON) group, ICS-induced FM model (FM) group, FM model with EA treatment (EA) group, FM model with sham EA treatment (Sham) group, and TRPV1 gene deletion () group. In the result, ICS-induced mechanical and thermal hyperalgesia increased pro-inflammatory cytokines including IL-6, IL-17, TNFα, and IFNγ in the plasma, as well as TRPV1, IL-17RA, pPI3K, pAkt, pERK, pp38, pJNK, and NF-κB in the somatosensory cortex (SSC) and cerebellum (CB) lobes V, VI, and VII. Moreover, EA and but not sham EA countered these effects significantly. The molecular mechanism may involve the pro-inflammatory cytokines, including IL-6, IL-17, TNFα, and IFNγ. IL-17A-IL-17RA play a crucial role in peripheral and central sensitization as well as neuroinflammation and cannot be activated without TRPV1 in the ICS mice model. EA alleviated FM-pain-like behaviors, possibly by abolishing the TRPV1- and IL-17A-related pathways. It suggests that EA is an effective and potential therapeutic strategy in FM.
纤维肌痛(FM)是一种与心理障碍相关的广泛存在的肌肉骨骼疼痛,其发病机制尚不清楚。一种假说认为,炎性细胞因子会增加中枢和外周敏化以及神经炎症,导致促炎细胞因子水平升高,例如在FM患者和动物模型中增强的白细胞介素-17A(IL-17A)。自2008年以来,已建立了C57BL/6小鼠间歇性冷应激(ICS)诱导的FM样模型,并证明该模型具有模拟FM患者临床症状的特征,如机械性异常性疼痛、痛觉过敏以及女性疼痛为主。电针(EA)是缓解FM患者疼痛的有效治疗方法,但其机制尚不完全清楚。据报道,电针通过瞬时受体电位香草酸受体1(TRPV1)途径减轻ICS小鼠模型中的疼痛样行为。有限的信息表明,TRPV1阳性神经元会触发IL-17A介导的炎症。因此,我们假设在ICS诱导的小鼠FM样模型中,IL-17A会被电针和TRPV1缺失所灭活。我们将小鼠分为对照组(CON)、ICS诱导的FM模型组(FM)、电针治疗的FM模型组(EA)、假电针治疗的FM模型组(Sham)和TRPV1基因缺失组()。结果显示,ICS诱导的机械性和热痛觉过敏会增加血浆中包括IL-6、IL-17、TNFα和IFNγ在内的促炎细胞因子,以及体感皮层(SSC)和小脑(CB)V、VI和VII叶中的TRPV1、IL-17RA、pPI3K、pAkt、pERK、pp38、pJNK和NF-κB。此外,电针和TRPV1基因缺失可显著对抗这些作用,而假电针则不能。分子机制可能涉及包括IL-6、IL-17、TNFα和IFNγ在内的促炎细胞因子。在ICS小鼠模型中,IL-17A-IL-17RA在周围和中枢敏化以及神经炎症中起关键作用,且没有TRPV1就无法被激活。电针可能通过消除TRPV1和IL-17A相关途径来减轻FM疼痛样行为。这表明电针是FM一种有效且有潜力的治疗策略。